CHILD HEALTH ASSOCIATE/ PHYSICIAN ASSISTANT PROGRAM

1st and 2nd Year Clinical Handbook

University of Colorado Denver Jacqueline Sivahop, MS, PA-C School of Medicine Lead Clinical Educator Department of Pediatrics Summer 2013 (303) 724-1341

TABLE OF CONTENTS

Introduction ............................................................................................................................... 1 Communication ......................................................................................................................... 2 Clinical Coordinating Team ................................................................................................... 2 Communication with the Program ......................................................................................... 2 Program Information ............................................................................................................. 3 Email Requirements .............................................................................................................. 3 Voicemail .............................................................................................................................. 3 CHA/PA Clinical Website ...................................................................................................... 3 Definition of the Preceptor Role .............................................................................................. 4 Preceptor-Student Relationship .............................................................................................. 4 Meetings Regarding Clinical Rotations ................................................................................... 4 General Goals of Clinical Rotations ........................................................................................ 5 Rotations for the First Year ...................................................................................................... 5 Rotations for the Second Year ................................................................................................. 6 Scheduling 1st and 2nd Year Clinical Rotations ....................................................................... 7 Required Rotations .............................................................................................................. 7 International Rotations ......................................................................................................... 7 Vacation Weeks during 2nd Year Summer Semester ............................................................ 7 Typhon and Patient Logging .................................................................................................... 8 Typhon ................................................................................................................................. 8 Patient Logging through Typhon .......................................................................................... 8 1st Year Patient Logging ................................................................................................ 8 2nd Year Patient Logging ............................................................................................... 8 Student Evaluation: ORIME ...................................................................................................... 9 1st and 2nd Year Rotation Requirements ................................................................................ 10 Student Requirements and Expectations ...................................................................... 10-11 Clinical Course Requirements ............................................................................................ 12 Student Credits, Grading, Remedial Action, Student Accommodations .............................. 13 Absences from Clinical Rotations ......................................................................................... 14 Inclement Weather ............................................................................................................. 14 Emergency or Illness .......................................................................................................... 14 Other absence requests ..................................................................................................... 14 Vacations/School Breaks ................................................................................................... 14 Travel Questions and Additional Costs................................................................................. 14 Student Travel Questions ................................................................................................... 14 Student Costs during 1st and 2nd Year Clinical Rotations .................................................... 15 Rotation Injuries/Exposures................................................................................................... 16 Overview of Requirements for Progression to 3rd Year........................................................ 17 Clinical Rotation Requirement ............................................................................................ 17 Comprehensive Clinical Skills and Written Examination ..................................................... 17

Other Items .............................................................................................................................. 17 Sites Visits ......................................................................................................................... 17 Appendices ........................................................................................................................ 19-49 Appendix A: Contract Request Form ............................................................................. 19-21 Appendix B: University Needlestick and Bodily Fluid Exposures & Workers’ Compensation Procedures ...................................................................................... 23-25 Appendix C: Workers’ Compensation and Medical Malpractice Coverage .................... 27-31 Workers’ Compensation ............................................................................................... 29 Medical Malpractice Coverage for Students ................................................................. 31 Appendix D: 1st and 2nd Year Objectives, Requirements & Preceptor Responsibilities .. 33-38 Appendix E: 1st and 2nd Year Syllabi ................................................................................... 39 Appendix F: Policy on Student Absences from Clinical Rotations .................................. 41-44 Appendix G: Checklist and Pearls ................................................................................. 45-48

INTRODUCTION Welcome to your 1st and 2nd Year Clinical Rotations! This is an exciting time to introduce you to clinical medicine and the role of a Physician Assistant in patient care. It is also a time for you to begin to practice your physical diagnosis skills and begin to apply what you are learning in your didactic courses to direct patient care. This handbook is designed to aid you in understanding the role that you, the CHA/PA Program and your preceptor have in your 1st and 2nd year clinical rotations. Detailed information on program requirements, expectations, course requirements and objectives for the 1st and 2nd year will be reviewed. Please read this document and keep it as a reference when questions arise. As with course work requirements, descriptions and policies are subject to change. In the event of change, students will be notified as soon as possible. We know your 1st and 2nd year will be two rewarding years of personal and professional growth, preparing you for your 3rd year of clinical rotations. We look forward to helping you along this journey.

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COMMUNICATION

CLINICAL COORDINATING TEAM

Position Contact Person Contact Information

Lead Clinical Educator

Jacqueline (Jackie) Sivahop, MS, PA-C

Office: 303-724-1341 Jacqueline.Sivahop@ucdenver.edu

Clinical Site Educator Joyce Nieman, MHS, PA-C

Office: 303-724-7288 Joyce.Nieman@ucdenver.edu

Clinical Administrator/Immunizations Laura Casias

Office: 303-724-1343 Laura.Casias@ucdenver.edu

Clinical Administrator/Rotation Scheduling Janice Baker

Office: 303-724-1336 Janice.S.Baker@ucdenver.edu

International Rotations David Eckhardt MS, PA-C

Office: 303-724-1347 David.Eckhardt@ucdenver.edu

Communication with the Program You are required to check email daily and to respond as soon as possible when requested to do so.

Issue Contact Person Other Information Concerns about a rotation (non emergent)

Jackie OR Joyce

You will receive follow-up within 1 business day.

Emergent need after business hours

Jackie OR Joyce Pager: 303-266-0530

Emergent need during business hours

Jackie OR Joyce

Office number: 303-724-1341 Office number: 303-724-7288

You cannot be at a rotation (illness, injury, family emergency, other absence)

Jackie

First notify the preceptor and then notify Jackie explaining the situation.

Preceptor illness or vacation Jackie

Notify Jackie as soon as you are informed

Chemical Exposure, Needle stick Injuries Jackie Notify Jackie immediately after

medical treatment is sought Injured while on a clinical rotation

Jackie

Notify Jackie immediately after medical treatment is sought

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Program Information Child Health Associate/Physician Assistant Program 13001 E. 17th Place, Building 500 Mail Stop: F543 Aurora, Colorado 80045 Phone: 303-724-7963 Fax: 303-724-1350 Website: www.medschool.ucdenver.edu/paprogram Email Requirements:

Email is the first line of communication with the program. Email is checked during business hours. o Communications from students on weekends will be answered for emergent issues only.

However, please utilize the emergency pager for emergency situations. Emergent is defined as life-threatening or a situation that is offensive or flagrant to

the student.

