general information - web viewchief executive officer ... discuss the theories of: a. maslow. b....

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Change of Award Self-Study Report Instructions This Self-Study Report (SSR) Template is designed for accredited programs that are applying to change the award level. MAERB Policy 120 details the guidelines for that change. This abbreviated template asks the program to provide information that is specifically relevant to this change as well as provide an overview of the program. In submitting this information to the MAERB Office, you would send it on one thumb drive to the MAERB Office at the following address: MAERB, 20 N. Wacker, Ste. 1575, Chicago, IL 60647. The MAERB office reviews the finished Change of Award SSR for completion and may contact the Program Director if there are missing elements. Then there is a “paper” review conducted by a MAERB board member. Materials need to be submitted and approved prior to the start of the new award granting option. In order to easily navigate the Self Study Template in MS Word, you should display the navigation pane. To do so, click on the View tab and then check the Navigation. Page 1 of 59

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Page 1: General Information -   Web viewChief Executive Officer ... Discuss the theories of: a. Maslow. b. Erikson . c. Kubler-Ross. ... (EMR) and a practice management system

Change of Award Self-Study Report

Instructions This Self-Study Report (SSR) Template is designed for accredited programs that are applying to change the award level. MAERB Policy 120 details the guidelines for that change. This abbreviated template asks the program to provide information that is specifically relevant to this change as well as provide an overview of the program.

In submitting this information to the MAERB Office, you would send it on one thumb drive to the MAERB Office at the following address: MAERB, 20 N. Wacker, Ste. 1575, Chicago, IL 60647.

The MAERB office reviews the finished Change of Award SSR for completion and may contact the Program Director if there are missing elements. Then there is a “paper” review conducted by a MAERB board member. Materials need to be submitted and approved prior to the start of the new award granting option.

In order to easily navigate the Self Study Template in MS Word, you should display the navigation pane. To do so, click on the View tab and then check the Navigation.

You will then be able to click the various headings in order to go to a specific section. The navigation pane enables you to quickly review all of the sections.

The SSR template is a MS Word fillable form that needs to be completed. Also, there are a number of appendices that the program will need to submit in order to supplement the information in the SSR.

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Because the document is locked, spell check is not operative. It is recommended that narratives are created on a separate word document, so that you can copy and paste effectively.

In the following section, you will find a list of all the additional documents that need to be included in the Appendices. In addition, there is a mandatory naming convention that you will need to follow. You must submit the Self-Study Report as a Word document on a thumb drive with the appropriate appendices.

Self-Study AppendicesOutlined below are the different Appendices required to accompany the Change of Award Self-Study; these appendices provide documentation for the CAAHEP Standards. The following charts provide the mandatory naming conventions in the column “File/Folder Name” for the different folders and files along with a detailed description of the specific appendices. At the end of this document, you will find an abbreviated chart, in “Instructions and Schema for Organizing the Change of Award Self-Study Submission,” that outlines precisely how to organize the Self-Study for submission.

Standard I Appendices

I.APP Standard I Folder for Appendices

Type File/Folder Name Description from Self-StudyFile IA.NarrHis Appendix I-A The program history (medical assisting program

length, credit hours and practicum hours) in order to provide the context for the current program. Explain why the program is planning to change its award designation. As MAERB Policy 120 outlines, the outcome history of the previous award program does apply to the new award level. Include at least one paragraph that details the program’s ability to meet the outcome thresholds. Consider the following points:

• Changes made in the resources to help improve performance on the outcomes

• Changes made in the curriculum to help improve performance on the outcomes

• Changes made in community outreach to help improve performance on the outcomes

File IB.OrgCh Appendix I-B Organizational Chart(s) displaying the school’s management structure from executive officers to administrative staff, with specific attention paid to the medical assisting program’s personnel within the institutional structure.

Standard II Appendices

II.APP Standard II Folder for Appendices

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Type File/Folder Name Description from Self-StudyFile IIA.PrgGoals Appendix II-A Written Statement of Program Goals

As is outlined in the Standard, every program needs to develop goals in order to best evaluate the specific needs for program planning, implementation, and evaluation. Every program responds to this requirement differently. The goal can be the “minimum expectation” that is outlined in Standard II.A. Please include a document that outlines what the specific goals will be for the program whose award is changing.

File IIB.ChgsExp Appendix II-B Description of how the needs and expectations have changed and how the program has responded to the changes

This narrative should outline how the needs and expectations of the communities of interest have changed, and the manner in which the program has responded to those changes. As a general rule, programs rely upon the Advisory Committee meeting minutes, surveys of students and employers, and other assessment documentation. These documents provide the background for how the program learns about the needs and expectations of the communities of interest in order to guide the changes.

File IIC.AdvMtg Appendix II-C Copy(ies) of the Advisory Committee Minutes that specifically references this change in award.

NOTE: If there are minutes of several meetings, use a folder with the name “IIC.AdvMtg” and label the individual files “YY.MMAdv.”

Standard III Appendices

III.APP Standard III Folder for Appendices

Type File/Folder Name Description from Self-StudyFolder IIIA.ProgDirWkbk Appendix III-A Program Director Workbook Please note that if

the Program Director has already been approved, there is no need to submit a Program Director Workbook.

File PDWkbk Program Director Workbook

File JobDes Program Director Job Description

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File Resume Resume

File Transcript Transcripts

File EdThTech Educational Theory and Techniques documentation

File Certificate Copy of certificate documenting achievement and currency in one of the four NCCA-accredited credentials: CMA (AAMA), RMA (AMT), NCMA (NCCT), CCMA (NHA)

Folder IIIB.FacWkbks Appendix III-B Faculty Workbooks for all faculty teaching courses unique to the medical assisting program Please note that if all the faculty have already submitted workbooks, there is no need to submit a Faculty Workbook.

Folders (# of Faculty)

LastName.First Initial

One folder for each MA faculty that contains the workbook and supplementary materials that should be named as outlined below.

File FacWkbk Faculty Workbook

File JobDes Job Description

File Resume Resume

File Transcript Transcripts (This material is necessary if the faculty is documenting their qualifications through education.)

File ContEd Continuing Education Certificates (This material is necessary if the faculty is documenting their

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qualifications through continuing education.)

File EdThPract Educational Theory and Techniques documentation

Folder IIIC.PracCrdWkbks Appendix III-C Practicum Coordinator Workbooks Please note that if the Practicum Coordinator(s) has already been approved, there is no need to submit a Practicum Coordinator Workbook.

Folders (# of Practicum Coordinators)

LastName.First Initial

One folder for each Practicum Coordinator that contains the workbook and supplementary materials that should be named as outlined below.

File PCWkbk Practicum Coordinator Workbook

File JobDes Practicum Coordinator Job Description

File Resume Resume

File IIID.GrPolCog Appendix III-D Grading policy, including grading scale and pass score for cognitive domain objectives

List the specific grading scale (such as A = 93-100% or A = 550-600 points) and specifically indicate what constitutes a passing grade. In addition, it is important to list the grading value, such as, for example, the tests are worth 40% of the grade and so on.

