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Clinical Dress Code

1) Students are required to wear their student badges at all times, in a location that is clearly visible. 2) Scrubs are not permitted except while in the operating room, unless otherwise indicated by your preceptor. Scrubs may be required by preceptors during the clinical year. They shall be ceil blue with matching tops and bottoms, or those required by specific hospitals or specialty/surgery centers. No patterned or other color scrubs are permitted. Drawstrings should be tied at the level of the umbilicus and the scrub top and drawstring should be tucked into the pants. Lab coats MUST be worn over scrubs except when otherwise directed by your preceptor. 3) There are to be no logos or script visible on the undergarment. Underwear must not be visible through clothing or above the waistband of pants or skirts. 4) Open toed shoes, sandals, and sneakers are not acceptable. Athletic shoes or medical grade clogs and conservative socks are to be worn with scrubs ONLY. If heels are worn they must be conservative and are not to exceed 2" in height. Socks or hosiery must be worn at all times. 5) All clothing must be clean and pressed. 6) Men will wear dress pants with shirt and tie along with closed toed shoes. 7) Women will wear a dress, skirt, or slacks with an appropriate blouse and close-toed shoes. Dresses and skirts must be no shorter than the kneecap. 8) Permitted jewelry includes: watch, wedding band, and small earrings for women (single pierced earrings only; double piercings are NOT allowed). Men are not allowed to wear any earrings. No other jewelry is permitted, including bodily piercings. 9) Hair must be conservative, neat, and clean at all times. Long hair must be tied back or pinned up away from the face and off the collar. 10) Beards and mustaches must be clean, neat and trimmed. Mustaches must not hang below margin of the upper lip. Some clinical rotations may prohibit facial hair, therefore, students must abide by the policies and procedures of the clinical rotation. 11) Nails should be clean, short, and trimmed. Acrylic nails are not permitted as they harbor bacteria and they can scratch. Nail polish is not permitted while at the clinical rotation site(s). 12) Cosmetics/Perfume should be minimal, and are forbidden by many clinical sites. Many patients and staff members are allergic or sensitive to odors. 13) Tattoos should be covered at all times with long sleeves or socks. If a tattoo is located on the neck, it must be covered. 14) Personal hygiene must be maintained. 15) Jeans, sweatpants, shorts, Capri pants, leggings, skorts, miniskirts, sweatshirts, strapless or spaghetti strap tops or dresses, plunging or revealing necklines, midriff skirts, and t-shirts are NOT acceptable during clinical rotations. 16) If the individual clinical rotation requires the student to wear their institution-specific ID badge, then the student must wear both institutions' ID badges (theirs plus the NSU badge). Each clinical site may have additional dress code policies and procedures. Program faculty and preceptors have the right to prohibit a student from patient care activities if his/her appearance does not meet the dress code standards. Inappropriately dressed students will be asked to leave the rotation site and/or campus and will receive an unexcused absence until they return properly attired. In addition, the missed clinical time will need to be made up.

Safety Procedures...

⋆All Students must follow the safety policies and procedures that are established by each clinical site. All fire hazard and public safety rules must be followed to ensure a safe clinical rotation experience. Students should be aware of the location Material Safety Data Sheet (MSDS) manual in each facility, as well as the needle stick policies at their clinical sites. ⋆Most clinical institutions provide security personnel. If the student feels that they are in danger, he/she should call the institution's security department or 911. The student must also notify the Clinical Director of any concerns of safety immediately. ⋆The student is responsible for following OSHA Guidelines for universal precautions at the clinical rotation site, including the use of gloves, care of sharp objects, use of eyewear, protective clothing, and other precautionary measures.

CSP Dismissal Criteria

A student may be dismissed by the Committee on Student Progress for any historical academic or clinical performance deficiencies as evidenced by the following: 1. 1 or more failures of a clinical rotation. 2. 2 or more passed EOR retests 3. 2 or more failed performance tests which includes any 2 SOAP notes, 2 Written Complete H & PE, 2 Oral Case Presentations, 2 OSCEs, or any combination of two of the above. 4. Any 1 rotation failure + 1 EOR exam failure

Name Changes

A student or former student may change the full, legal name on his or her permanent academic record by completing a Change of Information Form and submitting the appropriate documentation to the Office of Registrar, as soon as possible.

Mission Failure: Passing Clinical Rotation***

All components of the Clinical Rotation must be passed in order for the student to pass the course. A failing grade on any component of the rotation grade will result in referral to the Committee on Student Progress for further disciplinary action and possible rotation failure. Students may not move on to their next rotation without successfully completing their previous rotation.

Malpractice insurance

All clinical students are covered under Nova Southeastern University's professional liability policy while at scheduled rotations. It is expected that all incidents involving students and patients will be reported immediately by phone and in writing to the PA Orlando Program.

Mission failure: unethical behavior**

Any unethical or unprofessional behavior will be grounds for immediate dismissal from the PA Program

Mission Failure: student learning**

Clinical Preceptors are not responsible for teaching all items in the Clinical Rotation Course Syllabus. Students are expected to learn all of the information on the objective lists, regardless of whether or not the preceptor discusses every objective with them. As a graduate student, you are expected to look up medical objectives and required medical information that you do not know or are less familiar, as you will be taking care of patients.

Student Responsibilities to the Program

Complete all required clinical prerequisites detailed later in this handbook. To attend all rotations as scheduled. To IMMEDIATELY notify the program of any problems as they occur. If there are ANY concerns with a preceptor, site, or schedule, and the student does not notify the program, until after they have received a negative evaluation from a preceptor, fails an H/P, SOAP note, OSCE, or EOR exam, then the student may fail the rotation, unless there are extenuating circumstances. The student may be called to the CSP for these deficiencies in order to explain his/her concerns. To complete all required tasks, including paperwork for each rotation, in the time frame that is required, or be subject to a late penalty on assignments. Failure to comply with deadlines may also result in referral to the CSP for discipline concerns. To complete rotation objectives prior to the onset of the rotation and periodically throughout the rotation. It is the responsibility of the student to complete the specific objectives through the clinical experience or through independent study. It is difficult for a clinical site to afford the student the experience needed to complete all objectives; therefore, independent study is needed to ensure student success. To learn all of the information on the objective lists, regardless of whether or not the preceptor discusses every objective with them. As a graduate student, you are expected to look up medical objectives and required medical information that you do not know or are less familiar, as you will be taking care of pts. To prepare for and participate in periodic site visits. It is the student's responsibility to be ready for a site visit at any time after the start of the 2nd week of the rotation to present a case and a SOAP note, if requested by the faculty. To prepare for and participate in Exam Master, Clinical Problem Solving (CPS), OSCE (Objective Structured Clinical Exams), End of Rotation seminars and/or Comprehensive Subject Exams (CSEs) for each rotation. To prepare for observed subject clinical exams (OSCEs) that will be administered on or before the end of rotation seminar (EOR) in the clinical year. To attend all EOR events for each rotation. Failure to attend an EOR is reason for referral to the CSP, unless there are extenuating circumstances and the student has received prior approval from the Clinical Director and Program Director. To schedule adequate time for reading, studying, preparing for the PANCE exam, and completing all required tasks. To keep all lines of communication open between yourself, your family, your support groups, your preceptor, and the program. Students are required to maintain availability of housing in the Orlando area throughout their clinical year -even if they are at a distant clinical site. Requests will be taken for preferences of rotations as available in surrounding counties; however, it is unlikely that all rotations will be able to be provided in surrounding counties so maintaining Orlando housing availability is essential. Additionally, it is entirely possible that each student will be placed in one or more rotations with University-approved housing in one of the identified medically underserved areas. It is the student's responsibility to make arrangements in advance for pets or other personal obligations.

Mission Failure: relationship/fraternization**

Failure to comply with relationship/fraternization policies will result in immediate referral to the CSP, with disciplinary actions up to and including dismissal from the program. As a graduate student, you are expected to look up medical objectives and required medical information that you do not know or are less familiar, as you will be taking care of patients.

Rotation Grading: For rotations 1-8

For rotations 1-8, the written exam at EOR and the Preceptor Evaluation each make up 50% of the students' final rotation grades. All other rotation assignments will be Pass/Fail. Late assignments are subject to a penalty of up to 5 points off the final rotation grade per late assignment. Course grade for Core Rotations 1-8 is calculated as follows (pic) ⋆Everything else is Pass/Fail ⋆Late assignments are subject to a penalty of up to 5 points off the final rotation grade per late assignment.

Additional Clinical Year Assignments

In addition to the weekly assignments above, there are other assignments and evaluations the students must complete during the clinical year. These assignments have been created to meet accreditation standards, which are designed to ensure student preparedness to graduate and enter clinical practice.

Mission Critical Information:Hybrid Elective Rotation

In the event that a Hybrid Elective Rotation course is required, either the Selective Rotation or Clinical Elective Rotation are the courses that are typically replaced. If the Clinical Elective Rotation is replaced, the student will lose their option to complete an out of territory/state clinical rotation, even if the change is through no fault of their own.

Mission Critical Information: Signed Preceptor Assignments

Of all the assignments due during clinical rotations, four of them require a preceptor signature to be considered complete: ⋆Rotation Schedule ⋆Mid-Rotation Student Self-Evaluation ⋆Attendance Sheet Preceptor Evaluation of Student

Personal Expenses

Parking/Travel ⋆Students are responsible for all parking and travel costs incurred during the clinical year. This also applies when students are sent to distant clinical rotation sites. Meals Some sites may provide meals at their own discretion. The Program does not require nor request that any site provide meals. The Program does not provide meals to students

Parking/Travel

Students are responsible for all parking and travel costs incurred during the clinical year. This also applies when students are sent to distant clinical rotation sites.

Meals

Some sites may provide meals at their own discretion. The Program does not require nor request that any site provide meals. The Program does not provide meals to students

Mission Critical Information: Clinical Director

THE CLINICAL DIRECTOR RESERVES THE RIGHT TO MAKE REVISIONS TO THE CLINCIAL YEAR HANDBOOK AT ANY TIME WITH APPROVAL OF THE CURRICULUM COMMITTEE. CHANGES WILL BE GIVEN TO ALL STUDENTS IN WRITING.

Mission Critical Information:Student Exposures/Incidents**

Ultimately, the student is responsible for initiating care after exposure. All costs incurred from an accident or exposure are the sole responsibility of the student.

Mission failure: username documentation **

Under no circumstance must a student document in the electronic medical record under someone else's username. This is an ethical violation, and such acts will be strongly apprehended. Offending students will be required to appear before the Committee on Student Progress.

Mission failure: student employee**

Under no circumstance shall the student act as an employee or an administrator of the site. (This is not the same thing as performing medically-related activities)

ITEM # 1 - Clinical Rotation Failures

When a student fails a clinical rotation, the student will be referred to the CSP for review.

What is your most valuable tool for surviving the clinical year?

a positive attitude on each of your 9 clinical experiences

PANCE

A graduate's first opportunity to take the PANCE examination is seven days after program completion. The deadline is 180 days from the beginning of the exam timeframe to take the exam. These dates will be reflected in the student's exam application acknowledgement e-mail. A candidate may only take PANCE once in any 90-day, period or three times in a calendar year.

Failed Rotations

A failure of a single rotation by any of the above listed means will result in the student reporting to the Committee on Student Progress. Depending on the circumstances, the student may be dismissed or be allowed to repeat that rotation within the next term. In the case of a repeated rotation, graduation will be delayed to allow time for the student to successfully complete the required repeat rotation and additional tuition will be charged. After one rotation failure, the failure of another EOR exam will usually result in dismissal without another retest/remediation after referral to CSP. The Program Director makes the final decision pending the CSP recommendations.

Mission Critical Information: Failed Rotations

A failure of any rotation will result in referral to the Committee on Student Progress. Depending on the circumstances, the student may be dismissed or be allowed to repeat that rotation within the next term. In the case of a repeated rotation, graduation will be delayed to allow time for the student to successfully complete the required repeat rotation and additional tuition will be charged. After one rotation failure, the failure of another EOR exam will usually result in dismissal without another retest/remediation after referral to CSP.

NSU PA Orlando students on clinical rotation must not:

Be used as substitute employees on clinical rotations. Appear at the university or clinical sites under the influence of alcohol or drugs. Exhibit any behavior that may jeopardize the health and safety of patients, preceptors, faculty, or fellow students. In the event of the temporary absence of his/her assigned preceptor, the preceptor or his/her designee will identify an alternate qualified preceptor. At no time will the student work without having a preceptor clearly identified and present. Rotate at clinical sites where they have been an active patient within the last 6 months.

Insurance (Malpractice)

Malpractice Insurance - All clinical students are covered under Nova Southeastern University's professional liability policy while at scheduled rotations. It is expected that all incidents involving students and patients will be reported immediately by phone and in writing to the PA Orlando Program.

First Rotation failure + one EOR exam failure

1. A student who has already failed one rotation and then fails any subsequent EOR test without any documented significant extenuating circumstances may be recommended for dismissal. 2. If there are documented significant extenuating circumstances, the student may be recommended for dismissal or continued in the program under academic probation, as recommended by the CSP.

Second rotation failure:

1. If a student fails a repeated rotation for the second time and/or has a second rotation failure from a different rotation without any documented significant extenuating circumstances, the student may be most likely recommended for dismissal. 2. If there are documented significant extenuating circumstances, the student may be recommended for dismissal or continued in the program under academic probation as recommended by the CSP.

First rotation failure:

1. The student may be recommended for dismissal or allowed the opportunity to repeat the clinical rotation at the discretion of the clinical director as soon as a rotation becomes available and placed on academic probation which will be documented on the official transcript. 2. If allowed to repeat the rotation, the student will not graduate with the class. The student may be allowed to walk at graduation with the class. The student's time in the program will be extended for the duration of the added rotation. The rotation shall not replace the required electives. Associated additional tuition for the rotation will be required. The student will graduate if the repeated rotation is successfully completed.

First Referral to CSP - First EOR Written Test Failure:

1. The student will be required to come to the Committee on Student Progress (CSP) and will be allowed one opportunity to retest the clinical EOR written examination. The student will meet with their Academic Advisor and the Clinical Director for the plan of action (see form). It is the student's responsibility to meet with the appropriate faculty members. 2. If the student successfully passes the retest, the rotation will be noted as passed with the highest retest grade as 75%. The student will proceed with the program on in-house academic warning unless there are documented significant extenuating circumstances for the student. 3. If the student fails to pass the retest, the student then fails the rotation and the policies as stated in Item #1 then apply.

Rotation grades

6-Week Core/Selective Site evaluation/Oral Case (if conducted) P/F EOR Seminar participation P/F Weekly Schedule P/F Exam Master® results P/F Mid- and End-of-Rotation Pt Encounters/Procedure Logs P/F Attendance Logs P/F Clinical Year Interactive Participation Modules P/F Written Case Reports (H&P/SOAP Notes, Admit Orders) P/F Preceptor Evaluation 50% EOR Written Examination 50% Total 100% 4-Week Clinical Elective Rotation Site evaluation/Oral Case (if conducted) P/F Rotation paperwork P/F Exam Master® results P/F Mid- and End-of-Rotation Patient Encounters/Procedure Logs P/F Attendance Logs P/F Preceptor Evaluation 40% OSCE Examination 30% Written Comprehensive Summative Exam 30% Total 100% Hybrid Clinical Elective (if used) Test Question Bank® Assignments (Exam Master, UWorld, etc.) P/F Clinical Trial Reviews P/F Case Study Assignments P/F Discussion Board Assignments P/F Patient Encounters/Procedure Logs P/F Virtual Patient Encounter Assignments (ShadowHealth, Aquifer, etc.) 40% OSCE Examination 30% Written Comprehensive Summative Exam 30% Total 100% Final rotation grades will be submitted as letter grades with values as follows: Alpha Grade Scale Percent A 4.00 94-100 A- 3.75 90-93.99 B+ 3.50 87-89.99 B 3.00 83-86.99 B- 2.75 80-82.99 C+ 2.50 77-79.99 C 2.00 75-76.99 F 0.00 0-74.99 The final rotation grades will be available at the end of the semester when they are submitted to the University Registrar and compiled into transcript form. If there is a discrepancy on the posted grade, the student is to notify the Clinical Director no later than one week after the previous EOR. As mentioned previously, all late or missing assignments are subject to a late penalty off the final rotation grade. Students must pass each component of their clinical rotation in order to successfully complete the rotation course and move on to the next rotation. A failing grade on any component of the rotation grade will result in referral to the Committee on Student Progress for further disciplinary action and possible rotation failure. Students may not move on to their next rotation without successfully completing their previous rotation.

Rotation Work Schedule

A completed work schedule must be filled out on the Rotation Work Schedule form by the student, stating the preceptor's expected hours they anticipate the student will work during the entire rotation. This should include a minimum of 36 hours per week, or as designated by the main clinical preceptor. This assignment must be signed by the MAIN preceptor or their designee to be considered complete. This assignment is graded as PASS/FAIL.

Leave of Absence

A leave of absence may be granted by the Program Director for extended illness or absence from a rotation. A student seeking a voluntary leave of absence must submit the request in writing to the Program Director and Clinical Director. The Program Director will determine and notify the student in writing whether a leave of absence will be granted and the conditions and time frame under which the student may return to school. In making this request, the student understands that he or she may not be eligible to return to the Program before the next academic year, and may, at the discretion of the Program Director and/or Dean, be required to repeat coursework previously taken if the leave of absence is for an extended period of time as defined by the department. On an individual basis, the Program Director will consider emergencies, special requests, and special issues arising that cause the student to request a leave of absence. All student requests are considered confidential and are treated as such by the faculty. Decisions made by the Program Director do not set a precedent for subsequent decisions.

Dismissal

A student may be dismissed from the PA Program at any time for academic or professional behavior reasons. Any student who is in jeopardy of dismissal from the program will be notified in writing to appear before the CSP. Once the issue is addressed, the committee will arrive at a decision and will present it to the Program Director for final action.