Voicemail: o Individual voicemail is checked routinely throughout the work day by the Clinical Team

member you contacted. Voice mail messages will be answered within one business days.

When a member of the Clinical Team is unavailable for any reason, appropriate contact information will be supplied via email or out-of-office phone message.

CHA/PA Clinical Website: o The CHA/PA Program has a password-protected clinical website. The website is located at

www.medschool.ucdenver.edu/paprogram o You must sign-in (located at the bottom of the page)

Username: University\username Password: Your university password

o You will be able to access Needlestick policy, Malpractice Insurance, Clinical Site Information, Syllabi and Objectives, Clinical Handbooks, etc.

o Clinical Site Information Form A form that students will fill out to provide general information about the site/rotation

• Parking, dress attire, who works there, do you need to bring lunch, etc.

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DEFINTION OF THE PRECEPTOR ROLE

The preceptor is an integral part of the teaching program. Preceptors will serve as role models for the student and, through guidance and teaching, will help students’ perfect skills in history taking, physical examination, effective communication, physical diagnosis, succinct recording and reporting, problem assessment, and plan development including a logical approach to further studies and therapy.

THE PRECEPTOR-STUDENT RELATIONSHIP

The preceptor should maintain a professional relationship with the PA student and at all times adhere to appropriate professional boundaries. Social activities and personal relationships outside of the professional learning environment should be appropriate and carefully selected so as not to put the student or preceptor in a compromising situation. Contact through web-based social networking sites (e.g., Facebook, MySpace) should be avoided until the student fully matriculates through the educational program or completes the rotation where the supervision is occurring. If the preceptor and student have an existing personal relationship prior to the start of the rotation, a professional relationship must be maintained at all times in the clinical setting. Please consult the clinical coordinator regarding specific school or university policies regarding this issue.

MEETINGS REGARDING CLINICAL ROTATIONS

Meetings with the Lead Clinical Educator o There will be regularly scheduled meetings with the Lead Clinical Educator o If you require additional meetings with the Lead Clinical Educator, please email her with your

request and your availability for a meeting.

Meetings with the Clinical Team o If you need to meet with Joyce, Laura or Janice, please email them with your request and

your availability.

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GENERAL GOALS OF CLINICAL ROTATIONS

Clinical rotations take students from the theoretical classroom setting to an active, hands-on learning environment to prepare them for a lifetime of continued refinement of skills and expanded knowledge as a practicing PA. To this end, the goals of the clinical rotation include:

• Apply didactic knowledge to supervised clinical practice • Develop and sharpen clinical problem-solving skills • Expand and develop the medical fund of knowledge • Perfect the art of history taking and physical examination skills • Sharpen and refine oral presentation and written documentation skills • Develop an understanding of the PA role in health care delivery • Prepare for the Physician Assistant National Certifying Exam (PANCE) • Develop interpersonal skills and professionalism necessary to function as part of a medical team

Clinical Rotation Objectives for 1st and 2nd Year Clinical Rotations can be found on the CHA/PA Clinical website or in Appendix D.

ROTATIONS FOR THE FIRST YEAR

During the 1st Year of the CHA/PA Program, students will complete a total of two (2) clinical rotations:

1 Rotation in the Fall Semester 1 Rotation in the Spring Semester

Clinical rotations occur on Tuesdays only and are 7-weeks in length. The other 7-weeks of the semester will be utilized for didactic courses.

1st Year Clinical Rotations can occur in a variety of settings including: primary care, adult specialty care and pediatric specialty care.

For those students involved in the CU-Unite Track, placement in a continuity urban-underserved clinical rotation will occur in either the fall or spring semester.

1st Year Rotations are generally “observational” in that the 1st year student will observe the preceptor perform all elements of patient care. In some instances, preceptors may ask the 1st year student to practice obtaining a patient history and performing physical examination skills.

1st Year Clinical Rotations (Courses are Subject to Change):

Semester Rotation Description Fall Semester One 7-week clinical rotation (assigned to either Session 1 or Session

2) Spring Semester One 7-week clinical rotation (assigned to either Session 1 or Session

2)

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ROTATIONS FOR THE SECOND YEAR During the 2nd Year of the CHA/PA Program, students will complete a total of four (4) clinical rotations:

2 Rotations in the Summer Semester 1 Rotation in the Fall Semester 1 Rotation in the Spring Semester

Clinical rotations during the summer occur daily for a two-week duration. Clinical rotations during the fall and spring semesters occur on either Tuesdays or Fridays only and are 7-weeks in length. The other 7-weeks of the semester will be utilized for didactic courses.

During the 2nd Year, there are two required clinical rotations that must occur. These rotations are surgery in the summer and palliative care in either the fall or spring semester. The remaining two clinical rotations can occur in a variety of settings including: primary care, adult specialty care and pediatric specialty care.

For those students involved in the CU-Unite Track, placement in a continuity urban-underserved clinical rotation will occur during the fall or spring semester. An optional CU-Unite clinical rotation to Costa Rica will be offered during the summer semester. This will add an additional clinical rotation to the 2nd Year.

For those students involved in the Global Health Track, the student will work with the Global Health coordinator and David Eckhardt to schedule an optional Global Health Track clinical rotation during the summer semester. This will add an additional clinical rotation to the 2nd Year.

For those students involved in the Rural Track, an optional rural immersion week may be offered during the spring semester. This is not a clinical rotation but rather a rural track experience.

2nd Year Rotations allow for increased autonomy in that the 2nd year student will work with the preceptor to refine their history and physical examination skills and begin to formulate a differential diagnosis, assessment and plan. The level of autonomy will depend on the preceptor, site and/or student performance.

2nd Year Clinical Rotations (Courses are Subject to Change):

Semester Rotation Description Summer Semester One 2-week clinical rotation in a surgical setting One 2 week clinical rotation in a community clinic Optional: CU-Unite Track Rotation (CU-Unite students only)

Optional: Global Health Track Rotation (Global Health Track students only) Optional: Rural Immersion Week (Rural Track students only)

Fall Semester One 7-week clinical rotation in either a community clinic or palliative care (either Session 1 or Session 2)

Spring Semester One 7-week clinical rotation in either a community clinic or palliative care (either Session 1 or Session 2)

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SCHEDULING 1st and 2nd Year ROTATIONS

All clinical rotations will be assigned by the Clinical Team.

