PA Clerkship Specific Policies
Clerkship Specific Policies
General Information
After successfully completing the didactic phase of PA training, students will transition to the clinical year. This time is known as the Supervised Clinical Practical Experience (SCPE).Rotation length and requirements:
The SCPE currently consists of eight clinical clerkship courses, each spanning approximately 6 weeks. The current disciplines consist of the following: Family Medicine, Pediatrics, Internal Medicine, Psychiatry, Surgery, Emergency Medicine, Prenatal Care & Gynecology, and one selective clerkship course. Students are expected to be actively engaged in taking responsibility for their education by mastering the knowledge objectives outlined in the clerkship syllabi.Didactic lectures, Rounds, and other academic opportunities:
Students are required to attend all learning activities of the rotation. In many hospitals and academic sites, this will include didactic lectures offered to all medical learners (including medical students and residents), participate in daily rounds, Grand Rounds, and other conferences.General Duties and Tasks:
PA students are educated in taking medical histories and performing physical examinations, developing differentials, ordering diagnostic studies, developing a diagnosis, treatment plans, and educating patients before entry into the supervised clinical experience. Clinical clerkship courses enable PA students to sharpen their primary care skills and learn the art of medical practice.The primary goal is for the student to gain practical experience, develop skills as a healthcare practitioner, and learn the roles of other members of the healthcare team. The supervised clinical experience also emphasizes the dependent role of the PA and the Physician-PA Team concept.Professional Liability
All clinical facilities require students to have professional liability insurance. Professional liability insurance is provided by the SHP, and information regarding the provision of liability insurance is described in the affiliation agreement between TTUHSC and the facility. All questions regarding professional liability insurance addressed to the students should be referred to the Clerkship Coordinator. Students are covered by this liability insurance only while they are in a clinical setting, laboratory, or classroom approved by the TTUHSC PA Program administration.The SHP provides professional liability coverage for students that work or study in a clinical environment with limits of $1,000,000/$3,000,000. This coverage only applies to activities that are part of and a requirement of students’ curriculum. Depending on each student’s personal financial situation, this may or may not be adequate coverage. It is recommended that you meet with a financial advisor or attorney of your choice to determine whether or not you need to purchase additional coverage.
Clerkship Region Assignments
Clinical Regions:
Students will be assigned a clinical region at the discretion of the faculty during the Spring semester of the didactic year. The TTUHSC PA program has established regions based around TTUHSC campuses in Amarillo, Lubbock, Permian Basin, Abilene, and El Paso.Assignment Process: The assignment process is coordinated by the Director of Clinical Education and the assignments are approved by the Clinical Faculty Team. The number of students per region is determined yearly based on the sufficiency and availability of clinical sites. The following criteria may be considered in the selection process: Academic standing and performance, GPA, Professionalism, Professional Service, indicators of future practice in populations similar to regional assignments. Clerkship region assignments are final.Travel Requirements Outside of Home Region:
Students are not guaranteed all clerkship course sites will be located within their assigned region. Students may be required to move between regions or outside of the TTUHSC regions based on site/preceptor availability in specific disciplines or for other unexpected situations. Students will be responsible for all travel expenses during the clinical year.
Clinical Site Scheduling
Solicitation and scheduling of sites/preceptors:
All clinical sites are solicited and schedules are assigned by the faculty of the TTUHSC PA program Clinical Team. The program faculty will review, evaluate and approve all preceptorships for the suitability of the program. All clinical clerkship courses are scheduled by the Student Training Education and Placement System utilized by EXXAT. Students will have input into their experience placements through the submission of preferences.Student solicitation of site strictly prohibited:
Students may not contact providers or preceptors to seek or schedule clinical clerkship course experiences. Students may suggest sites and preceptors to the Clerkship Coordinator, but all communications with preceptors for the purposes of scheduling and affiliation will be done by program faculty and staff.Rotation rescheduling:
Please note that occasionally, the situation may arise with little notice that a preceptor is unable to fulfill the scheduled clinical experience.This may result in rescheduling with another preceptor, relocation of a student to another region, or limited activities while affiliation agreements or contracts are in process. Students must remain flexible when unexpected situations arise. In this case, the student had two choices:- Accept the rotation assignment provided by the clinical team to replace the original rotation - the Clinical Team will make every effort to secure a clinical rotation site/preceptor for the student. The student may not find their own rotation.
