2015-06-23Syllabus_ClinMed-III_20151 PHYSICIAN ASSISTANT MASTERS PROGRAM School of Allied Health Professions Loma Linda University Course Syllabus COURSE:Clinical MedicineIII, PAST 543 5 units COURSE DESCRIPTION: A continuation of the study of common medical disorders encountered in primary care, and the managementofthesedisorders.Includestheclinicalpresentation,etiology,pathophysiology, diagnostic work-up, and management of the conditions studied. Based upon NCCPA blueprint. QUARTER:Summer, 2015 COURSE COORDINATOR: Frank Sirna, PA-C CONTACT INFORMATION:Office:909-558-7295 Email: fsirna@llu.edu Office hours: Monday-Friday by appointment. Friday is my usual clinical day, so I may not be available on Fridays. ALTERNATE CONTACT INFORMATION:See Memo regarding the alternate contact list if you are having difficulty contacting the Course Coordinator COURSE LECTURERS:See list of adjunct faculty on class schedule LECTURE SCHEDULE: Mondays: 1:00 4:50 p.m. Thursdays:1:00-3:50 PM Additional times as scheduled and TBD (see attached calendar) Dates and times vary to meet guest speaker needs LOCATION: Evans Hall Amphitheater, Room 216 ACADEMIC INTEGRITY: Actsofdishonesty,includingtheft,plagiarism,givingorobtaininginformationduring examinations,orknowinglyprovidingfalseinformationisunacceptable.Instructorsand studentsarechargedwiththeresponsibilityofreportinginstancesofsuchbehaviortothe departmentchairperson.Thedepartmentchairpersonisresponsibleforinvestigatingsuch reports.Substantiated violations will be brought before the dean for disciplinary action.Such action may include, but is not limited to, academic probation or dismissal for the program. 2015-06-23Syllabus_ClinMed-III_20152 ACCOMMODATIONS: Ifyouareanindividualwithadisabilityandneedreasonableaccommodationstofully participate in class, please obtain the Student Information and Requested Accommodation form from Dr. Craig Jackson, Dean of the School of Allied Health Professions, Nichol Hall Room 1603. REQUIRED TEXTS: Each student must obtain a copy of the required texts within the first 2 weeks of the quarter, as books not purchased by this time will be returned to the publisher. Cecils Essential of Medicine, 8th Ed; Saunders/Elsevier. (2010) Practical Radiology: A Symptom Based Approach. F.A. Davis, 2013 Dubin. Rapid Interpretation of EKGs. Cover Publishing. (Current edition)** **This is a self-learning, programmed text, you will need your own copy Note: These 3 texts are NOT available through the LLU Library as an on-line text. You will need to purchase a hard copy or E-version for your own use Current Medical Diagnoses and Treatment, 2015, McGraw-Hill/Lange Publishing* Fitzpatrick et al. Color Atlas of Skin Diseases. McGraw-Hill. (Current edition)* *Copies are available in the on-line LLU library. Check the main library Access Medicine website. These are full access electronic copies of all chapters. You may use the on-line version or purchase your own hardcopy version. SUGGESTED RESOURCES: Recommended for the Emergency Medicine Topics: Current Emergency Diagnosis and Treatment 7e, 2011, McGraw-Hill/Lange (CEDT 7e)* *Copies are available via the LLU library website Access Medicine OTHER RESOURCES AND REQUIRED READING: A large number of medical, pharmacology, and basic science texts are available via the LLU Library Access Medicine website: http://www.accessmedicine.com/features.aspx Please Note: 1.Selected sections of the current edition of ANY of the medical texts on the library Access Medicine website or texts from concurrent courses may be listed as REQUIRED reading during the quarter. 2015-06-23Syllabus_ClinMed-III_20153 2.Accessible texts, websites, and handouts listed as required reading in the schedule are all testable and may be used for test items on examinations. 3.Any standard, current edition of a text or selected, peer reviewed websites, may be used as references when submitting written assignments and for in-class presentations. 4.See the reading column of the Clinical Medicine III schedule. 5.Electronic versions of handouts, Power Point presentations, PDF documents and slide sets, hyperlinks, and videos will be made available on Canvas in lieu of hardcopy printouts for the majority of our courses unless notified otherwise. Learning Objectives, Test Items, Testable Material, and Study Guides: 1.Learning objectives specific for the lecture or series of lectures on specific topics will be posted on Canvas. 2.These specific learning objectives will be used as a basis for constructing test items for the written examinations. 3.These learning objectives should be used as a study guide when preparing for section or final examinations in this course. 4.We get frequent requests for high yield notes, study guides or other helps to focus studying for exams. The learning objectives for each speaker and topic or series are that material. 