If you have a site that you are interested in going to, please schedule an appointment to meet with the Lead Clinical Educator to discuss the rotation that you are interested in.

o Once the Clinical Team has approved your request, a completed Contract Request Form

must be submitted. A Contract Request Form is required for new clinical rotations (Appendix A). The Contract Request Form must be filled in complete and signed before it is submitted. By signing the Contract Request Form, you acknowledge that you are committed to this rotation. Changes will be allowed only in exceptional circumstances (i.e., illness of preceptor or student).

The CHA/PA website provides an online Contract Request Form that you can fill out, print and submit to the Clinical Team. The web address is: www.medschool.ucdenver.edu/paprogram. You must sign-in to access this form.

o International Rotations

An international rotation experience may be offered to 2nd Year students during the summer semester of the 2nd Year. All international rotations will be coordinated by the student with the direct assistance of David Eckhardt. These rotations are subject to review and approval by the Program’s Student Promotions Committee.

Key Feature Description International Rotation International rotations are considered either community clinic or elective rotations

during the 2nd Year Where Can You Go The only available 2nd Year international rotation is through Guatemala or Costa

Rica. When Can You Go The timing will be determined by David Eckhardt and coordinated with the Clinical

Team. Financial Responsibility

Students will have the financial responsibility for tuition, travel (must purchase travel insurance), room/board, health and malpractice insurance (if required).

University Policy Students will not be allowed to attend rotations that are deemed unsafe for travel by the State Department or the University of Colorado Denver. Students must understand that if monies are required as a deposit for guaranteed travel, this money may be forfeited if the political or health condition of the visiting country changes prior to the rotation.

Requirement Upon Return from Site

Please see discuss with David Eckhardt.

Vacation Weeks during 2nd Year Summer Semester

o In the spring of your 1st Year, you will be given a preference sheet where you will chose one 2-week block in the summer semester that will be “guaranteed” off for your vacation.

o The remaining 8-weeks will be open for the Clinical Team to assign your surgery and community clinic rotations.

o Track rotations will be factored into the scheduling too (i.e., Global Health Track, CU-Unite, Rural Immersion Week and LEADs activities).

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TYPHON AND PATIENT LOGGING

Typhon o Typhon is the tracking system that is used for clinical rotations.

Provides you with your clinical rotation schedule including the contact information for your preceptor(s).

Tracks your clinical rotation evaluations through the EASI system. Evaluations are completed by you about your preceptor(s) and your preceptor(s) complete an evaluation about you.

Allows you to log your patient encounters. o An email with your username and password will be provided to access Typhon. o You will be required to access Typhon for the items listed above throughout your three years

of training at the CHA/PA Program.

Patient Logging through Typhon o You will be required to log your patient encounters during your clinical rotation in your 1st, 2nd

and 3rd Year. o Compliance with HIPAA is an absolute. o Patient Logging is monitored by the Clinical Team and is a component of your clinical rotation

grade.

o 1st Year Patient Logging You are required to log all of the information that is “required” on the patient logging

worksheet in Typhon. In the 1st Year only – you do not have to log ICD-9 or CPT codes. You may practice

these medical billing codes with your preceptor(s) if you choose to. Patient logging must be completed 7 days after the completion of the clinical rotation.

o 2nd Year Patient Logging

You are required to log all of the information that is “required” on the patient logging worksheet in Typhon.

In the 2nd Year you will be required to log ICD-9 or CPT codes. Please practice formulating and entering these medical billing codes.

Patient logging must be completed 7 days after the completion of the clinical rotation.

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STUDENT EVALUATION: ORIME

ORIME Method of Evaluation o The CHA/PA Program is utilizing an improved evaluation method for clinical rotations. The

O.R.I.M.E. method will allow our preceptors to assess our students’ performance in a developmental approach. The assessment will allow students to identify areas of improvement and strengths, guide their future educational goals, and provide a measure of their progression over three clinical years.

Professional Role Level of Student Description of Role

O – “Observer” • Most 1st Year CHA/PA Students • 2nd

Year CHA/PA Students in

surgical or specialty practice

• The learner is not participating in direct patient care; rather they are observing the preceptor in most aspects of healthcare delivery.

R – “Reporter” • Some 1st Year CHA/PA Students

by the end of the their first year (May) • All 2nd Year CHA/PA Students

• The learner can accurately gather and clearly communicate facts to the preceptor. • Mastery of performing a history and physical exam. • Can recognize normal and abnormal findings. • Confidence to label a new problem • Answers the “what” questions as they relate to patient care.

I – “Interpreter” • Advanced 2nd Year CHA/PA Students for common problems • All 3rd

Year CHA/PA Students –

Early in the 3rd Year

• The learner begins to prioritize identified problems. • Development of differential diagnosis. • Using clinical findings and diagnostic studies to help support a diagnosis. • Answer the “why” questions as they related to patient care.

M – “Manager” • All 3rd Year CHA/PA Students – Late in the 3rd Year

• The learner should be able to provide at least 3 reasonable options in their diagnostic and therapeutic plans. • Answers the “how” questions for getting things done.

E – “Educator” • Highly advanced 3rd Year CHA/PA - Students at the end of their training

• The learner will define important questions to study and differentiate current evidence. • Shares leadership within a team. • Learns from one’s own experience to become an educator.

Created by Cathy Ruff and David Eckhardt: CHA/PA Assessment Committee

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1st and 2nd YEAR ROTATION REQUIREMENTS Student Requirements and Expectations Expectations and Requirements

Description

Rotation Length/Dates All rotations occur one day per week for 7-weeks during the 1st

Year and 2nd Year fall and spring semesters. 2nd Year summer clinical rotations will occur daily for two-weeks. Start and end dates for Session 1 and Session 2 during the fall and spring semesters will be provided to the student when available. Start and end dates for 2nd Year summer clinical rotation blocks will be provided to the student when available.

Preparation for Rotation You must study for clinical rotations. Make a commitment to read at least one article or textbook section that is appropriate to your rotation every day. Ask your preceptor for learning issue opportunities.

Supervision Students are supervised by licensed/board certified physicians, physician assistants, or nurse practitioners at all times. Under no circumstances should a student in the CHA/PA program be permitted to practice independent of direct supervision. The preceptor or designee with equal education and qualifications must be on site. Under no circumstance should the CHA/PA student be used as an employee of the practice or represented to the clientele as such. Students should not be used as clerical staff or research assistants.