CSP Referral Criteria

A student may be referred to the Committee on Student Progress for academic or clinical performance deficiencies evidenced by any of the following items: 1. First or one EOR test failure. 2. One failure of a clinical rotation. 3. Two passed EOR written retests 4. Two failed Performance tests: includes any 2 SOAP notes, 2 Oral Case Presentations, 2 OSCEs, 2 Written Complete H&PE, or any combination of two of the above. 5. One rotation failure + one EOR exam failure 6. Any failed component of the Graduate Project 7. Any Discharge from a rotation by the Preceptor

Patient and Procedure Logging / Key Experience Measures (Benchmarks)

ARC-PA requires both the evaluation of students in the clinical setting and student patient encounter/procedure logs. The patient encounter log and the procedure log are collectively known as key experience measures, which are used to track student progress at meeting defined learning outcomes over the course of the year. The term 'benchmark' is used interchangeably with key experience measure. In addition to student evaluation, the patient encounter and procedure logs serve to aid the PA Program in evaluating the educational experience provided by a given clinical rotation site. The template for documenting these encounters and procedures is found electronically on eClas. The patient encounter log documents the quantity of patients seen for specific patient complaints and/or diagnoses and the student's/preceptor's level of participation in the encounter. This form also serves to help the student know how and in which direction to guide their self-study for the particular rotation in preparation for the Comprehensive Summative Exam. The procedure log is a summary recording of all the procedures the student performed while on the particular rotation during the clinical year. This documents the quantity of specific procedures encountered by the student during each rotation, the student's/preceptor's level of participation in the performance, and a rating of the student's technical ability, when appropriate. In addition, this form may aid the student in obtaining hospital privileges after graduation. This assignment is graded as PASS/FAIL. NOTE: At the end of the clinical year, each student is required to print out or electronically download and save at least two copies of their complete patient encounters and procedure logs for future documentation of their PA training. These logs will likely be required of the student for future applications to hospitals for privileges.

Documentation & Medicare Compliance

According to CMS guidelines, medical students have distinct limitations on what they may document on Medicare patients. Effective January 1, 2018, the guidelines are as follows: The Centers for Medicare and Medicaid Services (CMS) is revising the Medicare Claims Processing Manual, Chapter 12, Section 100.1.1, to update policy on Evaluation and Management (E/M) documentation to allow the teaching physician to verify in the medical record any student documentation of components of E/M services, rather than re-documenting the work. Students may document services in the medical record. However, the teaching physician must verify in the medical record all student documentation or findings, including history, physical exam and/or medical decision making. The teaching physician must personally perform (or re-perform) the physical exam and medical decision making activities of the E/M service being billed, but may verify any student documentation of them in the medical record, rather than re-documenting this work. Although Medicare has no absolute rules governing PA students and documentation, PA programs have previously been strongly advised by the American Academy of Physician Assistants (AAPA), Office of Federal Affairs, to heed the AAMC guidelines. In addition, the clinical Preceptor must always supervise and/or provide necessary components of a given service to the Medicare beneficiary. The NSU PAO Program will abide by these guidelines. - When a PA student is unable to document in a chart, the student is advised to document the patient encounter on a separate piece of paper so that the student can continue practicing their documentation skills and obtain feedback from the preceptor. In any clinical site, the preceptor reserves the right to have the student document on their own paper if they or the practice has established protocols in place or is not comfortable with the student writing/documenting on the clinics charts. - It is pertinent to follow the guidelines set by the institution regarding the use of personal username information. Under no circumstance must a student document in the electronic medical record under someone else's username. This is an ethical violation, and such acts will be strongly apprehended. Offending students will be required to appear before the Committee on Student Progress.

Exam Failure Notification

After each EOR exam is validated, if a student failed the exam, the student and their advisor will receive email notification regarding his/her academic performance on the exam. This notification must be reviewed and signed by the student, and the student must make an appointment to see both his/her academic advisor and the Course Director regarding the failure. This appointment is mandatory and must be made within two (2) school days from the notification date. The advisor will counsel the student accordingly and a PLAN of Action form will be completed. If the student qualifies for a retest, the student will be notified in writing of the date and time of the retest. Students who fail their EOR exam will not be allowed to present to their next rotation until they have successfully passed the retest and completed all requirements for passing the rotation.

Make Up Policy

All absences will be reviewed, and a determination will be made by the Clinical Director and Program administration about whether any further information is required or action taken. When possible, all time missed from rotation is to be made up (hour-for-hour) at the discretion of the preceptor. For time that cannot be made up at the clinical site, students will be responsible for completing additional assignments for each day missed of the rotation. This is in addition to the baseline requirements for each rotation, not in place of them. If more than 2 days are missed during a 6 week rotation, or 1 day during the 4 week rotation, the NSU PA Orlando Executive Team will consider the circumstances and determine if the student is eligible to move on to the next rotation or is required to repeat the rotation due to excessive absenteeism.

Academic Honesty

All students enrolled in the NSU Orlando PA Program are expected to follow the academic honesty policies and procedures in the University, College, and Program handbooks. The Dr. Pallavi Patel CHCS Student Handbook defines academic dishonesty as follows: 1. Cheating: intentionally using or attempting to use unauthorized materials, information, or study aids in any academic exercise 2. Fabrication: intentional and unauthorized falsification or invention of any information or citation in an academic exercise 3. Facilitating Academic Dishonesty: intentionally or knowingly helping or attempting to help another to violate any provision of this code 4. Plagiarism: the adoption or reproduction of ideas, words, or statements of another person as one's own without proper acknowledgment Faculty members, Directors, and/or Chairs, with reasonable cause to believe that a student has committed an act of academic dishonesty will refer that student to the Committee on Student Progress, whose recommendation will be forwarded to the Program/Department Chair. If the student appeals the decision of the Department Chair, the appeal must be in writing and submitted to the chair of the Academic Honesty Committee (AHC) within five business days (excluding holidays and weekends) after the date of receiving notification of the Department Chair's decision. For further information, please refer to the Dr. Pallavi Patel CHCS Academic Honesty Policy and Procedure section. Students who suspect another student of academic dishonesty are required to report the violation to a faculty member immediately, and may request to do so anonymously. Students who knowingly fail to report instances of academic dishonesty will be referred to CSP for further action.

Written Case Reports

All written assignments must be de-identified per HIPAA guidelines prior to submission to ensure patient confidentiality. The written case presentations (H&P notes, SOAP notes, and Surgical notes) will be graded based on provided rubrics. These assignments must be handwritten. Typed or other digital formats will not be accepted, and a Certificate of Authorship is required for all written assignments. Failure to include a Certificate of Authorship will result in a failing grade for this assignment, and will trigger a late penalty if not provided before the posted due date. The treatment and intervention sections of each case write-up must be supported by 3 reputable, evidence-based medicine journal references, written in AMA format (American Medical Association Manual of Style (11th ed.). Students who receive a failing grade (less than 80%) on their written assignment will be expected to meet with their advisor. The student will be given the opportunity to remediate their assignment and will receive an 80% for that portion of their rotation grade regardless of the grade on the second write up. If the second write up receives a failing grade, the student will be referred to the CSP, and may fail the clinical rotation course. This assignment is graded using standardized rubrics and counts towards the student's final rotation grade.

Failing Grades

An "F" will be given for any rotation in which the student fails to: - Achieve a 75% or greater for the cumulative rotation grade. - Achieve a passing grade on performance tests such as oral case presentations, written examinations, or OSCEs. - Complete a required H&P, SOAP note, or Surgical note (with or without remediation) - Participate in EOR seminar events. - Achieve a 75% or greater on the computerized Clinical Summative Evaluation (CSE) final exam (with or without remediation). - Demonstrate an acceptable level of maturity and professionalism. NOTE: If a preceptor requests a student to be removed from a rotation, the student will receive an automatic "F" for the rotation. A student may be removed by the preceptor calling the Clinical Director, by the preceptor asking the student to report to the Clinical Director, or a combination of both actions. Students who fail a rotation will be referred to the Committee on Student Progress for evaluation and determination of subsequent action,up to and including dismissal from the program.

Exam Review and Validation Process

An examination review is available to all students immediately upon completion of the exam in the computer lab only through the CANVAS system. In most cases, CANVAS allows students to review the questions answered incorrectly and to see the correct answer choice. Students will not have an opportunity to review their exams after leaving the testing lab. Once the exam validation has been completed, students may meet with their faculty advisor to discuss relevant topics to review concerning their individual performance on the exam. If the faculty advisor is not available, the student should request a meeting with the course director instead. The students are not to communicate with each other in any way regarding their exams. This includes both verbal and non-verbal communication. In addition, the students are forbidden to communicate with anyone (including the Clinical Director, the Clinical Support Coordinator(s), the Administrative Assistant, or their Faculty Advisor) that they have failed an examination until after the examination validation process. A formal exam review process is conducted immediately following completion of each exam. All high-miss questions and other questions with poor statistical metrics will be reviewed, and determinations regarding full or partial give backs of those questions will be determined during this time as per the academic policies of the program. Since there is a formal exam review process in place, students may not challenge any specific questions on an exam.

Mission Failure: unexcused absence**

Any absence not related to reasons on the previous slide, or inappropriately documented, will count as unexcused. Unexcused absences will result in referral the the CSP.

CSP Dismissal Criteria......

Any of the following is grounds for dismissal by the CSP: ⋆1 or more failures of a clinical rotation ⋆2 or more passed EOR retests ⋆2 or more failed performance tests which includes any 2 SOAP notes, 2 Written Complete H & PE, 2 Oral Case Presentations, 2 OSCEs, or any combination of two of the above. ⋆Any 1 rotation failure + 1 EOR exam failure

CSP Referral Criteria......

Any of the following is grounds for referral to the CSP: ⋆First or one EOR test failure ⋆One failure of a clinical rotation ⋆Two passed EOR written retests ⋆Two failed Performance tests: includes any 2 SOAP notes, 2 Oral Case Presentations, 2 OSCEs, 2 Written Complete H&PE, or any combination of two of the above. ⋆One rotation failure + one EOR exam failure ⋆Any failed component of the Graduate Project ⋆Any Discharge from a rotation by the Preceptor

Mission Critical Information

Any policies or unclear situations not addressed in the Clinical Year Handbook will fall under appropriate policies set by and contained within the Orlando Academic Student Handbook, or the Dr. Pallavi Patel College of Health Care Sciences Student Handbook.

GRADUATE PROJECT

Any student failing to complete any component of the Graduate Project will be required to come to the Committee on Student Progress. The Graduate Project will be handled as a clinical course/rotation and all CSP policies pertaining to a rotation failure will apply. Potential dismissal from the program can result due to student failure to complete and pass the Graduate Project. THE CLINICAL DIRECTOR RESERVES THE RIGHT TO MAKE REVISIONS TO THIS HANDBOOK AT ANY TIME WITH APPROVAL OF THE CURRICULUM COMMITTEE. CHANGES WILL BE GIVEN TO ALL STUDENTS IN WRITING.

Program Withdrawal

Any student wanting to withdraw from the NSU PAO Program must submit to the Program Director a statement in writing explaining in detail the reason for the withdrawal and expected plans, if any, to return. An exit interview with the Program Director will be required. A student who withdraws in "good standing" academically will be allowed to reapply to the program after an interview with the program administration without going through the full admissions process.

Housing

As a courtesy, the program provides housing at some rural clinic sites, which may or may not be utilized by students as they wish. This housing is for assigned STUDENTS ONLY. At times, male and female students may occupy separate rooms in the same housing. Pets of any kind are NOT allowed. The Program reserves the right to change housing assignments at any time. The housing sites should be cared for as you would your own home. Although the University provides cleaning services periodically, students are expected to thoroughly clean up before they leave. Students are to remove all personal items including clothes, food, beddings, and household goods from the apartment at the time of move-out. Whatever they brought into the unit, should be removed at the time of move-out. Windows should be closed and locked, and curtains/blinds kept open. All lights and water faucets should be turned off. Return unit keys to the leasing office and return exit surveys to Program Coordinators for review. Your mindset should be "leave it better than you found it." - All food in the fridge and freezer should be thrown away. o If it belongs to you, throw it away before you move out. o If it belongs to the other student(s) currently living there, they should throw it away before they move out. o If it doesn't belong to anyone currently living there, throw it away. If someone doesn't want it thrown away, it now belongs to them and they are responsible for discarding it when they move out. - All trash needs to be taken to the dumpsters before you move out and not left inside the apartment, in hallways, or in storage rooms (even if you are told it is for holding garbage). - Clean up any spills or messes you made before moving out. It is understood that other programs share these housing arrangements, but every student is expected to take the initiative and clean up before they move out. You will be responsible for any damages and all long distance phone calls. If the key to the house is lost or misplaced, the student is required to pay the full replacement fee. Any problems/concerns with the housing should be addressed with the Clinical Director. Failure to follow all housing guidelines may result in referral to the Committee on Student Progress, and/or a grade of "Fail" for the rotation Participation.

6-WEEK CLINICAL ROTATION ASSIGNMENT OVERVIEW

Assignments for weeks one through five are due no later than 11:59pm on the Friday of that week. Assignments for week six are due no later than 9:00am on the first day of EOR. At the week six End of Rotation (EOR) Seminar, the original copies of all weekly assignments (weeks one through six) must be submitted with a Clinical Year Student File Checklist form. This packet is due to the student's advisor no later than 9:00am on the first day of EOR. Week 1: Rotation schedule signed by the preceptor submitted to CANVAS. Week 2: No assignments due Week 3: -Mid-rotation self-evaluation/assessment signed by preceptor and submitted to CANVAS. - Mid-rotation key experience measures (benchmarks) submitted to CANVAS. Week 4 o Written assignment with Certificate of Authorship submitted to CANVAS. H&P (Internal Medicine, Family Medicine, and Pediatrics) Behavioral Health SOAP Note (Behavioral Health) SOAP (OB/GYN, Emergency Medicine, and Selective Rotations) Surgical Notes and Order Set (Surgery) Week 5: No assignments due Week 6 o End-of-rotation key experience measures (benchmarks) submitted to CANVAS. o Attendance sheet from eClas signed by the preceptor and submitted to CANVAS. o Student Evaluation of Clinical Site submitted to CANVAS. o Student Evaluation of Preceptor submitted to CANVAS. o Preceptor Evaluation of the Student signed by the primary preceptor and submitted to CANVAS. o Exam Master ® results (See separate document) submitted to CANVAS. o Written End of Rotation (EOR) exam (per the EOR schedule).

4-WEEK ELECTIVE ROTATION ASSIGNMENT OVERVIEW

Assignments for weeks one through three are due no later than 11:59pm on the Friday of that week. Assignments for week four are due no later than 9:00am on the Wednesday of that week. Typically, there is no End of Rotation Seminar for the 4-week Clinical Elective Rotation, so the EOR packet is due to the student's advisor on the Wednesday of week 4. This is also currently the only rotation where students may submit their EOR packet digitally, rather than as original documents. As with the 6-week End of Rotation (EOR) Seminar, the packet must be submitted with a Clinical Year Student File Checklist form. This packet is due to the student's advisor no later than 9:00am on the Wednesday of week 4. Week 1: Rotation schedule signed by the preceptor submitted to CANVAS. Week 2 o Mid-rotation self-evaluation/assessment signed by preceptor and submitted to CANVAS. o Mid-rotation key experience measures (benchmarks) submitted to CANVAS. Week 3: No assignments due Week 4 o End-of-rotation key experience measures (benchmarks) submitted to CANVAS. o Attendance sheet from eClas signed by the preceptor and submitted to CANVAS. o Student Evaluation of Clinical Site submitted to CANVAS. o Student Evaluation of Preceptor submitted to CANVAS. o Preceptor Evaluation of the Student signed by the primary preceptor and submitted to CANVAS. o Exam Master ® results (See separate document) submitted to CANVAS. o Written End of Rotation (EOR) exam (per the EOR schedule). Under usual circumstances, there are no written assignments and no written End of Rotation exams for the 4-week Clinical Elective Rotation. All other rotation paperwork should be completed as normal unless otherwise directed by the Clinical Team.

Commencement

Attendance at Commencement is mandatory per the policies of the Health Professions Division. If a student needs to be excused from graduation, they will need to obtain permission from the Dean of PA Education. The University Registrar's Office coordinates all NSU commencement exercises, processes degree applications, and distributes diplomas. Additional information is available online at www.nova.edu/commencement. To obtain information about hotel accommodations and travel please refer to the following link: http://www.nova.edu/travel/hotels.html

Commencement...

Attendance policy

Attendance

Attendance at all clinical rotation activities are required. Students are expected to follow reporting instructions and to notify the program of any errors or changes in their anticipated schedule. Students must notify the Clinical Director of how they may be reached during regular office hours and of any permanent or temporary mailing address or phone number change, to include an emergency contact and functional cellular number. College holidays do not apply in the clinical year. Preceptors are not obligated to give the student days off on weekdays or weekends. It is not appropriate and against clinical year policy for students to give the preceptor which days they are requesting off at the start of the rotation. It is respectful and professional to adhere to the preceptor requirements for the rotation. Remember, the more time a student spends at the site, the more opportunity there is for learning to take place. (ALSO SEE PA STUDENT ROLES AND EXPECTATIONS).

EOR Exam Absence

Attendance at all testing is mandatory. If an emergency arises, you must notify the Clinical Director as soon as possible. If the emergency arises after usual business hours you should leave a voice mail message on the Clinical Director's voice mail (407) 264-5158 and/or the Program Director (407) 264-5151. If a student is absent for an exam, the students' circumstances will be considered by the Physician Assistant Program administration and either a makeup exam will be arranged or the student will receive a zero, be given a retest, and referred to the CSP. The highest grade possible for this retest examination will be a 75%. Students must provide objective documentation for any absence. If an emergency requires evacuation of the testing room, the student must leave ALL exam material at his or her testing station and quietly and quickly leave the exam room. Arrangements to continue the exam, makeup the exam, or retest will be made based upon the situation and availability of a testing site.

