The faculty of the Southern California University of Health Sciences (SCU) Master of Science Physician Assistant (MSPA) Program (MSPA Program or PA Program) have developed this Clinical Student Handbook to provide specific informational guidelines regarding the clinical year. This handbook is a supplemental guide to the program didactic handbook and existing SCU policies and procedures. We recommend that each student familiarize themselves with existing University Policies for further information where indicated; if there is a conflict, the program’s clinical policies supersede the university policies.

Any concerns regarding policies or information contained in this handbook should be directed to the Program Director of the Master of Science: Physician Assistant Program. Corrections may be made whenever there have been any necessary changes within the MSPA program. All pertinent faculty, staff, and students will be made aware of any updates or changes, in writing, immediately.

Any matter or circumstance that is not contained in the handbook will be reviewed and decided by the program faculty and, when necessary, with input from the Office of the Provost. The information within this handbook is accurate at the time of publishing. Students are responsible for meeting all program standards.

The University reserves the right to make appropriate changes to the handbook as needed to comply with accreditation standards or changes in the health care or higher education environment. These updates will be posted within the University Catalog and/or the associated Clinical handbook for student access.

Clinical Clerkship

What is Clerkship?

Purpose

In compliance with program completion requirements and accreditation standards, PA students must participate in a broad spectrum of clinical services. These services should include, but are not limited to:

Outpatient care
Inpatient care
Women’s Health
Gynecological care
Prenatal care
Emergency room care
Mental and Behavioral Health
Surgical
Pre-operative care
Intra-operative care
Post-operative care

The goal is to ensure that students are exposed to care across the patient’s lifespan, in a myriad of settings such as, preventive, emergent, acute, and chronic.

The Master of Science Physician Assistant program offers an Integrative Medicine rotation; the program is among the first to expose Physician Assistant students to integrative healthcare practices.

What Courses Constitute Clerkship?

The Clinical Clerkship includes 16 courses, 55 credits, and 1,600+ hours of supervised clinical practice experiences (SCPEs), Physician Assistant Comprehensive Examinations (PACE), Clinical Integration Weeks (PACL IN1-3), and the Physician Assistant National Certifying Examination Preparedness Intersession (PA708).

SCPEs (PACR 601-610; Clinical Rotation 1-10): Supervised clinical practice experiences (SCPEs) allow clinical students to refine clinical and technical skills through clinical reasoning, critical thinking, and problem-solving in clinical encounters. The supervised clinical practice experiences (SCPEs) courses occur in Terms 5-7 and are designed to provide students with the opportunity to achieve program learning outcomes and course learning outcomes under the supervision of a preceptor in the assigned field, usually in off-campus health settings.

PACE (PACE 1 and PACE 2): The first Physician Assistant Comprehensive Examination (PACE 1) is a formative assessment designed to evaluate a student’s mastery of program learning outcomes and consists of a written Physician Assistant National Certifying Examination (PANCE)-like exam that covers all content learned in the didactic phase and an Objective Structured Clinical Examination (OSCE) that includes assessment of interpersonal and communication skills, professionalism, and technical skills. The second Physician Assistant Comprehensive Examination (PACE 2) is a summative assessment designed to assess the student’s total fund of knowledge for the didactic and clinical phases of the program. The first Physician Assistant Comprehensive Examination (PACE 1) is administered before students enter clinical rotations (Term 5) and the second Physician Assistant Comprehensive Examination (PACE 2) is administered within four months of graduation (Term 7).

Clinical Integration Week (PACL IN1-3): This series of three courses occurs in term 5 and term 7. These courses provide clinical year students with activities that enhance student’s ability to apply medical knowledge, clinical and technical skills through clinical reasoning, and problem solving in the clinical setting. These courses are also designed to reinforce clinical learning outcomes to aid in student competency. These courses will also aid in the preparation of the student for the Physician Assistant National Certifying Examination (PANCE).

PA 708: The Physician Assistant National Certifying Examination Preparedness Intersession is offered at the end of the 7th trimester and supports student preparation for this examination and thus for licensure as a Physician Assistant.

Clinical Clerkship Courses

Course	Term
PACE 1 - Physician Assistant Comprehensive Examination 1	5
PACL IN0 - Introduction to Clinical Rotations	5
PACR 601 - Clinical Rotation 1	5
PACR 602 - Clinical Rotation 2	5
PACR 603 - Clinical Rotation 3	5
PACL IN 1 - Clinical Integration Week 1	5
PACR 604 - Clinical Rotation 4	6
PACR 605 - Clinical Rotation 5	6
PACR 606 - Clinical Rotation 6	6
PACR 607 - Clinical Rotation 7	6
PACL IN 2 - Clinical Integration Week 2	7
PACR 608 - Clinical Rotation 8	7
PACR 609 - Clinical Rotation 9	7
PACR 610 - Clinical Rotation 10	7
PACL IN 3 - Clinical Integration Week 3	7
PACE 2 - Physician Assistant Comprehensive Examination 2	7
PA 708 - Physician Assistant National Certifying Examination Preparation Intersession	7

Travel Requirements

Students are responsible for their transportation, housing, and living expenses during the clinical year. Expenses will vary depending on the location of each rotation site. It is the student’s responsibility to plan for the expense of clinical rotations away from campus.