5.Unless specified otherwise, the primary text or texts are the final arbiter for any test items that are contested or questioned 6.Test items may come from lecture material and/or assigned reading. TESTS, GRADING and ACADEMIC PROGRESS: The final grade is based upon total points attained through exams, assignments, and class participation. Each student must attain 75% of total points available to pass course Midterm50 points Final Comprehensive Exam100 points Workshops, Presentations, Papers10 (if any, may change) Professionalismmultiplier (0.90-1.0) [Points are tentative for all of the above and may change] The points for each item may be adjusted as needed. The class will be notified in advance of any changes. Any papers will be treated as the equivalent of a section exam. 2015-06-23Syllabus_ClinMed-III_20154 The minimum score to pass this course is 75%. However, in order to remain in good standing in the PA Program and the School of Allied Health Professions, a 3.0 GPA in required. See the PA Program and LLU-SAHP student hand books for more information. Minimum passing score on all examinations is 75%. Letter grades will be assigned as follows: A93-100%B83-86% C75-76% A-90-92% B-80-82% C-70-74% B+87-89% C+77-79% D65-69% Quizzes, either in class or on-line, workshops, or short papers may be added to this course in order to reinforce learning or as a part of interactive learning. Since these may be one-time occurrences and not repeatable, points not earned due absence, even if excused, may not be able to be made up. Eachexaminationmustbepassedinordertopassthiscourse.Thisincludeseachsection, midterm, and final examination that may be given. Any failed section ormidterm examination willresultinremediationandmayresultindisciplinaryactionincludingprogramacademic probation. Class presentations or term papers will be counted as the equivalent of a section examination unless indicated otherwise. Failure of the comprehensive final examination will result in a FINAL COURSE GRADE OF C- as the highest possible grade, regardless of the total points earned in the course. Failure of the comprehensive final examination will result in disciplinary action that may result inregisteringforatutorial,coursefailure,deceleration,dismissalfromtheprogram,orother action as determined by the program faculty. Failureofthecomprehensivefinalexaminationmayresultinthestudentregisteringfora tutorial the following quarter if all other academic and professional performance in the program has been acceptable.Successfulcompletionofthetutorial willrequirepassingan examinationthatisthe equivalent of the Clinical Medicine III comprehensive examination. Per SAHP policy, the grade for the tutorial will be a C which will replace the original failing course grade. NOTE: Each of the Clinical Medicine series of courses must be passed with a grade of C+ or higher in order to progress to the Clinical Year without restrictions or Program Academic Probation. REMEDIATION: SeetheStudentHandbookfordetailsontheremediationprocessforfailedexaminationsor courses.Therewillbenore-takesof examinationsgranted.Ifastudent misses an exam for an excused absence, he or she will be given a different exam than the one given to the rest ofthe class. 2015-06-23Syllabus_ClinMed-III_20155 EXAMINATION POLICIES AND PROCEDURES All tests and examinations are serious occasions.Therefore, we ask that the following behaviors be observed in order to minimize distraction and anxiety during testing. 1.All tests will begin on time.Please plan to arrive early enough to stow your coat, books and other gear outside of the classroom. Sharpen your pencils before the test begins. 2.Please be certain to keep your eyes on your own paper. 3.Talking between students or other forms of communication is not allowed during testing. 4.Any corrections to a test will be posted on the whiteboard at the front of the classroom.Check for any changes before turning in your test. 5.Scantron/computerscoredexaminationsarefrequentlyused.However,certainerrorscan occur when these answer sheets are filled in. Please check the following prior to turning your answer sheet: Your ID number is correct All bars/bubbles have been appropriately filled in-no blank items Only one bar/bubble is filled in per test item unless instructed otherwise No test items have been skipped Your answer marks line up correctly with the test item (i.e., #20 correctly lines up with #20 as intended, not 19 or 21, etc.) Review your test and answer sheet prior to turning these in to be sure you have no skips, alignment errors, or other problems 6.Whenyouhavefinishedtesting,exittheclassroomquietlyandmoveawayfromthe classroom before engaging in conversation. 7.NOTE: Once you have turned in your examination and answer sheet and have exited the examination room,you will NOT be allowed to make any changesto youranswer sheet under any circumstances. 8.Lost points due to alignment errors, skips, double marking, or filling in the wrong bubble will not be credited back under any circumstances unless the respective test item(s) has/have been nullified or otherwise adjusted for the class as a whole. 9.If the scanner is unable to read your answer sheet, we will contact you. 2015-06-23Syllabus_ClinMed-III_20156 10.Examination by demonstration requires extra concentration on the part of the examiner and the examinee. Feedback will be provided only after completion of the examination.Hinting by body language during physical exams may result in scoring penalties for the patient. 