Identification A name tag identifying you as a Physician Assistant student must be worn at all times. If the specific sites require additional identification, it is the responsibility of the student to comply. If separate badges are required at hospital sites, it is the responsibility of the student to complete paperwork necessary to obtain the required identification. You are required to identify yourself to patients by your name and by your Child Health Associate/Physician Assistant student status. You should also explain to patients your working relationship with the preceptor. When you sign a chart, you must identify your student status, e.g., Susan Smith, CHA/PAS-1, CHA/PAS-II, PAS-1, or PAS-II. Your signature on any official paperwork (e.g., charts, prescriptions) must be countersigned by your MD or DO preceptor, or by your PA preceptor with countersignature by the PA’s supervising physician.

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Proper Attire Dress code is casual business attire. All necklines must be high enough not to expose cleavage. Shoes that are closed at the toe are appropriate attire. Students may be asked to wear scrubs at certain sites, and white coats may be required. If scrubs are checked out to the student while on rotation, it is the student’s responsibility to return them once the rotation is complete. Jewelry is to be kept to a minimum. Pierced areas on the body should be free of ornament. Tattoos will be covered.

Equipment You are responsible for providing your own diagnostic equipment, pen with black ink, and any quick references (e.g., Harriet Lane Handbook, “peripheral brain”).

Work Hours/Attendance You are required to work the hours of the preceptor or the preceptor’s designee. On call for surgical rotations may be required, and you must discuss the schedule with the preceptor at the beginning of the rotation. Occasionally, a rotation will require an “on-call” night or an overnight shift (these will only occur during the summer months).

Unexcused absences may be brought to the attention of the Student Promotion Committee and may results in failure of the rotation (See Appendix F for full Absence Policy Description).

Refer to the Clinical Website for FAQs (winter weather, closed campus, etc.).

Clinical Passport You are responsible for having the Clinical Passport with you at all rotations in case the site does not have necessary paperwork to facilitate a timely start to the rotation. This passport packet is given to each student by the Clinical Administrator during the month of August preceding the start of the 1st year and in the month of May preceding the start of the 2nd year. The Clinical Passport includes: Malpractice coverage Letter of Good Standing Background check; completion of

HIPAA compliance; Bloodborne Pathogen/ExposureControl/Needlestick Training, TB Mask Fitting

Student immunizations Workers’ Compensation Coverage

Registration You are responsible for updating your personal contact, demographic and emergency contact information in CU-SIS to allow for registration each semester. You must update this information by: May 15th, August 15th and December 15th.

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Clinical Course Requirements Responsibility Description

Attend Clinic Each assigned day. Typhon Patient Logging Logging patient contacts is required and will be completed no later

than 7 days after completing the rotation. After this time the account may be locked by the Clinical Team and the student must contact the program to discuss what is required to complete patient logging. If your Typhon account has been inactive you must contact the Clinical Team immediately. You are required to review the Typhon graph printout with your preceptor(s) at the end of the rotation.

Evaluations – Preceptor of Student

The preceptor evaluation of the student is electronic and is sent directly to the preceptor by the program. If the preceptor prefers paper evaluation forms please print out a pdf form for him/her. This form can be found on the CHA/PA website under “Preceptors”, “Preceptor Resources”. It is your responsibility to meet with your preceptor to review your performance mid-way through the rotation, and arrange a time near the end of the rotation to meet and discuss your evaluation. Evaluation forms are due in the CHA/PA office within 7 days after the completion of your rotation.

Evaluations – Student of Preceptor

You are required to submit an evaluation of your preceptor after each rotation. The student evaluation of the rotation is online. The student evaluation of the preceptor is due to the CHA/PA Program no later than 7 days following completion of the rotation. If an evaluation form is not received by the 7th day following completion of the rotation, your status will be brought to the Student Promotion Committee and you may fail your clinical rotation.

Bloodborne Pathogen/Needlestick recertification

This course must be completed yearly through Blackboard/Canvas

Immunizations All immunizations must be up-to-date to continue clinical rotations. Please check Typhon daily to ensure that your immunizations are up-to-date. Influenza vaccinations are now required every year.

PPD skin test Must be checked yearly. Please check Typhon daily to ensure that your immunizations are up-to-date.

HIPAA Course completion must occur through Blackboard.

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Student Credits, Grading, Etc. Credits

A total of 4 credits are required for the 1st Year and a total of 8 credits are required for the 2nd Year. Each rotation in the 1st and 2nd Year are 2 credits each.

Grades

Grades are assigned by the Course Director for the clinical rotation. The Lead Clinical Educator is the Course Director for all courses except for the Guatemala clinical rotation. The course director may consult the preceptor, the Clinical Team and/or the Student Promotion Committee. All grades are recorded as pass/fail.

An incomplete (“I”) grade will be assigned if any of the three requirements for the rotation have

not been received by the University designated grade submission date (see Appendix D for student requirements). The student will not be able to progress to the next level of training (1st Year to 2nd Year) if a grade of “I” has been recorded and not rectified. This may result in an extended program and delayed graduation. Please refer to the CHA/PA Academic Policies at the following website: (http://www.ucdenver.edu/academics/colleges/medicalschool/education/degree_programs/PAProgram/currentstudents/Pages/StudentResources.aspx)

REMEDIAL ACTION Please refer to the CHA/PA Academic Policies at the following website: (http://www.ucdenver.edu/academics/colleges/medicalschool/education/degree_programs/PAProgram/currentstudents/Pages/StudentResources.aspx)

STUDENT ACCOMMODATIONS Students requesting accommodations should contact the Office of Disability Resources and

Services located in Building 500, Room W1103; phone number 303-724-5640. Their staff will assist in determining reasonable accommodations as well as coordinating the approved accommodations.

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ABSENCES FROM CLINICAL ROTATIONS Students are expected to be at their clinical rotation on the day assigned.

Inclement Weather

o 1st and 2nd years are not expected to attend class if campus is closed. If campus is closed and you will NOT be attending clinic, it is your responsibility to contact your preceptor to notify them that you will not be there (and why.) If campus is closed and you choose to attend clinic anyway, you must contact the Lead Clinical Educator (by email) to let them know you will be at clinic. (Note: anytime you miss clinic for any reason you should email the Lead Clinical Educator.) Contact the preceptor first then the Clinical Educator if you must miss clinic due to inclement weather.

Emergency or Illness

o If you are ill and it would be inappropriate for you to see patients, or if there is an emergency, you must contact your preceptor. (Note: anytime you miss clinic for an illness/emergency you must email the Clinical Educator to discuss make-up options.)