Mission Failure: Pets**

Bringing pets to student housing can cause the University to incur fines and potentially lose their affiliation agreement with those housing sites. As a result: Students who bring pets and/or service animals to student housing without prior University approval will be referred to the Committee on Student Progress for further action.

Equipment

COPIES Handouts are posted on CANVAS for each student to print on their own, if desired. The departmental copier is not for student use. E-MAIL University e-mail communication will be conducted only via your NSU email address. Students must check their e-mail every day for important clinical year updates. Emails to students that require a response or action should be completed within 24 hours of the request. FAX MACHINE The NSU PAO program's fax machine is not available for general public/student use. Evaluations will not be faxed to your clinical site. TELEPHONES Students are not allowed to use departmental office phones. No personal phone calls, local, or long distance calls are allowed. CELL PHONES If you use a cellular phone, you are expected to use it in a discreet manner and observe and respect students, faculty, staff, patients, and any others when using the equipment. Telephone ringers can be very distracting, and most classroom, office, and patient situations require instruments to be silenced or not brought into the area at all. Please limit your cell phone usage to only researching relevant information during clinical rotations. Most clinical preceptors do not appreciate students using cell phones during clinical hours.

Student Responsibilities to the PA Program

Complete all required clinical prerequisites detailed later in this handbook. To attend all rotations as scheduled. To IMMEDIATELY notify the program of any problems as they occur. To complete all required tasks, including paperwork for each rotation, in the time frame that is required, or be subject to a late penalty on assignments. To prepare for and participate in periodic site visits. To prepare for and participate in Exam Master, Clinical Problem Solving (CPS), OSCE (Objective Structured Clinical Exams), End of Rotation seminars and/or Comprehensive Subject Exams (CSEs) for each rotation. To attend all EOR events for each rotation. To keep all lines of communication open between yourself, your family, your support groups, your preceptor, and the program. Students are required to maintain availability of housing in the Orlando area throughout their clinical year—even if they are at a distant clinical site. Students will be responsible for maintaining and updating their curriculum vitae (CV) after each rotation. Students will be required to contact their next rotation 2 weeks in advance to confirm reporting instructions, and are to provide the new preceptor with their CV in that correspondence

Scheduling Rotations

Considerable time and effort have go into planning and arranging the rotation schedule for students over the course of a clinical year, with special consideration given to the needs of the student, faculty, Program, and clinical rotation sites/preceptors. The NSU PA Program of Orlando adheres to its assignments and schedule after distribution to the students prior to the start of the clinical year and before each subsequent semester, and, in the case of elective rotation, after confirmation with the clinical preceptor/site chosen. Because changes create problems and a burden for everyone involved, the PA Program does not routinely allow changes to scheduled rotations throughout the clinical year. In the case of exceptional circumstances, however, changes may be made at the discretion of the clinical team or Program Director. These changes may be necessary for many reasons, including preceptor schedule changes, program scheduling difficulties, student request, natural and manmade disasters, or Program discretion. In the event the change of schedule is not due to student request (most often, due to site constraints), as much advance notice as possible will be given to the student and comparable experiences will be assigned, when possible. Once the clinical director has approved a change, the change is enacted and cannot subsequently be revoked by the student. Please note that while students may request a rotation change, the Program is under no obligation to comply with the request unless there are legitimate safety concerns. Students may be allowed to re-visit a rotation site or specialty along the course of the clinical year curing their Clinical Elective Rotation only, and with the same Elective limitations as mentioned previously in this document. A student is not allowed to re-visit a rotation or specialty more than one time. The Clinical Director reserves the right to choose a rotation for a student to accomplish during the clinical year. The designation of a site may be reserved for students who demonstrate academic or clinical deficits in a particular specialty. The deficits may be cited via failure of end of rotation examinations, preceptor evaluations, personality conflicts that inhibit the student's learning experience at the site, or lack of patient encounter or patient procedure logging in the eClas system.

General Behavior & Attitude

Discretion and professional behavior are required; student interactions must be courteous and respectful at all times. Students who fail to demonstrate an acceptable level of maturity and professionalism may receive a failing grade for the rotation, and may be dismissed from the Program. Students must be appropriately responsive to lawful requests from their instructors, preceptors, and clinical sites. Students should offer criticism or suggestions in a thoughtful and reasonable manner that fosters respect and trust. While on rotations, students should be prepared to discuss the history of the PA profession, explain how PAs function within the medical community, and the role of the PA student with patients, preceptor, and other personnel at the site(s). On clinical rotations, students gain from their experiences in direct proportion to the effort they put forth. PA students are expected to function at the level of a fourth-year medical student. In this role, it is recommended that the student take advantage of all learning opportunities. Students cannot act as regular office staff, and at no time may students be considered or represented by themselves or their site as employees of the facility at which they are rotating. While on rotations, students should actively look for learning opportunities, and seek knowledge through questioning, patient care, and outside reading. Report early, stay late, volunteer for call, and know the patients well. Observation alone is rarely sufficient. Students are expected to be active participants in patient care, which may include (but not be limited to) examining patients, writing in medical records, computer patient chart involvement, performing and assisting in medical procedures, presenting patients, formulating differential diagnoses, ordering and interpreting labs and other diagnostic exams, formulating treatment plans, and acting as members of a patient-centered health care team. Students must present every patient to their preceptor or designee prior to the implementation of any final diagnostic or therapeutic plan. All chart entries and orders must be countersigned by the preceptor immediately. Students may not care for or discharge patients independently. Professionalism is also assessed with student behaviors when not actively at the clinical site. Conduct in the community, including adherence to local and regional laws, treatment of student housing, and conduct in public areas reflect on the student, the Program, and the University. A student deemed to be acting unprofessionally in any setting during the clinical year will be referred to the Committee on Student Progress. Unprofessional conduct may result in failure of the clinical rotation, delay of graduation, and/or dismissal from the Program.

Religious Observations

During the clinical phase, if the schedule of patient care conflicts with the student's religious observances, after notification to the Clinical Director, the student should arrange with the Preceptor and the Clinical Director how to make up the missed time. The nature of clinical training is to prepare the student to assume responsibility for patient care, and this is critical to student's clinical training. Only major religious holidays/observations will be considered for absence purposes.

Operative Notes and Admission Orders

During the hospital-based rotations of SURGERY, students will be required to submit a multi-part Operative Note (Pre-, Intra-, and Post-Op Orders, with Admission Orders) on a patient requiring admission to the hospital.

End-of-Rotation Seminar (EOR)

EOR events are usually scheduled to take place the last two to three days of the clinical rotation. A schedule of events will be provided by the Clinical Director, but the schedule is subject to change at any time with notice. Attendance at all sessions of the end of rotation seminar is mandatory in order to progress to the next rotation. Failure to attend the EOR seminar in its entirety may result in automatic failure of the rotation and referral to CSP.

End of Rotation Preceptor Evaluation of Student

Each clinical site has a preceptor responsible for the rotation and the evaluation of the student. The preceptor evaluates the student based on regular observation and review of clinical performance. Other staff members as designated by the preceptor, who have worked a minimum of 5 (five) days with the student, may be consulted for evaluation input or to submit an evaluation. Evaluations from multiple preceptors who meet this requirement will be averaged. Evaluations may be randomly selected each month for verification of authenticity; preceptors will be contacted to discuss the student's performance, grade, and appropriateness of other evaluators. Actions by students aimed at falsifying or inflating evaluations will be treated as academic dishonesty according to the Dr. Pallavi Patel CHCS Student Handbook. Fraudulent activity will result in referral to the CSP with consideration for possible dismissal from the Orlando PA Program. Students are responsible for obtaining and ensuring return of the evaluations. The level of clinical competency will be assessed in areas such as medical knowledge, history taking, performing physical exams, medical record keeping, problem solving, interpersonal skills, and professionalism. Evaluations should consider the student with respect to other students at the same level of training. Evaluation is essential to identifying learning difficulties and performance deficiencies. Mid- and end-of-rotation evaluations are required, and feedback regarding student performance should be given on an on-going basis. The preceptor evaluation of the student will be recorded on a rotation evaluation form provided by the PA department. This form is available on eClas. This assignment is graded using a scaled rubric, which counts towards the student's final rotation grade.

Mission Failure: Dress code**

Each clinical site may have additional dress code policies and procedures. Program faculty and preceptors have the right to prohibit a student from patient care activities if his/her appearance does not meet the dress code standards. Inappropriately dressed students will be asked to leave the rotation site and/or campus and will receive an unexcused absence until they return properly attired. In addition, the missed clinical time will need to be made up.

Student Evaluation of Preceptor and Clinical Site

Each student must provide accurate and prompt feedback on their clinical experiences, and will do so for both the clinical site and their clinical preceptor(s). These evaluations are important to the continued success of each clinical rotation and give important feedback to the PA clinical year program as well as the site. It is important to give feedback on the course as a whole, not only the educational value, but the organization, logistics, and overall experience with both the site and the Orlando PA program. The clinical site evaluation is completed using the Student Evaluation of Clinical Rotation form, and the preceptor evaluation is completed using the Student End of Rotation Evaluation of Preceptor form, both found electronically on eClas. This assignment is graded as PASS/FAIL.

Attendance Sheet

Each student must submit their Duty Hours Attendance Sheet, signed by the MAIN preceptor or their designee to be considered complete. The schedule and student attendance are evaluated to assure the proper amount of experience and hours to award credit for each rotation. The template for documenting these hours is found electronically on eClas. If a student must miss a day of their clinical rotation, he or she is required to submit a Student Absence form as soon as the situation is known or as soon as possible after an untoward event. STUDENTS ARE REQUIRED TO MAKE UP EVERY HOUR MISSED BEFORE THE END OF THE ROTATION. This assignment is graded as PASS/FAIL.

Medical Mission Trips

Each year, the NSU Orlando PA Program makes available to current students the opportunity to participate in a medical mission trip, such as prior trips to Guatemala and Puerto Rico. These trips afford students in good standing an opportunity to practice their skills in a supervised, international setting. Only trips offered by the NSU PA Orlando Program will be permitted. - Accepted forms of documentation: Official confirmation letter (on letterhead) from the organizing body/persons verifying your attendance, or verification in writing from accompanying faculty (Puerto Rico) that you attended.

Rotation Grading: 4-Week Clinical Elective Rotation

Everything else is Pass/Fail Late assignments are subject to a penalty of up to 5 points off the final rotation grade per late assignment.

Rotation Grading: Hybrid Elective Rotation

Everything else is Pass/Fail Late assignments are subject to a penalty of up to 5 points off the final rotation grade per late assignment. Grading for the Hybrid Elective Rotation is as follows: ⋆Virtual/Simulation 40% ⋆OSCE Examination 30% ⋆Summative Exam 30% Everything else is Pass/Fail Late assignments are subject to a penalty of up to 5 points off the final rotation grade per late assignment.

Exam Master® Score Report Submission

Exam Master® score reports are to be timed tests (test mode) only, and follow the assignment guide below, based upon which rotation the student is currently completing (look at pic) The tests created should cover the objectives, topics, and subject matters related to the current medical area of the student's current rotation. Tests taken while on electives should be covering areas of weakness or a cross-section of medicine. The number of questions listed is the minimum number of questions in each exam. A smaller number of questions over multiple exams will not be accepted for this assignment. When there are not enough questions of a given specialty to complete an assignment, the student should supplement the remainder of questions from areas in which their performance is weaker. Endurance tests are optional, but are designed to help students build up the mental endurance they will need to complete the PANCE exam after graduation. While there is no requirement for students to complete and submit endurance tests, they are strongly encouraged to do so as a part of their own, self-paced Board preparation during the clinical year.

Mission failure: preceptor dismissal**

Failure to be professional and respectful after being assigned to a rotation site can be automatic grounds for dismissal from the rotation and/or the program, depending on the infraction. If the preceptor dismisses a student for any reason, then that student will fail the rotation. If a preceptor requests that a student be removed from a site, the student will automatically receive a score of zero "0" for the preceptor evaluation and fail the rotation. The student will be placed on a leave of absence for the remainder of the rotation time and report immediately to the Clinical Director. An appearance to the Committee on Student Progress will also be required. Depending on the circumstances, the student may be dismissed from the Program or required to repeat the rotation at a later date, resulting in a delayed graduation date and additional tuition.

Mission Failure: student paperwork**

Failure to submit any required assignments during the clinical year may result in referral to the CSP. Students will not be allowed to progress to the next rotation until all paperwork from the current rotation has been submitted.

Falsification of Records

Falsification of records is prohibited. Any act or statement containing false, incomplete, or misleading information intended to deceive or misrepresent any institution, person, business, or university is prohibited. Such actions of fraud will lead to immediate dismissal from the NSU PAO Program.

Insurance (Health)

Health Insurance - Because the Health Professions Division is concerned for the health and welfare of its students, student health insurance is required. Students must maintain a valid health insurance policy throughout their course of study in the program. Failure to maintain a valid insurance policy will result in the student being removed from clinical rotations until proof of compliance with this policy is provided. Any costs incurred through illness and/or hospitalizations during attendance at the PA Program are the sole responsibility of the student. If students have questions about the student health insurance plan at NSU, students may contact the student health manager at (954) 262-1263 or 800-922-3420 or www.collegiaterisk.com. If the student maintains comparable coverage that is greater or equal to that of NSU's policy, the student must complete the online waiver form available on the student medical center Web site at: www.nova.edu/smc under "Health Insurance."

Student housing

Housing is provided as a courtesy, but is not guaranteed for all clinical rotations. This housing is for assigned STUDENTS ONLY. At times, male and female students may occupy separate rooms in the same housing. Care for housing sites better than you would care for your own home. ⋆Students are expected to thoroughly clean up before they leave. ⋆All items brought into the unit should be removed at the time of move-out. - This includes clothes, food, beddings, and household goods. ⋆Windows should be closed and locked, and curtains/blinds kept open. ⋆All lights and water faucets should be turned off. ⋆Return unit keys to the leasing office and return exit surveys to Program Coordinators for review. You will be responsible for any damages and all long distance phone calls. If the key to the house is lost or misplaced, the student is required to pay the full replacement fee.

In certain circumstances, it may be necessary for the Program to place students into what kind of rotation?

Hybrid Elective Rotation a hybrid course during one or more of their clinical experiences. This is typically due to extenuating circumstances, and may or may not be used for individual students, or all students in a given cohort. In the event that this is necessary, the Hybrid Elective Rotation will take the place of another clinical year rotation, to be determined by the Program. The Hybrid Elective Rotation may be a blend of clinical and virtual educational experiences. The exact makeup of a given student's Hybrid Elective Rotation will vary based upon the events that triggered the need to use the course. Assignments for the Hybrid Elective Rotation may consist of any combination of the following: -Test bank practice questions, such as Exam Master, UWorld, or comparable software -Writing assignments, such as case studies, clinical trial reviews, and discussion board post -Clinical experiences -Simulated or virtual pt experiences -On-campus activities -Lectures, either in person or via a teleconferencing platform -Other activities as assigned by the Program

Mission Failure: preceptor student removal***

If a preceptor requests a student to be removed from a rotation, the student will receive an automatic "F" for the rotation. Students who fail a rotation will be referred to the Committee on Student Progress for evaluation and determination of subsequent action, up to and including dismissal from the program.

Removal from a Clinical Rotation

If a preceptor requests that a student be removed from a site, the student will automatically receive a score of zero "0" for the preceptor evaluation and fail the rotation. The student will be placed on a leave of absence for the remainder of the rotation time and report immediately to the Clinical Director. An appearance to the Committee on Student Progress will also be required. Depending on the circumstances, the student may be dismissed from the Program or required to repeat the rotation at a later date, resulting in a delayed graduation date and additional tuition. If there are issues interfering with the student's education, the student is responsible for discussing the matter with the Clinical Director, Program Director, Medical Director, or Faculty Advisor immediately. The Clinical Director and Administration will review the reason for the Program removing a student from a clinical site on a case-by-case basis.

Accident Reporting and Medical Care....

If a student believes he/she has had an exposure, the student must: Report all exposures and incidents (including needle sticks or mucous membrane exposure) ⋆To the clinical site and the supervising clinical preceptor immediately. ⋆To the PA Program and Clinical Director as soon as possible.. Comply with all accident and injury protocols established at the clinical site. ●While there is no guarantee or requirement for such, most of the clinical sites utilized by the NSU Physician Assistant Program can and will arrange for immediate care of students in the event of accidental injury without charge to the student, accepting assignment of the student's insurance. They will not, as a rule, take responsibility for subsequent costs involved in follow-up care, treatment, counseling, hospitalization or preventive care. ●In any situation involving the potential for exposure to blood or potentially infectious materials, you should always use Universal Precautions and try to minimize your exposure by wearing gloves, splash goggles, pocket mouth-to-mouth resuscitation masks, and other barrier devices.

Exam Failure and Retest

If a student fails to demonstrate the required competencies for a specific exam or rotation, the will be notified in writing as above and offered a remediation exam, if eligible per the Clinical Year CSP algorithm. If the student passes the remediation exam, the maximum score they can receive on the retest is 75%, regardless of performance. If the student fails the remediation exam, they will automatically fail the rotation course and be referred to CSP for further action

Illness or Injury (Medical Emergencies)

If a student needs extended time off for a personal or first-degree relative family illness or injury, documentation of the need must be provided by a licensed health care provider to the Program Director. For extended absences greater than 2 days, once the student is ready to resume the Program, documentation must be provided by the licensed health care provider that states the student is capable of returning to full program activities. - Accepted forms of documentation: Official "Provider's note" from your healthcare provider confirming your attendance at the appointment. o The note should not include any information about your medical history. o Your clinical preceptor may not be the person providing the medical excuse note. First degree family members are defined as someone's spouse, parents, grandparents, children, grandchildren, brothers, sisters, and the "-in-law", adopted, half-, and step- equivalent of these.

