PCAP Primary Care Associate Program

PRIMARY CARE ASSOCIATE PROGRAM

STUDENT MANUAL 2011-2013

Class of 2013

Disclaimer
The information contained in this Primary Care Associate Program Student Handbook is an extension of current policies and procedures of the Program, Stanford University School of Medicine and Foothill College. Since the implementation of curriculum is a dynamic process, the provisions listed in this Handbook are directive in nature and subject to change without notice. In case of change, students will be notified in writing.

On This PAGE

Mission of the Program

The mission of the Primary Care Associate Program is to:

Overview and History

The Primary Care Associate Program (PCAP) began in 1971 with the enactment of regulations by the California State Board of Medical Examiners the established the education and practice of physician assistants. The program is a cooperative effort between Stanford University School of Medicine and Foothill College, although Stanford is the sole sponsor for the program’s accreditation.

The PCA Program is a 21-month (seven quarters) PA program and leads to a Certificate of Clinical Proficiency from the Stanford University School of Medicine. Foothill College provides academic credit for all courses.

The program continues its community mission by identifying target areas, recruiting students from these areas, and implementing clinical training through a network of local PA coordinators and physician preceptors. The current target communities are:

Accreditation Status

The program was first accredited in 1976, and has been continuously accredited since then. The most recent decision of the Accreditation Review Commission on Education of the Physician Assistant (ARC-PA) was in March 2007, and the program was awarded five years of continuing accreditation. The next accreditation site visit will be in 2012.

Program Philosophy

The program strives to achieve its mission in all aspects of its operations, including student selection, didactic and clinical curriculum, and graduate outcomes. The faculty and students engage in teaching and learning, community outreach, and advocacy that focus on improving the health status of California’s citizens, particularly those in medically underserved areas.

Competencies of Program Graduates

The PCAP curriculum follows competencies guidelines established by the National Commission on Certification of Physician Assistants. These guidelines define the specific knowledge, skills, attitudes, and educational experiences needed in order to train physician assistants who provide uniformly high quality health care and demonstrate greater accountability in their profession. The competencies are:

Medical Knowledge

Medical knowledge includes an understanding of pathophysiology, patient presentation, differential diagnosis, patient management, surgical principles, health promotion and disease prevention. Physician assistants must demonstrate core knowledge about established and evolving biomedical and clinical sciences and the application of this knowledge to patient care in their area of practice. In addition, physician assistants are expected to demonstrate an investigatory and analytic thinking approach to clinical situations. Physician assistants are expected to: 

Interpersonal and Communication Skills

Interpersonal and communication skills encompass verbal, nonverbal and written exchange of information. Physician assistants must demonstrate interpersonal and communication skills that result in effective information exchange with patients, their patients’ families, physicians, professional associates, and the health care system. Physician assistants are expected to: 

Patient Care

Patient care includes age-appropriate assessment, evaluation and management. Physician assistants must demonstrate care that is effective, patient-centered, timely, efficient and equitable for the treatment of health problems and the promotion of wellness. Physician assistants are expected to: 

Professionalism

Professionalism is the expression of positive values and ideals as care is delivered. Foremost, it involves prioritizing the interests of those being served above one’s own. Physician assistants must know their professional and personal limitations. Professionalism also requires that PAs practice without impairment from substance abuse, cognitive deficiency or mental illness. Physician assistants must demonstrate a high level of responsibility, ethical practice, sensitivity to a diverse patient population and adherence to legal and regulatory requirements. Physician assistants are expected to demonstrate: 

Practice-based Learning and Improvement

Practice-based learning and improvement includes the processes through which clinicians engage in critical analysis of their own practice experience, medical literature and other information resources for the purpose of self-improvement. Physician assistants must be able to assess, evaluate and improve their patient care practices. Physician assistants are expected to: 

Systems-based Practice

Systems-based practice encompasses the societal, organizational and economic environments in which health care is delivered. Physician assistants must demonstrate an awareness of and responsiveness to the larger system of health care to provide patient care that is of optimal value. PAs should work to improve the larger health care system of which their practices are a part.
Physician assistants are expected to: 

The PA Competencies Online Center, “Physician Assistant Competencies,” National Commission on Certification of Physician Assistants, Accessed May 20, 2009

Program Structure and Organization

Division of General Medical Disciplines

The PCA program is part of the Division of General Medical Disciplines (DGMD), in the Department of Medicine. Dr. Mark Cullen is the DGMD Division Chief. The PCA program maintains a relationship with the Center of Education and Research for Family and Community Medicine.

Program Committees

The program’s governance and ongoing self-assessment is conducted by the following committees:

Principal Faculty/Staff Committee

The principal faculty/staff committee is chaired by the Program Director. It meets monthly to review issues of day-to-day program operation, long term planning and program development. Issues that require analysis and recommendations for action are referred to one of the other standing committees described below. Most actions regarding admissions, students and curriculum are made by the Principal Faculty/Staff Committee, based on recommendations of other standing committees. The Program Director and/or upper administration are responsible for actions regarding faculty and staff evaluation and budget-related resource issues.

The Principal Faculty/Staff Committee conducts an annual retreat to analyze graduate outcomes and the program’s educational effectiveness. Retreat agendas are set by the Program Director to assure that the program meets the minimum standards for accreditation and to pursue the program’s goal of educational excellence.

Curriculum Committee

The Curriculum committee evaluates all courses, utilizing student evaluations, instructor observations and student performance as criteria. The committee makes recommendations to Principal Faculty/Staff Committee for course and/or curricular modifications.

The Curriculum Committee analyzes student course and instructor evaluations, student performance, preceptor surveys, exit surveys, graduate surveys, PACKRAT and PANCE data, and graduate outcomes to monitor the curriculum for educational effectiveness. The committee utilizes national benchmarks for comparison with the program’s curricular content and sequence. The Curriculum Committee is chaired by the Medical Director, and includes the principal faculty.  Adjunct faculty and site visitors attend when possible, and their input is sought as pertinent to the issues.

Student Progress Committee (SPC)

The Student Progress Committee serves three main functions:

The committee reviews each student’s performance throughout each quarter to determine the student’s eligibility for progress to the next quarter and makes recommendations to the Program Director regarding approving or delaying each student’s progress.  The Student Progress Committee creates and oversees implementation of individual educational plans for those students approved for remediation, deceleration, or leave of absence. At the end of the program, the Student Progress Committee recommends eligible students to the Program Director for graduation, based on successful completion of graduation requirements and the summative evaluation.

The SPC analyzes aggregate student data related to attrition, deceleration, remediation and performance in all PCA program courses. The committee utilizes national/regional benchmarks and analyzes trends in student data in the context of admissions demographics and curricular changes. The SPC draws members from principal faculty who oversee major course content (didactic, pre-clinical, preceptorship). The duties of chair of the committee rotate annually among members. Current members are:

Ron Garcia, PhD (Chair)
Annette Bettridge (voting member)
Camille Gordon (voting member)
Fred Tovar (non-voting member)

Admissions Committee

The Admissions Committee is responsible for setting policy for the program’s admissions process, including screening of applicants, the validation process and student selection.

The Admissions Committee reviews admissions policies and procedures, and assures the accuracy and consistency of admissions publications (web site, outreach material and applications). The committee reviews and evaluates admissions requirements, including prerequisite courses, to assure adequate applicant preparation for the program’s curriculum. The committee analyzes trends in the applicant pool and student enrollment, using national and/or regional benchmarks. Current members are:

           Ron Garcia, PhD (Chair)
           Fred Tovar
           Emilio Francisco

Program Governance

The standing committees outlined above form the governance structure of the program.

Matters related to finance and personnel are reserved for the Program Director and/or upper level administration. The Program Director convenes an executive committee, consisting of the her/himself, Medical Director and Associate Program Director. The Executive Committee provides advice to the Program Director on strategic planning issues.

Stanford PCAP Student Society

The PCA class of 2006 established the Student Academy of the American Academy of Physician Assistants (SAAAPA). For officers, structure and duties see www.saaapa.aapa.org. The current president and members of the student society addresses the incoming class during new student orientation to discuss the function of the Society. SAAAPA officers are elected by the class and receive guidance by a principal faculty sponsor. It is the PCAP requirement that the SAAAPA officers to maintain good academic and clinical standing to be able to continue in their roles.

