̨ÍåSwag

Introduction

The physician assistant (PA) degree is recognized as an undifferentiated professional degree that requires the development of entry level knowledge and skills in multiple domains of health care.  PA education requires the development of judgment through a wide range of learning activities and supervised clinical practice experiences in preparation for making appropriate, autonomous clinical decisions while practicing on interprofessional health care teams directed by physicians.  

The purpose of this document is to ensure that all students entering the ̨ÍåSwag Physician Assistant Program (the PA Program) are aware of and understand the requirements of our program and the profession, so that informed decisions can be made regarding pursuit of this profession. Nothing in this document is meant to deter the application or participation of any student who is able to complete the requirements of the PA curriculum with or without reasonable accommodations.

Policy

The PA Program has a responsibility to assure the public that its graduates are fully prepared to be competent and caring entry level physician assistants. Thus, it is important that students possess the intelligence, integrity, compassion, social responsibility, and physical and emotional capacity necessary to acquire the knowledge and skills needed to practice medicine safely and competently as a PA. The PA Program endeavors to select applicants who have the ability to become highly competent clinicians.  Admission and progression decisions will be based on academic achievement, related requirements, and the non-academic technical standards described within this document. These technical standards and essential skills are an integral requirement for participation in the academic and clinical program, for graduation, and for practice as an entry level PA. 

The ̨ÍåSwag Student Handbook details services available to students with disabilities and these services are coordinated by the Office of Accessibility Services in the Student Success Center. The PA Program, in accordance with Federal and New York State law, is committed to equal opportunity and a nondiscriminatory environment for all persons. No qualified person with a disability shall be excluded from admission, participation, or denied benefits or subjected to discrimination solely by reason of his or her disability. It is the responsibility of the applicant or student with disabilities to provide supporting documentation and to request those accommodations that he/she feels are reasonable and are needed to execute the essential requirements described within this document. When requested, ̨ÍåSwag will provide technological compensation and reasonable accommodations to otherwise qualified students with disabilities; however, it is essential that each student be able to perform in a reasonably independent manner.  Requests for accommodations are reviewed individually, on a case-by-case basis, to determine whether there are any reasonable accommodations or available options that would permit the candidate to satisfy the standards. An accommodation is not reasonable if it poses a direct threat to the health or safety of others, if making it requires a fundamental alteration of an essential element of the curriculum, if it lowers academic standards, or poses an undue administrative or financial hardship.  The use of a third party (e.g., an intermediary or surrogate) to perform any of the functions described in this document may constitute an unacceptable modification as it is necessary that the student be able to meet the technical standards and demonstrate all of the essential skills of a PA with or without reasonable accommodation.

The procedures for dissemination and acknowledgement of these technical standards and essential skills are as follows. All accepted applicants will be referred to this document through postings on the university’s website and will be provided hard copy upon receiving an offer of acceptance to the program. Accepted applicants (and parents/guardians if the student is <18 years of age) will be asked to review and sign this document at the time of deposit.  Any questions or concerns regarding the technical standards or essential skills should be directed to the Director of Accessibility Services in the Student Success Center who will ordinarily consult with the PA Program Director, and other experts, regarding non-classroom related laboratory or clinical accommodations.  Students with documented disabilities are encouraged to meet with the Director of Accessibility Services when reviewing/signing.  This document will also be reviewed with students in the PA Program in related meetings and courses and will be included in the Physician Assistant Student Manual.

Technical Standards and Essential Skills for Physician Assistant Practice

Technical standards and essential skills refer to those physical, cognitive, and behavioral abilities required for satisfactory completion of all aspects of the curriculum, and the development of professional attributes required by the profession of all students at graduation.  The holder of a PA degree must have the knowledge and skills to function, with great autonomy, in a broad variety of clinical situations and to render a wide spectrum of patient care and emergency treatment. In order to carry out the activities described below, candidates must have abilities, attributes, and skills in five major areas:

1. Observation and Sensory,
2. Communication,
3. Motor,
4. Intellect: including conceptual, integrative, and quantitative abilities, and
5. Behavioral and social attributes.

Observation and Sensory

The student must be able to observe demonstrations, experiments, laboratory exercises in the basic sciences, clinical laboratory diagnostic tests (e.g. pregnancy, rapid flu, rapid strep, urinalysis), patient monitoring devices (e.g. telemetry, glucometer, pulse oximetry, thermometer, sphygmomanometer), diagnostic images and reports (e.g. electrocardiograms, plain radiographs, CT Scans, MRI, spirometry), and patients for the purposes of assessment and diagnosis accurately at close range and at a distance.  The student must have the ability to discern and comprehend dimensional and spatial relationships of structures.

Upon completion of relevant course work, the student must be able to assess skin, subcutaneous tissues, muscles, ligaments, tendons, joints, nerves, lymph nodes, and intra-abdominal organs through palpation. The student must be able to perceive the presence of abnormalities in a specific body system such as masses or inflammation in the eyes, oropharynx, nostrils, abdomen, and pelvis, and must also be capable of perceiving the signs of disease through visual, auditory, tactile, and olfactory means as manifested throughout the comprehensive head to toe physical examination of the patient.  The process of physical assessment includes, but is not limited to, information that is derived from observation and palpation of body surfaces, palpable changes in various organs and tissues, and auditory information such as patient voice, and heart/lung/bowel/vascular sounds.  PA students must have the ability to examine and be examined during the process of learning and practicing the technical skills of physical examination.