Other Absence Requests

o If you need to miss clinic (for reasons other than for an acute illness or an emergency), you must get approval from the Lead Clinical Educator prior to approaching your preceptor. Please refer to the CHA/PA absence policy (Appendix F) for further information regarding absences.

Vacations/School Breaks

o For 1st and 2nd year students, attendance during Winter Break and Spring Break is not required.

TRAVEL QUESTIONS AND ADDITIONAL COSTS

Student Travel Questions Travel Question Description Other Information

Rural Clinical Site – Living Expenses

Within rural Colorado, the Colorado Area Health Education Center Program (AHEC) has some funds for living in Colorado sites and may be of assistance in locating housing. Ultimately, housing decisions are the responsibility of the student.

Contact Laura Casias, at 303-724-1343 for all questions related to rural living expenses and needs.

International Rotations – Travel and Living Expenses

Travel and living expenses for international rotations are the student’s responsibility.

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Student Costs during 1st and 2nd Year Clinical Rotations

Additional Costs Description Other Information

All expenses related to clinical rotations

All expenses related to clinical rotations are the responsibility of the student.

Examples: sites may charge for parking, food cards, use of scrubs, background checks, drug screens, etc. These expenses should be anticipated and budgeted for prior to beginning of the scheduled rotation.

Student Fingerprints for Clinical Rotations

If required to have fingerprints for specific rotations, the student must pay the $5.00 fee for the AMC police to provide this service.

Specific fingerprint cards are available from Laura Casias.

Drug Screens 5-panel drug screen in the 1st Year; 9-panel drug screen in the 2nd Year

These are University of Colorado requirements that must be performed prior to the start of the 1st Year clinical rotations and prior to the start of the 3rd Year clinical rotations. These costs have been included in student fees. Additional drug screen requirements for clinical rotations beyond the two described above will be at the expense of the student.

TB Mask Fitting TB Mask Fitting for Clinical Rotations.

TB Mask Fitting occurs in the fall of the 1st Year and the fall of the 2nd Year. This expense is included in the student fees.

Immunizations/TB Tests

University Requirement for all students in clinical rotations.

Please see the CHA/PA Website for more information.

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ROTATION INJURIES/EXPOSURES The University of Colorado has adopted policies and procedures for handling exposure to infectious

disease including, but not limited to HIV, hepatitis and tuberculosis. Students in the CHA/PA Program are required to adhere to UCD guidelines.

Exposure/Injury Description Contact

Needlestick and bodily fluid exposures

Students that have needlestick or bodily fluid exposures should seek immediate medical attention in the Emergency Room of the hospital where the work related incident occurs or through recommendations listed on UCD Procedures page (see Appendix B) Contact the Clinical Team Immediately after care is initiated

Jackie OR Joyce

Injured during clinical rotation

See UCD Workers’ Compensation Claim Procedures (Appendix B) Contact the Clinical Team Immediately after care is initiated

Jackie OR Joyce

Communicable Disease (e.g., meningitis)

Follow procedures as described under needlestick and bodily fluids exposure (Appendix B) Contact the Clinical Team Immediately after care is initiated

Jackie OR Joyce

Information on Procedures for Exposure/Injury can be found at the CHA/PA Website under “Current Students”, “Clinical Site Information”, “Clinical Forms, Policies and FAQs” Rotation Injuries or Exposures” (Log-In Required) OR in Appendix B

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OVERVIEW OF REQUIREMENTS FOR PROGRESSION TO 3rd Year

To complete the 2nd Year and progress to the 3rd Year of the CHA/PA Program, you must complete the following during your 2nd Year:

Requirement Description

Clinical Rotations You must satisfactorily complete 4 clinical rotations and all clinical course requirements

Comprehensive Clinical Skills and Written Examinations

You must pass the Comprehensive Clinical Skills and Written Examination with a 70% or above.

Didactic Training You must satisfactorily complete the didactic courses of the 2nd Year.

Clinical Rotation Requirement:

o All clinical rotations are graded on a pass/fail basis. o Satisfactory completion of a rotation means achieving a passing grade for both the

cognitive and non-cognitive aspects of each rotation as well as completing the Clinical Course Requirements. All 4 evaluations from preceptors must be received by the CHA/PA office no later than due date determined by the University Registrar’s Office.

Comprehensive Clinical Skills and Written Examination:

o The Clinical Skills and Written Comprehensive Examinations are given in April of the 2nd Year.

o The written examination is a ½ day test consisting of 150 questions on Pediatrics and Adult Medicine. It is advised that you begin preparing for the Comprehensive Written

Examination in the spring of your 2nd Year. Further information on these two examinations (dates, format, etc.,) will be provided to you in January of your 2nd Year.

OTHER ITEMS Site Visits

A representative of the Program may be visiting the rotation site during the time you are there. The purpose of a site visit is to monitor learning, assure that the rotation is appropriate for CHA/PA students, and identify areas for improvement. The site visit is intended to assess the learning environment, not to evaluate your knowledge. You are encouraged to discuss any concerns you have about a site with the Clinical Team.

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Appendix A Contract Request Form

www.medschool.ucdenver.edu/paprogram - “Current Students”

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CONTRACT REQUEST FORM

Student’s Name:_________________________________ Date:_____________ 1. Preceptor(s) first & last names & title (example: MD, DO, NP, PA-C, etc): ______________________________________________________________________ 2. Preceptor’s Email Address: ____________________________________________ 3. Name and title of supervising physician (required if preceptor is a PA or NP): ______________________________________________________________________ 4. Name of Practice/Clinic:_______________________________________________ Physical Address (Street, City, State, Zip): ______________________________________________________________________ Mailing Address: (if different from physical address): ______________________________________________________________________ 5. Telephone and fax numbers, include area codes and extension: Phone: _____________________________ Fax: ______________________________ 6. Office Manager’s Name:_______________________________________________ 7. If you will need surgery permissions list the surgery centers, hospitals, etc. that you will be going to. The Office Manager is usually the one who can provide this information. Hospital Name City and State Phone Number ______________________________________________________________________ ____________________________________________________________________________________________________________________________________________ 8. Type of Practice (Family, Pediatrics, Internal Medicine, etc. If a specialty, identify if pediatric or adult and the specific specialty:___________________________________ 9. Exact dates/months practice can take you. Clinical coordinator will contact site to confirm. ______________________________________________________________________ 10. If this is an out of state rotation does this site take students from other PA programs: Yes/No If yes: Program name:_________________________________________________