Mission Failure: days off**

If more than 2 days are missed during a 6 week rotation, or 1 day during the 4 week rotation, the NSU PA Orlando Executive Team will consider the circumstances and determine if the student is eligible to move on to the next rotation or is required to repeat the rotation due to excessive absenteeism.

At Risk Students

If the clinical rotation poses a known, potential personal risk to the student or if the student is pregnant, the unborn child, Clinical Director will review the potential risk with the student. If the student chooses to discontinue an assigned rotation based on potential risk for the student, the student should provide the Clinical Director with a written statement from a treating physician that details the reasons for the leave. A leave of absence, if granted, may delay graduation. 1) If a student is informed as to a potential risk and decides to continue the internship, they must provide: a. A written statement from the student's treating physician containing recommendations and stating any restrictions affecting delivery of physical therapy services by the student to patients. b. Restrictions that may preclude or substantially limit patient care activities may result in the student being terminated from the internship. c. Resumption of the internship will require a physician's clearance of the student to resume all required activities (without restrictions) and will be rescheduled based on clinic availability. d. In cases of pregnancy, a written Informed Consent signed by a spouse may also be required. 2) Students exposed to an infectious disease, for which they have not been immunized, will immediately inform the Clinical Director. The student will be responsible for the medical expenses. Depending on the test results the student may be required to withdraw from the course or program, make up time, or require a rescheduled or an added clinical rotation experience which may delay graduation. 3)Students who sustain any injury, illness, or debilitating condition, during a rotation (at the clinic or at home) may endanger the safety of patients, themselves, and others, and may not return to the clinic until medically cleared. Written medical clearance must indicate that the student is able to participate in all skills; direct and indirect, without any potential for endangering themselves, patients, or others. 4) Students are required to immediately notify the Clinical Director and the Program Director or the Department Chair, of any changes in their physical condition that can potentially affect judgment and safe performance that may endanger patients, themselves, or an unborn child.

Absence Procedure...

If the student must miss time from a rotation, all of the following must be completed by the student: ⋆The Preceptor, the student's Faculty Advisor, and the Clinical Team must be notified as soon as possible and no later than 9:00 AM on the day of the absence. - For non-traditional shifts, such as like emergency medicine, obstetrics, or on call, the student must notify the above parties no later than 1 hour before the shift starts. - If the appropriate party cannot be reached, then you must leave a message regarding your absence and a number where you can be reached. The student must complete and submit the Student Clinical Absence form with all relevant documentation within 24 hours of returning to the clinical site. To be considered complete, the documentation must include: ⋆NSU PA absence form (with both preceptor and student signatures) ⋆Official documentation for the absence is required (detailed in the Clinical Year Handbook). The original documentation must be included in the student's EOR packet and submitted on the first day of EOR.

In certain cases, why hybrid course?

In certain circumstances, it may be necessary for the Program to place students into a hybrid course during one or more of their clinical experiences. This is typically due to extenuating circumstances, and may or may not be used for individual students, or all students in a given cohort. In the event that this is necessary, the Hybrid Elective Rotation will take the place of another clinical year rotation, to be determined by the Program. The Hybrid Elective Rotation may be a blend of clinical and virtual educational experiences. The exact makeup of a given student's Hybrid Elective Rotation will vary based upon the events that triggered the need to use the course. Assignments for the Hybrid Elective Rotation may consist of any combination of the following: ⋆Test bank practice questions, such as Exam Master, UWorld, or comparable software ⋆Writing assignments, such as case studies, clinical trial reviews, and discussion board post ⋆Clinical experiences ⋆Simulated or virtual patient experiences ⋆On-campus activities ⋆Lectures, either in person or via a teleconferencing platform ⋆Other activities as assigned by the Program

Prerequisites for Clinical Rotations

In order for a student to participate in clinical rotations, the student must meet standard requirements. Students may not attend a clinical site rotation until the requirements of the previous rotation have been met. Prerequisites for clinical rotations include: Successful completion of all didactic course work, and signed recommendation to proceed to the clinical phase II. Incomplete grades are not acceptable. Minimum cumulative GPA of 2.5 (or numerical average of 75 or greater) prior to beginning rotations. Minimum cumulative GPA of 2.5 (or numerical average of 75 or greater) has to be maintained while on clinical rotations. Registration for the clinical rotations at the beginning of the semester. Physical examination documenting the student is in good physical and mental health. Maintain a valid health insurance policy. Failure to maintain a valid health insurance policy during the clinical year will result in the student being removed from rotations until proof of compliance is submitted. Provide an annual update and recertification relating to any convictions, guilty pleas, or no contest pleas prior to the start of the rotation. Completion of all required immunizations and testing (MMR, Varicella, Polio, Td/Tdap, Hepatitis B series, PPD with or without chest x-ray as indicated), maintenance of yearly TB testing while on rotation, and drug screening as requested. The student is responsible for maintaining their personal immunization record, and it is recommended that the student carry this record with them to their site on the first day of each rotation. Serum titers for immunization proof are acceptable in some cases. Although the annual influenza vaccine is not required by Nova Southeastern University, several hospitals require that the student obtain an influenza vaccine in order to participate in patient care activities with their institution. The influenza vaccine will be at the student's expense. Failure to demonstrate an up-to-date immunization status on request will result in removal from the rotation until proper proof of "current" immunization status is presented. Current American Heart Association CPR (Healthcare Provider), ACLS, and PALS certifications. Maintain evidence of training on Universal Precautions and HIPAA training provided by the Program. Must pass the criminal background check. Maintain a functional cell phone and NSU email and have the ability to videoconference via NSU-approved videoconference service. All program communication will be directed to the student's NSU email account. Students are required to check NSU email accounts daily while on clinical rotations. All email requests must be responded to within 24 hours to the Clinical Director or the faculty and staff.

Comprehensive Summative Exam (CSE)

In preparation for the PANCE, and as part of a comprehensive, multi-faceted evaluation of the student's progress during the clinical year, the student will take a one hour and forty minute computerized Comprehensive Summary Examination, consisting of 100 Board-style questions prior to the completion of the clinical year. This exam is calculated as a significant portion of the final rotation grade for the PAO 6401 Clinical Elective Rotation, and may be given at any point during the final 4 months of the clinical year. The student must achieve a minimum score of 75% to pass the exam. Failure to do so will result in a meeting with their academic advisor and the Clinical Director to discuss the remediation process, as well as a referral to the CSP. To be eligible for graduation with the class, a remediation exam must be taken and passed with a 75% or greater. A maximum grade of 75% will be recorded for the retest exam, regardless of actual performance on the retest. If the student fails to pass the retest exam, he/she will fail the rotation, and be referred to the CSP for further action and possible consideration of dismissal from the Program.

Inclement Weather Policy

In the State of Florida, hurricanes are prevalent during a significant portion of the year. Nova Southeastern University provides a 24-hour "Hurricane Hotline" for this type of emergency. The hotline number is (954) 262-7300. Local hurricane shelter information may be obtained through county governmental information telephone numbers. Students are expected to discuss the inclement weather policy for their assigned rotation site with their preceptor during orientation. Students are expected to follow the policies and procedures for their respective clinical site. Students may be required to call a specific telephone number to determine the clinical site's status. The hospital or clinic may be open, operating at a later time, or closed. If the clinic is operating on delayed time or closed, please notify the Clinical Director. Absences due to college or clinic closings do not have to be made up.

Concluding the Clinical Rotation

It is expected for the student to formally close the clinical rotation relationship by issuing a letter thanking the preceptor for their participation with the clinical rotation, and for the experiences during their time at the site.

Mission failure: student requesting days off**

It is not appropriate and against clinical year policy for a student to give the preceptor which days they are requesting off at the start of the rotation. It is inappropriate for a student to place personal demands/requests upon their availability to the preceptor at the site. The only exceptions are fulfillment of Program and University obligations (e.g. badging for an upcoming rotation).

Mission Failure: requesting days off**

It is not appropriate and against clinical year policy for students to give the preceptor which days they are requesting off at the start of the rotation.

Student Identification

It is the responsibility of the PA Student to identify himself/herself as a Physician Assistant Student from Nova Southeastern University to the clinical staff and the patients. A student must wear a white lab coat with the NSU PA Program badge on the left sleeve. In addition, the NSU Identification Badge must be worn at all times when at the clinical site, even if the clinical site issues their own identification badges.

Student Introduction

It is the responsibility of the student to contact the preceptor or their designee 2 weeks prior to the start date of the clinical rotation to verify the meeting time and place on the first day of training. The preceptor may offer general instructions such as parking or driving instructions and any other information that is related to the clinical institution. If the preceptor is no longer available or if the student has any questions or concerns, it is the student's responsibility to contact the Clinical Director. If the student is unable to reach the clinical site or preceptor within 1 week of the scheduled rotation start date, they are to notify the Clinical Team immediately.

All clinical year rotations are considered what?

MANDATORY, regardless of whether or not students have met their key experience measures (benchmarks). However, the order of the clinical rotations will vary with each student's assignment based on site and preceptor availability

Patient Confidentiality

Medical ethics forbids violation of patient confidentiality. The student and preceptor alike should be sensitive to this issue. Any discussion regarding a patient's diagnosis, care, and condition should be conducted with discretion and in a private setting. All current federal patient privacy protection rules by the Health Insurance Portability and Accountability Act (HIPAA) guidelines must be followed as per university policy. Students must adhere to the following guidelines with regards to (HIPAA) regulations: - Pt info should not be discussed where others can overhear the conversation such as hallways, elevators, water coolers, at home, or at social events. - Dictation of patient information should occur in places where others cannot hear the dictation. - Confidential papers, reports, or computer printouts should be kept in a safe and secure place. - Confidential papers should be picked up ASAP from copiers, mailboxes, or faxes. - Confidential papers should be appropriately disposed of by being shredded. - Accessing any information other than what is required to do your job is a violation of confidentiality policies. - It is the student's duty and responsibility to keep all health care information confidential. Students are not allowed to photocopy any portion of the patient's medical record or photograph a patient without the written permission from the clinical institution. - Computer passwords must not be written down or shared with anyone else. - You cannot use someone else's password to access an institution's or practice's computer system. Students will receive HIPAA training and certification in the classroom setting. Some hospital orientation sessions require a repeat HIPAA training session. The Orlando PA program also expects the student to remove any references to institutions or patients when providing information on an assignment. Any breach of confidentiality will result in a 0 (zero) for the assignment and referral to the CSP.

Other Special Considerations

Military Service A student called to serve in the military service must show their orders to the Program Director as soon as they are received. The student will be eligible for readmission after completing the required military service. If the duty is for a limited time, then the Program Director will evaluate the situation on a case-by-case basis. Pregnancy If a student becomes pregnant, she is advised to notify the Clinical Director as soon as possible. A medical provider's note is required giving permission to participate in clinical rotation training after each scheduled physician visit. If a student decides to remain in the Program, it is recommended that she evaluates the risk of exposure to infectious diseases and utilize safety precautions. Pregnant students have several options regarding their continuance in the Physician Assistant Program. The Program Director will discuss each option with the student so that she may make an informed decision. The options are as follows: 1. Continue in the clinical education, provided a medical provider's note indicating physical ability to participate in clinical settings has been submitted. A standard six-week maternity leave will be granted. The student must complete any missed assignments and time in the clinic. 2. Continue didactic courses that semester only. Students selecting this option must complete missed courses during the following academic year. 3. Leave the program and re-enter at the appropriate semester the following year.* * The student will need to demonstrate clinical competence and meet the requirements for readmission to the Program. Such requirements may be passing a written and/or oral examination, taking a comprehensive written exam, a practical exam and/or any other specific assignments requested by the PA Program Faculty. Funeral The student must notify the Clinical Director as soon as possible and make arrangements to make up missed coursework or rotation time.

Mission Failure: housing policies**

Missed clinical time as a result of failure to follow housing policies or report the need for or presence of service animals in a timely manner will result in CSP referral, as well as possible grade penalties and/or failure of clinical rotations.

Student Work Hrs

NSU Orlando PA Program follows the duty hour guidelines recommended by the Accreditation Council for Graduate Medical Education (ACGME). Clinical and educational work hours must be limited to no more than 80 hours per week, averaged over a four-week period, inclusive of all in-house clinical and educational activities, and clinical work done from home. In addition to these guidelines, NSU PA Orlando adds these additional requirements: ⋆A suitable work schedule will be determined by the preceptor or his/her agent and should include a minimum of 36 hours per week. ⋆Students should have at least one full day completely free from patient care responsibilities per a 7-day work week. ⋆No student is expected to be in the hospital or clinic setting more than 30 consecutive hours All Rotations: Days, nights, weekends, and holidays are expected to be worked on all rotations if scheduled by the preceptor or their designee. Emergency Medicine Rotation: Students should expect to work an average of 3-4 shifts (8-12 hours each) per full week of the emergency medicine core rotation (depending on the standard for the assigned site). For partial weeks, such as during EOR week, the student should work a minimum of 1-2 shifts. Surgery and Internal Medicine Rotations: Students should expect to work at least ten to twelve hours per day on their surgery and internal medicine rotations (not including call and weekends).

Student Work Hours

NSU Orlando PA Program follows the duty hour guidelines recommended by the Accreditation Council for Graduate Medical Education (ACGME). Clinical and educational work hours must be limited to no more than 80 hours per week, averaged over a four-week period, inclusive of all in-house clinical and educational activities, and clinical work done from home. In addition to these guidelines, NSU PA Orlando adds these additional requirements: - A suitable work schedule will be determined by the preceptor or his/her agent and should include a minimum of 36 hours per week. - Students should have at least one full day completely free from patient care responsibilities per a 7-day work week. - No student is expected to be in the hospital or clinic setting more than 30 consecutive hours. - All Rotations: Days, nights, weekends, and holidays are expected to be worked on all rotations if scheduled by the preceptor or their designee. - Emergency Medicine Rotation: Students should expect to work an average of 3-4 shifts (8-12 hours each) per full week of the emergency medicine core rotation (depending on the standard for the assigned site). For partial weeks, such as during EOR week, the student should work a minimum of 1-2 shifts. - Surgery and Internal Medicine Rotations: Students should expect to work at least ten to twelve hours per day on their surgery and internal medicine rotations (not including call and weekends).

Student Rights

Nova Southeastern University complies with the Family Educational Rights and Privacy Act of 1974. FERPA, also known as the Buckley Amendment, which is designed to protect the privacy of educational records, and to provide guidelines for the correction of inaccurate and misleading data. The Program is permitted to provide directory information without the students consent unless he or she requests in writing that such information not be disclosed. At Nova Southeastern University, directory information is defined as: student's name, local and home addresses, email address, telephone numbers, date and place of birth, dates of college attendance, enrollment status, major field of study, participation in activities and sports, degrees, honors and awards received, year in school, and anticipated graduation date. The student may request that directory information be kept confidential by completing a Request to Prevent Disclosure of Directory Information Form (located on the Registrar's Web site at www.nova.edu/registrar. The form must be renewed annually. Further information on Nova Southeastern University's policy and procedures on compliance with FERPA can be obtained from the Registrar.

Clinical Activity

NSU PA Orlando students on clinical rotation must: - Work under the direct supervision of a licensed physician, physician assistant, nurse practitioner, nurse midwife, or other Florida licensed health care provider, who is supervised by a licensed physician. - Follow the NSU PAO program dress code, which includes: o Wear a Nova Southeastern University patch on their lab coats o Display a visible nametag designating their student status and association with the university, and o Identify themselves as physician assistant students at all times. - Always work under the supervision of a preceptor. They may not function in the place of an employee, or assume primary responsibility for a patient's care. Students shall not treat and discharge a patient from care without consultation with a clinical preceptor or supervising Florida licensed practitioner. - Perform only those procedures authorized by the PA Department, clinical site, and preceptor. - Adhere to all regulations of the PA Department and the clinical sites. - Deliver health care service to patients without regard to their race, religion, creed, national origin, sexual orientation, socioeconomic status, disability, disease status, and/or political beliefs. - Sign all charts and written orders with the student's name clearly written, followed by the designation "PA-S". At no time may the student use other professional titles (e.g. RN, EMT, etc.) while on clinical rotation. - Have all chart entries written orders, and prescriptions immediately countersigned by the preceptor or assigned designee. - Know your limits. Do not consent to assess any patient or perform any procedure that is beyond your ability. Ask for assistance. - Observe the highest level of patient confidentiality at all times, and maintain compliance with the Health Insurance Portability and Accountability Act (HIPAA) guidelines NSU PA Orlando students on clinical rotation must not: - Be used as substitute employees on clinical rotations. - Appear at the university or clinical sites under the influence of alcohol or drugs. - Exhibit any behavior that may jeopardize the health and safety of patients, preceptors, faculty, or fellow students. - In the event of the temporary absence of his/her assigned preceptor, the preceptor or his/her designee will identify an alternate qualified preceptor. At no time will the student work without having a preceptor clearly identified and present.

Occurrence / Incident Reporting

NSU's policy is that students are required to report all occurrences or incidents that occur during clinical rotations. The following procedure should be followed: 1. The student must immediately notify the Clinical Director. 2. The student must furnish the Clinical Director with any documents notifying of a potentially compensable event - i.e. professional liability claim or legal action. 3. The Clinical Director will furnish the written documentation or oral report to the appropriate NSU HPD Risk Manager. 4. The student will promptly comply with all requirements of the NSU HPD Risk Manager regarding the incident. The Clinical Director must document the incident alert in the student file.