PCAP Student Class Representatives

Each class elects 2 student representatives. Student representatives meet formally and informally with their classmates to gather information in the aggregate about student issues and concerns. The student representatives communicate these issues and concerns directly to the principal faculty and Program Director. Successful student representatives are effective communicators and are able to identify issues that are of concern to the student body. Class representatives need to maintain passing academic and clinical grades in order to be eligible to continue in their roles. At the discretion of the Program Director, class representatives can be recalled and replaced at any time if they are not fulfilling their role appropriately.

Program Personnel

Program Faculty and Staff Contact Information

The program’s faculty and administrative staff work as a team to deliver the PCA curriculum. Key information about each member of our team is listed below:

 

Program Faculty

Name

Title

Phone

Email

Lucinda Hirahoka,
FNP, PA-C, MPH

Program Director
Principal Faculty

650-498-4474

hirahoka@stanford.edu

Valerie Berry, MD

Medical Director
Principal Faculty

650-725-5445

vberry@stanford.edu

Ron Garcia, PhD

Assoc. Program Director
Principal Faculty

650-725-0354

ron.garcia@stanford.edu

Arturo Armendariz
FNP, PA-C, MPH

San Diego
Regional Coordinator

619-302-1465

arturoa@stanford.edu

Annette Bettridge, FNP, PA-C

Academic Coordinator
Principal Faculty

650-725-5455

annbett@stanford.edu

Tracy Fearnside,
PA-C

Clinical Instructor
Principal Faculty

650-736-7773

tfearn1@stanford.edu

Carlos Flores,
PA-C

Kern County
Regional Coordinator

661-304-9750

cflores6@stanford.edu

Camille Gordon,
FNP-C, PA-C

Clinical Instructor
Principal Faculty

650-498-5242

camilleg@stanford.edu

Patti Hee,
PA-C, MPH

Clinical Instructor
Principal Faculty

925-352-8977

phee@stanford.edu

Heather Hirsh, PA-C, MPAS

Ventura/LA
Regional Coordinator

650-725-6959

hlhirsh@stanford.edu

Veronica Jauregui, FNP, PA-C

Imperial
Regional Coordinator

760-791-5437

veronicajauregui@ymail.com

Chantal Lobue,
PA-C

Humboldt
Regional Coordinator

707-954-1157

chantalobue@gmail.com

Sheila Siegel,
PA-C, MPAS

Clinical Instructor
Principal Faculty
Salinas
Regional Coordinator

650-725-5343

ssiegel@stanford.edu

Peter Stonington,
MS, PA-C

Clinical Instructor
Principal Faculty

650-736-4283

pstonington@stanford.edu

Carl Tjerandsen, PA-C

Clinical Instructor
Principal Faculty

415-987-4217

carltjer@stanford.edu

Michele Toussaint, PA-C

Clinical Instructor
Principal Faculty

650-725-5340

mtouss@stanford.edu

Administrative Staff

Cynthia Ahrendsen

Preceptor/E*Value Administrator Assistant

650-723-8267

cahrends@stanford.edu

Doris Chou

Financial Manager

650-725-5338

leavers@stanford.edu

Emilio Francisco

Admissions Coordinator

650-725-6959

emiliof@stanford.edu

Randy Fauver, PhD

Data Manager

650-725-4481

rfauver@stanford.edu

Anne Parry

Program Coordinator

650-723-6432

aparry@stanford.edu

Fred Tovar

Director of Student Affairs

650-725-5342

ftovar@stanford.edu

PHYSICIAN ASSISTANT PROFESSION

Definition

The Physician Assistant (PA) is licensed to practice medicine with physician supervision. As part of their comprehensive responsibilities, PAs conduct physical examinations, order and interpret diagnostic studies, diagnose and treat illnesses, counsel on preventive health care, assist in surgery, and write prescriptions. PAs are trained in intensive programs accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). PAs work in primary care, surgery and specialty practice and in ambulatory, inpatient, emergency and long-term care settings. (Source:  AAPA, 2008)       

Legal Basis for Practice in California

PA legislation was adopted in California in 1971 and amended in 1975 and 2007. The current law gives joint authority over the practice of PAs to the Allied Health Division of the Medical Board of California and the Physician Assistant Committee (PAC). The PAC is responsible for approving training programs for PAs and to certify PAs for practice in California. Requirements for PA practice in California include:

PA Organizations

AAPA American Academy of Physician Assistants
The AAPA is the national organization representing PAs in all specialties and all settings. The AAPA advocates for the PA profession and for quality patient care through its activities related to legislation/regulation, health policy, reimbursement, and access. Member services include continuing medical education (CME) and networking with PAs and other health professionals. The House of Delegates (HOD) is the policy making body of the AAPA. It meets annually to deliberate on a variety of professional issues. AAPA web site:  www.aapa.org
           
SAAAPA Student Academy of the American Academy of Physician Assistants
SAAAPA is the national organization for student enrolled in PA programs. SAAAPA has an elected board and participates in many AAPA activities. It advocates for PA students and provides information about financial aid, survival tips, and clinical pearls. Web site:  www.saaapa.aapa.org

CAPA California Academy of Physician Assistants
CAPA represents PAs in California and addresses state-level issues of legislation/regulation, reimbursement for services, employment, and quality patient care. CAPA sponsors two annual well-attended CME conferences. With one of the largest PA populations in the U.S., CAPA sends a large delegation of representatives to the AAPA’s House of Delegates. Web site:  www.capanet.org

PAEA Physician Assistant Education Association
PAEA is the national organization representing PA education and PA programs. PAEA advocates for excellence in PA education through research, faculty development, governmental affairs, and curricular innovation. Web site:  www.PAEAonline.org
 
NCCPA – National Commission on Certification of Physician Assistants
NCCPA is the national organization charged with assessing PA graduate suitability for entering clinical practice and for maintaining certification while continuing in practice. The NCCPA administers the PANCE for graduates entering the profession and the PANRE, a recertification examination which PAs must pass every six years to continue their certification. Web site:  www.nccpa.net

ARC-PA Accreditation Review Commission on the Education of Physician Assistants
The ARC-PA is the national organization which accredits PA programs. Its commissioners are drawn from national PA organizations, physician organizations and the public. Web site:  www.arc-pa.org

PAC The Physician Assistant Committee of the Medical Board of California protects consumers by licensing physician assistants and approving physician assistant training programs. The Committee ensures that licensees and approved programs have met the minimum licensure requirements. Web site:  http://physicianassistant.ca.gov

CURRICULUM

Curriculum Philosophy

The program’s curriculum, which draws upon the student’s prior academic, clinical and life experience, is conducted on an accelerated timeline. The student is expected to be an independent, adult learner. Faculty members and clinical preceptors facilitate the student’s acquisition of core knowledge, skills and professional.

The following source documents are used to develop, implement and evaluate the curriculum:

  1. ARC-PA Standards for accreditation of PA programs
  2. PAEA Annual Report (national survey of PA program characteristics)
  3. Competencies for the Physician Assistant Profession, developed by AAPA, ARC-PA, NCCPA and PAEA
  4. PANCE blueprint, developed by the NCCPA
  5. California Physician Assistant Committee guidelines for legal practice of PAs

Curriculum Structure

Students undergo 7 quarters of education whose objectives are based on competencies expected of physician assistants, as well as fulfilling the PCA program mission. The training addresses 5 broad areas:

Over the course of 7 quarters students participate in approximately 34 weeks of didactic and skills training, and 46 weeks of preceptorship experience. A large proportion of the didactic training takes place in quarters 1-3, with most of the preceptorship experience occurring during quarters 4-7. All lectures and skills training take place at Stanford/Foothill campus. For their preceptorship/clinical experience students are placed with a physician in their home community. Students return to Stanford each quarter for integrated instruction and testing.

Curriculum Delivery

The delivery of the PCA program content is based on five educational concepts: 

Systems-based organization is an educational model where medicine is approached by studying functions of each separate body system in health and disease.

Evidence-based information ensures that curriculum information is current, pertinent, appropriate and promotes practice that is standardized, effective and safe.

A spiral curriculum is one in which concepts are presented initially in basic fashion, then revisited in more depth, going from simple recall of information to critical thinking and application, providing opportunity for integration of new content and concepts.

Patient-centered medicine ensures that the needs of the patient are identified and addressed.

Inter-professional teamwork ensures that the student can communicate with and incorporate the expertise of other professions for the benefit of the patient.

Adult learners often have modes or learning styles that respond best to independent, self-directed inquiry; the program makes an effort to support the style of learning each student brings to the study of the material.