Note: The submission of this request form is a binding contract and cannot be changed. Site confirmed by Clinical Team _____________________________ _ Course Number _________ Reviewed by the Clinical Team______________ Entered into Scheduler ___________ Letter Sent _____________

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APPENDIX B University NeedleStick and Bodily Fluid

Exposures

Workers’ Compensation Procedures

http://www.ucdenver.edu/life/services/student-health/needlesticks/Pages/default.aspx Also available: www.medschool.ucdenver.edu/paprogram

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UNIVERSITY OF COLORADO DENVER NEEDLESTICK & BODILY FLUID EXPOSURES

WORKERS' COMPENSATION CLAIM PROCEDURES Medical Treatment: Employees and student interns that have needlesticks or bodily fluid exposures should seek immediate medical attention in the Emergency Room of the hospital where the work related incident occurs. Exceptions are:

• University of Colorado Hospital (UH) - Go to the Infectious Disease Clinic at Anschutz Outpatient Pavilion, 1637 Aurora Court, 7th floor, between 8:00 AM and 4:00 PM Monday -Friday, or the Emergency Room after hours.

• Denver Health Medical Center (DHMC) - Go to the Occupational Health and Safety Center (corner of 6th Avenue and Bannock, 4th Floor) between 8:00 AM - 3:30 PM Monday through Friday or the Emergency Room after hours.

• Employees/Student Interns working in small clinics or in laboratories off campus should go to the nearest emergency room or facility that can perform a blood draw.

• Students, volunteers or others not covered by workers’ compensation should contact their personal healthcare provider.

For non-emergency or follow up medical care for your workers’ comp injury, you must go to one of the following Designated Medical Providers listed below: Designated Medical Providers: Designated Medical Providers:

HealthOne Occupational Medicine HealthOne Occupational Medicine 1444 S Potomac #200, Aurora CO 80012 Phone: 303-214-0000

9195 Grant St., #100, Thornton, CO 80229 (303) 292-0034

120 Bryant St., Denver, CO 80219 Phone: 303-936-9700

5044 W. 92nd Ave., Westminster, CO 80031 (303) 650-0445

1515 Wazee, Suite D, Denver, CO 80202 Phone: 303-534-9550

125 E. Hampden Ave., Englewood, CO 80113 (303) 788-9292

Rocky Mountain Medical Group Rocky Mountain Medical Group 14100 E. Jewell Ave. Ste 15, Aurora Co 80112

Phone: 720-748-7072

730 West Hampden Ave. Ste 200, Englewood CO 80110 Phone: 303-762-0900

Claim: You must file an online workers’ compensation claim form within 4 days of the injury/exposure. https://urm.cusys.edu. Failure to file a claim timely may result in penalties to you, including financial responsibility for treatment. Payment: University Risk Management, not your health insurance, is responsible for payment of services related to an on-the-job-injury/exposure. Send bills from authorized medical providers for an on-the-job injury to:

University Risk Management 1800 Grant Street, Suite 700 Denver, CO 80203 Phone: 303-860-5682 Fax : 303-860-5680

Please direct any workers’ compensation questions to University Risk Management (303) 860-5682 (888) 812-9601 or University of Colorado Denver Risk Management 303-724-1269.

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APPENDIX C Workers’ Compensation

UCD - Medical Malpractice

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UNIVERSITY OF COLORADO WORKERS' COMPENSATION COVERAGE FOR STUDENTS

This policy statement describes the Workers' Compensation coverage available to students of the University of Colorado.

1. To be covered' by Workers' Compensation (WC) the student must be considered an employee or "be involved In a bona fide cooperative education or student internship program sponsored by an educational institution for the purpose of providing on-the-job training for students;" 8-4030217)(a) C.R.S.

2. A student is considered an employee of the University of Colorado(CU) and under the CUWC policy when they are on the payroll (student workers, residents, Interns, and some fellows), or receive "payment In kind", such as benefits (l.e., health, dental, life, or disability Insurance), paid directly by CU.

3. A student at CU is not considered to be an employee for WC purposes unless that Job training is outside the University. For example, University Hospital (UH) Is separate from the University and student is working at UH are covered; whereas the Sands Clinic and the Dental School are part of the University, so students working in these units are not covered.

4. If the student in the on-the-job training is paid by the outside employer, the student is considered to be an employee of the outside employer and subject to that employer's WC policy. In some cases, the employer may assume WC coverage for an unpaid student through a written agreement.

5. Those students who are not paid by the outside employer, who are not by contract covered by the outside employer's insurance, who are not paid by CU, AND who are placed with the outside employer for the purpose of training or learning trades or occupations; ARE covered under the workers' compensation Insurance of the sponsoring school, namely CU's insurance carrier, the University of Colorado Risk & Insurance Management Fund. 8-40-302(7) C.R.S. and 8-40-202 (1)(a) IV C.R.S.

6. Accident, injury, and occupational disease are covered for employees under WC and students who qualify under the provisions outlined in the above paragraphs. Coverage is not provided for exposures to diseases, including needle sticks. The University of Colorado's Self-Insurance fund may elect to pay medical expenses resulting from exposures, but does not incur any future liability in doing so. 8-40-201, 8-41-302 C.R.S.

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MEDICAL MALPRACTICE COVERAGE FOR STUDENTS

Name: Effective: June 1, 2008 through termination/graduation from the Child Health Associate/Physician Assistant Program To Whom It May Concern:

The University of Colorado provides professional liability coverage for its students through a combination of self-insurance and commercial insurance. This coverage is subject to the terms of the University of Colorado Self-Insurance and Risk Management Trust Coverage Document. The extent of coverage under the Trust may be limited by the nature of their training program with the University. Coverage extends to an individual who is duly enrolled and matriculated as a student at the University of Colorado Health Sciences Center for all professional and educational activities that are within the course and scope of the individual’s responsibilities as a student.

The Trust's coverage extends to employees, students and volunteers defined in the Trust Coverage Document and in

accordance with the Colorado Governmental Immunity Act (C.RS. 2410-101 et. seq.). These employees, students and volunteers are considered to be public employees under the Colorado Governmental Immunity Act and their liability is limited by the Act as follows:

• For any injury to one person in any single occurrence, the sum of $150,000; • For any injury to two or more persons in any single occurrence, the sum of $600,000; except in such instance, no

person may recover in excess of $150,000.