The majority of clinical rotations while enrolled in the SCU MSPA Program are within a 100-mile radius of campus and students will be expected to travel to rotation sites within this radius. Students may be required to participate in clinical rotations that are located beyond a 100-mile radius of the University as a requirement of their clinical year.

Any additional costs associated with out of the area or out of state rotations are the responsibility of the clinical year student. Additional financial aid may be available on a case-by-case basis for certain approved costs as determined by the Office of Financial Aid.

Correspondence

The PA Program’s primary mode of communication will be university assigned email accounts. The Program will not use personal email accounts for communication. Therefore, it is imperative that students check their SCU email account daily. In addition, the PA program can also use cell phone, voicemail, US mail and text messaging to contact the students when necessary. Students are expected to respond to all communication within 48 hours. A failure to respond may be viewed as unprofessional behavior, which may result in the student being referred to the Student Progress Committee for review of professionalism.

Students may contact the PA Program Office or Associate Program Director of Clinical Education by email/phone at any time with messages returned within 48 hours when reasonable.

For emergency situations while on rotation it is imperative to contact the Associate Program Director of Clinical Education/Clinical Director, Ashley Larsen, MPA, PA-C immediately at: (562) 475-5159

Site and Practitioner Affiliations

SCU’s MSPA Program is affiliated with a number of clinical sites within an approximate 100 mile radius of the University.

Students may identify sites to the program that may/may not be local to campus and the clinical team will pursue the contact(s) as deemed fit. Students should not contact sites (already contracted or not) or attempt to schedule their own rotation(s) and will be referred for professionalism concerns to the MSPA Student Progress Committee (SPC) if they do.

Prerequisites

Prior to initiating the clinical experience, students must complete required courses, training, certification, clearance, criminal background check, drug screening, health insurance, personal information, and any site-specific requirements.

Courses

Students must successfully complete all didactic courses and be in good academic standing before starting their clinical assignments.

Training

Students must successfully complete the following trainings: HIPAA compliance, Title IX,/SB493, WHO PPE, and Blood Borne Pathogens training

Certification

Students must successfully demonstrate current certification in Basic Life Support (BLS) and Advanced Cardiovascular Life Support (ACLS) before the start of rotations.

Clearance

Students must successfully demonstrate clearance in all required areas to participate in rotations.

Tuberculosis (TB)

Clinical students must upload evidence of QuantiFERON-TB/PPD [two-step process] with or without chest x-ray if needed. Failing to obtain or provide documentation may place the student at risk of being administratively dismissed from the program. Students are required to keep all TB records current.

Immunization

Completion of all required immunizations (MMR, DTaP, Varicella, Hepatitis B vaccine and/or serum titer levels, influenza). Failing to obtain or provide documentation for any additional required vaccines may delay graduation.

*Not being immunized might prevent the student from being assigned to a facility. The program is not obligated to identify a clinical site that will accommodate the student, which means the student may be at risk of being administratively dismissed from the program. Students are required to keep all immunization records current.

Criminal Background Check and Drug Screening

Students must successfully complete a criminal background check and drug screening before the start of rotations and at any other time during the clinical year as required by clinical rotation sites.

This may include Live Scan or other third-party companies, drug testing, or any institution-specific background clearance requirements. Students may be required to cover any cost associated with this clearance.

Student Health Insurance

Students are required to maintain an active health insurance policy while enrolled in the program. Insurance cards must be uploaded to EXXAT and approved prior to matriculation. Health insurance must remain valid for the duration of the program. If a student changes to another health insurance policy during their time in the program, a new insurance card must be uploaded at that time.

Personal Information

Student contact information must be current and on file in EXXAT prior to the commencement of clinical year. If there are any changes, the student must update this information in EXXAT as soon as possible. Students are responsible for maintaining a current address, cell phone number, email address, and emergency contact information in EXXAT at all times.

Site-specific Requirements

Certain clinical sites may have requirements that are site-specific, including additional vaccinations, drug screens, background checks, etc. Please note that failing to obtain or provide documentation for any additional required vaccines may delay graduation. Students must comply with any site-specific requirements as a prerequisite for participation.

Applying or Registering

After successfully completing the pre-clinical year, MSPA students will enter a 12-month clinical training phase of the program. During this phase, students will complete ten Supervised Clinical Practice Experiences (SCPEs).