Didactic Coursework

Students receive formal class-room education in basic sciences, core medical knowledge, and acquisition of skills for clinical practice, professionalism and multiculturalism. The didactic curriculum prepares students for preceptorship experience.

Basic Science courses are presented in Quarter 1-3. These include:

Core medical knowledge is presented throughout the curriculum in the Core Medicine courses, with the following emphasis by quarter:

Instruction in information literacy and practical skills in evidence based medicine is embedded in the Core Medicine courses.

Skills for clinical practice are presented in Quarters 1-4. These courses occur in sequence with the Core Medicine content of each quarter. The components of the skills for clinical practice are:

Professionalism and multiculturalism is taught throughout the curriculum in dedicated courses, with the following emphasis by quarter:

Preceptorship Experience
The initial emphasis in clinical training is to ensure that students experience primary care practice, including a mix of family medicine, internal medicine, pediatrics and women’s health sufficient to provide a broad base of experience in health care of all genders, ages, and across the life span. In keeping with our mission students are required to have a portion of their primary care training occur at an officially determined medically underserved site. In later quarters students complete rotations in emergency medicine, inpatient care, surgical settings, and long-term care facilities.

Before a student is allowed to undergo supervised clinical training, the PCA Program takes responsibility for

(NOTE: although a fundamental belief of the program is that students should ideally undergo clinical training in their home community, if a suitable preceptor is not available in the student’s home community then the student will be required to travel or relocate in order to complete clinical training. Students may not decline suitable sites.

Professional Liability

All members of the faculty-student-preceptor team must be mutually indemnified. Students enrolled in the Primary Care Associate Program are, through their enrollment, covered by malpractice insurance in the amount of at least one million dollars ($1,000,000). Stanford employees and agents such as Site Visitors and Faculty Advisors are covered for malpractice by the terms of their employment. We require that physician preceptors carry malpractice insurance for themselves and their employees.

Course Descriptions

Course descriptions for each of the required courses listed on the following table are available through the Foothill College web site,

http://www.foothill.edu/bio/programs/primary/catalog.php?Department=P%20C

Courses

In order to matriculate into the core courses, all students accepted into the PCA program must complete the following orientation course. The course includes self-paced on-line modules as well as 2 days of on-campus orientation.

Quarter

Course Name

Course #

Units

Spring

Orientation to Primary Care Associate Program

PCA 50

1

Satisfactory completion of the following courses is required in order to earn the PCA program’s Certificate of Proficiency:

Quarter

Course Name

Course #

Units

Summer  (Q1)

Basic Science/Microbiology/Infectious Disease

PCA 51A

2

 

Anatomy/Physiology/Pathophysiology I

PCA 52A

5

 

Pharmacology I

PCA 53A

3

 

Pre-Clinical I

PCA 54A

3

 

Professionalism/Multicultural Medicine I

PCA 55A

1

 

Core Medicine I

PCA 56A

6

 

 

 

 

Fall (Q2)

Anatomy/Physiology/Pathophysiology II

PCA 52B

5

 

Pharmacology II

PCA 53B

3

 

Pre-Clinical II

PCA 54B

3

 

Professionalism/Multicultural Medicine II

PCA 55B

0.5

 

Core Medicine II

PCA 56B

8.5

 

 

 

 

Winter (Q3)

Pre-Clinical III

PCA 54C

4

 

Professionalism/Multicultural Medicine III

PCA 55C

0.5

 

Core Medicine III

PCA 56C

9

 

Preceptorship I

PCA 60A

4

 

 

 

 

Spring (Q4)

Pre-Clinical IV

PCA 54D

1

 

Core Medicine IV

PCA 56D

5

 

Preceptorship II

PCA 60B

6

 

 

 

 

Summer (Q5)

Core Medicine V

PCA 56E

1.5

 

Preceptorship III

PCA 60C

7

 

 

 

 

Fall (Q6)

Core Medicine VI

PCA 56F

1.5

 

Preceptorship IV

PCA 60D

7

 

 

 

 

Winter (Q7)

Professionalism/Multicultural Medicine IV

PCA 55D

3

 

Core Medicine VII

PCA 56G

2

 

Preceptorship V

PCA 60E

6

 

Total

 

98.5

Criteria for Successful Completion of the Program

In order to graduate from the Primary Care Associate Program and be awarded a Certificate of Clinical Proficiency from Stanford University School of Medicine, a student must achieve passing grade (“C” or better) in each required course in the curriculum. The student must also meet minimum passing standards of a Summative Evaluation, given at the end of their training, which includes demonstration of:

In order to graduate students must also complete payment of all tuition, fees and library charges.

General Information

Technical Standards

The abilities and skills which students must possess in order to complete the training associated with the PCA Program are referred to as Technical Standards. These essential abilities are a group of minimal physical and cognitive abilities as well as sufficient mental and emotional stability to confirm that students are able to complete the entire course of study, participate fully in all aspects of PA training, and be deployable as competent PAs, with or without reasonable accommodation.

The PCA program has the ethical responsibility for the safety of patients with whom students and graduates will come in contact, and to the public to assure that its graduates can become fully competent PAs. Thus, it is important that persons admitted to the PCA program possess the intelligence, integrity, compassion, humanitarian concern, and physical and emotional capacity necessary to practice medicine. Students must verify that they meet these Technical Standards prior to or at the time of matriculation to the PCA Program and maintain them during their PCAP training. Students are obligated to alert the PCA program of any change in their ability to fulfill the technical standards. Students found to be in violation of the Technical Standards are at risk for dismissal from the program.

Technical Standard I: Observation

Students must be able to observe demonstrations and participate in physical examination sessions, clinical skills workshops, observe the difference of normal versus pathological states. They must be able to obtain a medical history and perform a complete physical examination in order to integrate findings based on these observations and to develop an appropriate diagnostic and treatment plan.

Technical Standard II: Communication

Students must be able to communicate effectively and sensitively with patients, their families, and members of the health team. Students must be able to communicate effectively with patients from different social and cultural backgrounds, as well as develop effective professional rapport with patients and co-workers. Students must be able to record examination and diagnostics results clearly, accurately and efficiently. Students must be able to communicate effectively in English with patients, family and other health care professionals in a variety of patient settings.

Technical Standard III: Motor Function

Students must possess the capacity to perform physical examinations and diagnostic maneuvers. They must be able to respond to emergency situations in a timely manner and provide general and emergency care. They must possess adequate sensory function and motor coordination to fulfill minimum competency objectives for inspection, palpation, percussion and auscultation necessary to perform a physical examination. They must possess sufficient postural control, neuromuscular control and eye-to-hand coordination in order to utilize standard medical/surgical instruments to participate in the inpatient and outpatient setting and other clinical activities.

Technical Standard IV: Intellectual-Conceptual, Integrative and Quantitative Abilities

Students must be able to learn through a variety of modalities including, but not limited to, classroom instruction; small group, team and collaborative activities; individual study; preparation and presentation of reports; and use computer technology. Students must have the mental capacity to assimilate and learn a large amount of complex, technical and detailed information in order to formulate diagnostic and therapeutic plans.

Technical Standard V: Behavioral and Social Attributes

Students must have the emotional stability to function effectively under stress and to adapt to an environment that may change rapidly, without warning, and/or in unpredictable ways. They must accept responsibility for learning, exercising good judgment, and promptly completing all responsibilities attendant to the diagnosis and care of patients. They must understand the legal and ethical standards of the medical profession. Students must be able to work effectively, respectfully and professionally as part of the healthcare team, and to interact with patients, their families, and health care personnel in a courteous, professional, and respectful manner. Students must be able to contribute to collaborative, constructive learning environments; accept constructive feedback from others; and take personal responsibility for making appropriate positive changes.

Technical Standard VI: Ethical and Legal Standards

Students must be able to understand the basis and content of both general and medical ethics. The student must possess attributes that include compassion, empathy, altruism, integrity, responsibility, and tolerance. Student must be able to recognize limitations in their knowledge, skills and abilities and to seek appropriate assistance with their identified limitations. Students whose performance is impaired by abuse of alcohol or other substances are not suitable candidates for admission, promotion, or graduation. In addition, should the student be convicted of any felony offense while in the PCA program, they agree to immediately notify the program as to the nature of the conviction. Failure to disclosure prior or new offenses can lead to disciplinary action that may include dismissal. Students must meet the legal standards to be licensed as a physician assistant in the State of California.