11.We believe in the confidentiality of test scores and will distribute all test results to individual students in a confidential manner, as soon as possible, usually via Canvas. 12.Test scores graded by Scantron may be available within 24 hours. However, due to technical problems beyond our control, this may not always be feasible, but grades will be posted as soon as possible. Examinations with essay, SOAPE notes, or other hand written sections will take longer to grade and post. 13.Dishonestysuchascheatingisunacceptablebehavior.Inappropriatetestingbehavior reflectsunsatisfactoryprofessional development and thereforeleads to academicreview of the student and possible dismissal.Do not provide or receive unauthorized assistance on exams.Do not remove exams from designated review areas or obtain exam material prior to distributionbyfaculty.Irregularitiesyouobserveintest-takingshouldbereferredtothe proctor or course instructor.See the heading labeled Academic Integrity under the section Student Life in the LLU Catalog and in the Student Handbook in University Policies section under the Academic Integrity Policy heading. a.In an examination setting the department chair and the exam proctor will meet with the student privately, immediately or at an appointed time, to discuss the details of the unsatisfactory behavior.A written report will be placed in the students file.The student will be referred to the dean of the School of Allied Health Professions for further action. b.In a non-examination setting the department chair will meet privately with the student to discuss the details of the behavior.A written report will be placed in the students file.The department faculty will decide on further disciplinary action. 14.It is expected that students will take examinations (and quizzes) at the regularly scheduled time.Totakeanexaminationatatimeotherthanwhenitisscheduled,thestudentmust secure the consent of the instructor and the department chair and must file with the instructor a permit obtained from the Physician Assistant Program Office. A fee of $50 is charged for a special examination. 15.During examinations, a qualified staff or faculty member will be in the room monitoring the exam for any inappropriate testing behavior. Students may also be monitored electronically at the discretion of the faculty. 16.Computer based examinations may have special instructions and limitations that you must follow. This may include:A limited amount of time to complete a section or an entire section The inability to return to a section once you have indicated it is completed. 2015-06-23Syllabus_ClinMed-III_20157 17.Written assignments, essays, and short answer questions must use correct Standard English grammar and spelling in order to receive full credit. 18.Examination dates may be moved by faculty from the original date and time indicated in the respective quarter schedule as needed. 19.Students may request a scheduled Physician Assistant program examination to be moved from the original date and time if ALL of the following requirements are met: All students agree (a unanimous decision) The vote to change the examination date and/or time was secret/anonymous The request is made in writing to the respective faculty/course coordinator via e-mail by the class president in a timely manner (at least 24 hours prior) The program faculty are able to accommodate the change EXAMINATION REVIEW POLICIES 1.The Loma Linda University Master of Physician Assistant Program utilizes a variety of written and practical examinations to determine student progress as well as to evaluate program effectiveness. 2.Current Program Policy: Keys will not be posted in order to preserve examination integrity and security. 3.Program faculty may schedule a review of an examination for the entire class if possible. 4.Any student that has questions regarding any specific test item, the scoring of an examination, or feels that he/she did not perform well on the examination should make an appointment with the respective course director to review that examination. 5.Requests to re-evaluate a specific test item may be sent to the course coordinator or primary instructor via e-mail, but must include documentation supporting the request to change the keyed test item answer. 6.Students requesting to evaluate a specific examination should email the course director within 7 calendar days of the examination date to make an appointment to review the examination. Examination reviews requested after 7 calendar days are scheduled at the discretion of the course instructor and may be denied without explanation. 7. Students that achieve a score of 80% or less will be given priority when requesting to review an examination. Students that achieve a score of 90% or greater on an examination may request to review the examination, but will be accommodated at the discretion of the course director. 2015-06-23Syllabus_ClinMed-III_20158 8.Open door or Walk-in examination review requests are not recommended or encouraged and are at the discretion of the course instructor. 9.Examinations or posted keys may not be copied, photographed or used for extensive note taking. 