The program schedules all SCPE assignments; students are not required to locate their own clinical rotations or preceptors. Preferences for all sites and rotations are submitted through EXXAT; rotations will be assigned by the program based on student academic and professional performance, preference, and availability of preceptors and facilities.

The ten SCPEs will consist of eight core required four-week rotations and two elective four-week rotations.

Core four-week rotations. Core rotations in the following disciplines will be assigned: Family Medicine, General Internal Medicine, Women’s Health, Pediatrics, Emergency Medicine, General Surgery, Integrative Health, Behavioral and Mental Health.

Elective four-week rotations. Students have two elective rotations; opportunities vary by term. These rotations will be assigned for students. Students requiring remediation of any pre-clinical or clinical experience or course may forfeit elective experiences in part or entirely to complete remediation requirements and to progress and complete the program.

Completion Requirements

To successfully complete clerkship, students must pass all courses, successfully submit and/or complete all required evaluations and assessments, track and report all required timesheets, and track and report all required patient logs.

Courses

To complete the clinical phase successfully, students must pass all 16 courses described in “What Courses Constitute Clerkship.” These courses complete the “Clinical Clerkship” degree completion requirements described in the MSPA Program section of the University Catalog.

Course Failure

Course failures may result in Academic Warning, Academic Probation, or Academic Dismissal as outlined in University Catalog Academic Policies . All failed courses must be successfully remediated to progress in the Program. Students who have either earned a failing grade for any course or who have failed the Preceptor Evaluation of the Clinical Student will be referred to the Student Progress Committee (MSPA SPC) for review and disposition, including creation of an Academic Development Plan (ADP). The faculty advisor will also be notified. Any student who a preceptor requests to be removed from a clinical rotation will be suspended from clinical rotations pending investigation by the Physician Assistant Student Progress Committee (MSPA SPC). Removal from a clinical rotation will result in automatic failure of the clinical course and may result in dismissal from the program.

Any student who fails a course and is eligible to continue in the Program must remediate the course. See the MSPA “Remediation” and “Course Failure” policies in the University Catalog. Students will be given only one opportunity to remediate a course.

Evaluations and Assessments

During the clinical year, students are required to pass End of Rotation (EOR) Examinations and all Clinical Rotations (with their associated evaluations):

End of Rotation (EOR) Examinations

End of Rotation Examinations (EORs) are given at the end of each core Supervised Clinical Practice Experience (SCPE) rotation (except Integrative Health).

Clinical students must pass each End of Rotation examination with a score of 70% or better. Performance on EORs will be evaluated by the Clinical Director and the Student Progress Committee. Students who earn an EOR score between 70-74.99% will be considered to have a low passing score and may be required to complete additional assignments to improve competency in low performance areas. Students who earn less than 70% on an EOR exam have failed their examination and will be required to complete a remediation assignment as stipulated in their Academic Development Plan. Any failed EOR requires an additional attempt; failure to achieve a passing score on the retake EOR will result in a rotation course failure (refer to the MSPA program’s course failure policy). Additionally, students with consistently low passing EOR scores may be required to remediate to demonstrate competency in low performance areas. See “Clinical Phase Evaluation and Remediation” in the MSPA program section of the University Catalog, including “End of Rotation Exams.”

EOR examinations will be given at the SCU campus or via a remote testing platform. If a student is completing a rotation at a distant location, testing arrangements can be made to complete their EOR without returning to campus. All examinations must begin and end within the allocated time. Students who arrive late for an examination will not be given additional time to complete the examination.

No personal items are permitted in the testing environment, including hats, backpacks, purses, hoodies, or digital/electronic devices. The desk/workspace should be clear of any extra items; one piece of blank scratch paper and a writing tool may be on the work area. Students may have a glass of water or cup of coffee as long as the container is free of writing. Nothing else should be on the walls or workspace during the exam except for the testing device.

Students may use the restroom, but the test time will continue to run.

Any student that violates any testing policy will be assigned a non-passing grade for the examination. The student will be recommended for disciplinary action, which may result in dismissal from the program.

Additional Zoom/Remote Policies for End of Rotation (EOR) Examinations

Any Proctoring costs for examinations at out of the area assignments will be at the student’s expense.

The student is required to have two internet connected devices, one for testing and one for Zoom proctoring. PRIOR to joining the testing environment, the following should be verified and prepared.

Testing device. The student must ensure that the testing device is able to open the Physician Assistant Education Association (PAEA) Exam testing platform; this browser works best in Google Chrome.

Proctoring device. The proctoring camera must remain on for the entirety of the examination. The camera should face the student and the testing device at all times. Students are also required to keep their microphones unmuted during the duration of the examination.

Students who leave to use the restroom may place in the chat that they are using the restroom so the proctor is aware.