Adapted from Stanford School of Medicine Technical Non-Academic Standard, http://med.stanford.edu/md/admission/technical _standards.html, Accessed May 20, 2009

Process for Requesting Accommodations, Americans with Disabilities Act

Prior to matriculation students must

Students with special needs or those who feel they may not meet the Technical Standards are urged to contact the Director of Admissions to determine whether they can meet the requirements with or without reasonable accommodations. Revealing a disability is voluntary; however, such disclosure is necessary before any accommodations may be made in the learning environment or in the Program’s procedures. Information about disabilities is handled in a confidential manner. Foothill College provides services for students who have been admitted to the PCA program and who have questions regarding accommodations for an established disability or evaluation of a potential disability. Students will be referred to

Foothill College Disability Resource Center
Room 5801
Main Campus

Margo Dobbins, DRC Coordinator will coordinate reasonable accommodations for students with documented disabilities in compliance with the Americans with Disabilities Act. Contact Ms. Dobbins at (650) 949-7038 or by email: DobbinsMargo@foothill.edu
More information is available at http://www.foothill.edu/al/drc.php

Requests for accommodations require program and institutional approval, which can be a lengthy process, including meetings between student, Program Director and DRC Coordinator. A student who intends to seek accommodations must submit notice of that intent in writing to Director of Student Affairs, Fred Tovar ftovar@stanford.edu

Deadline for submitting this written notice is June 1, 2012.

Occasionally a student develops or discovers a disability after enrollment in program courses. In this case it is the student’s responsibility to alert the PCA Program as soon as that disability is suspected or identified so that appropriate evaluation and discussion of accommodations can occur. If at any time the student develops a condition that would negatively impact health and safety of the student, program faculty, staff, other students or patients then the Program has the right and obligation to suspend the student form all or part of program activities until the condition can be evaluated.

Student Employment Policies

Class Visitors

Adults may be permitted to visit Stanford or Foothill College sites under the guidance and prior approval of the Director of Student Affairs. Applicants, accepted students and others may visit classes for short periods of time on an intermittent basis. Given the nature of the training program, some classroom events are not suitable for visitors. In general minor children (including children of students) are not allowed as visitors. Rare exceptions may be granted with prior approval.

Advanced Placement

The program does not offer advanced placement.

Articulations with Other Institutions

The PCA program maintains cooperative arrangements with a number of educational and service institutions throughout California.

Foothill College provides academic credit for all course work in the program and awards an Associate of Science (AS) for students who apply for the degree.

The PCA program offers an articulation with San Jose State University’s Department of Health Sciences for a Bachelor of Science (BS) degree.

The PCA program offers an articulation with St. Francis University’s Physician Assistant Program for a Masters of Medical Science (MMS) degree.

Information about these options can be obtained by contacting Lucinda Hirahoka Hirahoka@stanford.edu or Fred Tovar ftovar@stanford.edu Deadline:

Students must indicate their desire to seek the St. Francis MMS by the end of Quarter 1.

REGISTRATION, ENROLLMENT, and FEES

Foothill College General Registration Information

To register for Foothill College classes, follow the telephone registration instructions or online registration instructions published in the Foothill Schedule of Classes available online at www.fhda.edu. Please note: online information is subject to change. Students are encouraged to check the Web site frequently. For more information, call the Admissions & Records Office at (650) 949-7325.

Enrollment

Students are enrolled as Foothill Community College students. The PCA program follows the Foothill Academic Calendar published online at www.fhda.edu. Though students are enrolled in Foothill College courses, didactic coursework and skills training take place primarily at the Stanford campus or Foothill Middlefield campus, provided by PCA program faculty, School of Medicine faculty, community clinicians and educators. At graduation students receive a Certificate of Clinical Proficiency from the Stanford School of Medicine. Completion of the PCA program courses qualifies the student for an AS degree through Foothill College.

Student Fees and Expenses

The fees listed below reflect the seven quarters for the academic year 2011-13. If a student extends beyond the customary seven quarters, or requires remedial enrichment courses during enrollment, additional fees will be assessed.

Estimated Costs for Academic Year: 2011-2013

California Resident

 

 

Foothill College Enrollment fees

 

 

$17/unit x 21units
(Quarter 0 and Quarter 1)

 

$     357

 

$ 24/unit x 77.5 units
(new state fee starts Quarter 2-7)

 

 

$  1,860

 

Foothill Student Fees 

 

 

$     328

 

Stanford University School of Medicine Certification Fees*

 

 

 

$ 6,750/quarter x 7 quarters

 

 

$ 47,250

 

Total Educational fees:                               

 

 

$ 49,795

Books & medical equipment  

 

$   2,200

Home computer or laptop  with email & internet access      

 

$   1,500

Fee for required online logging software

 

$        90

 

Total California Resident Cost:                 

 

 

$ 53,585

*Certification fee is established by Stanford University School of Medicine and applies to the quarterly certification process conducted by the Primary Care Associate Program.

Non-California Resident

 

 

Foothill College Enrollment fees

 

 

Quarter 0-7
$119/unit x 98.5 units

 

 

$  11,721.50

Foothill Student Fees 

 

$     328

 

Stanford University School of Medicine Certification Fees*

 

 

 

$ 6,750/quarter x 7 quarters

 

 

$ 47,250

 

Total Educational fees:                               

 

 

$ 59,299.50

Books & medical equipment  

 

$   2,200

Home computer or laptop  with email & internet access      

 

$   1,500

Fee for required online logging software

 

$        90

Total Non-California Resident Cost:                     

 

$ 63,089.50

Living expenses vary among individuals and are excluded from this table. These figures are provided for planning purposes only, and are subject to change. Fees typically are increased for the second fall quarter of the program.

The following estimates pertain to expenses required by the PCA Program and by various agencies for certification and licensure:

Graduation Costs not covered by the program Approx.  $100
PANCE fee Approx.  $450
Licensure fee – California Medical Board Approx.  $200
DEA Application Approx.  $400
Background check Approx     $60
Health Clearances varies

Refund of Fees

Foothill College tuition fees may be refunded under certain circumstances. The specific policy is listed in the quarterly Foothill College Schedule of Classes. Any questions concerning tuition and fees should be directed to the Foothill College Admissions and records Office. Foothill College policy on tuition and fee refunds please see http://www.foothill.edu/reg/fees.php.

The Stanford certification fee may be refunded if the student withdraws from the course within the first month of the quarter.

FINANCIAL AID

Students should begin planning their financial strategy before applying to the PCA program. Presentations on financial aid from representatives of Foothill College are included during Orientation. Information is available at Foothill Financial Aid http://www.foothill.edu/aid/

National Health Service Corps (NHSC)

Primary care providers who join the Corps receive up to $170,000 in loan repayment for completing a five-year service commitment. The NHSC offers loan repayment support with an initial award of up to $60,000 for two years of full-time service. After the initial two-year commitment, providers may be eligible to receive additional support in exchange for continued service; up to $170,000 for five years of service. With continued service beyond five years, clinicians may be able to pay off all their student loans. Students pursuing a degree in qualified health professions can receive a scholarship now and serve later. Scholarships for tuition, fees, a monthly stipend, and other reasonable educational expenses are available for up to four years. Students who receive scholarships can choose their primary care specialty. They then serve at least two years at a NHSC-approved site in a high-need area. Please go to the NHSC web page for more information
National Health Service Corp: http://nhsc.hrsa.gov/

Other Sources of Financial Aid Information

Students are encouraged to seek additional sources of public and private sector money, as well as pursue those sources listed here. Students are strongly encouraged to apply for the Cal Grant C, as former students have had success in obtaining this grant. A listing of many potential money sources can be found in the following publications:

Web resources include:

All four sites allow students and educators to sign up for a free email newsletter offering information on college admission, scholarships and financial aid, careers, college life, and other important subjects of interest to students, counselors, parents, and teachers.

Another good source for scholarship information can be found at SuperCollege.com.

STUDENT HEALTH and WELLNESS

Health Insurance

  1. Access to basic health care services is available through Foothill College Health Services (see below).
  2. Students who are injured while performing educational functions (such as receiving a needle-stick injury in clinic) are covered by workman’s compensation for evaluation and treatment of the injury (see below for policy and protocol for injuries and exposure to bloodborne pathogens).
  3. Students must assume financial responsibility for any other health care cost beyond 1&2
  4. Any student that suffers illness, accident or injury must provide medical clearance to the Student Progress Committee in order to continue/resume students activities
  5.  Although health insurance is not required by Foothill College, the PCA program strongly encourages students to enroll in a health plan that will cover them during the program. Lack of health insurance can delay a student in getting care for a medical problem, which may delay the student’s academic progress.
  6. Principal faculty including the medical director and the program director do not provide health care for students, except in an emergency situation when other health care providers are not available.

