PHYSICIAN
ASSISTANT
PROGRAM

CLINICAL YEAR
2005-2006

Rotation Policies for the PA Student

PREREQUISITES FOR CLINICAL ROTATIONS

Before your first rotation, you must have the following:

• Proof of health insurance.
• Current BLS, ACLS, and PALS certification.
• Up-to-date immunizations, including MMR, DPT, HBV, and polio, or proof of immunity.
• Proof of TB test within past 12 months and repeat TB testing every 12 months.
• Current physical examination and updated medical history.

Some rotation sites may want documentation of the above for their own files; we recommend you take proof of your immunizations and TB test results with you on the first day of each rotation. If your compliance with the above cannot be verified, you will be removed from your rotation until you can prove compliance. Although the College does keep the immunization documents you provided for its own files, the College is not responsible for keeping your medical records updated, nor can it provide these documents to others without a written release from you.

In addition, before you begin a rotation, you must have met these criteria:

• Successful completion of all didactic course work.
• Successful completion of each previous rotation, or arrangement with the Clinical Coordinator to finish an "Incomplete" or remediate an unsatisfactory rotation grade later.

CLINICAL ACTIVITY

While on a clinical rotation, you function as an integral part of the medical team. You will be assigned to a licensed clinician who will serve as your preceptor. You will perform histories and physicals, assess  assigned patients, assist in formulating management plans, perform various procedures, and otherwise participate significantly in patient care as determined by the preceptor. You will be responsible for monitoring patient progress, reporting to the supervising preceptor, and implementing the preceptor's plans. You will be required to attend lectures, read articles, and give case presentations as assigned by the preceptor.

You will be given as much hands-on experience as the preceptor believes you are capable of handling. The best way to demonstrate your capability and worth is to look for work actively, ask questions, engage in outside reading, report early, stay late, and volunteer for call.

You are an invited guest of each rotation site and, as such, you should leave a positive impression of yourself, the College, and the physician assistant profession. Be sure that your interactions are courteous and respectful at all times, and be prepared to discuss the PA profession, how PA's function within the medical community, and your role as a PA student. 

Despite your best efforts, you may from time to time encounter people who are not supportive of you or the PA profession. Additionally, students and preceptors may experience difficulties that strain their relationships. You are expected to deal with such problems in a mature and professional manner. If the situation cannot be resolved, consult Barb Williams immediately.

GUIDELINES

PA students are expected to adhere to the following guidelines while on assigned rotation:

1.	Physician assistant students on clinical rotation must work under the direct supervision of a licensed physician or physician assistant, nurse practitioner, or nurse midwife who is supervised by a licensed physician.
2.	Students must wear a Jefferson College of Health Sciences patch on their student-length lab coats and a visible name tag designating student status, and they must identify themselves as physician assistant students to all patients and staff at all times.
3.	Students will not see patients, make a diagnosis, or carry out any procedure or treatment plan without the explicit prior approval of the preceptor or designee.
4.	Students will never work without a clearly identified on-site supervisor. If the preceptor is to be absent, he or she will identify an alternate preceptor for the student. The student will notify the program of any unexpected preceptor change lasting more than one day.
5.	All charts and written orders must be signed with the student's name clearly written followed by the designation "PA-S" unless told otherwise by the rotation site. At no time may the student use other professional titles (e.g. RN, EMT) in written form or otherwise while on clinical rotation.
6.	All chart entries and written orders must be countersigned in accordance with rotation site policy.
7.	Students will not consent to assess any patient or perform any procedure that is beyond their ability.
8.	Students will observe the highest level of patient confidentiality at all times.

Top of Page

ATTIRE

Business attire is required for all rotations. Be guided by the preceptor’s instructions for exceptions to this rule. Scrubs are generally not permitted except in surgery. Inappropriately dressed students will be asked to leave the rotation site and will receive an unexcused absence until they return properly attired. In addition, you must wear the JCHS identification badge during all patient encounters.

You are required to wear a short student lab coat on rotation. Long lab coats are NOT acceptable.

MEDICAL DIAGNOSTIC EQUIPMENT

You should take your own medical diagnostic instruments (stethoscope, ophthalmoscope, otoscope, reflex hammer, etc.) to all rotations.

PARKING AND TRAVEL

You are responsible for all parking and travel costs incurred, with the exception of the Community Medicine rotation, in which you will receive a set amount of reimbursement for travel as provided by the Federal PA Training Grant.

MEALS AND HOUSING

All expenses related to meals and housing while on clinical rotations are the your responsibility. Some sites may provide meals; however, the program does not require that any site provide meals. 

The program provides housing at some rural clinic sites, which you may or may not elect to use. This housing is for assigned students only. No children, friends, or pets are allowed to stay at any time. At times male and female students may occupy separate rooms in the same housing. The program reserves the right to change housing assignments at any time. 

You should care for the housing sites as you would your own home. Clean up before you leave. You will be responsible for paying for any damages. Use your cell phone for long-distance calls.

MALPRACTICE INSURANCE

All clinical students are covered under the Jefferson College of Health Sciences professional liability policy while at assigned rotations. It is expected that all reportable incidents involving students and patients will be reported immediately by phone and in writing to the Clinical Coordinator.

If you need to report an accident or exposure to hazardous substance or communicable disease, follow these steps:

• Fill out the Carilion Employee Event form. As a student on rotation you are considered an employee.
• Complete whatever forms are required by the institution where the incident happened.
• Be sure the Program gets copies of everything, including any follow-up work done. The Program office keeps a copy and gives a copy to the College's Safety Office, Tommy Harper.

The College is not responsible for any bills created by this incident; this is the reason we require students to have medical insurance.

UNIVERSAL PRECAUTIONS

You must follow 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.

PATIENT CONFIDENTIALITY

Medical ethics and HIPAA (Health Information Portability and Accountability Act) forbid violation of patient confidentiality. Both you and your preceptor should be sensitive to this issue. Any discussion regarding a patient’s diagnosis, care, and condition should be conducted with discretion and preferably in private. You should identify patients by initials or chart numbers in case studies and other written reports. Failure to adhere to HIPAA standards will result in dismissal from the Program.

ARREST POLICY

All students attending the Jefferson College of Health Sciences are considered to be responsible adults. As such, they must maintain the professional standards and behavior expected by the Physician Assistant profession. PA students on clinical rotations represent the College, the Program, and the profession at all times. It is expected that each PA student be familiar with the College’s “Code for Student Conduct” as written in the Student Handbook.

In the unexpected event that a PA student is accused of a violation of the code, especially if the student is arrested or removed from a clinical site, it is the responsibility of the student to notify the Clinical Coordinator immediately. The Clinical Coordinator will then notify Program and College officials. Failure to notify the Program immediately will result in further disciplinary action.