- Not accept the rotation selection from the clinical team - the student may suggest alternative rotation sites/preceptors to the team. By choosing this option, the student agrees that if another rotation cannot be arranged, the student may be required to extend their program, delaying graduation.
Student Requirements for Clinical Sites
Contacting preceptors/sites:
Students must contact their next supervising clinical preceptor a minimum of four (4) weeks prior to the start of each supervised clinical experience.Onboarding and orientation requirements:
In addition to contacting the clinical preceptor, students are required to contact any facility in which training will also occur and complete all onboarding requirements prior to arrival. The Clinical Team will be able to answer questions or concerns regarding the policies and requirements for specific clinical sites. Students must comply with any facility-required background checks, health screenings, drug screening, or other requirements.Failure to contact clinical sites or complete requirements may result in a delay in clerkship. This will delay a student’s graduation pending completion of the clerkship course. It is the responsibility of the student to notify and complete any necessary paperwork required for each supervised clinical experience.
BLS, ACLS, and PALS Certification
Students will be required to complete BLS, ACLS, and PALS certification as a part of didactic training and maintain certification through program graduation. Students who fail to complete these certifications during scheduled times will be required to do at their own expense prior to deadlines defined by the Clinical Team during the didactic year.
Blood and Bodily Fluid Exposures
Report any blood or body fluid exposures (i.e. needle sticks) to Nicole Hines, RN, your assigned Clinical Coordinator, supervising physician, hospital employee health, your clinical coordinator immediately, and Infection Control Managing Director. See Blood & Body Fluid Exposure Plan. (Please be advised that there are clinical situations where you might be exposed to toxins that could be harmful, particularly in the case of pregnancy: Example: bone cement while on a surgery rotation. We encourage you to be aware of this and notify your faculty advisor so that appropriate measures can be taken.)https://hscweb.ttuhsc.edu/health-professions/documents/current/Blood-Borne-Pathogen-Policy_Feb2018.pdf
Expectations of Clerkship Students
Timely Communication during Clerkships
The following should be used to direct communications appropriate during clerkship experiences:| Issue | Timeliness of Communication | Contact Person |
| Emergency | 24/7 | 432-620-1135 |
| Urgent rotation concerns during business hours | During normal business hours, as soon as possible | Clerkship Coordinator, by email or phone |
| Non-urgent rotation concerns | During normal business hours | Clinicalteam.paprogram@ttuhsc.edu
|
| Absence due to illness or emergency | During normal business hours, as soon as possible | First, notify the preceptor and then your Faculty Advisor and Clinicalteam.paprogram@ttuhsc.edu |
| Preceptor illness or vacation | During normal business hours, as soon as possible | Clinicalteam.paprogram@ttuhsc.edu
|
| Blood or Bodily Fluid Exposure | Seek medical care urgently, contact preceptor. Contact Office of Institutional Health as soon as possible during business hours | Seek medical care and contact Nicole Hines, Office of Institutional Health |
| Change of address or contact information | Within 5 business days | PA Program Business Coordinator and Registrar’s Office |
Identification during Clinical Experiences
Name tags and Badges:
A name tag identifying the student as a Physician Assistant Student MUST be worn at all times during the clinical experience. If a specific site requires additional identification, it is the responsibility of the student to comply. It is the student’s responsibility to complete the paperwork necessary to obtain required badges and return badges to the site prior to departure.Greeting Patients and Student Identification Requirements:
Students are required to identify themselves to patients by their name and by TTUHSC student status. The student must explain to patients their working relationship with the preceptor.Signing charts:
When a student signs a chart, they must identify their student status, ex. PA-S2. Any official paperwork or chart must be co-signed by the preceptor.
Student Supervision
Students must be supervised by their preceptor that is a licensed provider at all times. Students may only rotate with approved preceptors. Under no circumstances should a PA student be permitted to practice independent of direct supervision.Accept only tasks for which the student has been properly trained and perform procedures only under the direct supervision of the preceptor or designated secondary preceptor within the practice.Under no circumstances should a PA student be used as an employee of the practice or represented to patients as such. Students should not be used as clerical staff, medical scribes, or research assistants.