File IIIE.GrPolPsAf Appendix III-E Grading policy documenting inclusion of the requirement for successful completion of all psychomotor and affective domains competencies

List the specific grading policy that applies to the courses for psychomotor and affective domains objectives and how the competencies are being conducted. Include the documentation that informs students that they must successfully achieve every psychomotor and affective domain in the specific course in order to pass the course.

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Folder IIIF.Syllabi Appendix III-F Syllabi for courses in which the MAERB Core Curriculum objectives are taught and assessed. You do not need to include General Education courses if they do not include objectives or competencies from the MAERB Core Curriculum.

Files (# of Syllabi)

Ten Character Description of the Courses (individual documents)

Examples:MA190AdminMA201MdTrmMA211Clin1MA212Clin2

Folder IIIG.PracPol Appendix III-G Description of how practicums are established and students evaluated throughout their practicum experience, as appropriate (provide Policy).

Provide the policies and requirements for students to complete the Practicum requirement, such as the following:

• Review of course syllabi• Weekly on-campus meeting schedule and/or practicum site

schedule for students• Attendance policy• Uniforms• Professionalism (Appearance, Attitude, Behavior)• Weekly journals • Weekly evaluation of the student by the Practicum site• Final Practicum Evaluation by Practicum Coordinator

Files (# of Policies)

Ten Character Description of the Policies (individual documents; not all these documents may apply as these policies might be consolidated in the syllabus)

Examples:SyllPracSchedPSAttPolUnifPolProfWklyJourWklyEvalFinEvalPP

Syllabus for PracticumSchedule for PracticumAttendance PolicyUniform PolicyProfessional BehaviorWeekly JournalWeekly EvaluationFinal Evaluation

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Standard V Appendices

You need to include the material listed below only if the material is going to change due to the change in award. It is perfectly appropriate to include draft versions of what will be changed with the change of award, as the publication may be delayed until the change in award has been approved. Even if there have been no changes, you will need to insert a document with the correct name. Inside the document, just indicate “Not Applicable.”

Type File/Folder Name Description from Self-StudyFolder VA.Pubs Appendix V-A Copy of announcements, catalogs, publications,

handbooks, and advertising pertaining to the Medical Assisting program

A few sample documents are listed below, but it depends upon the program.

File StCat Student Catalog

File StHand Student Handbook

File CrseCat Course Catalog

File VB.AcadCal Appendix V-B Academic CalendarFile VC. AdmPol Appendix V-C Admissions policy

Include the program’s policy regarding admission into the medical assisting program, including pre-requisites, if any. It may be that the medical assisting program uses the institutional policy; if so, that policy should be included.

File VD.TechStds Appendix V-D Technical Standards, if used

NOTE: “Technical Standards” can include such details as “students must be able to lift 20 pounds, climb on step stools, and so on.” Many programs do not have specific technical standards and simply use the institutional admission standards

File VE.AdvPl Appendix V-E Advanced placement policy(ies), via transfer of credit, experiential learning, or other method

The program’s policies regarding transfer of credits and credit for experiential learning need to be included. If your program does not accept advanced placement, transfer credit, or credit for experiential learning, there needs to be a policy/statement that explains that to the students.

File VF.Critgrad Appendix V-F Criteria for Graduation

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File VG.Clinwrk Appendix V-G Policies and processes by which students may perform clinical work while enrolled in the program

File VH.PractPol Appendix V-H Practicum policies (supervision, non-remuneration)File VI.CreditHrs Appendix V-I Number of credits required for completion of the

programFile VJ.Tuition Appendix V-J Tuition/Fees and other costs required to complete the

programFile VK.StWthdrwl Appendix V-K Policies and processes for student withdrawal from

the programFile VL.Refunds Appendix V-L Policies and processes for refundsFile VM.StGrvnce Appendix V-M Student grievance policyFile VN.AffAgr Appendix V-N Sample copy of the affiliation agreement or

memorandum of understanding used for practicum sitesFile VO.SftyPol Appendix V-O Policies and procedures assuring adequate safety of

patients, students, and faculty.

General InformationTitle of Medical Assisting Program Click here to enter text.Address of Institutional Webpage for Program, if applicable

Click here to enter text.

Award currently granted Choose an item.Award being applied for Choose an item.

Sponsoring Institution Click here to enter text.Mailing Address 1 Click here to enter text.Mailing Address 2 Click here to enter text.City, State, Zip Click here to enter text.Institution Phone Number Click here to enter text.Website Click here to enter text.

Name and Contact information for person with the central responsibility for the preparation and submission of the Change of Award Self-Study Report.

Name and Credentials Click here to enter text.Title Click here to enter text.Mailing Address Click here to enter text.City, State, Zip Click here to enter text.Phone Number Click here to enter text.Email Click here to enter text.

Contact InformationChief Executive Officer (to whom all correspondence will be directed)

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Name and Credentials Click here to enter text.Title Click here to enter text.Mailing Address Click here to enter text.City, State, Zip Click here to enter text.Phone Number (include hyphens)

Click here to enter text.

Email Click here to enter text.

Dean or comparable administrator (MAERB wants the information about the person to whom medical assisting Program Director reports)

Name and Credentials Click here to enter text.Title Click here to enter text.Mailing Address Click here to enter text.City, State, Zip Click here to enter text.Phone Number (include hyphens)

Click here to enter text.

Email Click here to enter text.

Program Director

Name and Credentials Click here to enter text.Title Click here to enter text.Mailing Address Click here to enter text.City, State, Zip Click here to enter text.Phone Number (include hyphens)

Click here to enter text.

Email Click here to enter text.

Practicum Coordinator 1

Name and Credentials Click here to enter text.Title Click here to enter text.Mailing Address Click here to enter text.City, State, Zip Click here to enter text.Phone Number (include hyphens)

Click here to enter text.

Email Click here to enter text.

Practicum Coordinator 2 (if applicable)

Name and Credentials Click here to enter text.

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Title Click here to enter text.Mailing Address Click here to enter text.City, State, Zip Click here to enter text.Phone Number (include hyphens)

Click here to enter text.

Email Click here to enter text.

Practicum Coordinator 3 (if applicable)

Name and Credentials Click here to enter text.Title Click here to enter text.Mailing Address Click here to enter text.City, State, Zip Click here to enter text.Phone Number (include hyphens)

Click here to enter text.

Email Click here to enter text.

If there are more than three Practicum Coordinators, please list the names below:

Click here to enter text.Click here to enter text.Click here to enter text.Click here to enter text.Click here to enter text.Click here to enter text.

Standard ICurrent Program Design

Length of program in months Click here to enter text.Total credit or clock hours Click here to enter text.Type of academic terms (semester, quarters, blocks)

Click here to enter text.

Number of cohorts admitted per year Click here to enter text.Total current enrollment Click here to enter text.