For claims subject to the protection of the Colorado Governmental Immunity Act, if a court of competent jurisdiction rules as a final judgment that the limitations of the Act are not applicable to the University, the University of Colorado Hospital, a particular public employee, faculty member or student, then the Trust provides secondary coverage through a commercial policy which has limits of at least $1,000,000 per occurrence and $3,000,000 in aggregate.

Yours truly, Jacqueline N. Sivahop, MS, PA-C Clinical Coordinator - Third Year Child Health Associate/Physician Assistant Program

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Appendix D

1st Year and 2nd Year GENERAL Objectives, Preceptor Requirements and Student

Requirements

Objectives for Surgery, Emergency Medicine and Women’s Health can be found on the website at: www.medschool.ucdenver.edu/paprogram --> “Current

Students” “Syllabi and Objectives”

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Child Health Associate/Physician Assistant Program GENERAL OBJECTIVES

FIRST YEAR CLINICAL ROTATIONS

Patient /Clinical Care:

• Obtain age-appropriate health history(s) from patient(s) under the guidance of the preceptor. • Perform physical examinations under the guidance of the preceptor. • Demonstrate the ability to orally present accurate patient information to the preceptor.

Medical Knowledge:

• Apply basic medical knowledge of common illnesses and diseases encountered.

Practice Based Learning and Improvement:

• Demonstrate ability to learn from system and individual errors. • Demonstrate ability to utilize information technology (literature, guidelines, and professional

websites) to gain information. System-Based Practice:

• Demonstrate knowledge of practice systems and community resources. Interpersonal and Communication Skills:

• Demonstrate the ability to interact appropriately with the clinical team under the supervision of a physician. This includes administrative personnel, health care professionals from all disciplines, patients and family members.

Professionalism:

• Demonstrate promptness, appropriate professional demeanor and commitment to ethical principles including confidentiality of patient information.

• Demonstrate sensitivity and responsiveness to factors of age, culture, gender, disabilities, ethnicity and socio-economic status encountered in the patient population.

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Child Health Associate/Physician Assistant Program GENERAL OBJECTIVES

SECOND YEAR CLINICAL ROTATIONS

Patient /Clinical Care: • Obtain age-appropriate health history(s) from patient(s) that are consistently complete with or

without the guidance of the preceptor. • Perform appropriate physical examinations with or without the guidance of the preceptor. • Demonstrate the ability to orally present organized, complete and accurate patient information to

the preceptor. • Demonstrate the ability to write a SOAP note that is generally organized, complete and accurate

and appropriate to the patient visit.

Medical Knowledge:

• Apply basic medical knowledge of common illnesses and diseases encountered.

Practice Based Learning and Improvement:

• Demonstrate ability to learn from system and individual errors. • Demonstrate ability to identify gaps in learning and receive feedback appropriately. • Demonstrate ability to utilize information technology (literature, guidelines, and professional

websites) to gain information. System-Based Practice:

• Demonstrate knowledge of practice systems and community resources. • Demonstrate ability to identify resources that would benefit specific patient needs.

Interpersonal and Communication Skills:

• Demonstrate the ability to interact appropriately with the clinical team under the supervision of a physician. This includes administrative personnel, health care professionals from all disciplines, patients and family members.

• Demonstrate appropriate communication with patients and families; developing active listening and open-ended interview techniques.

Professionalism:

• Demonstrate promptness, appropriate professional demeanor and commitment to ethical principles including confidentiality of patient information.

• Demonstrate sensitivity and responsiveness to factors of age, culture, gender, disabilities, ethnicity and socio-economic status encountered in the patient population.

• Demonstrate ability to fulfill basic patient care responsibilities when asked.

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Child Health Associate/Physician Assistant Program GENERAL REQUIREMENTS FOR 1st and 2nd YEAR STUDENTS

CLINICAL ROTATIONS

1. The student assigned to a rotation is expected to maintain the same clinical schedule as the primary

preceptor unless otherwise discussed with the Clinical Coordinator.

2. In case of an absence the student is required to directly contact the primary preceptor and clinical coordinator of the CHA/PA program. All missed time by a student must be made up per the primary preceptor’s schedule. Accepted absences would include illness or a family emergency. Missing an assigned clinic secondary to other class work is not an excused absence.

3. All work done by students must be observed or rechecked and cosigned by the preceptor or

per the site specific policy.

4. Prior to the beginning of each rotation the student should discuss areas of work that he/she would like to concentrate on during the rotation. These may include, but are not limited to, taking a history, physical diagnostic skills, developing differential diagnoses, development of a treatment plan, patient education plan, etc. Discussion should focus around these identified goals throughout the rotation.

5. It is encouraged that the primary preceptor and the student discuss progress throughout each

rotation and discuss the final evaluation at the end of the rotation. Students are required to confirm that the preceptor’s evaluation of the student is submitted (either electronically or paper-form) within 7 days from the last day of the clinical rotation. Clinical rotations are pass/fail; this is calculated by the Clinical Coordinators.

6. Synopsis of the Typhon patient logging is required for each rotation. This will be submitted at the

end of the rotation to your designated Clinical Coordinator. You are also required to present a synopsis to your preceptor on the last day of your rotation.

7. Students are required to log all patients into the Typhon logging system by the conclusion of each

clinical rotation.

8. Students are required to complete the online EASI evaluation of preceptor/sites at the conclusion of each rotation. Failure to complete either of these requirements may result in a failing grade for the rotation.

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CHILD HEALTH ASSOCIATE/PHYSICIAN ASSISTANT PROGRAM CLINICAL ROTATIONS

GENERAL RESPONSIBILITIES FOR 1st and 2nd YEAR PRECEPTORS

1. The student assigned to a rotation is expected to maintain the same clinical schedule as the primary preceptor unless otherwise discussed with the Clinical Coordinator.

2. In case of an absence the student is required to directly contact the primary preceptor and clinical

coordinator of the CHA/PA program. All missed time by a student must be made up per the primary preceptor’s schedule. Accepted absences would include illness or a family emergency. Missing an assigned clinic secondary for other class work is not an excused absence.

3. All work done by students must be observed or rechecked and cosigned by the preceptor or

per the site specific policy.

4. Prior to the beginning of each rotation the preceptor should discuss areas of work that he/she would like to concentrate on during the rotation. These may include, but not be limited to, taking a history, physical diagnostic skills, developing differential diagnoses, development of a treatment plan, patient education plan, etc. Discussion should focus around these identified goals throughout the rotation.

5. It is encouraged that the primary preceptor and the student discuss progress mid-way through each

rotation. Make every effort to discuss the final evaluation at the end of the rotation.