Clinical Rotations

While on rotation, student progress is monitored by timesheets (EXXAT/PRISM), logs of patient encounters (EXXAT/PRISM), rotation notes (Canvas), rotation check-off sheets (Canvas), reflective paper (Canvas), preceptor evaluations (mid-rotation and end of rotation) (EXXAT/PRISM), student evaluation of the preceptor and site (EXXAT/PRISM), and student evaluation of the course (EXXAT/PRISM).

About EXXAT/PRISM

EXXAT/PRISM is a web-based hub for the clinical experience. EXXAT/PRISM is the place to log time and patient encounters, provide and receive feedback, complete evaluations, and generate reports on the rotation experience - and can serve as a portfolio after graduation.

Evaluations and assessments are located in the Evaluation section of each rotation.

Timesheets (EXXAT/PRISM)

Students should log all hours spent on rotations daily - and must log all hours weekly - under the timesheet function. All activities assigned by the preceptor are included in these rotation hours including but not limited to: case presentations, journal readings, preparation for next patient or case, call hours, etc.

These hours must be verified and submitted at the conclusion of each week. The standard calendar week of Sunday to Saturday is followed while on clinical rotations.

*Failure to submit timesheets by the due date will result in a 10% deduction in the grade for those assignments and/or professionalism grade for each day that they are late.

Log of Patient Encounters (EXXAT/PRISM)

Students should log all patient encounters daily - and must log all patient encounters weekly.

These logs must be verified and submitted at the conclusion of each week. The standard calendar week of Sunday to Saturday is followed while on clinical rotations.

All required sections of EXXAT/PRISM patient logs need to be completed. No identifiable information should be entered. All patient logs should be complete. The Medical Decision Making (MDM) Template must include:

Age, sex, brief medical history, chief complaint (CC).
Top differential with medical reasoning
Plan
Other differentials (ddx) considered and medical reasoning as to why these are less likely
Always include life-threatening/serious medical conditions as ddx if applicable

MDM Example

This otherwise healthy 32-year-old male appears to have a musculoskeletal etiology for low back pain. Given history, mechanism of injury and physical exam findings, doubt fracture or dislocation requiring imaging today. Patient will be treated symptomatically with RICE. There is no evidence of epidural abscess or CNS infection based on lack of fever, immune status, and no recent spinal surgery or invasive procedures. Urine is negative for evidence of infection or hematuria so no clinical suspicion for pyelonephritis or renal calculi. No evidence of cauda equina syndrome based on lack of saddle anesthesia or bowel or bladder dysfunction. No evidence of acute neurovascular compromise based on exam. No evidence of soft tissue infection such as cellulitis or herpes zoster. Also considered acute coronary syndrome and abdominal aortic aneurysm, but less likely due to age, and no risk factors.

*Failure to submit required patient logs by the due date will result in a 10% deduction in the grade for those assignments and/or professionalism grade for each day that they are late.

Failing to log patient encounters will result in a non-passing or failing grade for the rotation and is considered non-professional behavior. This will result in the student being referred to Student Progress Committee SPC for evaluation of professionalism.

Rotation Notes (Canvas)

All students are expected to create a SOAP note for their required rotation note as well as have a SOAP note that can be available for review at the time of a clinical site visit by faculty. See “Medical documentation” in Program Specific Policies below.

Students must submit their required rotation note to Canvas no later than 11:59 PM on the Friday of their return to campus call back date.

*Failure to submit required rotation note by the due date will result in a 10% deduction in the grade for those assignments and/or professionalism grade for each day that they are late.dd

Rotation Check-off Sheets (Canvas)

Students must submit their required rotation check off sheet to Canvas, no later than 11:59 PM on the Friday of their return to campus call back date.

*Failure to submit required rotation check-off sheet by the due date will result in a 10% deduction in the grade for those assignments and/or professionalism grade for each day that they are late.

Reflective Paper (Canvas)

Students completing an elective or an integrative health rotation must submit their reflective paper no later than 11:59 PM on the Friday of their return to campus call back date to Canvas utilizing the Turn It In feature.

*Failure to submit required reflective paper by the due date will result in a 10% deduction in the grade for those assignments and/or professionalism grade for each day that they are late.

Preceptor Evaluations (EXXAT/PRISM)

There are two preceptor evaluations. These occur at week 2 (mid-rotation) and week 4 (end of rotation).

Mid-rotation Evaluation

The mid-rotation evaluation (to be completed and submitted at week 2) is a formative assessment that provides the students an opportunity to discuss any areas of concern or deficiencies with their preceptor prior to a final grade being assigned. The mid-rotation evaluation also makes it possible to remediate any areas of concern before the end of the clinical assignment.

End of Rotation Evaluation

The end of rotation evaluation is a summative evaluation used to assess the student during the entire rotation. In the end of rotation evaluation (to be completed and submitted at week 4) the preceptors will address any deficiencies or areas where the clinical student did not meet all the outcomes for that rotation.