Foothill College Health Services
Location:         New Campus Center, Room 2126
 
Hours:             Monday – Friday 8:30 AM–1 PM and 2–4:30 PM
                         (closed for lunch between 1 & 2 p.m.)

Contact:          Phone: (650) 949-7243
                         Fax: (650) 949-7160
                         http://www.foothill.edu/health/index.php

Clinic services include links to:


 
Psychological Services
Location:         New Campus Center, Room 2120
Hours:             Monday – Friday by appointment  (during school sessions only)
Contact:          Phone: (650) 949-7910
                         www.foothill.edu/psychservices/

For after-hours help please call:  
The 24-Hour Suicide & Crisis Service
County of Santa Clara
(650) 494-8420,  (408) 279-3312; 1 (855) 278-4204 (toll free)

 

Information on Injuries and Exposures to Bloodborne Pathogens

If a student is injured while attending class or at their preceptorship, Foothill College procedures will be followed.

For any serious injury: render appropriate first aid and seek immediate assistance from the nearest medical facility. Call 911 if appropriate.

For a less serious injury

In the Stanford area, students who experience an occupational injury, environmental hazard or exposure to bloodborne pathogens will be referred by Foothill College Health Services to:

Nova Care Occupational Health
20289 Steven’s Creek Boulevard
Cupertino, CA 95014    
(408) 996-8656

In the event of exposure to blood or body fluid, the following emergency procedures should be followed (left column). If students are unsure whether a significant exposure to bloodborne pathogens has occurred, or if their treating facility has questions regarding the latest in post-exposure protocols, resources are listed below (right column).

Students please note:

Medical Providers please note

 

If you experienced a needle-stick or sharps injury or were exposed to the blood or other body fluid of a patient during the course of your training, immediately follow these steps:

  • Wash needle sticks and cuts with soap and water.
  • Flush splashes to the nose, mouth, or skin with water.
  • Irrigate eyes with clean water, saline, or sterile irrigants.
  • Report the incident to your supervisor.
  • Report the incident to PCAP Program Director.

Immediately seek medical treatment.

 

If you have questions about appropriate medical treatment for occupational exposures, 24 hour assistance is available from the Clinicians' Post Exposure Prophylaxis Hotline (PEPline) at 1-888-448-4911
http://www.nccc.ucsf.edu/about_nccc/pepline/

CDC recommendations for the management of occupational exposures to blood & body fluids

MMWR Recommendations and Reports, Volume 54, Number RR-9, Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HIV and Recommendations for Postexposure Prophylaxis
www.cdc.gov/mmwr/PDF/rr/rr5409.pdf


MMWR Recommendations and Reports, Volume 50, Number RR-11, Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis
http://www.cdc.gov/mmwr/PDF/rr/rr5011.pdf

ACADEMIC ADVISEMENT

Faculty Advisors

Soon after acceptance into the program students are assigned a Faculty Advisor who

Each student is required to meet with his/her faculty advisor at the beginning of the first quarter and in each quarter subsequently. Students with academic difficulties, issues of poor professionalism or delayed progress may be required to meet with their faculty advisor more frequently. Faculty advisors utilize an Advisory Form (see Appendix V) to record issues discussed with students that may require further action or intervention.

Faculty advisors have regular office hours to meet with students. While the program maintains an “open door” policy, appointments with the faculty advisor are strongly advised, since faculty members have variable schedules.

Student Liaison

The PCA program appoints a Student Liaison who is available to provide guidance and information to students. The Student Liaison is a principal faculty member who helps the student understands the PCA program and Foothill College policies and student options when faced with Program decisions on course failure, delay, deceleration or dismissal. The current Student Liaison is Ron Garcia, PhD.

Student Resources

One of the recurring areas of confusion for PCAP students is regarding their official student identity. PCAP students are not enrolled as Stanford University students, and thus do not have access to Stanford facilities except as noted below. PCAP students by registration and payment of Foothill course and activity fees have access to all features of student life at Foothill College.

Housing

Housing is not available on the Stanford campus. Students are responsible for arranging their housing during didactic and clinical phases of the curriculum. Local newspapers can be helpful, as well as discussing housing strategies with senior PCAP students.

Transportation and Parking

Stanford is linked to local train and bus systems (Caltrain, VTA, SamTrans) and has the Marguerite, a convenient free campus-wide shuttle system. The PCA program sponsors students who wish to drive and park on campus, enabling them to buy an annual parking pass. More information is available at http://transportation.stanford.edu

Student Areas

Stanford School of Medicine has limited areas for student use and none dedicated for exclusive use by PCAP students. Students are expected to share common areas and lounges and behave in a considerate and professional manner. PCAP students may use

A bulletin board for posting information is located in the hall near Always M104.

Athletic Facilities/Swimming Center at the Stanford Campus

PCAP students are not permitted to use any of the athletic or swimming facilities. A number of shower facilities are available; consult senior PCAP students or faculty advisors.

Library Resources

The Lane Library provides a full-service learning environment including study areas and access to texts, periodicals and on-line resources. SUNet registration allows students online access to electronic copies of many of the core textbooks as well as downloadable tools useful in clinic practice. Refer to www.lane.stanford.edu

Coursework

PCAP student access to Coursework is sponsored through their SUNet ID.

Copy Machines

Students are not allowed to use the copy or fax machines in the Program office. Copy machines are available throughout campus and in the Lane Library.

Stanford Bookstore

519 Lausen Mall
Main Campus
Phone 650-329-1217
Fax 650-322-1936
Email Stanford@bkstr.com

Health and Safety Portfolio

Students accepted into the PCA program are required to complete important health and safety clearances before matriculating into core program activities. These clearances are based on current Centers for Disease Control Recommendations for health professionals, and guidelines current for Stanford Medical Center. Students are expected to maintain and update their portfolio of these and other clearances throughout their PCA program enrollment. Most of these clearances are initiated and fulfilled by meeting requirements of PCA50: Orientation to Primary Care Associate Program. The syllabus and requirements for this pre-matriculation course are reviewed at Orientation and posted on Coursework. Briefly the PCA 50 requirements include

Failure to complete these by the deadlines posted in the PCA 50 syllabus may result in course failure and delay in matriculation to core program activities. Other clearances (such as N95 respirator fit testing and ACLS training) will be organized by the program in later quarters.
 
Students will be asked to provide appropriate documentation, and sign releases that allow the PCA program to share their health and safety information with clinics, hospitals and other facilities where students train.

Student Contract

As soon as students establish communications with the program (completing their SUNet & Coursework activation) they will be provided with an electronic copy of the current Student Manual. A hard-copy signature page will be distributed that lists agreements between each student and the PCA program regarding important aspects of student training. Each student must

Students are not allowed to matriculate to core courses of the PCA program without signing the contract. If a student has questions regarding the contract s/he is encouraged to contact the Program Director.

ATTENDANCE POLICIES

Overview

Absence from campus-based lectures and events
If a student anticipates missing any required program event such as lecture, workshops, seminars or a test the student must

Fred Tovar will discuss the absence with the course director and, where applicable, lecturers, workshop/seminar leaders, faculty advisors.

Absence from Clinical Preceptorship

In order for a student to make adequate clinical progress students must meet minimum requirements per quarter for attending clinic or fulfilling rotational days. (See preceptorship syllabi for quarter requirements). It is the obligation of each student to manage his or her time in order to meet those requirements. Each student will negotiate a plan with his/her preceptor and site visitor and faculty advisor for fulfillment of clinical days and rotations. The student must contact the Clinical Coordinator regarding absences that may impact student progress. Any plan for addressing those absences must be reviewed and approved by the Clinical Coordinator.

A student who is unable to meet the clinical attendance and performance requirements for the quarter is not making satisfactory progress and may earn a not-passing grade for the quarter. A student must contact his/her site visitor and faculty advisor as soon as s/he is aware of any absences that may impact completion of the quarter clinical requirements. If the site visitor and faculty advisor, in consultation with the Clinical Coordinator, cannot make a satisfactory intervention then the issue will be referred to the Student Progress Committee for resolution.  