6. Preceptor is asked to review a synopsis of the students Typhon logging at the end of the students rotation.

7. Preceptors are encouraged to give direct feed-back to individual students regarding strengths and

weaknesses, however the clinical coordinator should be aware of all problems that arise as soon as possible so that solutions can be discussed with both the preceptor and student.

8. Please complete the online evaluation of the student at the end of the rotation. Students cannot

receive a passing grade for the course without a completed evaluation by their preceptor.

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APPENDIX E 1st and 2nd Year Syllabi

Please refer to the website below for Syllabi

information www.medschool.ucdenver.edu/paprogram

“Current Students” “Syllabi and Objectives”

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APPENDIX F Policy on Student Absences from Clinical

Rotations

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Policy on Student Absences from Clinical Rotations:

Policy on Student Absences from Clinical Rotations

Effective Fall Semester 2012

1st Year Rotations

Rotations occur on Tuesdays for seven consecutive weeks during the fall and spring semesters. Students are expected to work the hours of the preceptor(s).

All requests for absences must be submitted to the Clinical Educator prior to discussing this with the preceptor(s). Exceptions to this rule are acute illnesses or emergency situations for which the preceptor should be contacted first followed by the Clinical Educator.

If more than one clinical day is missed, the Clinical Educator will work with the Clinical Team and if needed, the Student Promotion Committee, to create a remediation plan.

Definition of “absences”:

a. An “excused” absence is an absence for which permission has been granted by the clinical coordinator and preceptor. Excused absences are considered to occur in voluntary and involuntary situations as defined below:

1. Voluntary Absences: An absence for an event or events such as personal appointments and family events. Voluntary absences are generally not permitted but unique circumstances must be submitted in writing to the Clinical Educator within 10 days from the requested day(s) off. If accommodations can be made, an appropriate plan will be developed by the Clinical Educator with or without assistance from the Clinical Team.

2. Involuntary Absences: An absence for serious illness, jury duty and academic difficulties. If a student has an illness or other emergency, they must contact their preceptor(s) as well as the clinical coordinator as soon as possible or prior to missing any time.

b. An “unexcused” absence is an absence for which permission has not been granted by the Clinical Educator. Unexcused absences may be brought to the attention of the Student Promotion Committee and may result in failure of the rotation.

2nd Year Rotations

Two clinical rotations occur daily for two-weeks during the summer semester. Rotations occur on either Tuesdays or Fridays for fourteen consecutive weeks during the fall and spring semesters. Students are expected to work the hours of the preceptor(s).

All requests for absences must be submitted to the Clinical Educator prior to discussing this with the preceptor(s). Exceptions to this rule are acute illnesses or emergency situations for which the preceptor should be contacted first followed by the Clinical Educator.

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If more than one clinical day is missed during a seven-week rotation, the Clinical Educator will work with the Clinical Team and if needed, the Student Promotion Committee, to create a remediation plan.

Definition of “absences”:

a. An “excused” absence is an absence for which permission has been granted by the clinical coordinator and preceptor. Excused absences are considered to occur in voluntary and involuntary situations as defined below:

1. Voluntary Absences: An absence for an event or events such as personal appointments and family events. Voluntary absences are generally not permitted but unique circumstances must be submitted in writing to the Clinical Educator within 10 days from the requested day(s) off. If accommodations can be made, an appropriate plan will be developed by the Clinical Educator with or without assistance from the Clinical Team.

2. Involuntary Absences: An absence for serious illness, jury duty and academic difficulties. If a student has an illness or other emergency, they must contact their preceptor(s) as well as the clinical coordinator as soon as possible or prior to missing any time.

b. An “unexcused” absence is an absence for which permission has not been granted by the Clinical Educator. Unexcused absences may be brought to the attention of the Student Promotion Committee and may result in failure of the rotation.

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APPENDIX G CHECKLIST and PEARLS

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Clinical Rotation Student Checklist

Name: _____________________________________________________________________________ Rotation Site: _______________________________________________________________________ Rotation Dates: ______________________________________________________________________ Prior to Beginning the Rotation: ___ Reviewed the Clinical Site Information Webpage on the CHA/PA Website ___ Reviewed and read the articles and supplemental materials available for the rotation on the CHA/PA

Website ___ Contacted my future preceptor to introduce myself

(recommend you do this 10-14 days prior to the rotation start date) ___ Asked about dress code (is a lab coat required?), directions, parking and facility, etc.

(if this is not on the CHA/PA Clinical Site Information Webpage) ___ Asked about hour to begin work and where to meet the preceptor ___ Remembered my name tag and equipment (label your equipment) 1st Day of the Rotation: ___ Remember to wear my name tag and bring my labeled equipment End of Rotation: ___ Reviewed “Preceptor Evaluation of the Student” with my Preceptor (online via Typhon or paper)

(Student is responsible for confirming the Program has received this within 7 days after the completion of the rotation – www.medschool.ucdenver.edu/paprogram/preceptor

___ Completed “Student Evaluation of the Preceptor” (Via Typhon EASI evaluation system online – due within 7 days after the completion of the

rotation) ___ Logged Typhon Patient Encounters and reviewed the case logs with the preceptor (Via Typhon – due within 7 days after the completion of the rotation) ___ Completed all objectives and requirements for this course ___ Completed the Clinical Site Information Form on the CHA/PA Clinical Website

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Making the Most of Your Clinical Rotation

DO: Arrive early, not just on time. On all rotations, you should arrive a few minutes early in order to be

ready to see the first patient (i.e., read the chart, organize diagnostic equipment, review lab and diagnostic studies previously ordered).

Call your preceptor and the Program’s Clinical Team if you are ill or cannot be at your rotation.

Call the Clinical Team if there is a change from the original contract (i.e., change of preceptor(s),

change of location of the clinic, change of hours, etc.)

Participate in activities that are suggested (i.e., attending noon conferences, observing procedures, etc.).

Be assertive. Ask for opportunities to see and do things.

Discuss any problems in the rotation with your preceptor. If the solution is not forthcoming, call the

Clinical Team.

Have a copy of your immunizations and “clinical passport” records with you. This is especially important if you are rotating at other Universities or large managed care organizations.

Read about what you see in clinic. Come prepared.

Have fun! Learn a lot!

DON’T Discuss diagnosis and treatment with patients before you have reviewed the case with the preceptor. Discuss patients in a public place.

Call patients by their first name.

Forget to discuss with your preceptor any topic you were to research.

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