If outcome deficiencies are identified, the clinical team will meet with the student to develop a remediation plan to address the deficiencies and formulate a plan for remediation. Any areas that are scored a 2 or below on the End of Rotation Evaluation will require remediation. Remediation plans will be developed by the clinical team. If it is noted that a student’s deficiencies on the rotation are too great, the student may be at risk of failing the course (refer to remediation and course failure policy in the MSPA program section of the University Catalog). Students will adhere to the plan set forth by the clinical team to successfully remediate any deficiencies or repeat the rotation if deficiencies are too great.

Clinical students must remind their preceptors/clinical supervisors to submit their mid-rotation evaluation and end of rotation evaluation for each clinical rotation assignment. It is the student’s responsibility to ensure that all rotation evaluations are completed by the preceptors.

Missing evaluations can result in a non-passing grade for the rotation as well as a non-passing grade for professionalism.

Student Evaluation of Preceptor and Site (EXXAT/PRISM)

The Evaluation of the preceptor and site will be available at the start of the rotation and must be completed by the last day of the rotation.

Survey completion is required to receive a passing grade for professionalism for the rotation. Failure to complete the evaluation could result in a non-passing grade for the rotation.

Student Evaluation of the Course (EXXAT/PRISM)

The Clinical Course evaluation will be available at the start of the rotation and must be completed by the last day of the rotation.

Survey completion is required to receive a passing grade for professionalism for the rotation. Failure to complete the evaluation could result in a non-passing grade for the rotation.

Scope of Practice

The student is not an employee of any clinical affiliate and should not be a substitute for or take on any responsibilities of a regular staff member assignments or duties. If a student has a concern about the responsibilities assigned by the clinical site or preceptor, the Associate Program Director of Clinical Education should be contacted immediately.

After the student has been successfully proctored by the preceptor, the preceptor will determine how much responsibility a student is ready to assume. Although students come to the program with a variety of life and medical experiences, all students must exhibit a baseline of medical knowledge and clinical skills to perform certain tasks successfully. Traditional tasks assigned to a PA student may include, but are not limited to, the following:

Taking histories and performing physical examinations
Assessing common medical problems and recommending appropriate management
Performing and assisting in diagnostic and therapeutic procedures
Assisting the preceptor in hospital/nursing home rounds recording progress notes, transcribing specific orders of the preceptor- as approved by the facility
Participating in virtual telehealth/telemedicine visits
Following protocols or standing orders of the preceptor
Presenting patient cases orally and in a written problem-oriented format
Discussing the basic pathophysiologic mechanisms that have produced the signs, symptoms, and disease processes under investigation
Completing assigned reading and preparing presentations as requested by clinical preceptors and/or program faculty
Attending all teaching rounds and conferences;
Following the assigned on-call/shift schedule

Students will deliver needed care to patients without regard to patient characteristics, including but not limited to race, age, gender identity, gender expression, sexual orientation, creed, socioeconomic status, political persuasion, or national origin.

The Role of the Preceptor/Clinical Supervisor

Students preparing to become healthcare providers must be given opportunities to practice the clinical skills they will be expected to utilize as professionals. These skills include patient interviewing, physical examination of patients, communication with patients and colleagues, interpretation of diagnostic studies and clinical data, and demonstration of behaviors consistent with professionalism. Students are expected to apply and practice their skills so that they may become more useful members of the healthcare team, both as lifelong learners and as future healthcare professionals. 

Students inevitably enter clinical training with varying levels of healthcare experience and capability, and so delegated responsibility for patient care may need to progress incrementally over the student’s period of training. It is optimal for preceptors to delegate as much responsibility as a given student can manage, while still providing the necessary supervision to ensure a quality learning experience for the student and the safety/well-being of patients. 

A clinical preceptor will be a leader and guide in facilitating a student’s patient encounters, helping the student gain clinical experiences that are relevant to the practice of medicine and appropriate for the student’s achievement/ experience level. As the student’s patient care responsibilities are progressively advanced, they should be able to manage all elements of a patient encounter, from the initial chief complaint to discussing final treatment plans. All students should be given guidance before participating in any patient encounter as to how the preceptor and/or health care practice system would like patient encounters to occur and/or be documented. Additionally, preceptors should keep in mind that students just starting out on their clinical rotations may need additional supervision before they feel comfortable enough to work more autonomously.

To make the learning experience more meaningful for students, preceptors are encouraged to be receptive to student questions and to preview patient charts with students before encounters. After completing these encounters, students should be given a chance to present their history and physical exam findings to their preceptor, transcribe/dictate appropriate notes, review accompanying diagnostic studies, generate a differential diagnosis and treatment plan, and complete follow-up patient phone calls as needed. 