PROFESSIONALISM

Professional Behavior Standards

Students enrolled in the PCA Program must develop, demonstrate and adhere to standards of professional behavior consistent with the principles of the PA profession, medical ethics, and state and federal laws. Student progress in meeting professionalism goals is evaluated throughout the student’s training. Each quarter, principal faculty will complete an evaluation form addressing the various aspects of the student’s demonstrated professionalism and adherence to policies of behavior. Such evaluation includes informal observation of behavior in classroom, interactions with peers, faculty and staff, participation in seminars/practice groups, and conduct in clinical and administrative settings. Lapses of professionalism will be addressed by use of the Advisory Form (see Appendix V). Students showing repeated or serious lapses of expected professional behavior at any time during their training will be referred to the Student Progress Committee,

The PCA program incorporates guidance from three sources in defining goals for professional behavior of its students:

Foothill College Policies

The PCAP student is expected to

Students who fail to adhere to the Foothill College Policies are referred to SPC.

Stanford University Policies

The PCAP student is expected to

 PCA Program Policies

The PCAP student is expected to:

*adapted from:  Danielsen RD et al. The Culture of Cheating: From the Classroom to the Exam Room. Journal of Physician Assistant Education. 2006, Vol 17, #1, pg 24.

PCAP Didactic Behavior Policies

With respect to the program’s didactic curriculum, the student is required to:

PCAP Clinical Behavior Policies

With respect to the program’s preceptorship curriculum, the student is required to:

PCAP Dress & Grooming Standards for Clinical Settings
(adapted from the Dress Code of Stanford Medical Center)

General

Female Students:  Dresses, pant or skirts outfits suitable for a clinical environment and worn with appropriate shoes and hosiery/socks. Shoes must be clean and in good condition. Long white coat required, unless waived in specific clinical settings.

Male Students:  Shirts and trousers suitable for an office/clinic environment with appropriate shoes and socks. Tie optional. Long white coat required, unless waived in specific clinical settings. Shoes must be clean and in good condition.

All Students:  A clean, professional appearance is expected and includes clean nails and a hairstyle that does not interfere with duties. Jewelry is acceptable if it does not interfere with work duties. Perfume/cologne is discouraged, but if worn should be mild and unnoticeable to others. Make-up should be conservative.
No blue denim jeans, hats, caps, tank tops, shorts, spandex wear, sweats, flip-flops, cutoffs or skintight leggings. Midriff, chest and back must be covered. Scrubs should be worn only in designated areas. Tattoos and piercings may be viewed by preceptors and facility personnel as unprofessional and my limit the students clinic options.

Hospital settings may have more specific requirements about dress and grooming. Questions about dress and grooming should be directed to the Program Director or the Medical Director.

Name badges with photo identification as a PA student must be worn and visible at all times.

PROBLEM SOLVING & CONFLICT RESOLUTION

Learning and practicing medicine involves working with a wide variety of people. Conflicts and misunderstanding can occur. The danger in allowing conflicts to remain unresolved is that they detract from the educational environment and from learning.

The following process for resolving problems and conflicts does not apply to disputes about

The procedures for disputing these are described elsewhere in this Manual. In addition, issues of discrimination and harassment are addressed by a different process (see below).

Conflict Resolution

The PCA program expects students in conflict to

If a conflict arises between students, student and preceptor, or student and faculty member, PCAP committee or staff member that is not amenable to direct communication, students should seek help. PCA program faculty and staff representatives identified below can act as mediators and assist with problem solving and conflict resolution. Whenever PCAP personnel are asked to act as mediators they must fill out an Advisory Form documenting the meeting (see Appendix V).
Foothill College has established a complaints and grievance procedure for students who believe they have been treated unfairly. However, the student must make a good-faith effort to follow the PCA program conflict resolution process prior to going to the next step of accessing Foothill College.

Failure to follow the conflict resolution process may be cited as an example of poor professionalism.

Guidelines below indicate usual areas where conflict or problems arise, and suggestions for resources for help. The student is directed to ask for assistance in the order presented, with the faculty advisor often being the initial contact.

Personal Issues

Financial Issues:  Fred Tovar, Director of Student Affairs

Didactic Course Issues

Preceptorship Issues

Student Progress Committee (SPC)

A student who disagrees with a decision made by SPC should follow the conflict resolution process described below. The student should

If the conflict cannot be resolved then the student may wish to pursue the grievance process described below.

Conflict Resolution Process

Discrimination and Harassment

Stanford University requires all PCA program faculty and staff to receive training and regular updates on policies and procedures related to discrimination and harassment. Students receive training during the Orientation course via HealthStream training modules. The PCA program follows the Foothill College guidelines regarding the policies and procedures for processing student grievances and allegations of discrimination and harassment. If a student believes s/he is experiencing discrimination and/or harassment, students are not required to try to resolve the issue through the conflict resolution process above. A grievance procedure has been defined by Foothill College to protect student rights, described here http://www.foothill.edu/services/studentright.php. A student should immediately contact their faculty advisor and Program Director when there is an issue of discrimination or harassment.

Disciplinary Actions

Disciplinary action will result from repeated minor lapses and/or any significant lapse in professional behavior. Disciplinary action may include written documentation in the student’s permanent file, official reprimand, suspension, and/or dismissal.

Official Reprimand formally recognizes a violation of any policy, core value or expected behavior outlined in this Manual and Appendix I-IV, and directs the student to avoid future infractions.

Suspension is defined as exclusion from a didactic and/or clinical setting. Suspension may be enacted by the Student Progress Committee (SPC) for any of the following:

Additionally, preceptors, site visitors and faculty have the right to immediately suspend a student from clinic or hospital if the student is acting in a manner that is unsafe or unethical. The person initiating the suspension must report the events to the Chair of SPC and Program Director as soon as possible. SPC will investigate and determine an appropriate disposition, which may include resolution, sanctions or dismissal. See section regarding illness or injury that impacts student’s progress.

Dismissal may result from violations of a variety of PCA program policies, including behavioral and academic. See below for the policy and procedure for dismissal.

GRADING & TESTING POLICIES & PROCEDURES

Academic Performance Standards

Standards of acceptable performance for didactic courses and preceptorship are summarized in course syllabi and/or course manuals and are reviewed verbally at the course introduction and quarter overview.

Grades

The program assigns course grades, based on criteria identified at the beginning of each quarter or course. The minimum passing grade for each course is a “C” (70.0%). The program does not “round up” examination or course grades to the next whole number. In some circumstances the PCA program employs a standardized “curve” to calculate letter grades. This curve does not change the 70% minimum to pass, and is usually created to recognize, for example, that 86% in a challenging course may deserve a grade of “A”.

Some courses include components that must be passed in order to pass the course, regardless of the overall course average. These components are identified in individual course syllabi.

Students must earn a “C” or better in all courses to stay in good academic standing.

The “Incomplete” grade is available only by SPC designation for situations where the student does not attain quarter goals. The grade of Incomplete is not automatic; the grade is given only following SPC review. A student who receives an “Incomplete” in a course must satisfactorily progress in all required activities by the deadline designated by SPC. Failure to make satisfactory progress in all requirements may result in an “F” in that course, which may result in dismissal. An “Incomplete” grade automatically changes to an “F” grade if not successfully made up in one year.

Each student is assigned a code word identifier in order to post grades and other group announcements confidentially. Scores are posted as soon as possible after each examination and at the conclusion of each quarter.

Didactic Course Testing and Grades

Students are given regular, meaningful feedback on their academic progress through various assessments tools. Depending on the course, quizzes, midterms and final exams may be a multiple choice written or electronic exam, performance check-off, OSCE, practicum, reflection paper, written SOAP note or oral presentation. Content tested is based on instructional objectives posted in syllabi and unit goals and objectives, and include material from lectures and reading from required texts. The minimum passing grade for each quiz & final examination is 70.0%. Please consult individual course syllabi for specifics of testing and assignment of grades.

Preceptorship Evaluation and Grades

Students are given regular, meaningful feedback on their performance in supervised clinical practice (primary care preceptorships and hospital-based rotations). Depending on the preceptorship, site visits observation, preceptor evaluations, multiple choice written or electronic exam, practicum examinations and written assignments (including write-ups of patient cases) are utilized to evaluate students’ clinical knowledge, skills and behavior in the clinical setting. The minimum passing grade for each Preceptorship course examination is 70.0%; if a Likert scale 1 through 5 is used, the minimum passing score is 3 for each section of the Preceptor evaluation form.

