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Physician Assistants practice in a wide variety of primary care and specialty settings and with a focus on patient centered care. Given this, learning outcomes for students must reflect competency in a broad range of areas encompassing the comprehension and application of medical knowledge, patient care, interpersonal and communication skills, ethics and professionalism, medical science research and interpretation of that research, and interprofessional collaboration.  NGU competencies and outcomes focused on these categories include the following:

1.  Record a Complete and Accurate Medical History

Outcomes: On any patient in any setting, the student will be able to: 

    • Establish effective rapport with patients and their families in a manner that will enhance the history taking process
    • Obtain and record a complete and accurate chief complaint
    • Obtain and record a complete and accurate history of the present illness that includes the symptom location, quantity, quality, timing, setting, aggravating and relieving factors, and other associated factors
    • Obtain and record a complete past medical and surgical history, psychosocial history, and family history
    • Obtain and record a comprehensive review of systems noting pertinent positive and negative findings as they relate to the history of present illness
    • Obtain and record interval history pertaining to ongoing disease states
    • Obtain a problem-focused history
    • Obtain and record a follow-up history of an improved or deteriorating patient condition
    • Obtain and record the medical history components from patient friends or family when necessary

    2.  Perform a Complete and Problem-Focused Physical Examination

    Outcomes:  On any patient in any setting, the student will be able to:

      • Demonstrate techniques of gaining patient confidence and providing reassurance about the examination in a manner that will enhance the collection of data and maintain patient dignity
      • Distinguish normal from abnormal physical examination findings for males and females of any age group
      • Demonstrate the appropriate use of the necessary instruments and tools for the physical examination with proper techniques that incorporate Universal Precautions
      • Perform and record the findings from a comprehensive physical examination
      • Demonstrate ability to alternate the sequence and content of the physical examination to correspond with the special needs of the patient and the presenting complaint
      • Perform and record a problem-focused physical examination utilizing conventional formats and nomenclature.

      3.  Establish a Working Diagnosis and Differential for Non-Emergent Condition/s

      Outcomes:  The student will be able to:

      • Formulate a problem list and a differential diagnosis for each patient problem identified during patient encounters
      • Demonstrate deductive reasoning skills in processing clinical data in the development of a differential diagnosis

      4.  Order, Perform, and Interpret Appropriate Diagnostic Procedures, and Laboratory Tests

      Outcomes:  Utilizing the data collected from the medical history and physical examination findings, the student will be able to:

      • Utilize a problem list or differential diagnosis to identify the diagnostic procedures and laboratory studies that are indicated to aid in establishing the diagnosis
      • Educate the patient about the benefits and risks associated with specific laboratory tests and diagnostic procedures
      • Demonstrate the necessary skills and techniques to safely and properly collect specimens including, but not limited to:
        • Bacteriologic samples for culture, sensitivity or gram stain from various sources
        • Viral samples from various sources
        • Venous or arterial blood samples
        • Urine samples, sterile and non-sterile
        • Stool specimens
        • Tissue samples
        • Sputum sample
      • Order, interpret the results and discuss the implications of laboratory tests including but not limited to:
        • Urinalysis by dipstick and microscopic examination
        • Glucose testing
        • Vaginal specimen
        • Pregnancy tests
        • Rapid strep screen
        • KOH prep for fungal infection
        • Prostate specific antigen
        • Complete blood count with differential
        • Erythrocyte sedimentation rate and C-reactive proteins
        • Stool for blood, ova and parasites
        • Electrolytes, liver enzymes, serum lipid profiles, hemoglobin A1c and other commonly utilized blood chemistries
      • Order, interpret and discuss the implications of diagnostic procedures, including but not limited to:
        • 12 Lead EKG
        • Rhythm strips
        • Pulmonary function testing
      • Order and interpret radiologic studies of the head, spine, chest, abdomen, pelvis and extremities.
      • Outline the indications for and analyze the information provided by the following imaging modalities:
        • CT scans
        • MRI and MRA
        • Fluoroscopy
        • Ultrasound
        • DEXA scan
        • Mammography
      • Identify the techniques and indications for bronchoscopy, upper endoscopy, colonoscopy, and flexible sigmoidoscopy
      • Examine the techniques and outline the indications for thoracentesis, paracentesis, and lumbar puncture
      • Examine the techniques and outline the indications for an excisional biopsy, endometrial biopsy, arthrocentesis and joint injection
      • Outline the required preparation for imaging studies and office procedures

      5.  Identify, Discuss, Perform, and Order Appropriate Therapy and Treatment Modalities

      Outcomes:  The student will be able to:

      • Distinguish between the various electrolyte solutions for intravenous therapy and indications for their use
      • Outline the use of blood and blood products, indications, risks and potential complications
      • Administer injections intradermally, subcutaneously, intravenously, and intramuscularly.
      • Educate patients about nutritional requirements and the treatment of nutritionally related health problems
      • Identify medications used for the treatment of medical conditions and their mechanism of action, metabolism, excretion, indications, contraindications, drug-drug interactions and potential side effects
      • Manage non pharmacologic treatment and follow-up of common medical conditions
      • Prescribe medications as a part of patient management
      • Identify and manage medication interactions and adverse effects
      • Outline common complementary and alternative medicine modalities