Clerkship Attendance Policies
Attendance:
Students are required to attend clinic at scheduled times and work the hours set forth by their designated preceptor (minimum of 8 hours/day, 40 hours per week). This is required throughout the entire length of the clinical rotation experience. While on clinical rotations, students will be “on duty” at the discretion of their supervising preceptor; it is not limited to the 8:00 am – 5:00 pm schedule.This includes the potential of working weekends, holidays, and on-call hours. In order to successfully complete the professional curriculum on time, rotations must be started and completed as scheduled. Requests for time off (arriving late, leaving early, personal days, appointments, etc.) must be pre-approved by the Faculty Advisor prior to seeking approval from the preceptor.Clinical Absences:
Any illnesses or absences must be reported to their assigned academic advisor and Clerkship Coordinator immediately. All missed clinical hours must be recovered on an hour for hour basis. Missed clinical hours may be recovered during the rotation if time allows or at other times as approved by the DOCE through the Clinical Coordinator. If a student misses clinical time during the clerkship, the student will be required to maintain a time log to be co-signed by the supervising clinical preceptor. This will be used by their Clinical Coordinator to evaluate the need for additional clinical time in that area.Excused Absences and Personal Days:
All anticipated absences must be pre-approved by the Faculty Advisor prior to requesting the absence from the Preceptor. Absence approval will be considered on a case-by-case basis.See attendance policy in section 2
Requirements of All Clerkship Courses
Mid-rotation Evaluations:
Students are required to submit a mid-rotation evaluation form to the Clerkship Coordinator by Wednesday during week 3 by 5:00 PM CST for each supervised clinical experience. If a student is unable to submit the Mid-Rotation Evaluation Form by the specified deadline, they are required to notify the Clinical Team prior to the deadline. If there are any problems, contact the Clinical Team or Clinical Site Coordinator ASAP for assistance.Failure to submit the Mid-Rotation Evaluation Forms as specified above may result in lost points on the professionalism grade and may be grounds for repeating the clerkship course.Patient and Procedure Logs:
The PA program utilizes EXXAT (https://exxat.com/), which is a web-based program designed for students participating in supervised clinical experiences. The system is designed to capture age, diagnosis, type of setting, and level of complexity as well as procedures. The system does not capture protected health information and no attempt should be made to include such data.Instructions for usage of this system will be given at the pre-clinical orientation training.Completion:
Patient logging is expected to occur every day of the clerkship. Patient logs must be completed no later than 5:00 PM on the Wednesday during the last week of the clerkship course. On the last day of the clerkship, the patient log will be reviewed by the Clinical Team. Students who fail to log a sufficient number of patient contacts may be subject to a reduction in their Professionalism grade or to repeat the clerkship as determined by the student progress committee.Patient Logs:
During the supervised clinical experience, students are required to document each patient encounter just as a practicing clinician would do. A patient encounter includes any patient with whom a patient was either observed or the student assisted in care, regardless of the patient’s age. While each clerkship course is different in terms of types of patient encounters, every patient should be logged. This is not only a requirement for successful completion of the clerkship course but this log may also assist you after graduation with employment and credentialing paperwork required for clinics and hospitals.Each supervised clinical experience has varying patient volume loads familiar to the Clinical Team. The Clinical Team will monitor for the expected volume of patients that should be seen during the specified clerkship. The student is responsible for ensuring they are meeting the requirements for the number of patient logging contacts.Procedure Logs:
The procedure log is a mandatory component of the supervised clinical experience. Completion of the REQUIRED procedures is a requirement of successful completion of the program. The procedures are available in the clinical year passport.Completion of Clinical Passport.
The Clinical Passport is required by the end of the clinical year. In order to complete each clinical skills requirement (History, Physical Exam, and Procedural), the preceptor must sign off that the student is "able to perform the skill with minimum supervision" or is "capable of performing this skill independently". Information on how to document the REQUIRED skills and utilization of the EXXAT system will be given at the pre-clinical year orientation.