10.Examination reviews are not intended as study sessions for final examinations. End of quarter reviews of previous examinations will not be allowed. ATTENDANCE: 1.Attendance is required for all classes.Tardiness is not acceptable.Excessive absences may result in a reduction of course grade. 2.Inform the office of any absence by calling (909) 558-7295. The student will be responsible for obtaining all missed course information. 3.The course coordinator/instructor may also be notified by e-mail if you will be late or absent from class or laboratory sessions. 4.We are now required to document the presence of each student in each course he/she registered for. This is a Federal Government requirement that the University must comply with. 5.Unless there is an examination or other documentation, each student is required to sign in at the start of each class or laboratory session to document his/her attendance. 6.It is EACH students responsibility to sign in at the start of each class. 7.Please DO NOT sign in for other students. 8.In addition to the sign in sheet, faculty may take roll call or otherwise verify the presence of each student in the classroom or laboratory session, regardless of location on or off campus. PHONE AND COMPUTER USE: 1.Each student is required to have a laptop, notebook, or similar electronic device that allows access to Canvas, the Internet, and the LLU e-mail system. 2.Electronic versions of handouts, Power Point presentations, PDF documents and slide sets, hyperlinks, and videos will be made available to each student in lieu of hardcopy printouts for the majority of our courses. You will need to access these for note taking during class. 2015-06-23Syllabus_ClinMed-III_20159 3.Our primary classroom has a 110-120 volt, 60 cycle AC electrical outlet and a data port at each seat. Please notify the course instructor/coordinator if you find any of these not functioning. 4.Both of our classrooms have LLU Wi-Fi system access. 5.Please feel free to use your computer to take notes or annotate any presentation to which you have been given access electronically. All sounds must be turned off, including keyboard and restart sounds. 6.Please restrict your computer use to note-taking and/or viewing class presentations. 7.DO NOT use your computer to check e-mail, surf the web, or other activities not related to the class. This is distracting for you and for others around you. If you are using the computer inappropriately, you may be asked to leave the class. 8.Turn all cell phones to quiet mode without vibration during all classes and laboratory sessions. 9.Do not engage in texting or in conversations during classes or laboratories or you may be asked to leave the classroom. If you exit the classroom to take a call, you may be asked not to return for the remainder of the class period. 10.Inappropriate computer and/or cell phone use may lead to a lower grade in any course and may place a student at risk for probation, suspension or dismissal from the program. PROFESSIONALISM: While there is a subjective nature to the measurement of professional behaviors, we emphasize objective observation of each students behaviors and compare them to the desired outcomes for our students. Various evaluation tools may be utilized to incorporate professionalism into the final course grade. These will be included in the grading matrix of this class at the discretion of the course instructor in consultation with the Physician Assistant Department Chair and Program Director.PleaseseetheDidacticStudentHandbook(p.12-13)formoreinformationregarding professional behaviors. For this course, a professional demeanor multiplier (PDM) will be used to determine your final grade for the course. Your objective grade will be initially calculated using the calculated average of your examinations and laboratory grade. The subjective portion using the multiplier will be basedonyourprofessionaldemeanor,includingthosebenchmarkbehaviorslistedinyour DidacticStudentHandbooksuchaspunctuality,attendance,positiveattitude,preparation, appropriate language andrespectfulness.The following rubric willbeusedtodetermineyour PDM for the course. Please note that not all bullet points must be satisfied for a student to receive a lower multiplier. 2015-06-23Syllabus_ClinMed-III_201510 MultiplierDescription of Behaviors x 1.00 Is punctual for class and never tardy Has no unexcused absences; always makes arrangements with instructor when absence is necessary Followsrulesandpoliciesconsistentlyandacceptsresponsibilityfor personallyfollowingthem(e.g.appearance,behavior,attendance, language, etc.) Pays attention in class and is not distracted and/or distracting to others Activelyparticipatesinclassdiscussions;appearsinterestedinand engages in educational activities Effectively resolves his/her conflicts or disagreements with faculty, staff, or students Collegial and respectful relationships with faculty, staff and students x 0.95 Is usually punctual for class but with one instance of unexcused tardiness Attends class with one instance of an unexcused absence; did not make arrangements with the instructor Usuallyfollowsrulesandpolicies;whenremindedaboutbreachesof rules or policies, accepts them and does not attempt to circumvent them Usually pays attention in