Netiquette (Network Etiquette)

Netiquette describes the culture of the internet and how someone properly communicates through networks (including computers, cell phones, and other smart devices). In today's technological age, netiquette is an important way of demonstrating professionalism and fostering an amiable work environment. The Golden Rule: Do onto others online as you would have done onto you. Some of the common rules are as follows: Be courteous and respectful at all times. Avoid flamewars or spam messaging. Profanity and slang are unacceptable. Use proper grammar and spelling in your communication. Watch your tone when writing. Do not write in ALL CAPS. Writing in this manner suggests that one is shouting or yelling. Be conservative when posting personal information on blogs and communication boards. Anything that is posted may be shared. Use discretion in everything you do on the internet. This includes creating social networking profiles and posting comments on the networking sites. Examples include, but are not limited to: LinkedIn, Twitter, Facebook, Second Life, Flickr, Reddit, Vero, Instagram, WhatsApp, Pinterest, Tumblr, YouTube, TikTok, and Snap Chat. Students are liable for anything posted to their social media sites, and the same laws, professional expectations, and guidelines are expected to be maintained as if you were interacting in person. NSU PAO Program supports your right to interact knowledgeably and socially. Guidelines have been developed to outline appropriate standards of conduct for your professional future and the reputation of our program: Social networking (or 'friending') NSU PAO Program faculty and staff, guest lecturers, clinical preceptors, or current/former patients while you are enrolled in the Program is strictly prohibited. Take responsibility and use good judgment. Incomplete, inaccurate, inappropriate, threatening, harassing posts, or use of profanity on your postings is strictly prohibited. Think before you post as your reputation will be permanently affected by the Internet and email archives. HIPPA laws apply to all social networking so it is the utmost priority to protect patient privacy by not sharing information or photographs. You must protect your own privacy as to not let outsiders see your personal information. Social networking is permanently timed and tracked. Therefore social networking during class, program activities, and clinical time is strictly prohibited. If you state a connection with the NSU PAO Program, you must identify yourself, your role in the program, and use a disclaimer stating that your views are that of your own and do not reflect the views of the NSU PAO Program. All laws governing copyright and fair use of copyrighted material must be upheld. Consult your faculty advisor, the Clinical Director, or the Program Director if you have any questions regarding the appropriateness of social networking use. You are prohibited from communicating with a member of the media or outside source attempting to gather information regarding the NSU PAO Program through the social network. Refer all questions regarding program information, policies and procedures to the NSU PAO Program Director. Failure to follow the above stated guidelines will subject you to referral to the CSP and possible dismissal from the NSU PAO Program.

Mission Failure: contacting another NSU PA programs**

No student is ever to directly contact another NSU PA program regarding clinical rotation sites. Students are NOT to directly contact a hospital network under any circumstance, whether in the Orlando region or not.

Second referral to CSP -Two passed EOR Written Retests:

Note: any student who has >2 passed EOR written retests will be referred to the CSP and be informed that: 1. Dismissal may be possible unless there are documented significant extenuating circumstances. 2. In-house Academic Warning status will most likely be elevated. 3. A third EOR written exam failure (no retest) may likely result in dismissal unless there are documented, significant extenuating circumstances which would then be addressed.

Nondiscrimination Policy

Nova Southeastern University and the NSU PAO Program do not discriminate or harass any persons on the basis of race, color, religion or creed, sex, pregnancy, national or ethnic origin, non-disqualifying disability, age, ancestry, marital status, sexual orientation, unfavorable discharge from the military, veteran status, political beliefs or affiliations, in compliance with section 504 of the Rehabilitation Act of 1973 and with Title IX of the Educational Amendment of 1972. The non-discrimination policy is consistent with all federal and state statutes, rules, regulations and/or local ordinances.

Sexual Misconduct & Harassment

Nova Southeastern University's intent is to protect all employees and students of sexual harassment. Sexual harassment is a violation of Title VII of the Civil Rights Act of 1964 and Title IX of the Educational Amendments of 1972. Sexual harassment undermines the integrity of the employment and academic environment, debilitates morale, and interferes with the effectiveness of employees and students. In accordance with the Equal Employment Opportunity Commission's promulgated guidelines, unwelcome sexual advances, unwanted requests for favors of a sexual nature, and any other unwanted verbal or physical conduct of a sexual nature are considered sexual harassment. Students aggrieved by a violation of this policy may file a grievance under the center's grievance procedure or may report the conduct to the Clinical Director or the Program Director. All reports or sexual harassment will be investigated thoroughly by either the NSU Title IX coordinator or the Office of Human Resources. At Nova Southeastern University, romantic and sexual relationships between a faculty member or preceptor and a student are subject to the prohibition against sexual harassment. Any individual who violates this policy will undergo disciplinary action, up to and including expulsion from the Program. For more information about the NSU Sexual misconduct and harassment policies, refer to the Academic Student handbook, or contact the ADA contact, Alnora Sands, [email protected].

Accident Reporting and Medical Care

Occasionally, accidents will occur on the clinical site. If a student believes he/she has been exposed to Hepatitis B Virus (HBV), Hepatitis C Virus (HCV) or Human Immunodeficiency Virus (HIV), especially if any of the signs or symptoms of these diseases has been experienced, the student should consult his/her healthcare provider as soon as possible. The student must report all exposures and incidents, (including needle sticks or mucous membrane exposure), to the hospital/clinic/practice and the supervising physician and/or immediate supervising clinical preceptor immediately following the incident. The student must comply with all accident and injury protocols established at the institution The Physician Assistant Program should be informed of any incidents as soon as possible either by telephone or in writing. A narrative of the event should be submitted in writing to the Clinical Director immediately and discussed in person by the next EOR. Ultimately, the student is responsible for initiating care after exposure to possible blood borne pathogens. The student may consult his/her private healthcare provider, or NSU affiliate health clinics for guidance and assistance. The Clinical Director must also be notified of any exposure/possible exposure. All costs are the sole responsibility of the student. Consistent with this financial responsibility, all students are mandated to have active health insurance at all times (first and second year) while enrolled in the PA program.

Conflict and Resolution

Occasionally, students and preceptors experience difficulties that strain their professional and educational relationship. As a result, estrangement may occur that impedes the learning process. Students are expected to deal with such problems in a mature and professional manner. If the situation cannot be resolved, then the Clinical Director should be consulted immediately. Please refer to the "Students Responsibilities to the Program" section. Students are expected to treat all patients, faculty, university staff, clinical preceptors, healthcare workers, patients, and fellow students with dignity and respect. Conflicts should be resolved in a diplomatic, reasonable manner. Students should be sensitive to, and tolerant of, the diversity of other students, rotation personnel, and patient populations. All clinical situations must be approached with respect for the privacy, confidentiality, and feelings of others. Displays of anger, which includes demeaning, offensive, argumentative, threatening language/behavior, or language that is insensitive to race, gender, ethnicity, religion, political preference, sexual orientation, or other personal characteristic will not be tolerated. Moreover, if a student violates any policy concerning their conduct, behavior, and professionalism as outlined above, they may be referred to the Committee on Student Progress and dismissed from the Program.

Mission Failure: student housing**

Only students currently on clinical rotations may stay in student housing. It is the student's responsibility to make arrangements in advance for pets, family members, or other personal obligations (home maintenance, expenses, etc.).

Excused Absences

Only the following will be considered an excused absence during the clinical year, and proper documentation must be submitted with the absence paperwork: - Medical emergencies of the student or their first degree family members - Bereavement - Jury Duty - Mission Trips, outlined below - Certain medical and educational conferences, outlined below - Residency and/or job interviews, as outlined below

Excused Absences.....

Only the following will be considered an excused absence during the clinical year, and proper documentation must be submitted with the absence paperwork: ⋆Medical emergencies of the student or their first degree family members ⋆Bereavement ⋆Jury Duty ⋆Mission Trips ⋆Certain medical and educational conferences ⋆Residency and/or job interviews More information about excused absences and acceptable forms of documentation can be found in the Clinical Year Handbook.

PA Program

Orientation of the preceptors and students To serve as a resource in developing quality rotation sites and to facilitate the introduction of the PA role to the general and medical communities To provide malpractice coverage for the student during rotation Provide the student with adequate clinical sites to obtain clinical experience for all required clinical rotations To evaluate student rotations and make suggestions for strengthening the experience as needed To maintain contact with the student in an attempt to anticipate problems and to provide a support network to the student outside of the rotation To provide continuing education seminars, end of rotation examination experiences, clinical skills testing experiences, and evaluation reports to the student during the clinical year To follow policies and guidelines for all students to ensure fairness and equitability

The PA Program's Responsibilities

Orientation of the preceptors and students to the policies and procedures of the clinical year. To serve as a resource in developing quality rotation sites and to facilitate the introduction of the PA role to the community, in general, and the medical community, specifically. To provide malpractice coverage for the student during rotation. To provide the student with adequate clinical sites to obtain clinical experience for all program required clinical rotations. To evaluate student rotations with periodic site visits via in person, webcam, email, or phone. Evaluations will be discussed with the student and the preceptor and suggestions will be made for strengthening the experience as needed. To maintain contact with the student in an attempt to anticipate problems and to provide a support network to the student outside of the rotation. To provide continuing education seminars, end of rotation examination experiences, clinical skills testing experiences, and evaluation reports to the student during the clinical year. To follow policies and guidelines for all students to ensure fairness and equitability

After Graduation

PA Graduates will have access to their Nova Southeastern University email addresses. Graduates will have library resources access for six months after graduation. The access is important in allowing students to maintain access to the PANCE study materials during preparation for the boards. A graduate's first opportunity to take the PANCE examination is seven days after program completion. The deadline is 180 days from the beginning of the exam timeframe to take the exam. These dates will be reflected in the student's exam application acknowledgement e-mail. A candidate may only take PANCE once in any 90-day, period or three times in a calendar year. The faculty encourages graduates to maintain contact with the university after graduation. The school will reach out to the alumni via email or via the closed Facebook® alumni page. The site has been instrumental in networking with our alumni for communicating potential jobs, continuing medical education (CME) activities, and any other opportunity that involve participation in the education of future physician assistant professionals. **Any policies or unclear situations not addressed in the clinical year handbook will fall under appropriate policies set by and contained within the Orlando Academic Student Handbook, or the Dr. Pallavi Patel College of Health Care Sciences Student Handbook.

Communications

Preceptor-to-Program Communications It is crucial for the preceptor and the Program to have an open line of communication. Preceptors may determine the preferred method of communication (phone, email, videoconference, etc.) and the best time for communication. The program will contact the Preceptor at the least disruptive time possible. Student-to-Program Communications Communication between students and the Program mainly consists of email. It is imperative that students maintain use of their Nova email accounts. All emails must be checked daily. If there is an email request made to the student, the student MUST reply within 24 hours of the time the communication was sent from the Program. If there is a question, concern, or problem that arises please contact the Clinical Director or the Clinical Coordinator immediately. The Program is organized to protect the student and facilitate the learning process of the clinical year. Student-to-Preceptor/Preceptor-to-Student Communications Communication between students and preceptors should be kept strictly on a professional basis. Telephone and e-mail communication should only occur during working days. The content of the conversations should only include professional topics that are pertinent to the rotation.

Early Identification Process

Processes are in place to identify students whose behavioral or academic performance puts them at risk of failure. The CSP policies address these situations in a progressive manner to identify struggling students early in the program. Examples of such policies include but are not limited to: preceptor evaluations, benchmark tracking, tracking student progress on test failures, number of retests and/or remediations, low semester or overall GPA as compared to the class cohort, and low percentile scores in PACKRAT. The goal of CSP monitoring is to identify struggling students

General Rotation Guidelines

Rotation assignments are entirely the prerogative of the Program Director and Clinical Director; and they maintain the prerogative of pre-approval on all program and program-related activities. All aspects of a student's program performance will be considered during deliberation concerning rotations, including, but not limited to grades and professional and ethical conduct. Students will be placed in rotations that are outside of the Orlando area depending on the availability of rotation sites, and every student has the potential to be placed in at least one rotation outside the immediate Orlando area. Many students will travel for several clinical rotations during the clinical year. For students who must travel to distant sites for their clinical experiences, every attempt will be made to provide university housing in such cases, but cannot be guaranteed. Any requests for rotations must be submitted in writing 3 months prior to the start of clinical rotations. All rotations are subject to approval by the clinical department. Students may request a specialty only for their clinical rotations, not a specific site or provider. Students may let the clinical team know if they have a preferred site, provider, or city, but the clinical team will make the final determination regarding student placement. Clinical rotations outside of the State of Florida will only be considered for the 9th rotation (Clinical Elective) prior to graduation and must not be hospital-based rotations or require hospital badging or credentialing. A preceptor site identification form must be filled out 6 months prior to the start date of the rotation to improve the student's chance of placement. Special Note: In the event that a Hybrid Elective Rotation course is required, either the Selective Rotation or Clinical Elective Rotation are the courses that are typically replaced. If the Clinical Elective Rotation is replaced, the student will lose their option to complete an out of territory/state clinical rotation, even if the change is through no fault of their own. Students will have until the Friday of EOR 7 (typically in June) to make their final selections for their Elective Rotation. As sites fill up quickly and will be filled on a first come, first served basis, students are strongly advised to make any requests as early as possible. Students should note that making a rotation request officially locks in their decision. Once a site has been requested and/or assigned by the clinical team, there will be no changes to the assignment once it has been confirmed by the site/preceptor. This includes requests due to new sites, new affiliation agreements, changes in student preferences, changes due to job offers, or other factors. Students who have not requested an elective rotation will be assigned one by the clinical team, and this assignment cannot be changed once made.

Unexcused Absences

Routine dental and doctor appointments, weddings, graduations, non-major religious holidays and observations, and other social events are NOT valid reasons for absenteeism. Absenteeism not reported as described above will be considered unexcused regardless of cause. All unexcused absences will be referred to the CSP for further review.

Site Evaluations

Sites are evaluated initially at the time of the affiliation agreement, and then on an ongoing basis while the affiliation agreement remains in place. Ongoing evaluations are typically completed during the student-focused site visits discussed in the previous section, but may be completed at other times as needed. Evaluations are completed using the "Comprehensive Site Evaluation Form" (see APPENDICES). There are multiple versions of the form available depending on the clinical specialty. The purpose of the site evaluation is to ensure ongoing quality control of the clinical educational experiences provided at the site, including preceptor(s), patients, facility, and ancillary staff. The optimal time to visit the site is during the mid-rotation time period (weeks 3-5). The site evaluator must interview the student and at least one preceptor during the site visit. Every effort should be made to speak with other staff that may be involved in the teaching, supervising, assisting, or orienting of the student. Additional site evaluations may be done if requested, desired, or indicated, and may be conducted virtually or in-person

Health Insurance

Student health insurance is required. Students must maintain a valid health insurance policy throughout their course of study in the program. Failure to maintain a valid insurance policy will result in the student being removed from clinical rotations until proof of compliance with this policy is provided. Any costs incurred through illness and/or hospitalizations during attendance at the PA Program are the sole responsibility of the student.

Criticisms, Gossip, and Rumors

Students are asked to refrain from negative comments about a person or an institution. Personal biases play a large part of negativity and many times obscure the truth. The Orlando PA Program cautions all students to refrain from speaking about a fellow student, a previous or present Preceptor, the Program and/or Program Faculty. Negative comments are not consistent with the Program's mission and damage the credibility of fellow students, future colleagues, and our institution. Failure to comply with this requirement may result in referral to the Committee on Student Progress for violation of professionalism standards

Class Preparation

Students are expected to arrive to all educational and clinical activities with the necessary lab instruments, texts, attire, and other materials as designated by the instructor, or may otherwise be excluded from participation in the activity. Students who are not properly prepared for competencies (OSCEs) will not be evaluated. The student will receive a grade of 0 (zero) and then will have to remediate the examination

Academic Integrity Policy

Students are expected to conduct themselves in an honest and ethical manner while pursuing their education at the NSU PAO Program. Should a student be accused of a breach in academic integrity or if he/she has questions regarding the due process to protect student's rights, the student may refer to the Student Handbook.

Student Contact Information

Students are expected to update their address and telephone numbers through the Office of Registrar, as well as the NSU PAO program as soon as possible. The student will be held responsible for any communication from university offices sent to the address or phone number last provided to the Office of the Registrar. No special consideration will be given to students who move and fail to receive the communication. Follow the following link to change your contact information: www.nova.edu/registrar/services.html

SPECIAL NOTE: PETS AND SERVICE ANIMALS

Students are forbidden to bring pets to student housing. Students who require the presence of a service and/or emotional support animal must notify the clinical team no less than 1 month prior to the start of the clinical year to allow time for the approval process. Students that require the presence of an official service/emotional support animal must have written approval from the ADA office prior to beginning their clinical year. If the need begins after the clinical year has started, it is the student's responsibility to request all accommodations as quickly as reasonably possible. It is the student's responsibility to properly notify the clinical team of their need for service/emotional support animals to be present during the clinical year, and to complete all ADA requirements in a manner that allows them to begin their clinical rotations on time. Rotation delays resulting from student failure to follow this policy will result in full penalties of missed rotation time and/or missed or late assignments, as described elsewhere in this handbook. Students who bring pets and/or service animals to student housing without prior University approval will be referred to the Committee on Student Progress for further action.

Student Professionalism

Students are invited guests of each rotation site and, as such, should try to leave a positive impression of themselves, Nova Southeastern University, and the Physician Assistant profession.

Student Professionalism..

Students are invited guests of each rotation site and, as such, should try to leave a positive impression of themselves, Nova Southeastern University, and the Physician Assistant profession. ⋆It is the student's duty and responsibility to keep all health care information confidential. ⋆Students are not allowed to photocopy any portion of the patient's medical record or photograph a patient without the written permission from the clinical institution. ⋆The Orlando PA program also expects the student to remove any references to institutions or patients when providing information on an assignment. Any breach of confidentiality will result in a 0 (zero) for the assignment and referral to the CSP.

Mission failure: social media**

Students are liable for anything posted to their social media sites, and the same laws, professional expectations, and guidelines are expected to be maintained as if you were interacting in person.

Eligibility for Clinical Rotations

Students are not permitted to rotate at clinical sites where they have been an active patient within the last 6 months. Students are also ineligible to rotate with members of their immediate or extended family. Students may rotate at clinical sites where their family members are employed, but are not to be supervised or evaluated by that family member

Comprehensive H&P Note

Students are responsible for a written comprehensive H&P for each required core rotation including: INTERNAL MEDICINE, FAMILY MEDICINE, and PEDIATRICS. The case must include a 3-generation minimum genogram in the Family History section

Letters of Reference

Students desiring letters of recommendation from faculty should make all requests in writing and provide adequate time to respond to the request. Information on the request (scholarship criteria, job opportunity, etc.) should be provided as well as an updated copy of your resume and/or student biographical information. Faculty reserves the right to refuse to write a letter of recommendation.