Required Progress

Students are required to demonstrate steady, adequate progress in each course in fulfillment of instructional goals and learning outcomes (see course syllabi for specifics.) Students not making adequate progress will be referred to the SPC. Failure to make progress may be grounds for delay, deceleration or dismissal.

Dispute of Test Results and Evaluations

Written Exams

At the conclusion of each written quiz or test, students submit their score sheets and keep the examination. The correct answers are posted soon after the conclusion of the exam. Within seven (7) calendar days following the exam, students may submit a written request for consideration of an alternative answer to the course coordinator. A request must include a rationale and reference from a text from the program book list and/or other Program course materials. References to texts and web-sites that are not on the Program book list will not be accepted.

The request is submitted to a Test Committee, which consists of the course coordinator, and two other principal faculty members. The Test Committee will generate a response within four (4) calendar days. If the request is granted, the student’s test score will be changed and (if applicable, the course grade).

The Test Committee’s decision concludes the review of didactic course test items.

Standardized Performance Exams

Students will receive copies of their score sheets for performance exams such as OSCEs, technical skills check-off, and practicum examinations as soon as possible after the testing event. In general, Practicum and OSCE scores will be posted within seven (7) working days after the testing days are concluded. A student with a failing Practicum score can review their examination by phone or in person with the Practicum Coordinator or designee at an arranged time before the next class week. The student may submit a written request for a scoring change with a rationale and reference from a text from the program book list and/or other program course materials. References to texts and web-sites that are not on the program book list will not be accepted. The written request must be submitted within seven (7) working days after the student has had the opportunity to review their examination.

The Practicum Coordinator will refer disputed items to a Test Committee including the practicum or event coordinator and at least two other principal faculty members. The Test Committee will generate a response within four (4) calendar days. If the request is granted, the student’s Practicum score will be changed (and if applicable, the course grade).

The decision of the Test Committee concludes the review of disputed performance test items.

 

Preceptor Evaluations

Students must receive an end-of-course or end-of-rotation evaluation from the preceptor who provided the primary supervision of the student. However, any preceptor who supervised the student may be asked by the Program to submit an evaluation of the student. SPC may elicit an early evaluation from a preceptor if there is concern about a student’s clinical progress and performance. Students must receive notice of their preceptorship evaluation scores within seven (7) days of receipt by the Program. If a student does not agree with the score or comments on the preceptor evaluation s/he should first discuss the concern with his/her site visitor who will seek clarification from the preceptor. If concern remains unresolved the student must submit a written request to the Clinical Coordinator within seven (7) working days outlining the cause of concern. The Clinical Coordinator will direct the investigation of the evaluation and send the information to the Student Progress Committee for resolution. SPC will generate a response within four (4) calendar days of their meeting, which may include accepting the evaluation as is, or developing a remediation plan. The decision of SPC concludes the review of the disputed preceptor evaluation. Students who disagree with SPC decisions may seek an appeal, described below in Appealing and Grieving Program Decisions.

ACADEMIC PROGRESS POLICIES

Definition of Satisfactory Academic Progress

Students are required to perform at the “C” or higher level in all courses to maintain satisfactory PCA program academic progress. Students with grades below “C” are reviewed by the Student Progress Committee.

A student must maintain a GPA of 2.0 each quarter to remain in good academic standing and to graduate from the PCA program.

Note:  Students enrolled in the St. Francis MMS option must maintain minimum course grades of “C” in order to continue with the MMS option.  

Academic Advisement

During a course

Each time a student fails a graded assignment or does not meet Program expectations (deadlines, professionalism or technical standards) s/he must meet with his/her Faculty Advisor or designee and complete an Advisory Form (see Appendix V). This process provides an opportunity for feedback and remediation of problems. At the meeting the student and advisor

SPC reviews all completed Advisory Forms and directs additional interventions, if indicated. A student’s failure to follow through on the plan created by the academic advisory may result in disciplinary action.

End of Course

A student who fails to achieve a minimum grade of “C” in a course and achieve minimum competency requirements must meet with his/her Faculty Advisor or designee to complete an Advisory Form. The Student Progress committee will review the form and meet with the student to discuss the course grade and the student’s insight into causes. See Course Failure, below.

PCA Program Probation

The PCA Program has internal rules regarding academic probation that are stricter than Foothill College rules (see Appendix I). Remediating a course failure is not automatic (see below). For students who do not achieve the minimum competency requirements posted in the course syllabus The Student Progress Committee determines if a student shall be placed on probation and offered remediation of a course grade. The probation lasts for the remediation period, which may vary, depending on the deficit to be corrected. A student will be placed on probation for the following quarter if the student does not achieve minimum competency in any course, assuming that the student is allowed by SPC to continue in the program and remediate the grade. If the student is able to successfully remediate the course grade or grades, the student returns to good academic standing. Probation may affect a student’s eligibility for financial aid.

A student whose progress is delayed for academic reasons beyond seven (7) quarters is placed on probation until the student graduates or is dismissed.

Course Failure

A student fails a course if s/he does not achieve the minimum competency requirements posted in the course syllabus. Each course has a number of components that measure competency

Students must demonstrate competence in all coursework in order to progress in the program. Failure to earn a minimum of a “C” grade in any course may be grounds for dismissal from the program.

Remediation

Performance During a Course

Students who do not demonstrate minimum competency and who are not making regular progress within a course are identified by the Academic Advisory process. SPC directs their remediation. Remediation may include review of failed assignments (one-on-one or in large group), direction for change in student study habits or help with problems, referral to Foothill College for evaluation for learning disability, or other referrals as deemed useful. Individual tutoring is not available during a course.

 

End of Course Performance

When a student does not achieve minimum competency in determining a final course grade, an advisory form is completed (see above and Appendix V) and sent to SPC for review and action. Each student’s situation is given careful and individual discussion regarding whether and how the course grade can be remediated. The following are general guidelines for what may be remediable:

If SPC determines that a course can be remediated, the student receives a grade of “Incomplete” for the course. An individual educational plan will be created for the student. This plan is a formal agreement between the student and the Program and must be signed by student and Chair of SPC. The plan will include

The Program reserves the right to revisit and amend the contract if new information evolves during the remediation. In this case the student will be informed in writing of the reason for the changes and will be asked to sign the amendment.

Remediating a course requires enrollment in an enrichment course that may include self-study, tutoring, extra assignments and re-testing. If a student requires tutoring or assistance beyond what the program can reasonably provide the student must assume the cost of that service. Didactic courses must be successfully remediated by week 4 of the subsequent quarter. In the event of a not achieving minimum competency in a preceptorship or rotation the remediation is to repeat the entire event, which may vary in length from 4 weeks to 12 weeks in duration. Students should realize that remediation incurs additional course fees and possibility for delay in graduation.

If the student fails to achieve minimum competency in goals of the enrichment course intended to remediate the grade of “Incomplete” then the student is not making progress and may be dismissed. If the student achieves minimum competency requirements for the enrichment course then the “Incomplete” is changed to a “C” and the student receives a grade in the enrichment course that reflects the requirements of its syllabus.

Deceleration and Leave of Absence Policy

Deceleration is defined as the loss of a student from the entering cohort, who remains matriculated in the PCA program.
Deceleration may come about through one of two mechanisms:

In both cases the student would be reassigned to a new class. Due to Foothill College policies and PCA course descriptions, students may not repeat courses for credit; credit earned in courses for which the student has achieved a passing grade would be retained. Student would audit all courses and participate fully to demonstrate retained competency (see competency policy below).
SPC determines the appropriateness of deceleration and, if granted, develops an individual contract with the decelerated student.

Leave of absence refers to a disruption in a student’s academic progress often due to life events such as medical, personal, or family issues that preclude continuing. A leave of absence may be short and remediable without deceleration, or it may extend one quarter or more. A student may petition SPC in writing for leave of absence. The request must include

If the reason for the request is based on difficulties in academic performance, the student must state his/her perceptions of causes of poor performance in the request and plans to improve performance. If the reason for the request is based on medical necessity the student will be required to submit a physician’s letter documenting ability to return to full participation in the program. If the student is requesting accommodations for his/her return to the program those are subject to Program approval, following referral and assessment by the Foothill Disability Resource Center.
 
If the SPC grants permission, SPC will set the terms of the period of absence and criteria for returning, and the student must demonstrate current competency, as determined by the SPC, before resuming progress in the appropriate quarter. (See Current Competency Requirements below.) If a student does not agree with the terms set by SPC he/she should refer to the process outlined below for appeal of SPC decision.