class, occasionally distracted and/or distracting to others Rarely participates in class discussions; engages in educational activities if called upon; appears disinterested at times Has occasional difficulty with disagreements or conflict resolution with faculty, staff, or students Occasionally displays less than ideal respect or collegiality x 0.90 Isfrequentlylatetoclasswithmorethanoneinstanceofunexcused tardiness Hasmorethanoneinstanceofanunexcusedabsence;doesnotmake arrangements with the instructor Sometimesdisregardsknownrulesandpolicies;sometimeswants exceptionstobemadeforhimorher;sometimestriestocircumvent established rules (e.g. appearance, behavior, attendance, language, etc.)Rarely pays attention in class, often distracted and/or distracting to others Appears to avoid participation in class discussions or other educational activities; usually appears disinterested Argumentative, displays difficulty with resolving his/her disagreements with faculty, staff, or students. Lack of respect, uncooperative with faculty, staff, students Revised: September 13 2013 2015-06-23Syllabus_ClinMed-III_201511 PHYSICIAN ASSISTANT MASTERS PROGRAM School of Allied Health Professions Loma Linda University PAST 542 Clinical Medicine II Spring Quarter, 2015 Course Learning Objectives This course is the second of a three quarter series of lectures and other classroom activities. The course presents accepted methods of evaluating, diagnosing, and treating conditions discussed in the class or in assignments. It focuses on the clinical relevance of data obtained from the history andphysicalexaminationanddiagnosticstudies.Inaddition,itemphasizestheprocessof synthesizing collected information to determine diagnoses and formulate management plans. This series of courses builds upon and correlates information from previous and concurrent coursesincluding,butnotlimitedto,Pharmacology,Anatomy,Pathophysiology,Physical Diagnosis, Diagnostic Methods, and other PA Program courses throughout the Didactic Year. You may need to go back and review material from other courses in order to get the most benefit from the material presented in this course. We use a variety of guest speakers that are content experts to present the highlights of the respective diseases. Due to time constraints, we cover common conditions and presentations and a basic core of knowledge to enable you to pass board exams. However, students must expect to do significant self-study to build upon and expand this knowledge in order to become effective clinicians. Course Goals: The above information and the following general course learning objectives are intended to help explain the structure, goals, and nature of this course. Pleasereadandrefertothisinformationifyouhaveanyquestions.Theintentistostate plainly how information is presented and tested to ensure that each student may successfully complete this course. 1.Our overall goal is for each to student to become a competent and compassionate Physician Assistant in harmony with the mission, vision, and goals of Loma Linda University. 2.Present the core of medical knowledge needed to successfully pass the National Boards. 2015-06-23Syllabus_ClinMed-III_201512 3.Providecontentexpertsthatcanexplainpertinentdiagnosticandtreatmentmodalitiesfor diseases encountered commonly in primary care practice. 4.Provideeachstudenttheopportunitytointeractwithcontentexpertstoensurethatthe presented material is understood. 5.Providestudentswithavarietyofspeakersandlearningactivitiesaspreparationfor supervised clinical practice. Course Learning Objectives: Students will demonstrate mastery of the course material by passing the examinations at or above the 75% mastery level. At the completion of this course, for the organ systems, body regions, and diseases discussed, the Physician Assistant student will be able to: 1.Explain the significance of each organ system in the disease process, the effects on the patient, including typical signs, symptoms, and physical findings 2.Indicate what other systems would be affected by a disease in addition to the primary system 3.Discuss the natural progress and outcomes of the respective diseases if not treated. 4.Recognize a disease based upon history, physical findings, and diagnostic study results. 5.Discuss the role of the physician assistant in the practice of medicine, including participation in the diagnosis and treatment of the indicated diseases. 6.Indicate the diagnostic studies that would confirm or rule out a suspected diagnosis, including common laboratory and imaging studies. 7.Determine how the etiology and epidemiology of each disease process contributes to morbidity and mortality in the general population. 8.Recommend first line treatments, preventive measures, and patient education in the management of these diseases. 9.Correlate treatment outcomes with prognoses or expected outcomes for the indicated diseases. 10.Distinguish between emergent and non-emergent medical condition and make recommendations for appropriate treatment and referral. 11.Relate a patients culture, race, and ethnic background to his/her healthcare needs and include this information when formulating diagnostic, treatment, and education plans.