Communication

The student must be able to communicate in English clearly, efficiently and effectively with instructors, fellow students, patients and family/caregivers, physicians and other members of the health care team verbally, non-verbally, and in written formats.  These communication skills require the ability to examine all information provided, including the recognition of the significance of non-verbal communication.  Immediate evaluation of information provided is necessary to allow for appropriate, well focused follow-up inquiry.  Communication skills include the ability to identify and seek out sources of feedback, and to effectively use and provide feedback for improving personal interaction.  

Upon completion of the relevant course work, the student must be able to clearly, effectively and efficiently communicate across the elements of patient management from examination through intervention and discharge planning.  Such tasks require the ability to communicate with both the patient and family/caregivers.  The student must be capable of responsive, empathetic, active listening to establish rapport in a way that promotes openness on issues of concern and competence with respect to cultural differences. The student must be able to receive, process, and express information on the patient’s status with accuracy to and from physicians, physician assistants, nurses, and other members of the health care team. This information needs to be communicated in a succinct yet comprehensive manner and in settings (e.g operating room, emergency department, intensive care unit, office) or circumstances (e.g. cerebrovascular accident, myocardial infarction, overdose, anaphylactic reaction, suicide attempt, patient prone to violence, respiratory distress, cardiac arrest, childbirth, intraoperative hemorrhage) in which time may be critically important to the safety and well-  being of not only the patient, but other providers and caregivers.  Effective communication also relies on the student’s ability to use appropriate judgment in seeking supervision and consultation in a timely manner as well as effectively addressing any potential cultural considerations.  Documentation of the elements of patient management from examination through intervention and discharge planning in a variety of formats (written and electronic) must be complete and accurate.

Motor

The student must have sufficient motor function to effectively move themselves and others in order to learn and competently perform the psychomotor tasks required for physical examinations and to provide medical care and treatment.

Upon completion of relevant course work, the student must demonstrate psychomotor skills related to patient physical examination, care, and treatment.  Additionally, the student must be able to physically ensure the safety of themselves and patients at all times including meeting the acceptable standards of universal precautions and sterile technique.  Examples of general care and emergency treatment reasonably required of a PA include intramuscular/intradermal/subcutaneous injections, incision and drainage of superficial infections, collection and processing of patient specimens, insertion of venous and indwelling Foley catheters, cast and splint application/removal, phlebotomy, assisting surgeons in the intraoperative setting and managing preoperative and postoperative surgical conditions, performing cardiopulmonary resuscitation, airway intubation and ventilation, cervical spinal stabilization, the application of pressure to stop bleeding, the suturing of simple wounds and general wound care, and the performance of a physical examination to include, but not limited to, otoscopy, ophthalmoscopy, auscultation of breath/heart/vascular/bowel sounds, palpation and percussion of organ systems, and rectal, pelvic, and musculoskeletal examinations.

Intellect: Conception, Integration, and Quantitative Abilities

The student must have the cognitive abilities necessary to master relevant content in the basic sciences and clinical courses at a breadth and depth determined by the PA profession.  These skills may be described as the ability to comprehend, memorize, apply, analyze, and synthesize material.  The student must be able to develop reasoning, problem-solving, and decision-making skills appropriate to the practice of medicine as a PA and must possess the ability to read, count, calculate, and measure.

Upon completion of relevant course work, the student must demonstrate the ability to question logically, to identify, generate, and evaluate elements of logical argument, to recognize and differentiate facts and assumptions, and to distinguish the relevant from the irrelevant.  The student must be able to recognize the limits of his/her ability, request assistance when necessary, and create a professional development plan based on their individual needs.

Behavioral and Social Attributes

The student must demonstrate personal attributes of caring, integrity, and cultural competence.  The student must possess the emotional health and stability required for full application and use of their intellectual abilities, the exercise of good judgment, the prompt and effective completion of all responsibilities under stress, and to adapt to a clinical environment that may change rapidly without warning and/or in unpredictable ways.  The student is expected to interact with others (i.e. classmates, instructors, patients, preceptors, patient’s family members, and other members of the health care team) in a respectful and responsible manner at all times.  The student must be able to accept and respond to constructive criticism and resolve conflicts in a socially acceptable and professional manner.  

Upon completion of the relevant course work, the student must be able to understand and demonstrate the basis and content of professional PA practice.  The student must possess the skills of a reflective practitioner including the ability to self-assess, self-correct, and self-direct; to identify needs and sources of learning; and to continually seek new knowledge and understanding. 

Conclusion

The faculty of the PA Program recognizes its responsibility to present candidates for the Master of Science in Physician Assistant Studies degree who have the knowledge and skills to function in a broad variety of clinical situations and render the full spectrum of medical care as an entry level PA practicing medicine on health care teams directed by physicians.
Any person denied admission to the PA Program or who is unable to successfully complete the PA Program solely due to his/her disability has the right to appeal the decision in accordance with the ̨ÍåSwag Grievance Procedure in Discrimination Cases, a copy of which may be obtained from the Office of Accessibility Services in the Student Success Center, Research Information Commons.