Professional Dress Code

Students in the PA Program must maintain a neat and clean appearance befitting students attending professional school. Therefore, attire should convey a professional appearance whenever the student is on campus, in classes or laboratory, and on clinical rotation. The NSU PAO Program places a high value on professional appearance. Not only is there a concern for professional impression, infection control, and cultural sensitivity, but it also helps build trust and confidence in both the patients and the health care providers.

Site Visit Case Presentation

Students are required to perform a case presentation during a site evaluation. The presentation will be assessed according to the previously discussed evaluation form. All cases must be real, but should be de-identified per HIPAA guidelines. In order to prepare, the students may utilize the SOAP note and oral presentation grading rubric. In addition, a 5x7 card may be used by the student in order to write down pertinent notes related to the oral case. The student will hand the SOAP note to the site visitor and the site visitor will make appropriate annotations/corrections. These assignments are considered to be PASS/FAIL. The student must pass this portion of the initial site visit in order to continue on to the next rotation. For the oral case presentation, the student must be prepared to do the following: - Present a full patient case including history, physical, assessment, work-up, plan, and hospital course to date. All aspects of the history must be included: CC, HPI, PMH, allergies with reaction, FH, SOC HX, and ROS. - A complete physical exam should also be included. Pertinent positive and negative findings are expected. Physical signs relating to the illness should be included. - A complete differential diagnosis is expected. There should be at least three different possibilities discussed. The student must be able to explain how each relates to the particular case, and what makes it more or less likely to be the cause of the patient's chief complaint. -Discuss what lab tests were ordered on the patient. Each student must be able to explain why each test was ordered and be able to interpret all test results. - Explain the final diagnosis that was given to the patient, and the primary factors that pointed to that particular dx. - Discuss the treatment plan. Students must give alternative treatments when applicable. Students must be prepared to discuss the pros and cons of the treatments and possible side effects. - Discuss the patient's prognosis? - Entertain questions from the site visitor and other students present at the meeting. Case presentations should be on challenging patient cases. The following types of cases are not appropriate for site visits, and will not be accepted: Routine follow-ups for stable chronic conditions Well visits (well child, well women, etc.) Annual physicals Sports or D.O.T. physicals Medication refills Other simple visits Students must achieve a passing grade on the oral case presentation in order to pass their rotation. Students failing to achieve a passing grade must present a second, different case, to their site evaluator (not their faculty advisor) during the end of rotation (EOR) seminar for the same rotation. Students who score a passing grade on the second case presentation will receive a passing score for their final oral presentation case grade. Students who fail to achieve a passing grade on the second attempt will be referred to the Committee on Student Progress for determination of subsequent action.

Criminal Offense Attestation

Students are required to provide an annual update and recertification relating to any convictions, guilty pleas, or no contest pleas prior to the start of the rotation with the exception of traffic violations.

Safety Procedures

Students are required to read and integrate the information regarding safety in the Campus Safety Manual published by the NSU Public Safety Department prior to commencement of clinical rotations. Any documented allergies to latex products should be reported to the preceptor and Clinical Director. This information should also be included in the student clinical file. Each student is responsible to supply the latex-free products they may need. All Students must follow the safety policies and procedures that are established by each clinical site. All fire hazard and public safety rules must be followed to ensure a safe clinical rotation experience. Students should be aware of the location Material Safety Data Sheet (MSDS) manual in each facility, as well as the needle stick policies at their clinical sites. Most clinical institutions provide security personnel. If the student feels that they are in danger, he/she should call the institution's security department or 911. The student must also notify the Clinical Director of any concerns of safety immediately.

Behavioral Health SOAP Notes

Students are required to submit a Behavioral Health SOAP note for their BEHAVIORAL MEDICINE rotation. The format of a Behavioral Health SOAP note is different from the standard SOAP note, so students should be careful to choose the correct rubric for documenting these patient cases.

SOAP Notes

Students are required to submit a standard SOAP Note for their OB/GYN, Emergency Medicine, and SELECTIVE rotations. For OB/GYN SOAP note cases, please limit cases to female patients only. Male cases in an OB/GYN rotation will not be accepted and will result in the requirement to submit another case on a different patient. Exception: transgender, non-binary, or gender non-conforming patient cases will be acceptable.

Absence Procedure

Students are required to submit attendance forms to the PA Program for each clinical rotation. Adherence to scheduled rotation hours and attendance at all end-of-rotation activities are mandatory. Failure to fulfill this requirement is considered in the evaluation of the student's academic performance and professional attitude, and may result in a failing grade for the rotation. If the student must miss time from a rotation, all of the following must be completed by the student: - The Preceptor, the student's Faculty Advisor, and the Clinical Team must be notified as soon as possible and no later than 9:00 AM on the day of the absence. o For non-traditional shifts, such as like emergency medicine, obstetrics, or on call, the student must notify the above parties no later than 1 hour before the shift starts. o If the appropriate party cannot be reached, then you must leave a message regarding your absence and a number where you can be reached. - The student must complete and submit the Student Clinical Absence form with all relevant documentation. o The documentation may be either emailed to all above parties or faxed to (407) 264-5140 to the attention of the Clinical Director within 24 hours of returning to the clinical site. - To be considered complete, the documentation must include: o Original NSU PA absence form (with both the preceptor and student signatures) o Official documentation for the absence is required (detailed below). - The original documentation must be included in the student's EOR folder by 9:30 AM on the first day of EOR.

Dress Code

Students are required to wear their student badges at all times, in a location that is clearly visible. Scrubs are not permitted except while in the operating room, unless otherwise indicated by your preceptor. Scrubs may be required by preceptors during the clinical year. They shall be ceil blue with matching tops and bottoms, or those required by specific hospitals or specialty/surgery centers. No patterned or other color scrubs are permitted. Drawstrings should be tied at the level of the umbilicus and the scrub top and drawstring should be tucked into the pants. Lab coats MUST be worn over scrubs except when otherwise directed by your preceptor. There are to be no logos or script visible on the undergarment. Underwear must not be visible through clothing or above the waistband of pants or skirts. Open toed shoes, sandals, and sneakers are not acceptable. Athletic shoes or medical grade clogs and conservative socks are to be worn with scrubs ONLY. If heels are worn they must be conservative and are not to exceed 2" in height. Socks or hosiery must be worn at all times. All clothing must be clean and pressed. Men will wear dress pants with shirt and tie along with closed toed shoes Women will wear a dress, skirt, or slacks with an appropriate blouse and close-toed shoes. Dresses and skirts must be no shorter than the kneecap. Permitted jewelry includes: watch, wedding band, and small earrings for women (single pierced earrings only; double piercings are NOT allowed). Men are not allowed to wear any earrings. No other jewelry is permitted, including bodily piercings. Hair must be conservative, neat, and clean at all times. Long hair must be tied back or pinned up away from the face and off the collar. Beards and mustaches must be clean, neat and trimmed. Mustaches must not hang below margin of the upper lip. Some clinical rotations may prohibit facial hair, therefore, students must abide by the policies and procedures of the clinical rotation. Nails should be clean, short, and trimmed. ⋆Acrylic nails are not permitted(they harbor bacteria and they can scratch) ⋆Nail polish is not permitted while at the clinical rotation site(s). Cosmetics/Perfume should be minimal, and are forbidden by many clinical sites. Many patients and staff members are allergic or sensitive to odors. Tattoos must be covered at all times, regardless of body location. Personal hygiene must be maintained. Jeans, sweatpants, shorts, Capri pants, leggings, skorts, miniskirts, sweatshirts, strapless or spaghetti strap tops or dresses, plunging or revealing necklines, midriff skirts, and t-shirts are NOT acceptable during clinical rotations. If the individual clinical rotation requires the student to wear their institution-specific ID badge, then the student must wear both institutions' ID badges (theirs plus the NSU badge).

Mission Critical Information:Student Housing and Pets/Animals**

Students that will require the presence of an official service/emotional support animal must have written approval from the ADA office prior to beginning their clinical year. If the need begins after the clinical year has started, it is the student's responsibility to request all accommodations as quickly as reasonably possible.

Mission Failure: student maturity**

Students who fail to demonstrate an acceptable level of maturity and professionalism may receive a failing grade for the rotation, and may be dismissed from the Program. A student deemed to be acting unprofessionally in any setting during the clinical year will be referred to the Committee on Student Progress. Unprofessional conduct may result in failure of the clinical rotation, delay of graduation, and/or dismissal from the Program. All clinical situations must be approached with respect for the privacy, confidentiality, and feelings of others. Displays of anger, which includes demeaning, offensive, argumentative, threatening language/behavior, or language that is insensitive to race, gender, ethnicity, religion, political preference, sexual orientation, or other personal characteristic will not be tolerated. Moreover, if a student violates any policy concerning their conduct, behavior, and professionalism as outlined above, they may be referred to the Committee on Student Progress and dismissed from the Program.

Job & Residency Interviews

Students who receive an invitation for Residency and job interviews should notify the clinical team, their advisor, and the preceptor as soon as possible. Approval to miss time for these interviews will be determined on a case-by-case basis at the discretion of the Clinical Director. - Accepted forms of documentation: Official letter (on official letterhead) from the interviewing body/persons.

Conference Attendance

Students will be limited to a maximum of two conferences during the clinical year, and only students who are in good standing and not at risk of failing to meet their clinical year benchmarks will be considered for approval. Preference will be given to American Academy of Physician Assistants (AAPA) and Florida Academy of Physician Assistants (FAPA) conferences, with any other conference approval to be determined on a case-by-case basis. - Accepted forms of documentation: Official documentation that is unique to that conference, proving attendance. I.e., a signed letter from one of the conference officials, an official logo/printed name badge, photos of you at the conference with officially branded and dated signs/merchandise, etc.

PA Student Role and Expectations

Students will be responsible for maintaining and updating their curriculum vitae (CV) after each rotation. Students will be required to contact their next rotation 2 weeks in advance to confirm reporting instructions and are to provide the new preceptor with their CV in that correspondence. While on clinical rotations, PA students function as an integral part of the medical team. In the inpatient setting, students are assigned to a preceptor, and often to a resident or other house staff member. They perform admission histories and physicals, make rounds on assigned patients, assist in formulating management plans, perform various procedures, and otherwise participate significantly in patient care as determined by the preceptor. In the outpatient setting, the student's function in a similar manner performing history and physical exams, proposing differential diagnoses, and assisting in formulating patient treatment plans. Students are responsible for monitoring patient progress, reporting to the supervising preceptor, and implementing the preceptor's plans. They are required to attend lectures, give case presentations and read assigned articles. Specific guidelines and objectives for each rotation are included in the rotation syllabus. Because of their medical background and previous work experiences, some of the students may be more clinically prepared than their fellow classmates. The student should be given as much hands-on experience as the preceptor feels he/she is capable of handling. The preceptor will determine student work hours and the student schedule will be based upon the hours of operation and normal business practices of the facility. Preceptors are not obligated to give the student days off on weekdays or weekends. College holidays DO NOT APPLY in the clinical year. It is not appropriate and against clinical year policy for a student to give the preceptor which days they are requesting off at the start of the rotation. It is inappropriate for a student to place personal demands/requests upon their availability to the preceptor at the site. The only exceptions are fulfillment of Program and University obligations (e.g. badging for an upcoming rotation). Examples of requests of a personal nature include weddings, birthday celebrations, non-major religious observations, family vacations, cruises, etc., and are NOT considered extenuating circumstances. Should extenuating circumstances arise, it is the student's responsibility to address this issue directly with the Clinical Director as soon as possible to determine whether time off will be granted or denied. The student's schedule is determined by the preceptor, not the Program, and should consist of a minimum of 36 hours per week and may include nights, weekends and holidays as well as an on-call schedule. It is not uncommon for students to work 80 hours per week while rotating in certain specialties. If less than 40 hours a week are completed, it must be justified by the main preceptor.

Academic Advising

Students will keep their same faculty advisor during the clinical year. The purposes of the faculty advisor system are: -To serve as a professional role model for the student -To act as a resource for both academic and personal concerns - To chart the student's progress through the program, providing help and guidance - To assist the student in defining personal career goals Students will meet with their advisor after each clinical rotation at the End of Rotation (EOR) seminar to discuss progress or any problems the student may be experiencing during the clinical year.

ADA Accommodations in the Clinic

Students with disabilities who request reasonable accommodations in the clinic for known conditions must meet with the Clinical Director within one week of receiving the clinical assignment(s). Reasonable accommodations that are authorized through the NSU ADA Coordinator are subject to approval by the clinical site. In compliance with the ADA, the Clinical Director is not permitted to discuss a student's disability with the clinical site unless written consent is received, which allows the Clinical Director to discuss the implications of a student's disability on the clinical rotation prior to the student's arrival. When written permission is not obtained, the Clinical Director will strongly encourage disabled students to disclose information to their assigned clinical sites, for the purposes of making accommodations that may impact clinical performance, time management, and scheduling. Facilities have the right to refuse placement for a student who requires reasonable accommodation.

Rotation Assignments

Successful completion means completing all items within the prescribed time limit as directed in the clinical handbook. The appropriate forms to complete each of the tasks are found in the Appendices in this handbook as well as on eClas and CANVAS. In order to successfully complete a rotation and move on to the next rotation, each student must successfully complete: There are assignments due nearly every week during clinical rotations, which are outlined below. In addition to this, students are expected to update the patient/procedure logs daily after their shift has ended. All assignments must be uploaded to the appropriate CANVAS module no later than the specified due dates/times listed in the assignment weekly overview below, or they will be considered late. Late assignments will be subject to a penalty of up to 5 points per late assignment off of the final rotation grade. Failure to submit any required assignments during the clinical year may result in referral to the CSP. Students will not be allowed to progress to the next rotation until all paperwork from the current rotation has been submitted.

Rotation Assignments........

Successful completion of assignments means completing all items within the prescribed time limit as directed in the clinical handbook. All assignments must be uploaded to the appropriate CANVAS module no later than the specified due dates/times listed in the assignment weekly overview below, or they will be considered late. Late assignments will be subject to a penalty of up to 5 points per late assignment off of the final rotation grade. Detailed information about weekly assignments is located in Section V. of the Clinical Year Handbook.

Tardiness...

Tardiness is defined as arriving 10 minutes or more late to the clinical site. Two or more incidences of tardiness will result in referral to the CSP and/or deduction of the final grade for that clinical rotation.

Tardiness

Tardiness is defined as arriving 10 minutes or more late to the clinical site. Tardiness to the clinical site and/or EOR is not only unprofessional, it is unacceptable. Students are expected to be professional at all times. Repeated episodes of tardiness may jeopardize the clinical affiliation between the NSU PAO Program and the institution. Two or more incidences of tardiness will result in referral to the CSP and/or deduction of the final grade for that clinical rotation. Tardiness Procedure The student is responsible for contacting the Preceptor, the Clinical Team, and their advisor of any tardiness. This includes leaving the clinical site early for any reason. If anyone must be contacted first, let that be the Clinical Director and then the Clinical Director will notify the Preceptor. Any time missed must be made up on an hour-per-hour basis. Students must arrange the time that must be made up with the Preceptor. If the student is unable to make up the time during regular business hours, then the time must be made up on the student's personal time which may include weekends. Students who cannot make up the time in the clinic will be given additional assignments to complete. Students must consider that if the rotation time is not complete, that this may prevent the student from beginning the next clinical rotation. Any student that does not meet the minimum attendance requirements of a clinical rotation will receive an "F" grade for the rotation

Clinical Year Committee on Student Progress (CSP) Policy

The Committee on Student Progress (CSP) is a formal proceeding conducted by the faculty of the NSU Orlando PA program upon receipt of information which necessitates possible academic or disciplinary action for a student. A student will be contacted with a written (email) or personal request for the student to attend a scheduled meeting to evaluate and discuss an academic or disciplinary question. Participation by legal representative with regard to preparation of the student's written or oral response is prohibited. No rules of evidence will be used. The meeting shall be internal, private, and closed to those not associated with the University. Non-University personnel are not available for consultation during these meetings. Legal representation or any other form of representation during the meeting is prohibited. No recording devices will be permitted during the meeting. All procedures and actions are aimed to safeguard and preserve the educational and developmental mission of the NSU Orlando PA Program. For further information, please refer to the NSU PA Orlando CSP policy and procedures, NSU PA Orlando Academic Handbook, and the Dr. Pallavi Patel CHCS Student Handbook.

Drug Policy - Zero Tolerance

The Dr. Pallavi Patel College of Health Care Sciences and the Nova Southeastern University Physician Assistant Program of Orlando have a zero tolerance policy for drug and alcohol use. Students will be asked to acknowledge awareness of this policy and agreement with the terms. If a student is on a prescription medication that may alter a drug screen, either a doctor's note or prescription should be presented at any time a random drug screen is required. Noncompliance is grounds for immediate dismissal from the program.

Objective Structured Clinical Examination (OSCE)

The NCCPA has removed the hands-on clinical portion of the PANCE exam. As a result, each PA Program is required to evaluate all students on their competency of performing physical examinations and clinical skills. At least once during the clinical year, each student will be required to demonstrate his/her ability to perform a problem-oriented physical examination. This comprehensive assessment includes performing a focused history and physical examination, including differential diagnosis, interpretation of pertinent diagnostic data, demonstration of an appropriate clinical procedure (where appropriate), development of an appropriate assessment and plan, and discussion of patient education and counseling. Students must take and pass the OSCE examination as part of their comprehensive, multi-faceted evaluation. The student must pass the OSCE with a minimum score of 80%. The OSCE exam is calculated as a significant portion of the final rotation grade for the PAO 6401 Clinical Elective Rotation. If a student fails to achieve a passing score, he/she will be given an opportunity to remediate the exam. If the student fails to pass the retest exam, he/she will fail the rotation, and be referred to the CSP for further action and possible consideration of dismissal from the Program.

