ARC-PA 5th ed Standard B1.05

The student is expected to adhere to the same high ethical and professional standards required of certified PAs. The professional conduct of the student is evaluated on an ongoing basis throughout the clinical phase of the program. Violations of standards of professional conduct are subject to disciplinary actions administered by GWU and by the program per the GWU Code of Conduct found in the Graduate Studies Handbook. Additionally, the GWU Department of PA Studies has explained the expectations of clinical year PA students to apply to the clinical environment.  Preceptors are directed to contact the DCE (or ADCE) immediately if they have any concerns about the student’s professionalism.

Examples of unprofessional behavior include, but are not limited to, the following:

  • Unreported absences
  • Tardiness
  • Unauthorized changes to submitted SCPE calendar (see SCPE Overview syllabus)
  • Failure to complete assignments by the specified due date
  • Failure to submit onboarding requirements by specified due dates
  • Failure to maintain professional language and tone in communications with program faculty/staff and clinical preceptors (email, telephone, text, social media, and face-to-face interactions)
  • Failure to respond to communication from program faculty/staff per the SCPE Communication section of this manual
  • Any verbal or written communication regarding anyone connected with the program that could be considered libel or slander
  • Failure to follow dress code
  • Lack of preparation for daily SCPE activity/coursework

Student Responsibilities

ARC-PA 5th ed Standards A3.07, A3.08

While adhering to professional standards, the student is expected to perform the following activities during the SCPE:

  • Attend SCPE as scheduled.
    • If a preceptor is not at the clinical site when the student is scheduled to be there, the student is not automatically excused from attending clinic. Instead, the student must contact the clinical team as outlined in the SCPE Communication Policy.
    • If available at the SCPE site, the student should attend other learning opportunities, such as grand rounds, lectures, conferences, morbidity/mortality conferences, tumor boards, etc.
    • Some preceptors may incorporate study time into the student’s schedule, which must be documented on the student calendar. However, the student is NOT TO ASK for time off for studying. (see Student Attendance section)
  • Obtain detailed histories.
  • Conduct physical exams.
  • Develop a differential diagnosis.
  • Formulate an assessment and plan.
  • Discuss patients with a preceptor.
  • Give oral presentations.
  • Appropriately document findings.
    • If the student has access to EMR, findings must be documented in the patient record and must be co-signed by the preceptor in the patient record.
    • If the student does not have access to EMR, then the student must chart a “shadow note” separate from the patient’s record. The note will not be removed from the site and must be reviewed with the preceptor. As a reminder, preceptors are asked to evaluate the student’s documentation on the Preceptor Evaluation of Student at the end of each SCPE.
  • Perform and/or interpret common lab results and diagnostics.
  • Educate and counsel patients across the lifespan regarding health-related issues.
  • Demonstrate emotional resilience, stability, adaptability, and flexibility during the clinical year.
  • Submit coursework as outlined per SCPE Specific Course Syllabus Information section. In addition, students should check Blackboard for the most up-to-date course assignment information.

GWU is a university of faith, and an essential element of faith is gratitude. Therefore, to demonstrate appreciation for preceptors and their staff who assist in PA education, it is highly recommended that the student sends “Thank You” notes at the conclusion of each SCPE.

Program Responsibilities

ARC-PA 5th ed Standards B3.01, B3.02, B3.03, B3.04, B3.05, B3.06, B3.07, B4.01, B4.02, B4.03

The program is responsible for the following aspects of the educational environment and activities during the clinical phase of the program:

  • Ensure that the student has successfully completed all required components of the didactic year prior to beginning SCPE.
  • Provide SCPE placement for the student.
  • Provide SCPE-specific learning objectives and orientation materials to the preceptor and the student.
  • Provide the preceptor with instructions on how to access the Preceptor Evaluation of Student.
  • Provide malpractice insurance for the student.
  • Perform clinical site visits in accordance with clinical site visit policy.
  • Develop and maintain clinical site affiliation agreements.
  • Continue to develop new relationships with preceptors and clinical institutions.
    • If the student identifies a new/potential clinical preceptor, the student must provide the program with contact information via the Preceptor/Site Request Form (link located in Blackboard).
  • Work with the preceptor and site to provide a healthy and safe clinical learning environment.
  • Interact with the preceptor, site, and student to be available to respond to any problems or concerns.
  • Respond in a timely manner to concerns raised regarding student behavior or actions that directly or indirectly jeopardize the health, well-being, and/or safety of patients, faculty, clinical site staff, or fellow student.
    • If such behavior is demonstrated or reported, the program retains the right to remove the student from a SCPE immediately.
  • Require the student to be trained in HIPAA and OSHA instruction regarding the risk of exposure and post-exposure protocols.
  • Ensure the student is trained in site-specific protocols such as COVID-19.
  • Require the student to be certified in Basic Life Support (BLS) and Advanced Cardiovascular Life Support (ACLS).
  • Obtain student feedback from the clinical preceptor.
  • Administer an End of Rotation TM (EOR) exam for all core SCPEs.
  • Assign a grade for the student after completion of the SCPE.
    • The program faculty, not the preceptor, is responsible for the final grade.

Preceptor Responsibilities

ARC-PA 5th ed Standard A2.16, B3.06, B3.07

Preceptor responsibilities include, but are not limited to, the following:

  • Must hold a valid license that allows them to practice at the SCPE site.
  • Be familiar with GWU/PA program policies and procedures via the orientation materials provided by the program.
  • Be responsible for the coordination of the student’s overall learning experience.
  • Ensure the student is provided orientation regarding site-specific policies and procedures.
  • Review the expectations and objectives for the SCPE with the student.
  • Provide ongoing feedback regarding clinical performance, knowledge base, and critical thinking skills.
  • Supervise, demonstrate, teach, and observe clinical activities to facilitate the development of clinical skills and ensure proper patient care.
  • Assign teaching or coordination of tasks to other qualified clinicians, such as attending physicians, residents, physician assistants, or nurse practitioners, as needed or desired.
  • Delegate increasing levels of responsibility to the student for clinical assessment and management of the patient.
  • Participate in the evaluation of clinical skills and medical knowledge base through the following mechanisms:
    • Direct supervision, observation, and teaching in the clinical setting;
    • Direct evaluation of presentations (including both written and oral);
    • Assignment of outside readings and research to promote further learning.
  • Review student documentation (including shadow notes) and cosign if the student note remains part of the official patient record.
  • Complete the Preceptor Evaluation of Student form during the final week of the SCPE.
  • Complete the Student Preparedness for SCPE evaluation at the end of Block #1. This is not an evaluation of the student’s performance at the completion of a SCPE but of cohort preparedness to undertake SCPEs, as a measure of the effectiveness of the didactic curriculum.
  • Complete the Final Assessment of Student Behavior & Preparedness survey for any student whom is precepted for their last Core SCPE.
  • Promptly notify the PA program of any circumstances that might interfere with accomplishing the above goals or diminish the overall training experience.
  • Maintain an ethical approach to patient care and student education.

Efficient Training of Students

ARC-PA 5th ed Standard A2.16, B3.06

The following are goals and ideas to offer as a means of providing efficient and effective training of the PA student:

  • The goal for the student is to have a chance to collect history and perform physical exams on every patient they see by the end of week one throughout the rest of the rotation assignment. This is after spending a few days shadowing and seeing patients in the room with the preceptor to establish trust and confidence.
  • While the student is working up a patient, the preceptor can be seeing other patients until the student is prepared to present the patient they have been evaluating.
  • The student is required to present history and physical exam findings to the preceptor. In addition, the student should discuss the diagnosis, differential (if applicable), and management plan for that patient.
  • The student and preceptor should return to the exam room to validate the student’s findings and offer learning points to the student.
  • If procedures are necessary, the student should be offered the chance to complete the procedure, but only with direct supervision from a preceptor or secondary preceptor(s).

This approach provides a nice flow and rhythm for day-to-day learning and limits the loss of revenue/time spent with patients for the preceptor.