The PA student must never be used as a substitute for a licensed clinical provider in any clinical setting. Students should not be allowed to evaluate, diagnose, treat, or discharge patients without the direct involvement and supervision of the clinical preceptor. 

The PA student should be involved in all activities that the preceptor would engage in during the clinical day. Students should not be exempt from on-call, evening, weekend, or holiday clinical responsibilities.

It is the responsibility of the preceptor to give the student opportunities to:

Obtain an appropriate history
Perform a pertinent physical examination
Interpret diagnostic studies
Communicate necessary and expected information in oral and written presentations
Correlate clinical and diagnostic data findings
Develop differential diagnoses
Develop treatment plans
Counsel and educate patients
Follow up with patients after discharge, as needed
Conduct oneself in a professional manner

Attendance

General

Students on clinical rotations must work under the direct supervision of a licensed preceptor/clinical supervisor. This includes Physicians, PAs, Nurse Practitioners, Nurse Midwives, Psychologists, Marriage Family Therapists, Social Workers, or other licensed health care professionals.

Students are expected to become an integral part of the health care team or practice to which they are assigned. This often means working nights, calls, weekends, and holidays. The clinical student’s schedule should match that of the preceptor. Students are to follow the Duty Hours guidelines during extended working times.

Students are expected to mirror the schedule of their assigned preceptor which may include weekends, nights, and holidays. If the assigned preceptor for any reason cannot supervise the student or must be away from the clinical rotation site, the student should notify the Associate Program Director of Clinical Education or Clinical Coordinators immediately by phone or email. Students who violate this policy may receive an Academic Warning.

Students are expected to attend all learning activities (e.g., grand rounds, lectures, workshops) assigned by their preceptor. Attendance is mandatory at all scheduled clinical year activities unless otherwise approved by the Associate Program Director of Clinical Education and/or the Clinical Coordinators. If a student misses any of the scheduled events, the student’s grade may be affected, and they may not be able to begin their next rotation.

Students in the clinical training year must adhere to the program-approved calendar for clinical rotations.

Schedules (including conflicts and errors)

Clinical rotation placements are determined by the program’s Clinical Team; placements on clinical rotations are final.

Students must adhere to their assigned clinical rotation schedule. Students should not do the following, or anything else to vary from the assigned schedule: ask the Clinical Team for an alternative placement, attempt to swap a rotation with classmates, or ask a preceptor to change a schedule. Students who are found to have asked for rotation placement and/or schedule changes may be referred to the Student Progress Committee (SPC) for a review of professionalism.

The clinical rotation schedules require extensive planning and coordination by the MSPA faculty, staff, and clinical sites. The program will attempt to accommodate any extreme circumstance whenever possible if advance notice is provided to the Clinical Team and at least six weeks before the scheduled date.

In certain circumstances, the clinical team may need to adjust clinical schedules on last minute notice due to a preceptor’s schedule or change in availability; this is done at the discretion of the program.

Attendance Requirements

Attendance is mandatory during the clinical year. To receive credit for a clinical rotation, students must be present for all scheduled shifts. The Associate Program Director of Clinical Education and/or the Clinical Coordinators must approve absence requests, whether scheduled or unscheduled.

If a student will be absent, (e.g., due to illness) or will be late (e.g., due to transportation problems), it is the student’s responsibility to contact the appropriate clinical preceptor and the Associate Program Director of Clinical Education and/or Clinical Coordinators and provide all appropriate documentation to the Program.

Students who are habitually late and/or absent will be referred to the Student Progress Committee (SPC) for review. Depending upon the situation, the student may be recommended for dismissal from the program.

Duty Hours

Duty hours at each site may vary. However, students are not expected to work more than 80 hours weekly, including taking call. In addition, students will receive one day off in seven days averaged over four weeks. Students should expect to work on average 40+ hours per week, five days a week, but no less than 32 hours a week. Specific sites may require extended hours due to the nature of the practice. Students are not to negotiate the schedule with the site. Students who are found to have negotiated their own schedule will be at risk of being referred to the Student Progress Committee (SPC) for evaluation of professionalism. Additionally, students may be at risk for failing a rotation if asked to not return by their preceptors due to negotiating their schedule or not attending scheduled rotation times.

Punctuality

Students are required to be on time to all clinical rotations. Students who are habitually will be referred to the Student Progress Committee (SPC) for review. Depending upon the situation, the student may be recommended for dismissal from the program.

Qualifying Hours

University Holidays/Closure

During the clinical year, students are expected to maintain the same clinical schedule as their assigned preceptor. Therefore, students may be required to participate during the weekend, holidays, and overnight. 

During the clinical year SCU observed University holidays are not followed. Students are expected to be present at the assigned site on all University holidays, provided that the site is operational, unless otherwise approved by the Associate Program Director of Clinical Education and/or Clinical Coordinators.