Student Files

The NSU PAO program believes in protecting the privacy of students' records, in compliance with the Family Educational Rights and Privacy Act of 1974. All records, such as application material, correspondence, and clinical evaluations, are kept in individual student files, locked in the main Clinical Support Coordinator's office. The files are available upon request for review by the students. PA students do not have access to the records or any confidential information of other PA students.

Student Health Records

The NSU PAO program does not have access to student health records. Students manage their own health records through Castle Branch (https://mycb.castlebranch.com/). Questions about student health records should be directed to the Student Medical Center. Nova Southeastern University Sanford L. Ziff Health Care Center Student Medical Center 3200 S. University Drive Davie, Florida 33328 Phone: (954) 262-1262 Dr. Pallavi Patel CHCS Student Affairs office will monitor Castle Branch, where all students must upload proof of completing the entire immunization requirement. Castle Branch will send weekly reminders to the email the students registered with when completing background check if they are not compliant with any requirement. Please note: DO NOT SEND ORIGINAL DOCUMENTS - YOU MUST KEEP A COPY FOR YOUR RECORDS. If you must send the forms to Castle Branch, please send them via certified mail.

Student-Focused Clinical Site Visits

The PA Program faculty communicates throughout the clinical year with students via a variety of methods to monitor student progress and clinical experiences. The purpose of these communications is to identify and address any issues that may arise in a timely manner. The Clinical Director or designated faculty member will make site visits as needed throughout the clinical year. Physical site visits may be scheduled or unannounced, and all students may expect to receive an in-person site evaluation at least during the first and last semesters of the clinical year. Additional site evaluations will be conducted for any student on academic or disciplinary probation, as well as for students deemed "at risk" by the program, regardless of probationary status. If a student is not present at the site when a faculty member performs a site evaluation, the student will fail the rotation. The student is required to have a problem-focused, handwritten SOAP note for the faculty member to review. In addition, a 3-5 minute oral presentation must be performed on the patient write-up. The SOAP note and oral presentation will be graded on a pass/fail basis. If not passed, the PA student must practice and repeat the assignment with a different case to the site evaluator at EOR seminar for the same rotation. During the site visit, the site visitor may request the following from the student: - Two examples of patient charting the student has completed on actual patients. - Discuss the procedures he or she has done in detail. - Demonstrate a working knowledge of all the patients on the service as well as an in-depth knowledge of the patients assigned directly to them. - Provide the site visitor with a copy of the completed mid-rotation evaluation. - Additional topics may be assigned at the beginning of each rotation for discussion. - Perform chart reviews with the student. - Observe the student performing a history and physical on a patient. For scheduled site visits, the student is to print out and complete the "Comprehensive Site Evaluation Form" (see APPENDICES) prior to faculty arrival for the site visit. During the site visit, both the preceptor(s) and student(s) are interviewed, and the visiting faculty member records comments and questions of the preceptor and facility. In addition, the student will be asked to present a case on a patient they have seen to the visiting faculty member, to review actual patient charting by the student, patient encounter/procedure logs, work hours, and/or comment on a case presented by a colleague.

Mission Critical Information: Presumed Infected Fluids**

The following materials are assumed to be infectious relative to blood-borne pathogens, particularly hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV): Blood, blood products, tissue, semen, vaginal secretions, breast milk, cerebrospinal fluid, amniotic fluid, peritoneal fluid, synovial fluid, pericardial fluid, pleural fluid, inflammatory exudates or any other body fluid contaminated with blood.

Student Identification of Clinical Site

The PA program has sufficient quality clinical sites to offer senior students for rotation purposes. However, a student may elect to identify preceptors for possible rotations. All students must adhere to the following self-identification guidelines: - If a potential preceptor informs a student that he may be interested in precepting, the student is required to provide the Clinical Director or Clinical Coordinator with the preceptor site identification form 3 months prior to the start date of the rotation. The form must include the name of the physician, practice name, address, phone/fax number, e-mail address, specialty of the requested rotation, and hospital affiliation information. - Students are NOT permitted to contact potential clinical sites (including hospital networks) outside the NSU PA-Orlando designated region without first receiving permission from the Clinical Director. o No student is ever to directly contact another NSU PA program regarding clinical rotation sites. o Students are NOT to directly contact a hospital network under any circumstance, whether in the Orlando region or not. - Students are NOT permitted to contact the site after they provide the information to the Clinical Director, as the Program will decide on whether or not to proceed with the site affiliation. If the Program decides to move forward with the affiliation, the student will be contacted about the Program's decision. Potential rotations are considered on an individual basis. No decision is a precedent for any subsequent decisions. - All clinical rotations must be pre-approved by the Clinical Director. The Clinical Director or designee will screen all potential sites for appropriateness. Once the Clinical Director gives approval, the site will be visited in person or via teleconference by a faculty member to ensure that the site is able to meet the needs of the student and Program. All hospital affiliations, contracts, and agreements must be completed and approved prior to utilizing the site.

Physician Assistant Clinical Knowledge Rating and Assessment Tool (PACKRAT)

The PACKRAT is a self-assessment tool utilized to evaluate the physician assistant student's knowledge as they begin clinical rotations, or to better prepare students for taking the national certification examination (http://packratexam.org/). The examination is administered in the advanced didactic term of training prior to clinical rotations, and then again toward the latter portion of the clinical year. The examination is an online test that consists of 225 questions and follows the current NCCPA blueprint. The PACKRAT better prepares the students for the certification exam by simulating the conditions and computer format that is experienced during the board exam. In addition, it provides faster results to the students.

Grievance Procedures for Nonacademic Disputes

The University recommends that students discuss problems before resorting to formal grievance steps. If and when grievance steps are perceived as necessary, students have a right to a fair process and hearing without retribution. Please refer to the most current version of the NSU Student Handbook for the appropriate steps

Work Policy

The clinical year is an intense learning experience. Individual rotation schedules may vary and rotations could be in different areas of the state. Taking an outside job is highly discouraged. Working for a preceptor as a paid employee at clinical sites used by Nova Southeastern University while enrolled in the PA Program is a conflict of interest and will not be allowed. Students are also not allowed to work in any capacity for the Nova Southeastern University Physician Assistant Program during their clinical phase.

What are the Goals of Clinical Year?

The clinical year transitions the student from a passive to an active learning situation in such a manner as to prepare them for the emergence and assumption of their professional role as PAs. To this end, the goals of the clinical year include: -To treat all preceptors, other health care providers, staff, and patients with respect, dignity, and professionalism at all times. -To apply knowledge learned in the didactic year to supervised clinical practice. -To develop and sharpen clinical problem-solving skills and critical thinking. -To add to the medical fund of knowledge. - To perfect the art of history taking & PE skills. -To sharpen and refine oral presentation skills. -To thoroughly embrace a pt education role as part of your profession. -To refine an understanding of the PA role in health care delivery. -To respect those who are training you to provide exceptional healthcare. -To prepare for the Physician Assistants National Certifying Examination. -To begin to develop an area of interest for employment after graduation. -To develop a resume and to gain self-confidence in the professional role. -To develop interpersonal skills necessary to function as part of a medical team.

Class Policy

The last 1-3 days of each rotation is reserved for the End of Rotation (EOR) Seminar. These seminars may include any of the following activities: - Computer-based testing - OSCE-type testing - Skills labs - Lectures - Small group work - Other activities as assigned Attendance to all EOR activities is mandatory. If a student must miss class he/she must notify the instructor in advance via email with the date and reason for missing class. Missing EOR seminar may result in referral to the CSP. Cell phones will be off and stored during class time. If there is an emergency situation when a student needs to have the cell phone on, this must be cleared with the professor.

For Seminars

The last 1-3 days of each rotation is reserved for the End of Rotation (EOR) Seminar. These seminars may include any of the following activities: ⋆Computer-based testing ⋆OSCE-type testing ⋆Skills labs ⋆Lectures ⋆Small group work Other activities as assigned Attendance to all EOR activities is mandatory. ⋆If a student must miss class he/she must notify the instructor in advance via email with the date and reason for missing class. ⋆Missing EOR seminar may result in referral to the CSP. Cell phones will be off and stored during class time. If there is an emergency situation when a student needs to have the cell phone on, this must be cleared with the professor.

Mid-Rotation Self-Evaluation

The mid-rotation self-evaluation is a student-generated self-evaluation that must be reviewed and signed by the MAIN preceptor or their designee to be considered complete. It is the intent of this assignment to be an opportunity to honestly reflect on their strengths and weaknesses in each rotation over the course of the clinical year. This form is found electronically on eClas. This assignment is graded as PASS/FAIL.

Student/Preceptor Relationship

The preceptors that participate with the NSU PA Programs are volunteers and are not employees under the supervision of the University. If a preceptor's behavior is unprofessional and inappropriate, the student is responsible for reporting this to the Clinical Director as soon as possible. Students are not to have anything other than a professional relationship with their preceptors and the staff at the rotation site. Fraternization is frowned upon and can be grounds for removal from the rotation and subsequent rotation failure. Students are strongly discouraged from attending private after-hours events with their preceptor(s), or going to the preceptor's place of residence. The student is expressly forbidden from having personal/intimate relationships with faculty, staff, preceptors, or other individuals at clinical sites during their time in the program. If a preceptor is experiencing a situation where he is unable to precept the student, it is acceptable for another licensed professional from the medical group to directly supervise the student All communication with the NSU PA Program and all preceptors is to be done in a professional manner. Students are not to socialize with their preceptors during or after rotation completion. Students are not to solicit their preceptors and/or their associates for future job opportunities while on rotation. Students are not to accept gifts from their preceptors. Students are not to present to their current, former, or future preceptors' workplace unannounced. Students are not to ask preceptors to take additional students for rotations, but instead should notify the program if additional students might be accommodated. Students are not to discuss their classmates with their preceptors

The Student/Preceptor Relationship

The preceptors that participate with the NSU PA Programs are volunteers and are not employees under the supervision of the University. If a preceptor's behavior is unprofessional and inappropriate, the student is responsible for reporting this to the Clinical Director as soon as possible. Upon notification and validating the student concerns, their affiliation with NSU may be revoked and, if necessary, a complaint will be filed with the appropriate agency. Students are not to have anything other than a professional relationship with their preceptors and the staff at the rotation site. Fraternization is frowned upon and can be grounds for removal from the rotation and subsequent rotation failure. Students are strongly discouraged from attending private after-hours events with their preceptor(s), or going to the preceptor's place of residence. The student is expressly forbidden from having personal/intimate relationships with faculty, staff, preceptors, or other individuals at clinical sites during their time in the program. Failure to comply will result in immediate referral to the CSP, with disciplinary actions up to and including dismissal from the program. If a preceptor is experiencing a situation where he is unable to precept the student, it is acceptable for another licensed professional from the medical group to directly supervise the student. The program requires the licensed professional's proof of licensure and certifications. The Clinical Director must be notified immediately by the student, preceptor, or clinical site administrator. Students are expected to adhere to the following guidelines: - All communication with the NSU PA Program and all preceptors is to be done in a professional manner and is to be conducted during their regular business hours (which understandably vary by specialty). - Students are not to socialize with their preceptors during or after rotation completion. - Students are not to solicit their preceptors and/or their associates for future job opportunities while on rotation. - Students are not to accept gifts from their preceptors. - Students are not to present to their current, former, or future preceptors' workplace unannounced. - Students are not to ask preceptors to take additional students for rotations, but instead should notify the program if additional students might be accommodated. - Students are not to discuss their classmates with their preceptors.

Universal Precautions and Exposure Policy

The student is responsible for following OSHA Guidelines for universal precautions at the clinical rotation site, including the use of gloves, care of sharp objects, use of eyewear, protective clothing, and other precautionary measures. Nova Southeastern University adheres to the guidelines of the Centers for Disease Control and Prevention (CDC). In accordance with the CDC Public Health Service Guidelines, this policy covers all exposures to blood/body fluids by any student during any component of the Program curriculum or any assigned supervised clinical experience. The following materials are assumed to be infectious relative to blood-borne pathogens, particularly hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV): Blood, blood products, tissue, semen, vaginal secretions, breast milk, cerebrospinal fluid, amniotic fluid, peritoneal fluid, synovial fluid, pericardial fluid, pleural fluid, inflammatory exudates or any other body fluid contaminated with blood.

Policies and Procedures

The student is responsible for reviewing and abiding by all stated policies and procedures. All program communication will be directed to the student's NSU email account. Students are required to check NSU email accounts daily while on clinical rotations. All email requests must be responded to within 24 hours to the Clinical Director or the faculty and staff. Location of Clinical Rotations ⋆Students will be placed in rotations that are outside of the Orlando area depending on the availability of rotation sites, and every student has the potential to be placed in at least one rotation outside the immediate Orlando area. ⋆Many students will travel for several clinical rotations during the clinical year. ⋆For students who must travel to distant sites for their clinical experiences, every attempt will be made to provide university housing in such cases, but housing cannot be guaranteed. ⋆The Program will not make travel exceptions based on students' personal requests or obligations (child care, pet care, transportation, budgetary/financial, etc.). It is the students' responsibility to arrange management of their own personal obligations during the clinical year. Requesting Clinical Rotations ⋆Any requests for rotations must be submitted in writing 3 months prior to the start of clinical rotations. ⋆All rotations are subject to approval by the clinical department. ⋆Students may request a specialty only for their clinical rotations, not a specific site or provider. - Students may let the clinical team know if they have a preferred site, provider, or city, but the clinical team will make the final determination regarding student placement. ⋆Clinical rotations outside of the State of Florida will only be considered for the 9th rotation (Clinical Elective) and must not be hospital-based rotations or require hospital badging or credentialing. ⋆Once a site has been requested and/or assigned by the clinical team, there will be no changes to the assignment once it has been confirmed by the site/preceptor. This includes requests due to new sites, new affiliation agreements, changes in student preferences, changes due to job offers, or other factors. ⋆Students who have not requested an elective rotation will be assigned one by the clinical team, and this assignment cannot be changed once made. Please note that while students may request a rotation change, the Program is under no obligation

General Overview: Student responsibility

The student is responsible for reviewing and abiding by all stated policies and procedures. The faculty reserves the right to review and revise policies as needed throughout the year. If this occurs, the students will receive a new policy and/or procedure in writing. While accomplishing the requirements of the clinical year, the students are expected to abide by the Nova Southeastern University Student Handbook of the Dr. Pallavi Patel College of Health Care Sciences, the Dr. Pallavi Patel College of Health Care Sciences policy of Academic Honor, and the American Academy of Physician Assistants, Code of Ethics of the Physician Assistant Profession. In addition, the student must abide by the policies and procedures of the Physician Assistant Program of Orlando's Clinical Year Handbook. Again, the student is responsible for reviewing and upholding the policies set in this handbook. The preceptor may contact the Clinical Director at any time and utilize the Clinical Incident Form to report any concerns regarding the student's conduct. Any unethical or unprofessional behavior will be grounds for immediate dismissal from the PA Program.

Jury Duty

The student must bring the notice of jury duty to the Clinical Director as soon as it is received. The Program Director will issue a letter documenting enrollment in the PA Program. Any missed work will be the responsibility of the student. Extended time away may result in repeating a specific course or rotation. - Accepted forms of documentation: Official Jury Duty notice that documents your name and dates of attendance.

Student Work Hours..

The student schedule will be based upon the hours of operation and normal business practices of the facility. Preceptors are not obligated to give the student days off on weekdays or weekends. College holidays DO NOT APPLY in the clinical year. The student's schedule is determined by the preceptor, not the Program, and should consist of a minimum of 36 hours per week and may include nights, weekends and holidays as well as an on-call schedule. It is not uncommon for students to work 80 hours per week while rotating in certain specialties. If < 40 hours a week are completed, it must be justified by the main preceptor

Preceptor's Role & Responsibilities

The supervising preceptor(s) is a licensed Physician and/or Certified Physician Assistant. In select cases, a Nurse Practitioner or Nurse Mid-Wife may also serve as a preceptor. In behavioral/mental health rotations, a licensed psychologist or counselor may serve as a preceptor To provide an appropriate environment and help to arrange a variety of pt encounters with a sufficient number necessary for an adequate learning experience for the student. To provide the required minimum number of clinical hours for the student to attend and participate in clinical activities at the rotation site. During this time, the preceptor must be available for supervision, consultation, and teaching, or designate an alternate preceptor. To acquaint the student at the onset of the rotation with the practice/site policies and procedures and review with the student the expectations and objectives for the rotation. To supervise, demonstrate, teach, and observe the student's clinical activities, in order to aid in the development of the student's skills and to insure proper patient care; to delegate increasing levels of responsibility to the student for clinical assessment and management as the student's skills develop; to co-sign all chart entries as required. To provide on-going feedback to the student regarding their clinical performance. To participate in the evaluation of the student's clinical skills and medical knowledge base through the following mechanisms: o Direct supervision, observation, and teaching in the clinical setting. o Provide the student with operative experiences (On surgical rotations and other rotations as appropriate). o Direct evaluation of student oral case presentation skills. o Assignment of outside readings and research to promote further learning. Participation in dialogue with faculty during site visits, in person or via webcam, to evaluate student's progress and to assist the student's learning process. Audit of charts to evaluate the student's ability to write appropriate and complete progress notes, histories, PEs, assessments, written orders, prescriptions, and treatment plans. Review of the student-generated mid-rotation evaluation and sign the form (Please note: if you stamp your name please sign as well). Complete, sign, and return on time the end of rotation evaluation forms. The preceptor will complete the form and return it to the school, but the advisor will assign a grade according to the evaluation. Immediately notify the Clinical Director of the PA Program by telephone of any circumstances that might interfere with the accomplishment of the above goals or diminish the training experience for the student. The PA Department strives to maintain open faculty-colleague relationships with its preceptors. Early notification of appropriate program personnel, should problems arise during a rotation, results in early problem solving without undue stress on the preceptor. In addition, open communication and early problem solving may help to avoid a diminution in the educational experience for the student. If any preceptor thinks a student is being unprofessional, lacks general competence, or is disruptive to the practice of medicine and/or the care of patients, the office staff, or other providers, then the preceptor reserves the right to dismiss the student from the rotation immediately, and refer him/her to the program for appropriate handling of the issues. The Preceptor should also notify the Clinical Director as soon as possible to report his/her concerns leading to the removal of the student The dedication and time it takes to train future health care providers should not be hindered by unprofessionalism and disrespect. Students should not disrupt this dedication or the atmosphere of trust, integrity, and mutual respect with our preceptors.