Explain how the length of the program, the total credit hours, the academic terms, and the number of cohorts admitted will change due to the proposed change of award.

Click here to enter text.

If the program is changing its award from an associate degree to a certificate or diploma, will the associate degree still continue to exist as an unaccredited program, or will the associate degree no

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longer be offered? If the former, will students who are awarded the certificate or diploma be able to continue into the associate degree?

If the program is changing its award from a certificate or diploma to an associate degree, will the certificate still continue to exist as an unaccredited program, or will the certificate or diploma no longer be offered?

Click here to enter text.

Program Modality

Is any portion of the program offered via distance education?

Click here to enter text.

If so, what percentage of the program is offered through distance education?

Click here to enter text.

Are any of the psychomotor and/or affective competencies in either “Foundations of Clinical Practices” or “Safety and Emergency Practices” of the MAERB Core Curriculum taught through distance education?

Click here to enter text.

If the answer is yes about assessing the psychomotor and/or affective competencies in either “Foundations of Clinical Practices” or “Safety and Emergency Practices,” please contact your Case Manager in order to ensure that you are in compliance with MAERB’s requirements in that area.

Standard IIAppropriateness of Goals and Learning DomainsDescribe the need and expectations of each of your communities of interest. What outcomes (retention, job placement, employer survey participation, employer satisfaction, graduate survey participation, graduate satisfaction, exam participation, exam passage) are the most important for that specific community of interest? You will need to identify the top two outcomes that are the most important to each community of interest.

Communities of Interest Briefly describe the needs and expectations of each of your communities of interest.

Identify the top two outcomes that are most important to each community of interest.

Students Click here to enter text. Click here to enter text.Graduates Click here to enter text. Click here to enter text.Faculty Click here to enter text. Click here to enter text.Sponsor Administration Click here to enter text. Click here to enter text.Employers Click here to enter text. Click here to enter text.Physicians Click here to enter text. Click here to enter text.Public Click here to enter text. Click here to enter text.Others: Click here to enter text. Click here to enter text. Click here to enter text.Others: Click here to enter text. Click here to enter text. Click here to enter text.

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Others: Click here to enter text. Click here to enter text. Click here to enter text.

Advisory Committee Representative Name Agency/OrganizationCurrent Student Click here to enter text. Click here to enter text.Graduate Click here to enter text. Click here to enter text.Faculty Click here to enter text. Click here to enter text.Sponsor Administration Click here to enter text. Click here to enter text.Employers Click here to enter text. Click here to enter text.MD, DO, NP, or PA Click here to enter text. Click here to enter text.Public (an individual who has never been employed in a healthcare environment and is not employed at an institution of higher learning with CAAHEP accredited programs)

Click here to enter text. Click here to enter text.

Others: Click here to enter text. Click here to enter text. Click here to enter text.Others: Click here to enter text. Click here to enter text. Click here to enter text.Others: Click here to enter text. Click here to enter text. Click here to enter text.

Briefly describe the background and work history of the Public Member to ensure that the qualifications comply with MAERB Policy 230:

Click here to enter text.

List the dates of the meetings that the Advisory Committee discussed this proposed change of award:

Click here to enter text.Click here to enter text.Click here to enter text.Click here to enter text.Click here to enter text.Click here to enter text.Click here to enter text.

Standard IIIBudget: Sufficiency of Program ResourcesWhat month does the program’s fiscal year begin?

Click here to enter text.

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List, combining if necessary, the actual medical assisting program budget from all funding sources in order to fill out the applicable amounts. If any of the items are in a shared budget with other departments, estimate the medical assisting portion based on a percentage of usage.

Description Expenditures of previous fiscal year

Current Fiscal Year budget

Projected budget for next fiscal year, if available

Fiscal Year Click here to enter text.

Click here to enter text.

Click here to enter text.

Full-time faculty salaries Click here to enter text.

Click here to enter text.

Click here to enter text.

Part-time faculty salaries Click here to enter text.

Click here to enter text.

Click here to enter text.

Other salaries Click here to enter text.

Click here to enter text.

Click here to enter text.

Clerical Support Click here to enter text.

Click here to enter text.

Click here to enter text.

Support Staff Click here to enter text.

Click here to enter text.

Click here to enter text.

Equipment Click here to enter text.

Click here to enter text.

Click here to enter text.

Supplies Click here to enter text.

Click here to enter text.

Click here to enter text.

Computer Resources Click here to enter text.

Click here to enter text.

Click here to enter text.

Instructional Reference Materials Click here to enter text.

Click here to enter text.

Click here to enter text.

Faculty Continuing Education Click here to enter text.

Click here to enter text.

Click here to enter text.

Staff Continuing Education Click here to enter text.

Click here to enter text.

Click here to enter text.

Totals Click here to enter text.

Click here to enter text.

Click here to enter text.

Click here to enter text.

Click here to enter text.

How many hours of practicum are required in the program? Click here to enter text.

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In what written documentation (Program Handbook, practicum syllabi, and so on) are the students informed that the practicum hours are unpaid?

Click here to enter text.

In what written documentation (agreement, orientation materials and so on) are the practicum site supervisors informed that the practicum hours are unpaid?

Click here to enter text.

Please indicate if any of these support services will change with the change of award. If there is no change, just indicate “No Change.”

Academic Advising Click here to enter text.Personal Counseling Click here to enter text.Academic Tutoring Click here to enter text.Financial Aid Click here to enter text.Computer Resources Click here to enter text.Library Click here to enter text.On-line Academic Resources Click here to enter text.Health Services Click here to enter text.Career Counseling Click here to enter text.Other Support Service Click here to enter text.Other Support Service Click here to enter text.Other Support Service Click here to enter text.Other Support Service Click here to enter text.

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Standard IVOutcomesBased upon the most recent ARF submitted and acknowledged by a letter from the MAERB office, provide information about the program outcomes:

Month and year of ARF submission:

Click here to enter text.

Where is the raw data maintained in order to ensure continuity? (Medical Assisting Office, Dean’s Office, Program Director’s office, and so on)

Click here to enter text.

Outcomes Outcome Results (percentage)

Comment on how the program tracks and/or collects the raw data for the outcome.

Retention (60% Threshold) Click here to enter text.

Click here to enter text.

Job Placement (60% Threshold)

Click here to enter text.

Click here to enter text.

Graduate Survey Participation (30% Threshold)

Click here to enter text.

Click here to enter text.

Graduate Satisfaction (80% Threshold)

Click here to enter text.

Click here to enter text.

Employer Survey Participation (30% Threshold)

Click here to enter text.

Click here to enter text.

Employer Satisfaction (80% Threshold)

Click here to enter text.

Click here to enter text.

Exam Participation (30% Threshold)

Click here to enter text.

Click here to enter text.

Exam Passage (60% Threshold)

Click here to enter text.

Click here to enter text.

Briefly comment on any trends and patterns that you have noted in the past three years for these outcomes. Please comment on all outcome thresholds, even if the program is meeting the thresholds.

