Course Description: Focuses on Integrating Subjective and Objective Findings of the Head, Thorax and Musculoskeletal Exam Into an Assessment and Plan of Care

PAS 6100: Physical Exam and Clinical Diagnosis I Fall 20XX

COURSE INFORMATION

Course Description: Focuses on integrating subjective and objective findings of the head, thorax and musculoskeletal exam into an assessment and plan of care. Includes techniques for oral and written presentations, relevant procedures, and assessment of specialty populations.

Credits: 3 Prerequisites: Enrollment in the Physician Assistant Master’s Program Day and Time: Location:

INSTRUCTOR INFORMATION

Instructor: Office: Phone: Fax: Email: Office Hours:

REQUIRED MATERIALS

Required Textbooks: all available on Access Medicine: http://accessmedicine.mhmedical.com/.

Text #1: LeBlond, R., Brown, D., DeGowin, R. DeGowin's Diagnostic Examination. 9th ed. New York, NY: McGraw-Hill; 2009. ISBN 978-0-07-160574-8

Text #2: Fortin VI, A., Dwamena, F., Frankel, R., Smith, R. Smith's Patient-Centered Interviewing: An Evidence-Based Method. 3rd ed. New York, NY: McGraw-Hill; 2012. ISBN 978-0-07-176000-3

Text #3: Stern, S., Cifu, A., Altkorn, D. Symptom to Diagnosis: An Evidence-Based Guide. 2nd ed. New York, NY: McGraw-Hill; 2010. ISBN 978-0-07-149613-1

Text #4: Nicoll, D., Lu, C., Pignone, M., McPhee, S. Pocket Guide to Diagnostic Tests. 6th ed. New York, NY: McGraw-Hill; 2012. ISBN 978-0-07-176625-8

Text #5: Henderson, M., Tierney Jr., M., Smetana, G. The Patient History: An Evidence-Based Approach to Differential Diagnosis. 2nd ed. China, McGraw-Hill; 2012. ISBN 978-0-07-162494- 7

Required Resources:

Papadakis, M. Quick Medical Diagnosis & Treatment. AccessMedicine. (2014) Available at: http://accessmedicine.mhmedical.com/. Accessed September 18, 2014.

COURSE OUTCOMES

At the end of this course, students will be able to:

1. Demonstrate techniques for interviewing patients based on a given situation. 2. Perform a complete HEENT (head, eyes, ears, nose, throat), cardiovascular, pulmonary and musculoskeletal exam. 3. Obtain and evaluate the following as it relates to an HEENT, cardiovascular, pulmonary and musculoskeletal assessment: a. Chief complaint b. History of present illness c. Pertinent negatives and pertinent positives d. Past medical history e. Social history f. Family history g. Review of systems h. Objective findings i. Assessment j. Plan of care 4. Formulate a diagnosis utilizing patient data. 5. Synthesize patient data and present a case in oral and written forms. 6. Demonstrate procedures for: ● HEENT: fluorescein staining, slit lamp examination, cerumen removal, nasal packing, foreign body removal, audiometry/tympanometry ● CV/Pulm: basic life support, endotracheal intubation, advanced life support, oxygen therapy, oropharyngeal/nasopharyngeal intubation, blood pressure measurement, peak flow measurement, nebulizer treatments, ECG interpretation ● MSK: casting, splinting, and joint injection/aspiration ● Bedside ultrasound ● Radiology (xray, MRI, CT) interpretation pertinent to HEENT, cardiovascular, pulmonary and musculoskeletal assessment. 7. Model professional behaviors consistent with developing level of competency based on the Professionalism Assessment rubric.

COURSE CONTENT

1. Patient interviewing skills a. rapport b. active listening c. empathy d. open ended-questions e. leading questions f. probing questions g. non-verbal communication 2. HEENT history and exam 3. Cardiovascular history and exam 4. Pulmonary history and exam 5. Abdominal history and exam 6. Exam maneuvers for specific populations including pediatrics, obstetrics and geriatrics 7. Exposure to relevant procedures and hands-on skills 8. Written and oral case presentations

COURSE OUTLINE—dates/schedule here

Unit 1: Patient interview technique Assigned readings: Lecture dates: Exam lab dates: Oral presentation dates:

Unit 2: HEENT assessment Assigned readings: Lecture dates: Exam lab dates: H&P note due: SOAP note due: Oral presentation dates: HEENT skills check-off dates: Exam #1 HEENT date:

Unit 3: Cardiovascular assessment Assigned readings: Lecture dates: Exam lab dates: H&P note due: SOAP note due: Oral presentation dates: Cardiovascular skills check-off dates: Exam #2 Cardiovascular date:

Unit 4: Pulmonary assessment 3

Assigned readings: Lecture dates: Exam lab dates: H&P note due: SOAP note due: Oral presentation dates: Pulmonary skills check-off dates: Exam #3 Pulmonary date:

Unit 5: Musculoskeletal assessment Assigned readings: Lecture dates: Exam lab dates: H&P note due: SOAP note due: Oral presentation dates: Musculoskeletal skills check-off dates: Exam #4 Musculoskeletal date:

COURSE ASSESSMENTS

Evaluation Criteria:

10% Exam #1: Interview (Outcome 1) 15% Exam #2: HEENT (Outcomes: 1, 2, 3, 4, 5) 15% Exam #3: Cardiovascular (Outcomes: 1, 2, 3, 4, 5) 15% Exam #4: Pulmonary (Outcomes: 1, 2, 3, 4, 5) 15% Exam #5: Musculoskeletal (Outcomes: 1, 2, 3, 4, 5) 5% Written assignments: H&P and SOAP notes (Outcomes: 2, 3, 4, 5) 15% Skills check-off (Outcome 6) 5% Oral presentations (Outcomes: 1 2, 3, 4, 5) 5% Class participation/compliance with course policy (Outcome 7)

Standards B1.02 The curriculum must include core knowledge about established and evolving biomedical and clinical sciences and the application of this knowledge to patient care. (Outcomes 1, 2, 3, 4, 6) B2.04 The program curriculum must include instruction in interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families and other health professionals. (Outcomes 1, 3, 5) B2.05 The program curriculum must include instruction in patient evaluation, diagnosis and management. (Outcomes (1, 2, 3, 4, 5) B2.07 The program curriculum must include instruction in technical skills and procedures based on current professional practice (Outcomes 6)

B2.09 The program curriculum must include instruction in basic counseling and patient education skills. (Outcomes 1, 3) B2.15 The program curriculum must include instruction regarding reimbursement, documentation of care, coding and billing. (Outcome 5)

Physician Assistant Competencies Medical Knowledge Physician assistants are expected to understand, evaluate, and apply the following to clinical scenarios: signs and symptoms of medical and surgical conditions; and history and physical findings and diagnostic studies to formulate differential diagnoses. (Outcomes 1, 2, 3, 4, 5)

Interpersonal and Communication Skills Physician assistants are expected to: create and sustain a therapeutic and ethically sound relationship with patients; use effective communication skills to elicit and provide information; and adapt communication style and messages to the context of the interaction. (Outcome 1)

Patient Care Physician assistants are expected to: demonstrate compassionate and respectful behaviors when interacting with patients and their families; obtain essential and accurate information about their patients; counsel and educate patients and their families; and perform medical and surgical procedures essential to their area of practice. (Outcomes 1, 2, 3, 4, 5, 6, 7)

GRADING

Students are graded according to the following grade scale:

96 – 100% = A A = Exceptional Work 93 – 95% = A- B = Acceptable Work 90 – 92% = B+ C = Minimally Acceptable Work 85 – 89% = B 82 – 84% = B- 78 – 81% = C+ 73 – 77% = C Below 73 % = F

Please see the policy regarding Academic Probation in found in the Physician Assistant Student Handbook. Link here

COURSE POLICIES

1. It is expected that assigned reading and “readiness” assignments are completed before the topic is covered in class. 2. Attendance is required. Due to the compressed nature of the PA curriculum, failure to attend all scheduled class sessions may result in a reduction of class grade. Please follow

the policy for class absences found in the Physician Assistant Student Handbook. Link here 3. Because this class involves guest speakers from the medical community, professional dress and presentation are required. This includes wearing appropriate clothing, arriving to class on time, and sitting upright with feet on the floor. Electronics will be put away and there will be no eating during class (beverages are allowed.)

Late and Make-Up Work:

Late assignments will not be accepted without prior arrangements between the faculty and the student. It is the student's responsibility to initiate such an arrangement, including an expected completion date for the assignment. Assignment extensions will be considered on a case-by-case basis.

Incompletes:

Please refer to the Physician Assistant Student Handbook for the Incomplete Policy. Link here

Course Evaluation:

Faculty strive for excellence in preparing and providing courses that will accomplish the mission of the PA program and it is crucial that we receive feedback from students. Graduate course evaluations are now completed online. You will be notified by e-mail when course evaluations are available and you are encouraged to complete and submit them prior to the end of the semester.

Equal Access Statement:

Students with disabilities, students who sustained injury in active military service, and students with chronic medical conditions are entitled to appropriate and reasonable auxiliary aids and accommodations through The Americans with Disabilities Act and Section 504 of the Rehabilitation Act of 1973. It is the student's responsibility to notify the Center for Equal Access as soon as possible to ensure that such accommodations are implemented in a timely fashion. For more information or to request academic accommodations, please contact the Center for Equal Access in Tower Hall 2126; by phone at (218) 723-6747, 218-625-4891; or via e-mail at [email protected]

Academic Honesty Policy:

Academic honesty and integrity are highly valued in our campus community. Academic honesty directly concerns ethical behaviors which affect both the academic environment and the civic community. Academic dishonestly seriously violates the integrity of the academic enterprise and will not be tolerated at St. Scholastica. The full text of the CSS Academic Honesty Policy is

6 found in the Student Handbook or online at http://www.css.edu/Academics/Office-of-Academic- Affairs/Academic-Honesty-Policy.html.