Clinical Year Test Administration Policies

This section establishes the testing policy and procedures required to preserve the integrity and fairness of the End of Rotation WRITTEN Exam, which are comprehensive subject examinations you will be taking during your clinical year. This policy applies to all students during their clinical year in the PA program and is established in accordance with the NCCPA/PANCE and the Board of Medical Examiners format for standardized medical aptitude testing. The exam administration and behavior expectations will follow the same format as the didactic year exams, unless otherwise specified. Students should refer back to their Academic Handbook for more detailed testing information. Failure to achieve a minimum score of 75% on the EOR test will result in the student having to take a retest for that respective rotation. The highest score achievable for the retest is a score of 75%, regardless of actual performance. Failure to achieve a score of 75% on the retest will result in a failure of the rotation and referral to the Committee on Student Progress for further action. Students are NOT to approach the Clinical Director or the Clinical Coordinator after the test to alert them of their test failure. NOTE: Dishonest acts, as defined in Academic and Clinical Year Handbooks, as well as College and University Handbooks, will subject the student to immediate disciplinary actions up to and including expulsion from the program. Such acts include any attempt to pass examinations and rotations by improper means and to aid or abet another student in a dishonest act. Any communication between students regarding Clinical Summative Evaluation (CSE) content will be considered a dishonest act and will subject the student to referral to the Program Director and then if appropriate on to the Dr. Pallavi Patel CHCS's Academic Honesty Committee. (See the Dr. Pallavi Patel CHCS Student Handbook)

Bereavement

Three days maximum are allowed for deaths in the student's immediate family which is defined as: the student's spouse, parents, children, siblings, grandchildren, grandparents. Time missed will be made up on an hour-for-hour basis. If hours of rotations missed are not made up, the student will be referred to the CSP for further consideration and action. - Accepted forms of documentation: Official obituary statement or documentation of the ceremony.

Graduation Requirements

To graduate from the NSU PA Orlando Program, students must: - Complete all nine rotations, assignments, practical skill evaluations, and competencies with a minimal GPA of 2.5 - Successfully complete all didactic and clinical coursework - Demonstrate professional behavior throughout the program - Clear all accounts with the Bursar's office At the completion of requirements for the Physician Assistant Program at Nova Southeastern University in Orlando, students will be required to participate in a Commencement ceremony on the main campus in Davie, Florida. Students that have fulfilled their requirements are eligible to sit for the Physician Assistant National Certifying Exam (PANCE), administered by the National Commission of Certification of Physician Assistant (NCCPA), and to apply for state licensures.

Student Responsibilities to the Site/Preceptor*

To keep scheduled hours as required by the program and the clinical site. Students are to contact the preceptor TWO WEEKS PRIOR to the start date of the rotation. To be sensitive to the pressures on the preceptor To be sensitive to the wishes of the patient To be sensitive of the way in which the preceptor deals with his/her patients. The student may not wish to adopt the same attitudes and behavior toward the patients; however, if there appears to be an issue, it should be discussed before a major problem develops To be sensitive to the demands the student's presence places on the office staff. To be respectful, courteous, appreciative, professional, and of good moral character at all times. To complete charting each day before going home. To complete preceptor assignments including reading lists and other projects along with the program's assignments. To be appreciative to the office staff. To take initiative in asking to see patients and assist in procedures.

Student Responsibilities to the Preceptor

To keep scheduled hours as required by the program and the clinical site. A signed preceptor work schedule noting the student's hours that are expected for the rotation is to be submitted to the clinical department by the end of the first week of the clinical rotation. Students are to contact the preceptor TWO WEEKS PRIOR to the start date of the rotation. To inform the preceptor on a regular basis of the student's individual rotation needs; this includes sharing with the preceptor where the student feels he/she "is" and where he/she "ought to be" in specific clinical requirements and clinical skills. To be sensitive to the pressures on the preceptor; the amount of time the preceptor can spend with the student may depend on the number of patients scheduled, the physician's concern about patients or other issues, or how tired he/she is. To be sensitive to the wishes of the patient and their willingness to share confidences or to have the student be partially responsible for their care. To be sensitive of the way in which the preceptor deals with his/her patients. The student may not wish to adopt the same attitudes and behavior toward the patients; however, if there appears to be an issue, it should be discussed before a major problem develops. To be sensitive to the demands the student's presence places on the office staff; check regularly with staff about the increased workload expected of them. If the student is aware and/or informed that the workload has increased to an unbearable level, the student should cooperate in the planning and alleviation of the situation, and consult with the program's clinical team. To be respectful, courteous, appreciative, professional, and of good moral character at all times while working with your preceptors on clinical rotations. Failure to be professional and respectful after being assigned to a rotation site can be automatic grounds for dismissal from the rotation and/or the program, depending on the infraction. If the preceptor dismisses you, then you fail the rotation. Also, if the preceptor contacts the program and says that there are serious issues, you may be failed immediately, and have to repeat the rotation. The decision will be made after a referral to the CSP for academic and/or unprofessional issues and discussion between the preceptor and program administration to include the Clinical Director, Medical Director, Program Director, and Academic Director. Discussions between preceptors and administration may be in person, via phone, email, or fax. To complete charting each day before going home. To complete preceptor assignments including reading lists and other projects along with the program's assignments. To be appreciative to the office staff. To take initiative in asking to see patients and assist in procedures. Under no circumstance shall the student act as an employee or an administrator of the site.

PANCE Examination

Upon completion of the Nova Southeastern University Orlando PA program, students will be eligible to take the Physician Assistant National Certifying Examination (PANCE), administered by the National Commission on Certification of Physician Assistants (NCCPA). To attain the PA-C designation, a passing score must be achieved on the PANCE. The minimum required score varies from year-to-year based on a variety of factors. PANCE is a computerized, multiple-choice test comprised of 360 questions that assesses basic medical and surgical knowledge. Instructions for taking the PANCE are found on the NCCPA website: https://www.nccpa.net/. A graduate's first opportunity to sit for the PANCE is seven days after program completion (provided the Program Director has confirmed your graduation.) This date will be reflected on your exam scheduling permit. The graduate will have 180 days from the beginning of your exam timeframe to the end of your timeframe in which to take the exam. These dates will be reflected on your scheduling permit. You may only take PANCE once in any 90-day period or three times in a calendar year. If there is any chance that you won't complete your PA program requirements on time, wait until you are confident of your program completion/graduation date prior to registering for the exam.

Performance Tests Failures

When a student fails >2 Performance tests which includes any 2 SOAP notes, 2 Oral Case Presentations, 2 OSCEs, 2 Written Complete H & PE or any combination of the 2 the following ensues: First CSP referral due to 2 failed Performance tests: The student will be recommended to be placed on in-house Academic Warning. The student will meet with the Academic Advisor and the Clinical Director for the plan of action. It is the student's responsibility to meet with the appropriate faculty members. Second CSP referral due to Performance tests: 1. At this point, if the student has >2 failed performance tests a recommendation for dismissal and/or continued Academic Warning is likely depending on overall academic/clinical performance along with any documented, significant extenuating circumstances. 2. If the failure of any performance test results in a rotation failure, then the policy for rotation failures applies.

Make-up Policy

When possible, all time missed from rotation is to be made up (hour-for-hour) at the discretion of the preceptor. ⋆For time that cannot be made up at the clinical site, students will be responsible for completing additional assignments for each day missed of the rotation. ⋆This is in addition to the baseline requirements for each rotation, not in place of them.

Emergency Medical Procedures

While there is no guarantee or requirement for such, most of the clinical sites utilized by the NSU Physician Assistant Program can and will arrange for immediate care of students in the event of accidental injury without charge to the student, accepting assignment of the student's insurance. They will not, as a rule, take responsibility for subsequent costs involved in follow-up care, treatment, counseling, hospitalization or preventive care. In any situation involving the potential for exposure to blood or potentially infectious materials, you should always use Universal Precautions and try to minimize your exposure by wearing gloves, splash goggles, pocket mouth-to-mouth resuscitation masks, and other barrier devices. If you are exposed, however, you should: 1) Remove and dispose of all contaminated personal protective equipment (PPE). Wash the exposed area thoroughly with soap and running water. Use non-abrasive, antibacterial soap, if possible. If blood is splashed in the eye or mucous membrane, flush the affected area with running water for at least 15 minutes. If the student sustained a needle stick injury, the exposed area should be squeezed (if appropriate), wash with soap and water, and scrub with betadine solution or alcohol. 2) Report the exposure to your supervising physician or immediate clinical supervisor AND to the hospital/clinic, and the PA program Clinical Director as soon as possible. 3) The individual must then report to Employee Health Services or the Emergency Department (ED) for initial and further instructions. 4) The individual sustaining significant exposure undergo post exposure prophylaxis (PEP) and will be counseled on the risk of HBV, HCV and HIV infection and transmission. 5) Many clinical facilities during the second year will begin the post exposure procedure(s) with the student. There is no mandatory requirement for them to do so. Any costs incurred by the student in following such a plan are the responsibility of the student. It is up to the student to ascertain costs (if any) in advance of accepting such services. 6) You may also go to the NSU affiliated Health Care Providers, or contact your personal primary care provider for care and follow-up. Refer to the CDC's website for follow up protocol, which can be located at: http://www.cdc.gov/HAI/index.html, or assistance is available through the CDC toll-free hotline 24 hours a day (1-888-448-4911) or through the National Clinician's Post exposure Prophylaxis Hotline (888) 448-4911. These procedures include documentation, treatment and follow-up recommendations.

End-of-Rotation Written Exam

With the exception of the Clinical Elective Rotation, a 50-question, multiple-choice examination is part each EOR seminar. The allotted time for the test is 50 minutes, averaging one minute per question. Under usual circumstances, no WRITTEN exam is given for the 4-week elective rotation. These exams are designed to test the student's knowledge of the rotation's clinical subject matter, as well as the medical procedures normally encountered in such a rotation. Failure to achieve a minimum score of 75% on the EOR test will result in remediation and CSP referral as outlined in the Clinical Year CSP Algorithm. Regardless of the score on the retest, the maximum score given for the exam will be 75%. Failure to achieve a score of 75% on the retest will result in a failure of the rotation and additional referral to the Committee on Student Progress for further action (See Appendix for CSP Algorithm).

SU PA Orlando students on clinical rotation must

Work under the direct supervision of their clinical preceptor(s) Follow the NSU PAO program dress code, which includes: ⋆Wear a Nova Southeastern University patch on their lab coats ⋆Display a visible nametag designating their student status and association with the university Identify themselves as physician assistant students at all times. Perform only those procedures authorized by the PA Department, clinical site, and preceptor. Adhere to all regulations of the PA Department and the clinical sites Deliver health care service to patients without regard to their race, religion, creed, national origin, sexual orientation, socioeconomic status, disability, disease status, and/or political beliefs. Sign all charts and written orders with the student's name clearly written, followed by the designation "PA-S". At no time may the student use other professional titles (e.g. RN, EMT, etc.) while on clinical rotation. Have all chart entries written orders, and prescriptions immediately countersigned by the preceptor or assigned designee. Know your limits. Do not consent to assess any patient or perform any procedure that is beyond your ability. Observe the highest level of patient confidentiality at all times It is the responsibility of the PA Student to identify himself/herself as a Physician Assistant Student from Nova Southeastern University to the clinical staff and the patients. A student must wear a white lab coat with the NSU PA Program badge on the left sleeve. In addition, the NSU Identification Badge must be worn at all times when at the clinical site, even if the clinical site issues their own identification badges.

Curriculum overview

Your clinical year will consist of: ⋆Seven Core Rotations (6 credits each) ⋆One Selective Rotation (6 credits) ⋆One Elective Rotation (4 credits) ⋆Hybrid Elective Rotation (6 credits) - as needed ⋆All clinical year rotations are required Core Rotations: ⋆Family Medicine ⋆Internal Medicine ⋆Emergency Medicine ⋆Pediatrics ⋆Surgery ⋆Prenatal Care and Gynecology ⋆Behavioral Health Selective: ⋆The student may choose* from a pre-determined list of clinical specialties Elective: Student's choice** Hybrid Elective Rotation */** Disclaimer: ⋆The student's ability to choose their own rotations is at the discretion of the Clinical Director. Students may lose their ability to choose based on academic standing, Program needs, completion of benchmarks, natural or man-made disasters, site or preceptor availability, or other factors. ⋆Selective Rotation options may vary from year to year, based on site and preceptor availability. ⋆The 4-week Clinical Elective Rotation can be in any* specialty, and is the only rotation where students may have the opportunity to leave the Orlando territory. *Students may choose from existing available sites, or self-identify their own. All potential clinical sites and preceptors must be vetted and approved prior to use.

What is clinical training composed of?

eight 6-week & one 4-week rotation: 7 required, 1 selective, and 1 electives. In addition there are 3 one-credit Graduate project courses

How are the 9 clinical year rotations divided?

into seven core rotations, one selective rotation, and one clinical elective rotation 7 core rotations including: Internal Medicine, Family Medicine, Pediatrics, Prenatal/Obstetrics and Gynecology, General Surgery, Behavioral Medicine, and Emergency Medicine. Selective Rotation will be in a specialty of medicine that roughly corresponds with the NCCPA Content Blueprint Organ areas. The specialties available for students to choose from will vary from year to year based on site/preceptor availability and the needs of the Program. Clinical Elective is an opportunity for students to explore an area of medicine of their choosing, but it is not guaranteed. While every attempt will be made to allow students free choice of their clinical elective site, the Program reserves the right to assign students to a clinical elective for any reason. - For students to be eligible to choose their own Clinical Elective, all required pt benchmarks must have been satisfied and no disciplinary issues exist. Students who have not achieved their benchmarks will forfeit their Rotation 9 Elective to ensure completion of benchmarks prior to graduation. - The Clinical Elective is the only clinical rotation where students may have the ability to travel outside of the NSU PA Orlando territory.

Netiquette (Network Etiquette)...

⋆Be courteous and respectful at all times. ⋆Avoid flamewars or spam messaging. ⋆Profanity and slang are unacceptable. ⋆Use proper grammar and spelling in your communication. ⋆Watch your tone when writing. Do not write in ALL CAPS. Writing in this manner suggests that one is shouting or yelling. ⋆Be conservative when posting personal information on blogs and communication boards. Anything that is posted may be shared. ⋆Use discretion in everything you do on the internet, including social media. ⋆Social networking (or 'friending') NSU PAO Program faculty and staff, guest lecturers, clinical preceptors, or current/former patients while you are enrolled in the Program is strictly prohibited. ⋆Take responsibility and use good judgment. ⋆Think before you post. ⋆HIPPA laws apply to all social networking. ⋆Protect your own privacy and personal information. ⋆Social networking is permanently timed and tracked. ⋆If you state a connection with the NSU PAO Program, you must identify yourself, your role in the program, and use a disclaimer stating that your views are that of your own and do not reflect the views of the NSU PAO Program. ⋆All laws governing copyright and fair use of copyrighted material must be upheld. ⋆Consult your faculty advisor, the Clinical Director, or the Program Director if you have any questions regarding the appropriateness of social networking use. ⋆You are prohibited from communicating with a member of the media or outside source attempting to gather information regarding the NSU PAO Program through the social network. ⋆Refer all questions regarding program information, policies and procedures to the NSU PAO Program Director.

Preceptor

⋆Licensed medical provider (physician, PA, NP, LMHC, etc.) ⋆Provide Learning experiences and opportunities ⋆Provide ongoing feedback, not just at the end ⋆Directly supervise, observe, and teach ⋆Assign additional readings/assignments ⋆Sign rotation paperwork, as necessary ⋆Notify the clinical team of student performance and concerns ⋆Provide the student as much hands-on experience as the preceptor feels he/she is capable of handling

ADA Accommodations

⋆Students with disabilities who request reasonable accommodations in the clinic for known conditions must meet with the Clinical Director within one week of receiving the clinical assignment(s). Reasonable accommodations that are authorized through the NSU ADA Coordinator are subject to approval by the clinical site. In compliance with the ADA, the Clinical Director is not permitted to discuss a student's disability with the clinical site unless written consent is received, which allows the Clinical Director to discuss the implications of a student's disability on the clinical rotation prior to the student's arrival. When written permission is not obtained, the Clinical Director will strongly encourage disabled students to disclose information to their assigned clinical sites, for the purposes of making accommodations that may impact clinical performance, time management, and scheduling. Facilities have the right to refuse placement for a student who requires reasonable accommodation.

Documentation and Medicare Compliance

⋆The Centers for Medicare and Medicaid Services policies allow the teaching physician to verify in the medical record any student documentation of components of E/M services, rather than re-documenting the work. Students may document services in the medical record. However, the teaching physician must verify in the medical record all student documentation or findings, including history, physical exam and/or medical decision making. The teaching physician must personally perform (or re-perform) the physical exam and medical decision making activities of the E/M service being billed, but may verify any student documentation of them in the medical record, rather than re-documenting this work. Although Medicare has no absolute rules governing PA students and documentation, PA programs have previously been strongly advised by the American Academy of Physician Assistants (AAPA), Office of Federal Affairs, to heed the AAMC guidelines. In addition, the clinical Preceptor must always supervise and/or provide necessary components of a given service to the Medicare beneficiary. The NSU PAO Program will abide by these guidelines.

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