Click here to enter text.

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Standard VPublications and Disclosure

Will any of the items and policies listed below change due to the change in award? If so, explain what changes are being made. If not, simply indicate that there is “No Change.” NOTE: If there are changes, you are asked to submit the changed document in the appendix for Standard V.

Academic Calendar Click here to enter text.Admissions policies and practices

Click here to enter text.

Technical Standards, if used by the program

Click here to enter text.

Policy on Advanced Placement Click here to enter text.Policy on Transfer of Credits Click here to enter text.Policy on Experiential Learning Click here to enter text.Criteria for graduation Click here to enter text.Policies and processes by which students may perform clinical work while enrolled in the program

Click here to enter text.

Practicum policies (supervision, non-remuneration)

Click here to enter text.

Number of credits required for completion of the program

Click here to enter text.

Tuition/fees and other costs required to complete the program

Click here to enter text.

Policies and processes for student withdrawal from program

Click here to enter text.

Policies and processes for refunds

Click here to enter text.

Student grievance policy Click here to enter text.

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Additional Forms for Standard IIIFaculty Information

Please provide a list of the faculty members who teach courses specifically designed and unique to the medical assisting program. If any of the faculty have not yet submitted faculty workbooks to MAERBs, workbooks will need to be submitted in an appendix.

Faculty Name and Credentials

Click here to enter text.

Email Click here to enter text.

Faculty Name and Credentials

Click here to enter text.

Email Click here to enter text.

Faculty Name and Credentials

Click here to enter text.

Email Click here to enter text.

Faculty Name and Credentials

Click here to enter text.

Email Click here to enter text.

Faculty Name and Credentials

Click here to enter text.

Email Click here to enter text.

Faculty Name and Click here to enter text.

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CredentialsEmail Click here to enter text.

Faculty Name and Credentials

Click here to enter text.

Email Click here to enter text.

Faculty Name and Credentials

Click here to enter text.

Email Click here to enter text.

Faculty Name and Credentials

Click here to enter text.

Email Click here to enter text.

Faculty Name and Credentials

Click here to enter text.

Email Click here to enter text.

Resource AssessmentPlease share the resource assessment for the current program.

Program Resource

What program Outcomes are affected by that resource and how? (for example, retention or job placement or so on)

Tools used to assess the resource (for example, surveys, evaluations, interviews)

Dates of Measurement

Results Action Plan (designed for maintenance or improvement)

Action Plan Follow-Up/Status

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Program Director

Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.

Practicum Coordinator

Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.

Faculty Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.Advisory Committee

Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.

Clerical Staff Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.Support Staff (Registrar, Admissions, Financial Aid, and so on)

Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.

Finances Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.Offices Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.Classrooms Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.Laboratories Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.Ancillary Student Facilities (library, food services, student health services, learning center)

Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.

Practicum Affiliations

Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.

Equipment Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.Supplies Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.

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Computer Resources

Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.

Instructional Reference Material

Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.

Faculty/Staff Continuing Education

Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.

Other Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.Other Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.Other Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.Other Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.Other Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.

What resource will be affected, if any, by the change in award?

Click here to enter text.

Curriculum Course ListIt is not necessary to list the general education courses. The only courses that should be listed are the ones that contain the MAERB Core Curriculum.

Course Number

Course Title # of Lecture Hours

# of Lab hours

# of credits (if applicable)

Cognitive objectives taught (yes/no)

Psychomotor/Affective Competencies taught (yes/no)

Term Taken Prerequisite, if any.

Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.

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Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here. Enter here.

Curriculum MapCognitive Objectives

Course Number (eg, MED 101, MED 107)

Assessment ToolList what type of assessment tool is used to measure the achievement of this objective. Be detailed (multiple choice, essay, presentation, fill-in the blank, report, and so on)

Crosswalk (if applicable) If the program creates its own course learning objectives and does not use the number and precise language of the cognitive objective on the syllabus, include the course learning objective listed on syllabus that covers the specific objective.

I.C Anatomy & Physiology

I.C.1. Describe structural organization of the human body Enter here. Enter here. Enter here.I.C.2. Identify body systems Enter here. Enter here. Enter here.I.C.3. Describe:

a. body planes Enter here. Enter here. Enter here.b. directional terms Enter here. Enter here. Enter here.c. quadrants Enter here. Enter here. Enter here.d. body cavities Enter here. Enter here. Enter here.

I.C.4. List major organs in each body system Enter here. Enter here. Enter here.

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I.C.5. Identify the anatomical location of major organs in each body system

Enter here. Enter here. Enter here.

I.C.6. Compare structure and function of the human body across the life span

Enter here. Enter here. Enter here.

I.C.7. Describe the normal function of each body system Enter here. Enter here. Enter here.I.C.8. Identify common pathology related to each body system including:

a. signs Enter here. Enter here. Enter here.b. symptoms Enter here. Enter here. Enter here.c. etiology Enter here. Enter here. Enter here.

I.C.9. Analyze pathology for each body system including:a. diagnostic measures Enter here. Enter here. Enter here.b. treatment modalities Enter here. Enter here. Enter here.

I.C.10. Identify CLIA waived tests associated with common diseases

Enter here. Enter here. Enter here.

I.C.11. Identify the classifications of medications including: a. indications for use Enter here. Enter here. Enter here.b. desired effects Enter here. Enter here. Enter here.c. side effects Enter here. Enter here. Enter here.d. adverse reactions Enter here. Enter here. Enter here.

I.C.12. Identify quality assurance practices in healthcare Enter here. Enter here. Enter here.I.C.13. List principles and steps of professional/provider CPR

Enter here. Enter here. Enter here.

I.C.14. Describe basic principles of first aid as they pertain to the ambulatory healthcare setting

Enter here. Enter here. Enter here.

II.C Applied MathematicsII.C.1. Demonstrate knowledge of basic math computations

Enter here. Enter here. Enter here.

II.C.2. Apply mathematical computations to solve equations

Enter here. Enter here. Enter here.

II.C.3. Define basic units of measurement in:

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a. the metric system Enter here. Enter here. Enter here.b. the household system Enter here. Enter here. Enter here.

II.C.4. Convert among measurement systems Enter here. Enter here. Enter here.II.C.5. Identify abbreviations and symbols used in calculating medication dosages

Enter here. Enter here. Enter here.

II.C.6. Analyze healthcare results as reported in: a. graphs Enter here. Enter here. Enter here.b. tables Enter here. Enter here. Enter here.

III.C Infection ControlIII.C.1. List major types of infectious agents Enter here. Enter here. Enter here.III.C.2. Describe the infection cycle including:

a. the infectious agent Enter here. Enter here. Enter here.b. reservoir Enter here. Enter here. Enter here.c. susceptible host Enter here. Enter here. Enter here.d. means of transmission Enter here. Enter here. Enter here.e. portals of entry Enter here. Enter here. Enter here.f. portals of exit Enter here. Enter here. Enter here.