      6.  Recognize Life Threatening Conditions

      Outcomes:  The student will be able to:

      • Recognize emergency cardiovascular conditions, including life-threatening dysrhythmias, in patients of any age in any setting and initiate standard treatment according to Advanced Cardiac Life Support recommendations.
        • Perform cardiopulmonary resuscitation
        • Establish hemostasis or control blood loss of hemorrhaging patients
      • Recognize and treat patients with:
        • Anaphylactic reactions
        • Respiratory distress
        • Drug overdose
        • Accidental poisoning
        • Envenomation
        • Heat illness
        • Dehydration
        • Ocular emergencies
        • Trauma
        • Acute abdominal pain
        • Gynecological and obstetrical emergencies
        • Acute chest pain
        • Pediatric emergencies
        • Congestive heart failure
        • Hypertensive crisis
        • Seizure
        • Altered mental status
        • Alcohol intoxication
        • Hyperglycemia
        • Diabetic ketoacidosis
      • Assist with or perform commonly encountered emergency procedures including but not limited to:
        • Endotracheal/nasogastric intubations
        • Defibrillation or cardioversion         
        • Arterial and venous line placement

      7.  Effectively Communicate with Patients, their Families, and other Medical Personnel

      Outcomes:  The student will be able to:

      • Present a systematic, clear and concise description of the patient's chief complaint, history of present illness, pertinent positive and negative findings, laboratory findings, diagnosis and treatment plan
      • Discuss information and counsel patients regarding the diagnosis, prognosis, and treatment of common disorders in a manner that promotes understanding.
      • Instruct patients about a variety of health education and disease prevention issues such as self-breast examination, self-testicular examination, skin cancer screening, exercise, weight management and smoking cessation.
      • Create medical documentation using a widely accepted format including but not limited to:
        • Admit history and physical exam
        • Discharge summary
        • Progress notes
        • SOAP notes
      • Clearly and effectively communicate in a respectful manner with individuals from diverse cultures, religions, and various lifestyles
      • Provide age appropriate anticipatory guidance for patients and their families across the lifespan
      • Effectively and professionally communicate bad news to patients and their families.
      • Facilitate communication between patients and their families about issues relating to end of life decision-making
        • Advanced directives
        • Grieving processes

      8.  Demonstrate the Impact Health Problems have on Individuals and Family Members

      Outcomes:  The student will be able to:

      • Discuss the physical, psychological, social, and economic impact that health problems create for patients and their families
      • Appraise patient encounters from an objective perspective necessary for rational assessment and treatment of the patientís health problems
      • Recognize the importance of preventative health care education for patients to prevent future disease states
      • Discuss difficulties encountered by patients attempting to adhere to prescribed therapeutic regimens and treatment plans
      • Recognize the right of the patient as a health care consumer to be informed regarding their physical status, therapy, costs, therapeutic alternatives, prognosis, and services available
      • Recognize the patientís right to privacy and confidentiality and treating privileged information with professional discretion

      9.  Utilize Critical Thinking Skills through the use of Evidence Based Medicine

      Outcomes:  The student will be able to:

      • Transfer clinical information needs into answerable clinical questions
      • Identify the best available evidence to answer clinical questions
      • Critically evaluate the available clinical evidence for its validity and usefulness
      • Apply the findings of the appraisals to the specific clinical scenarios/questions
      • Demonstrate skills necessary for life-long learning

      10.  Articulate the Unique Role of the PA in the Medical Team

      Outcomes:  The student will be able to:

      • Adhere to the tenants of ethical medical practice as a PA
      • Articulate the collegial and interdependent relationship of the PA and the physician
      • Integrate the role of the PA with the roles of other members of the inter-professional health care team
      • Explain the legal responsibilities of the PA-patient relationship
      • Articulate an understanding of the history and milestones of the PA profession
      • Describe the mechanisms of licensure, certification and recertification for the PA profession

      11.  Possess a Working Knowledge of the American Health Care Delivery System

      Outcomes:  The student will be able to:

      • Utilize community resources in health care delivery
      • Coordinate health care services including, but not limited to:
        • Care provided by multiple providers
        • Specialty consultations and referrals
        • Consultations with other members of the health care team
        • Complementary and alternative health care
        • Ancillary services
      • Employ risk management practices including continuous quality assurance
      • Utilize best practices to minimize the risk of medical malpractice
      • Utilize and employ current knowledge of reimbursement issues including documentation, coding and billing practices

      12.  Exhibit Ethical Behavior and Professional Conduct

      Outcomes:  The student will be able to:

      • Provide competent, compassionate and respectful medical service to all patients
      • Display honesty with patients and colleagues
      • Respond appropriately to persons of the health care team who exhibit impairment, lack of professional conduct or competence, or who engage in fraud or deception
      • Demonstrate a commitment to maintaining clinical competence
      • Comply with established principles governing intellectual honesty

      Competency and proficiency in these functions and tasks is a learning process that will gradually occur over the breadth of the PA program at North Greenville University.  Evaluation of these outcomes will occur via the use of multiple instruments, including, but not limited to, written and practical examinations, clinical preceptor evaluations, PANCE results, and graduate and post-graduate surveys.

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