Unique/Special Situations, and Vacations and Holidays

Students will not be given time off or vacation time while on clinical rotations and a clinical site cannot approve the student to take time off outside of what is usual for the practice or setting. Students do not accrue time off.

Students who experience certain unique/special situations (emergencies, unexpected illnesses, deaths, births, weddings, doctors’ appointments, etc.) may need time off and the program will assist with these types of absences. It is expected that students be present at their clinical rotations and understand that any time off must be made up.

Absence Request for Planned Absence

For a planned absence, an absence request must be filled out and emailed to the Associate Program Director of Clinical Education and Clinical Administrative Support. Absence requests must be received at least 6 weeks in advance of the beginning of the rotation. Under no circumstances should the student negotiate their schedule with the preceptor without first submitting an absence request and discussing their situation with the Associate Program Director of Clinical Education. An absence request is not guaranteed to be approved. An absence request can only be submitted if the student is in good academic and professional standing.

Leave of Absence

For information about leave of absence, please refer to the “Leave of Absence” policy in the University Catalog Academic Policies . A leave of absence may result in deceleration or delayed graduation.

Absences and Make-Up

Any absences during the clinical year, whether excused or not excused, will need to be made up to ensure that the clinical student has met the required number of hours for the clinical rotation and has satisfactorily completed the assigned outcomes for the rotation. All missed time - whether excused or unexcused - will be made up at the end of the clinical year. Make-ups are scheduled based on preceptor availability, which means the student’s date of program completion may be delayed.

Diagnostic Kit/Required Equipment and Resources

Students must bring all necessary equipment/tools to their assigned location every day. Specific tools may include, but are not limited to, the following:

Stethoscope
Otoscope/Ophthalmoscope
Reflex hammer
White coat/Photo Identification Badge
Notebook and pen for note keeping

Clinical Students should have the Up-to-Date application downloaded on their personal devices for easy access during clinical rotations.

All students are required to have access to any required textbooks for each clinical assignment.

Program Specific Policies

The program adheres to all University policies as outlined in the University Catalog, including the SCU Clinical Handbook. The policies below are either unique to the program, are in addition to University policy, and/or are more stringent than the University policies they reference.

Clinical Code of Conduct (Additions)

The following are in addition to the university Clinical Code of Conduct (see Section II of the Clinical Handbook ).

Professionalism

Students are given the privilege to serve as a guest at various clinical sites and should strive to make a positive impression. Discretion, integrity, honesty, courtesy, and respectful behavior are required and expected at all times and especially during the clinical year.

Students are expected to treat all patients, faculty, university staff, clinical preceptors, health care workers, healthcare staff, and fellow students with dignity and respect. Any conflicts should be managed diplomatically and tactfully. Students should be sensitive to and tolerant of diversity within the populations they will serve.

PA clinical education involves working in a patient-centered collaborative interprofessional environment with other healthcare providers, patients, staff, and other students. It is in this setting that personal information that is pertinent to patient care is often discussed and shared. These situations must be approached with respect to the privacy, confidentiality, and sensitivity of such individuals. Ideas, suggestions, and constructive criticism should be offered in a thoughtful and respectful manner that fosters trust and understanding.

Students should note that flagrant displays of anger, intimidation, or aggression may be grounds for failure of the rotation and/or dismissal from the program. This includes demeaning, offensive, argumentative, and threatening language/behavior, or conduct that is insensitive to race, religion, national origin, age, sex, marital status, citizenship, sexual orientation, gender identity or expression, disability, veteran status, medical condition, socioeconomic status, religious or political beliefs, or any status protected by law or executive order.

Students who fail to consistently demonstrate maturity and professionalism may receive a failing grade for the rotation.

If areas of deficiency in professionalism or interpersonal skills are identified, the following process will be followed:

The Program Director, Associate Program Director of Clinical Education, or the Clinical Coordinators will notify the student.
Students who fail an evaluation on professionalism or interpersonal skills will be reviewed by the Associate Program Director of Clinical Education or the Clinical Coordinators. 
The student may be referred to the Student Progress Committee (MSPA SPC) and a further review will be completed to confirm the faculty’s assessment of the situation or incident. The Student Progress Committee (MSPA SPC) will meet with the student to provide the student with an opportunity to discuss the factors that led to the failure or deficiency.

See the University’s policy on Professionalism in the Clinical Code of Conduct (in Section II of the Clinical Handbook ) for additional details.

Standards of Professional Appearance (Additions)

Students should adhere to the standards of professional appearance whenever representing the MSPA Program and the PA profession.

Students should adhere to the standard that is specified by their clinical site - either business attire or scrubs depending on the setting, in addition to the waist length white coat. The white coat is mandatory unless otherwise specified by the preceptor and program. The clinical Student should also display their name and student status on their short white lab coat (breast pocket location) at all times.