III.C.3. Define the following as practiced within an ambulatory care setting:

a. medical asepsis Enter here. Enter here. Enter here.b. surgical asepsis Enter here. Enter here. Enter here.

III.C.4. Identify methods of controlling the growth of microorganisms

Enter here. Enter here. Enter here.

III.C.5. Define the principles of standard precautions Enter here. Enter here. Enter here.III.C.6. Define personal protective equipment (PPE) for:

a. all body fluids, secretions and excretions Enter here. Enter here. Enter here.b. blood Enter here. Enter here. Enter here.c. non-intact skin Enter here. Enter here. Enter here.d. mucous membranes Enter here. Enter here. Enter here.

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III.C.7. Identify Center for Disease Control (CDC) regulations that impact healthcare practices

Enter here. Enter here. Enter here.

IV.C NutritionIV.C.1. Describe dietary nutrients including:

a. carbohydrates Enter here. Enter here. Enter here.b. fat Enter here. Enter here. Enter here.c. protein Enter here. Enter here. Enter here.d. minerals Enter here. Enter here. Enter here.e. electrolytes Enter here. Enter here. Enter here.f. vitamins Enter here. Enter here. Enter here.g. fiber Enter here. Enter here. Enter here.h. water Enter here. Enter here. Enter here.

IV.C.2. Define the function of dietary supplements Enter here. Enter here. Enter here.IV.C.3. Identify the special dietary needs for:

a. weight control Enter here. Enter here. Enter here.b. diabetes Enter here. Enter here. Enter here.c. cardiovascular disease Enter here. Enter here. Enter here.d. hypertension Enter here. Enter here. Enter here.e. cancer Enter here. Enter here. Enter here.

f. lactose sensitivity Enter here. Enter here. Enter here.g. gluten-free Enter here. Enter here. Enter here.h. food allergies Enter here. Enter here. Enter here.

V.C Concepts of Effective CommunicationV.C.1. Identify styles and types of verbal communication Enter here. Enter here. Enter here.V.C.2. Identify types of nonverbal communication Enter here. Enter here. Enter here.V.C.3. Recognize barriers to communication Enter here. Enter here. Enter here.V.C.4. Identify techniques for overcoming communication barriers

Enter here. Enter here. Enter here.

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V.C.5. Recognize the elements of oral communication using a sender-receiver process

Enter here. Enter here. Enter here.

V.C.6. Define coaching a patient as it relates to:a. health maintenance Enter here. Enter here. Enter here.b. disease prevention Enter here. Enter here. Enter here.c. compliance with treatment plan Enter here. Enter here. Enter here.d. community resources Enter here. Enter here. Enter here.e. adaptations relevant to individual patient

needsEnter here. Enter here. Enter here.

V.C.7. Recognize elements of fundamental writing skills Enter here. Enter here. Enter here.V.C.8. Discuss applications of electronic technology in professional communication

Enter here. Enter here. Enter here.

V.C.9. Identify medical terms labeling the word parts Enter here. Enter here. Enter here.V.C.10. Define medical terms and abbreviations related to all body systems

Enter here. Enter here.

V.C.11. Define the principles of self-boundaries Enter here. Enter here. Enter here.V.C.12. Define patient navigator Enter here. Enter here. Enter here.V.C.13. Describe the role of the medical assistant as a patient navigator

Enter here. Enter here.

V.C.14. Relate the following behaviors to professional communication:

a. assertive Enter here. Enter here. Enter here.b. aggressive Enter here. Enter here. Enter here.c. passive Enter here. Enter here. Enter here.

V.C.15. Differentiate between adaptive and non-adaptive coping mechanismsV.C.16. Differentiate between subjective and objective information

Enter here. Enter here. Enter here.

V.C.17. Discuss the theories of:a. Maslow Enter here. Enter here. Enter here.b. Erikson Enter here. Enter here. Enter here.c. Kubler-Ross Enter here. Enter here. Enter here.

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V.C.18. Discuss examples of diversity: a. cultural Enter here. Enter here. Enter here.b. social Enter here. Enter here. Enter here.c. ethnic Enter here. Enter here. Enter here.

VI.C Administrative FunctionsVI.C.1. Identify different types of appointment scheduling methods

Enter here. Enter here. Enter here.

VI.C.2. Identify advantages and disadvantages of the following appointment systems

a. manual Enter here. Enter here. Enter here.b. electronic Enter here. Enter here. Enter here.

VI.C.3. Identify critical information required for scheduling patient procedures

Enter here. Enter here. Enter here.

VI.C.4. Define types of information contained in the patient’s medical record

Enter here. Enter here. Enter here.

VI.C.5. Identify methods of organizing the patient’s medical record based on:

a. problem-oriented medical record (POMR) Enter here. Enter here. Enter here.b. source-oriented medical record (SOMR) Enter here. Enter here. Enter here.

VI.C.6. Identify equipment and supplies needed for medical records in order to:

a. Create Enter here. Enter here. Enter here.b. Maintain Enter here. Enter here. Enter here.c. Store Enter here. Enter here. Enter here.

VI.C.7. Describe filing indexing rules Enter here. Enter here. Enter here.VI.C.8. Differentiate between electronic medical records (EMR) and a practice management system

Enter here. Enter here. Enter here.

VI.C.9. Explain the purpose of routine maintenance of administrative and clinical equipment

Enter here. Enter here. Enter here.

VI.C.10. List steps involved in completing an inventory Enter here. Enter here. Enter here.

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VI.C.11. Explain the importance of data back-up Enter here. Enter here. Enter here.VI.C.12. Explain meaningful use as it applies to EMR Enter here. Enter here. Enter here.

VII.C Basic Practice FinancesVII.C.1. Define the following bookkeeping terms:

a. charges Enter here. Enter here. Enter here.b. payments Enter here. Enter here. Enter here.c. accounts receivable Enter here. Enter here. Enter here.d. accounts payable Enter here. Enter here. Enter here.e. adjustments Enter here. Enter here. Enter here.

VII.C.2. Describe banking procedures as related to the ambulatory care setting

Enter here. Enter here. Enter here.

VII.C.3. Identify precautions for accepting the following types of payments:

a. cash Enter here. Enter here. Enter here.b. check Enter here. Enter here. Enter here.c. credit card Enter here. Enter here. Enter here.d. debit card Enter here. Enter here. Enter here.

VII.C.4. Describe types of adjustments made to patient accounts including:

a. non-sufficient funds (NSF) check Enter here. Enter here. Enter here.b. collection agency transaction Enter here. Enter here. Enter here.c. credit balance Enter here. Enter here. Enter here.d. third party Enter here. Enter here. Enter here.

VII.C.5. Identify types of information contained in the patient's billing record

Enter here. Enter here. Enter here.

VII.C.6. Explain patient financial obligations for services rendered

Enter here. Enter here. Enter here.

VIII.C Third Party ReimbursementVIII.C.1. Identify:

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a. types of third party plans Enter here. Enter here. Enter here.b. information required to file a third party claim Enter here. Enter here. Enter here.c. the steps for filing a third party claim Enter here. Enter here. Enter here.

VIII.C.2. Outline managed care requirements for patient referral

Enter here. Enter here. Enter here.

VIII.C.3. Describe processes for:a. verification of eligibility for services Enter here. Enter here. Enter here.b. precertification Enter here. Enter here. Enter here.c. preauthorization Enter here. Enter here. Enter here.

VIII.C.4. Define a patient-centered medical home (PCMH) Enter here. Enter here. Enter here.VIII.C.5. Differentiate between fraud and abuse Enter here. Enter here. Enter here.

IX.C Procedural and Diagnostic CodingIX.C.1. Describe how to use the most current procedural coding system

Enter here. Enter here. Enter here.

IX.C.2. Describe how to use the most current diagnostic coding classification system

Enter here. Enter here. Enter here.

IX.C.3. Describe how to use the most current HCPCS level II coding system

Enter here. Enter here. Enter here.

IX.C.4. Discuss the effects of:a. upcoding Enter here. Enter here. Enter here.b. downcoding Enter here. Enter here. Enter here.

IX.C.5. Define medical necessity as it applies to procedural and diagnostic coding

Enter here. Enter here. Enter here.

X.C Legal ImplicationsX.C.1. Differentiate between scope of practice and standards of care for medical assistants

Enter here. Enter here. Enter here.

X.C.2. Compare and contrast provider and medical assistant roles in terms of standard of care

Enter here. Enter here. Enter here.

X.C.3. Describe components of the Health Insurance Portability & Accountability Act (HIPAA)

Enter here. Enter here. Enter here.

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X.C.4. Summarize the Patient Bill of Rights Enter here. Enter here. Enter here.X.C.5. Discuss licensure and certification as they apply to healthcare providers

Enter here. Enter here. Enter here.

X.C.6. Compare criminal and civil law as they apply to the practicing medical assistant

Enter here. Enter here. Enter here.

X.C.7. Define:a. negligence Enter here. Enter here. Enter here.b. malpractice Enter here. Enter here. Enter here.c. statute of limitations Enter here. Enter here. Enter here.d. Good Samaritan Act(s) Enter here. Enter here. Enter here.e. Uniform Anatomical Gift Act Enter here. Enter here. Enter here.f. living will/advanced directives Enter here. Enter here. Enter here.g. medical durable power of attorney Enter here. Enter here. Enter here.h. Patient Self Determination Act (PSDA) Enter here. Enter here. Enter here.i. risk management Enter here. Enter here. Enter here.

X.C.8. Describe the following types of insurance:a. liability Enter here. Enter here. Enter here.b. professional (malpractice) Enter here. Enter here. Enter here.c. personal injury Enter here. Enter here. Enter here.

X.C.9. List and discuss legal and illegal applicant interview questions

Enter here. Enter here. Enter here.

X.C.10. Identify:a. Health Information Technology for Economic

and Clinical Health (HITECH) ActEnter here. Enter here. Enter here.

b. Genetic Information Nondiscrimination Act of 2008 (GINA)

Enter here. Enter here. Enter here.

c. Americans with Disabilities Act Amendments Act (ADAAA)

Enter here. Enter here. Enter here.

X.C.11. Describe the process in compliance reporting:a. unsafe activities Enter here. Enter here. Enter here.b. errors in patient care Enter here. Enter here. Enter here.

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c. conflicts of interest Enter here. Enter here. Enter here.d. incident reports Enter here. Enter here. Enter here.

X.C.12. Describe compliance with public health statutes:a. communicable diseases Enter here. Enter here. Enter here.b. abuse, neglect, and exploitation Enter here. Enter here. Enter here.c. wounds of violence Enter here. Enter here. Enter here.

X.C.13. Define the following medical legal terms:a. informed consent Enter here. Enter here. Enter here.b. implied consent Enter here. Enter here. Enter here.c. expressed consent Enter here. Enter here. Enter here.d. patient incompetence Enter here. Enter here. Enter here.e. emancipated minor Enter here. Enter here. Enter here.f. mature minor Enter here. Enter here. Enter here.g. subpoena duces tecum Enter here. Enter here. Enter here.h. respondent superior Enter here. Enter here. Enter here.i. res ipsa loquitor Enter here. Enter here. Enter here.j. locum tenens Enter here. Enter here. Enter here.k. defendant-plaintiff Enter here. Enter here. Enter here.l. deposition Enter here. Enter here. Enter here.m. arbitration-mediation Enter here. Enter here. Enter here.n. Good Samaritan laws Enter here. Enter here. Enter here.

XI.C Ethical ConsiderationsXI.C.1. Define:

a. ethics Enter here. Enter here. Enter here.b. morals Enter here. Enter here. Enter here.

XI.C.2. Differentiate between personal and professional ethics

Enter here. Enter here. Enter here.

XI.C.3. Identify the effect of personal morals on professional performance

Enter here. Enter here. Enter here.

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XII.C Protective PracticesXII.C.1. Identify:

a. safety signs Enter here. Enter here. Enter here.b. symbols Enter here. Enter here. Enter here.c. labels Enter here. Enter here. Enter here.

XII.C.2. Identify safety techniques that can be used in responding to accidental exposure to:

a. blood Enter here. Enter here. Enter here.b. other body fluids Enter here. Enter here. Enter here.c. needle sticks Enter here. Enter here. Enter here.d. chemicals Enter here. Enter here. Enter here.

XII.C.3. Discuss fire safety issues in an ambulatory healthcare environment

Enter here. Enter here. Enter here.

XII.C.4. Describe fundamental principles for evacuation of a healthcare setting

Enter here. Enter here. Enter here.

XII.C.5. Describe the purpose of Safety Data Sheets (SDS) in a healthcare setting

Enter here. Enter here. Enter here.

XII.C.6. Discuss protocols for disposal of biological chemical materials

Enter here. Enter here. Enter here.

XII.C.7. Identify principles of:a. body mechanics Enter here. Enter here. Enter here.b. ergonomics Enter here. Enter here. Enter here.

XII.C.8. Identify critical elements of an emergency plan for response to a natural disaster or other emergency

Enter here. Enter here. Enter here.

Psychomotor Competencies

Course Number (eg, MED 101, MED 107)

Assessment Tool

List what type of assessment tool is used to measure the achievement of this competency. Be detailed (Check-off sheet, roleplaying with rubric, work product)

If the program creates its own course learning objectives and does not use the number and precise language of the psychomotor competency on the syllabus, include the course learning objective listed on syllabus that covers the specific competency.

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I.P Anatomy & Physiology I.P.1. Measure and record:

a. blood pressure Enter here. Enter here. Enter here.b. temperature Enter here. Enter here. Enter here.c. pulse Enter here. Enter here. Enter here.d. respirations Enter here. Enter here. Enter here.e. height Enter here. Enter here. Enter here.f. weight Enter here. Enter here. Enter here.g. length (infant) Enter here. Enter here. Enter here.h. head circumference (infant) Enter here. Enter here. Enter here.i. pulse oximetry Enter here. Enter here. Enter here.