See the University’s Standards of Professional Appearance in the Clinical Code of Conduct (in Section II of the Clinical Handbook ) for additional details.

Bloodborne Pathogens and Hazardous or Environmental Waste: Exposure Prevention and Exposure Process (Additions)

The Master of Science: Physician Assistant program adheres to all University policies as outlined in the University Catalog , including the Campus Safety Manual and SCU Clinical Handbook . The policies below are either unique to the program, are in addition to University policy, and/or are more stringent than the University policies they reference.

This policy provides students with a clearly defined process to address bloodborne pathogen and hazardous or environmental waste exposures in terms of prevention methods, procedures for care and treatment after exposure, and financial responsibility.  

All students are to adhere to universal precautions to prevent contact with blood or other potentially infectious materials. When differentiation between body fluid types is difficult or impossible to determine, all body fluids shall be considered potentially infectious materials.

Prevention (additions)

All students are required to practice measures that prevent the exposure and spread of bloodborne pathogens and other potentially infectious diseases. As a result of this mandate, the program requires all enrolled students to:

have the immunizations recommended by the Centers for Disease Control and Prevention (CDC) for healthcare workers, including titers to prove immunity when indicated, and annual tuberculosis screening. Immunization status must be submitted at the time of enrollment and updated periodically as required for clinical assignments.
complete the University-sponsored bloodborne pathogen training course during fall orientation. The course is repeated during the orientation to clinical rotations.
understand and apply the concepts and necessity of hand hygiene procedures and protocols. 
understand and apply the procedure for actual disposal of sharps and the associated precautions to prevent needlesticks. 
understand and use personal protective equipment (PPE) such as an N95 mask, shields, gowns, and gloves to prevent the spread of infectious diseases.
adhere to the University COVID-19 policies located in the University Policies section of the University Catalog.

Exposure Process (additions)

Students who have been exposed to a bloodborne pathogen, infectious disease, or environmental hazard must do the following: 

Wash their hands and any other affected skin area with soap and water and flush mucous membranes with water as soon as feasible.
Immediately seek care at the site or the nearest emergency department or medical facility.
Contact the course instructor.
Complete the Program’s Incident Report form on EXXAT/PRISM and email it directly to the Associate Program Director of Clinical Education.
Receive written clearance from the treating provider to return to school or clinic.

All injuries and illnesses must be documented on the program’s incident report form located on EXXAT/PRISM under student packet and must be submitted immediately to the Associate Program Director of Clinical Education and/or the Clinical Coordinators via email. Failure to promptly report injuries (within 72 hours of the event) will lead to referral to the SPC for a review of professional conduct.

Additionally, students who have questions or concerns should contact the program and follow guidance from the CDC for appropriate treatment and follow-up regarding exposure to possible bloodborne pathogens. This information can be found at

https://www.cdc.gov/niosh/topics/bbp/default.html

Students are required to maintain an active health insurance policy while enrolled in the program (see the clerkship prerequisite clearance policy regarding student health insurance). Students are responsible for the financial costs associated with the exposure, treatment, and follow-up of post-exposure care.

Medical Documentation

A critical part of professionalism is accurate and timely documentation. Therefore, students must follow all documentation policies and guidelines.

The Center for Medicare and Medicaid Services (CMS) guidelines only allow students to document a portion of the History and Physical Exam (the Past Medical History, Family History, Social History, and Review of Systems). It is imperative that the assigned clinical preceptor/supervising clinician personally documents all other key elements of the visit, e.g., physical examination, management/plan, orders.

If a particular site does not authorize or allow PA students to officially document patient notes in a paper or electronic chart, it is advisable for students to document the patient encounter on a separate piece of paper (a “practice” note) so that they can continue to refine their documentation skills and obtain feedback from the preceptor - which is critical to the student’s ongoing clinical learning and decision-making. Paper practice notes must never contain any identifiable data, should not leave the facility, and should be destroyed after fulfilling their practice purpose (there should never be duplicate records of the same visit).

The student must sign all charts appropriately, and the supervising physician/clinician must countersign all charts/ medical records. All charts and written orders must be signed (if applicable) with the student’s name clearly written, followed by the designation of “PA-S.” All charts must be co-signed by their approved preceptor(s) before discharging of the patient.

For example: Jan U. Ary, PA-S// Feb U. Ary, MD

Consistent with unviersity policy in the Clinical Code of Conduct (in Section II of the Clinical Handbook ), at no time on written orders/ materials may PA students use other professional titles, degrees, or certifications (e.g., MA, LVN, RN, EMT, PT, OT, DC, L.Ac., RT, etc.).

Employment

Due to the academic rigor and demands of the clinical practice year, it is highly discouraged that students are employed during the MSPA Program.

Clinical rotation placements and schedules will not be modified for students who are employed.