I.P.2. Perform:a. electrocardiography Enter here. Enter here. Enter here.b. venipuncture Enter here. Enter here. Enter here.c. capillary puncture Enter here. Enter here. Enter here.d. pulmonary function testing Enter here. Enter here. Enter here.

I.P.3. Perform patient screening using established protocols

Enter here. Enter here. Enter here.

I.P.4. Verify the rules of medication administration:a. right patient Enter here. Enter here. Enter here.b. right medication Enter here. Enter here. Enter here.c. right dose Enter here. Enter here. Enter here.d. right route Enter here. Enter here. Enter here.e. right time Enter here. Enter here. Enter here.f. right documentation Enter here. Enter here. Enter here.

I.P.5. Select proper sites for administering parenteral medication

Enter here. Enter here. Enter here.

I.P.6. Administer oral medications Enter here. Enter here. Enter here.I.P.7. Administer parenteral (excluding IV) medications Enter here. Enter here. Enter here.I.P.8. Instruct and prepare a patient for a procedure or a treatment

Enter here. Enter here. Enter here.

I.P.9. Assist provider with a patient exam Enter here. Enter here. Enter here.

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I.P.10. Perform a quality control measure Enter here. Enter here. Enter here.I.P.11. Obtain specimens and perform: Enter here. Enter here. Enter here.

a. CLIA waived hematology test Enter here. Enter here. Enter here.b. CLIA waived chemistry test Enter here. Enter here. Enter here.c. CLIA waived urinalysis Enter here. Enter here. Enter here.d. CLIA waived immunology test Enter here. Enter here. Enter here.e. CLIA waived microbiology test Enter here. Enter here. Enter here.

I.P.12. Produce up-to-date documentation of provider/professional level CPR

Enter here. Enter here. Enter here.

I.P.13. Perform first aid procedures for:a. bleeding Enter here. Enter here. Enter here.b. diabetic coma or insulin shock Enter here. Enter here. Enter here.c. fractures Enter here. Enter here. Enter here.d. seizures Enter here. Enter here. Enter here.e. shock Enter here. Enter here. Enter here.f. syncope Enter here. Enter here. Enter here.

II.P Applied Mathematics II.P.1. Calculate proper dosages of medication for administration

Enter here. Enter here. Enter here.

II.P.2. Differentiate between normal and abnormal test results

Enter here. Enter here. Enter here.

II.P.3. Maintain lab test results using flow sheets Enter here. Enter here. Enter here.

II.P.4. Document on a growth chart Enter here. Enter here. Enter here.

III.P Infection Control III.P.1. Participate in bloodborne pathogen training Enter here. Enter here. Enter here.III.P.2. Select appropriate barrier/personal protective equipment (PPE)

Enter here. Enter here. Enter here.

III.P.3. Perform handwashing Enter here. Enter here. Enter here.III.P.4. Prepare items for autoclaving Enter here. Enter here. Enter here.III.P.5. Perform sterilization procedures Enter here. Enter here. Enter here.

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III.P.6. Prepare a sterile field Enter here. Enter here. Enter here.III.P.7. Perform within a sterile field Enter here. Enter here. Enter here.III.P.8. Perform wound care Enter here. Enter here. Enter here.III.P.9. Perform dressing change Enter here. Enter here. Enter here.III.P.10. Demonstrate proper disposal of biohazardous material

a. sharps Enter here. Enter here. Enter here.b. regulated wastes Enter here. Enter here. Enter here.

IV.P Nutrition IV.P.1. Instruct a patient according to patient’s special dietary needs

Enter here. Enter here. Enter here.

V.P Concepts of Effective Communication V.P.1. Use feedback techniques to obtain patient information including:

a. reflection Enter here. Enter here. Enter here.b. restatement Enter here. Enter here. Enter here.c. clarification Enter here. Enter here. Enter here.

V.P.2. Respond to nonverbal communication Enter here. Enter here. Enter here.V.P.3. Use medical terminology correctly and pronounced accurately to communicate information to providers and patients

Enter here. Enter here. Enter here.

V.P.4. Coach patients regarding:a. office policies Enter here. Enter here. Enter here.b. health maintenance Enter here. Enter here. Enter here.c. disease prevention Enter here. Enter here. Enter here.d. treatment plan Enter here. Enter here. Enter here.

V.P.5. Coach patients appropriately considering:a. cultural diversity Enter here. Enter here. Enter here.b. developmental life stage Enter here. Enter here. Enter here.c. communication barriers Enter here. Enter here. Enter here.

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V.P.6. Demonstrate professional telephone techniques Enter here. Enter here. Enter here.V.P.7. Document telephone messages accurately Enter here. Enter here. Enter here.V.P.8. Compose professional correspondence utilizing electronic technology

Enter here. Enter here. Enter here.

V.P.9. Develop a current list of community resources related to patients’ healthcare needs

Enter here. Enter here. Enter here.

V.P.10. Facilitate referrals to community resources in the role of a patient navigator

Enter here. Enter here. Enter here.

V.P.11. Report relevant information concisely and accurately

Enter here. Enter here. Enter here.

VI.P Administrative FunctionsVI.P.1. Manage appointment schedule using established priorities

Enter here. Enter here. Enter here.

VI.P.2. Schedule a patient procedure Enter here. Enter here. Enter here.VI.P.3. Create a patient’s medical record Enter here. Enter here. Enter here.VI.P.4. Organize a patient’s medical record Enter here. Enter here. Enter here.VI.P.5. File patient medical records Enter here. Enter here. Enter here.VI.P.6. Utilize an EMR Enter here. Enter here. Enter here.VI.P.7. Input patient data utilizing a practice management system

Enter here. Enter here. Enter here.

VI.P.8. Perform routine maintenance of administrative or clinical equipment

Enter here. Enter here. Enter here.

VI.P.9. Perform an inventory with documentation Enter here. Enter here. Enter here. VII.P Basic Practice FinancesVII.P.1. Perform accounts receivable procedures to patient accounts including posting:

a. charges Enter here. Enter here. Enter here.b. payments Enter here. Enter here. Enter here.c. adjustments Enter here. Enter here. Enter here.

VII.P.2. Prepare a bank deposit Enter here. Enter here. Enter here.

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VII.P.3. Obtain accurate patient billing information Enter here. Enter here. Enter here.VII.P.4. Inform a patient of financial obligations for services rendered

Enter here. Enter here. Enter here.

VIII.P Third Party ReimbursementVIII.P.1. Interpret information on an insurance card Enter here. Enter here. Enter here.VIII.P.2. Verify eligibility for services including documentation

Enter here. Enter here. Enter here.

VIII.P.3. Obtain precertification or preauthorization including documentation

Enter here. Enter here. Enter here.

VIII.P.4. Complete an insurance claim form Enter here. Enter here. Enter here. IX.P Procedural and Diagnostic Coding IX.P.1. Perform procedural coding Enter here. Enter here. Enter here.IX.P.2. Perform diagnostic coding Enter here. Enter here. Enter here.IX.P.3. Utilize medical necessity guidelines Enter here. Enter here. Enter here. X.P Legal ImplicationsX.P.1. Locate a state’s legal scope of practice for medical assistants

Enter here. Enter here. Enter here.

X.P.2. Apply HIPAA rules in regard to:a. privacy Enter here. Enter here. Enter here.b. release of information Enter here. Enter here. Enter here.

X.P.3. Document patient care accurately in the medical record

Enter here. Enter here. Enter here.

X.P.4. Apply the Patient’s Bill of Rights as it relates to:a. choice of treatment Enter here. Enter here. Enter here.b. consent for treatment Enter here. Enter here. Enter here.c. refusal of treatment Enter here. Enter here. Enter here.

X.P.5. Perform compliance reporting based on public health statutes

Enter here. Enter here. Enter here.

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X.P.6. Report an illegal activity in the healthcare setting following proper protocol

Enter here. Enter here. Enter here.

X.P.7. Complete an incident report related to an error in patient care

Enter here. Enter here. Enter here.

XI.P Ethical ConsiderationsXI.P.1. Develop a plan for separation of personal and professional ethics

Enter here. Enter here. Enter here.

XI.P.2. Demonstrate appropriate response(s) to ethical issues

Enter here. Enter here. Enter here.

XII.P Protective PracticesXII.P.1. Comply with:

a. safety signs Enter here. Enter here. Enter here.b. symbols Enter here. Enter here. Enter here.c. labels Enter here. Enter here. Enter here.

XII.2. Demonstrate proper use of:a. eyewash equipment Enter here. Enter here. Enter here.b. fire extinguishers Enter here. Enter here. Enter here.c. sharps disposal containers Enter here. Enter here. Enter here.

XII.P.3. Use proper body mechanics Enter here. Enter here. Enter here.XII.P.4. Participate in a mock exposure event with documentation of specific steps

Enter here. Enter here. Enter here.

XII.P.5. Evaluate the work environment to identify unsafe working conditions

Enter here. Enter here. Enter here.

Affective CompetenciesCourse Number (eg, MED 101, MED 107)

Assessment Tool

List what type of assessment tool is used to measure the achievement of this competency. Be detailed (Check-

If the program creates its own course learning objectives and does not use the number and precise language of the affective competency on the syllabus, include the course learning objective

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off sheet, roleplaying with rubric, work product)

listed on syllabus that covers the specific competency.

I.A Anatomy & Physiology I.A.1. Incorporate critical thinking skills when performing patient assessment

Enter here. Enter here. Enter here.

I.A.2. Incorporate critical thinking skills when performing patient care

Enter here. Enter here. Enter here.

I.A.3. Show awareness of a patient’s concerns related to the procedure being performed

Enter here. Enter here. Enter here.

II.A Applied MathematicsII.A.1. Reassure a patient of the accuracy of the test results Enter here. Enter here. Enter here. III.A Infection ControlIII.A.1. Recognize the implications for failure to comply with Center for Disease Control (CDC) regulations in healthcare settings

Enter here. Enter here. Enter here.

IV.A NutritionIV.A.1. Show awareness of patient’s concerns regarding a dietary change

Enter here. Enter here. Enter here.

V.A Concept of Effective Communication V.A.1. Demonstrate:

a. empathy Enter here. Enter here. Enter here.b. active listening Enter here. Enter here. Enter here.c. nonverbal communication Enter here. Enter here. Enter here.

V.A.2. Demonstrate the principles of self-boundaries Enter here. Enter here. Enter here.V.A.3. Demonstrate respect for individual diversity including:

a. gender Enter here. Enter here. Enter here.b. race Enter here. Enter here. Enter here.

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c. religion Enter here. Enter here. Enter here.d. age Enter here. Enter here. Enter here.e. economic status Enter here. Enter here. Enter here.f. appearance Enter here. Enter here. Enter here.

V.A.4. Explain to a patient the rationale for performance of a procedure

Enter here. Enter here. Enter here.

VI.A Administrative FunctionsVI.A.1. Display sensitivity when managing appointments Enter here. Enter here. Enter here.

VII.A Basic Practice FinancesVII.A.1. Demonstrate professionalism when discussing patient's billing record

Enter here. Enter here. Enter here.

VII.A.2. Display sensitivity when requesting payment for services rendered

Enter here. Enter here. Enter here.

VIII.A Third Party ReimbursementVIII.A.1. Interact professionally with third party representatives

Enter here. Enter here. Enter here.

VIII.A.2. Display tactful behavior when communicating with medical providers regarding third party requirements

Enter here. Enter here. Enter here.

VIII.A.3. Show sensitivity when communicating with patients regarding third party requirements

Enter here. Enter here. Enter here.

IX.A Procedural and Diagnostic Coding IX.A.1. Utilize tactful communication skills with medical providers to ensure accurate code selection

Enter here. Enter here. Enter here.

X.A Legal ImplicationsX.A.1. Demonstrate sensitivity to patient rights Enter here. Enter here. Enter here.X.A.2. Protect the integrity of the medical record Enter here. Enter here. Enter here.

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XI.A Ethical ConsiderationsXI.A.1. Recognize the impact personal ethics and morals have on the delivery of healthcare

Enter here. Enter here. Enter here.

XII.A Protective PracticesXII.A.1. Recognize the physical and emotional effects on persons involved in an emergency situation

Enter here. Enter here. Enter here.

XII.A.2. Demonstrate self-awareness in responding to an emergency situation

Enter here. Enter here. Enter here.

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Instructions and Schema for Organizing the Change of Award Self-Study Submission

In the section above, you received detailed information about the Appendices that accompany the Self-Study that you submit. In this section, there is an extended discussion about how to organize the Appendices, using the naming convention that is outlined in the earlier section for your submission of the Self-Study. Here are some general rules of practice for organizing the Self-Study submission.

Even if you do not need to update any of the material in Standard V Appendices, you will need to insert a document with the correct name. Inside the document, just indicate “Not Applicable.”

There may be times in which you need to submit a folder rather just a file, due to the nature of the program’s documentation. If that is the case, follow the general practice and logic that is implicit in the naming convention.

You may only use PDF files, Excel Files, or Word files for the Appendices. The examples below are in Word just for the sake of convenience.

In submitting this information to the MAERB Office, you would send it on one thumb drive to the MAERB Office at the following address: MAERB, 20 N. Wacker, Ste. 1575, Chicago, IL 60647.

You will note that there are mandatory naming conventions and outlined below is a model for how to organize it. You should abbreviate the name of the institution and add an abbreviated location if you are part of an institution with several programs.

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Then the folders that contain the Appendices should follow this pattern:

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Example of documents for a Faculty Workbook folder:

Examples of Documents for a Practicum Coordinator Workbook Folder:

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