Current Competency Policy

The SPC may require a student to demonstrate current competency in didactic and/or preceptorship courses if the student is delayed. The SPC writes a contract with the student that may include the following:

If the student successfully completes all stipulations of the contract, the student resumes normal progress in the quarter in which the disruption in progress occurred.

Dismissal
A student may be dismissed from the program for any of the following:

Dismissal from the Program does not preclude the student from applying for enrollment in other courses/programs at Foothill College.

Dismissal Process

  1. The student receives written notice from the Chair of SPC that cause is present to consider dismissal from the Program (see list above)
  2. Student is referred to the Student Liaison for guidance in understanding program policy, procedures and student options
  3. The student meets with his/her Faculty Advisor to complete a written summary of what contributed to the event or events that are cause for dismissal
  4. The written summary is forwarded to SPC, along with any other documents that the student wishes SPC to consider in mitigation of dismissal
  5. The Chair of the SPC convenes a meeting of the committee to review and discuss relevant documents. The student is invited to present his/her information and requests.
  6. If the student does not elect to attend the meeting, the deliberation and decision will move forward without him/her present.
  7. Following this meeting, the SPC will render a decision regarding the student’s status in the program.
  8. The decision will be communicated to the student verbally, followed by written letter, delivered by certified mail.
  9. Failure to receive the certified letter does not alter the outcome of the process or the validity of the decision.
  10. If the student pursues an appeal related to this decision, the student will not be permitted to remain enrolled and attend classes during the appeals process.

Dismissal Process

Appealing and Grieving Program Decisions

Appeal

A student who disagrees with an SPC or other Program decision may pursue an internal PCAP appeal process that may be considered a form of conflict resolution. The Student Liaison provides guidance and information during the process.

Within 7 calendar days of the SPC or Program decision the student may request an additional meeting with to request clarification, discussion or reconsideration of a decision. The student should be prepared to submit new or additional information to help
support his or her cause.

Appeal Process

Grievance

If the student is not satisfied after the additional meeting he/she may petition the Program Director to initiate a review based on grievance of program action, described below. The student has 7 calendar days to contact the Program Director to initiate the petition for review. During the review the original SPC decision remains in force.

A grievance is a specific term used to describe a situation where the student feels the Program has subjected the student to an unfair decision or action. The rights protected under this procedure include, but are not limited to, those guaranteed by the established rules and regulations of the Foothill DeAnza Community College District, Foothill College, the Education Code of the State of California, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, and Title VII of the Civil Rights Acts of 1964. For a student in the PCA Program, this procedure described below will be applicable and stand in place of any grievance or appeal procedure of Foothill College to contest such act, unless the Program refers the student to a Foothill College procedure.

The purpose of this procedure is to provide a prompt and equitable means of resolving student grievances. This procedure is for student grievances only. This procedure shall be available to any student who reasonably believes a PCA Program decision or action has adversely affected his or her status, rights or privileges as a student. The procedures shall include grievances regarding:

  1. Course grades, to the extent permitted by Education Code Section 76224(a), which provides: “When grades are given for any course of instruction taught in a community college District, the grade given to each student shall be the grade determined by the instructor of the course and the determination of the student's grade by the instructor, in the absence of mistake, fraud, bad faith, or incompetence, shall be final.”
  2. Act or threat of intimidation or harassment. These procedures do not apply to sexual harassment or illegal discrimination.
  3. Act or threat of physical aggression.
  4. Arbitrary action or imposition of sanctionswithout proper regard to academic due process specified in the College procedures, unrelated to disciplinary actions.
  5. The exercise of rights of free expressionprotected by state and federal constitutions and Education Code Section 76120.

Additional circumstances:

  1. Sexual harassment. Complaints of sexual harassment should be addressed to the Director of Student Affairs, Fred Tovar. Unresolved complaints can be directed to the Dean of Student Affairs and Activities at Foothill College or the Dean of Student Development and EOPS at De Anza College.
  2.  Illegal discrimination. Complaints of discrimination on the basis of race, color, national or ethnic origin, age, gender, sexual orientation, marital status, or physical or mental disability should be addressed to the Director of Student Affairs, Fred Tovar. Unresolved complaints can be directed to the Dean of Student Affairs and Activities at Foothill College or the Dean of Student Development and EOPS at De Anza College.

As noted earlier in the Manual, issues of harassment and discrimination that occur during the course of student conflict are handled by reference to Foothill College guidance. The grievance here refers to student who feels an SPC decision involves discrimination or harassment.

In summary, a student may bring a grievance of a program decision only on the basis that he/she has been subject to one or more of the above 7 complaints of unfair or illegal treatment.

DEFINITIONS
Grievant. A student alleging that a college decision or action has adversely affected his or her status, rights or privileges as a student.

Party. The student, or any persons claimed to have been responsible for the student's alleged grievance, together with their representatives.

Program. The Primary Care Associate Program.

Program Director. The Program’s Director or his/her designated representative
Student Progress Committee (SPC). A designated group of program faculty and staff who monitor and assess student academic performance and professional behavior.

Faculty Advisor. A member of the Program faculty assigned to each student.

Student. A person currently enrolled in the Program.

Respondent. Any person claimed by a grievant to be responsible for the alleged grievance.

Work Day. A workday shall mean days during which the program is in session. This includes classroom and clinical days (may include a Saturday and/or Sunday) as noted in the Program calendar.

Student Grievance Process

Initial Actions
A student who believes that he or she has been treated unfairly by a Program action must make a reasonable, good faith attempt to resolve the matter on an informal basis. Any appropriate administrator, faculty member, or staff member may be invited to participate and assist in achieving an amicable resolution, as described in the section on Conflict Resolution. Asking SPC for a second meeting to discuss dismissal or other decision is an example of good faith attempt to resolve the matter.

Grievance Process
If the student is not satisfied with the results of the good faith attempt and/or the student believes that s/he has been treated unfairly by the Program, the student may file a grievance. The action being grieved must arise from items (1-7) listed above. The Student Liaison is available for guidance. A grievance is not valid which pertains to complaints about a Program policy of general application to all students.

The student may submit a written grievance of the incident or action to the Program Director within 7 calendar days of the incident, event or notification of program action that the student believes to be unfair. The grievance must include:

  1. Statement of action being grieved
  2. Inclusion of pertinent documents
  3. List of the relevant parties involved
  4. Description of the initial good faith Conflict Resolution Process and the outcome of the Process
  5. Statement of desired outcome of the student’s grievance
The Program Director may seek a meeting with the individuals involved, review documentation, and/or request additional information. The Program Director, upon review of the relevant documents and within 14 calendar days, will determine an appropriate disposition of the grievance and inform the student by phone, email and in writing

Appeal of Grievance Disposition

A student may wish to appeal the Program Director’s disposition of the grievance, which requires a formal hearing with representatives from PCA Program, Foothill College, Stanford School of Medicine and others as outlined below.

Formal Hearing
The student may initiate a formal hearing through a written request to the Program Director. The request should state the action that the student is appealing, and the reasons for the appeal. This written request must be submitted within 30 days of the conclusion of the original grievance process or within 30 days of the original action which the student believes was unfair, whichever occurs first.
The Program Director assembles a hearing panel consisting of at least three of the following:

The Program Director appoints one of the members as Chair of the hearing panel.
The Chair shall establish the procedures for the hearing and assure that the student:

A representative of the Program will also have the opportunity to present documents and statements to the hearing panel. This may include a statement from the Student Progress Committee. The findings and outcome of the hearing panel will be communicated to the student and the Program Director in writing. The decision is final and concludes the Appeal of Grievance disposition process.

STUDENT RECORDS

Student Access to Education Records

Student records are considered to be confidential in compliance with the Family Education rights & Privacy Act, also called FERPA (Section 438, Public Law 93380). PCAs student are NOT allowed access to other students’ records, which are kept in the Program offices in locked cabinets.
 
The Act requires educational institutions to provide student access to official education records directly related to the student. Consult the Foothill College Student Handbook for details about student access to their educational records.

Transcripts

Students’ grades are posted at the close of each quarter and a grade report is provided by Foothill College following each quarter.

Student and graduate official transcripts are maintained by the Foothill College Registrar and by the PCA Program in secure files in the Program office.

Permanent Records

Foothill College maintains the student’s official transcript permanently. The PCA Program maintains permanently a copy of the student’s admissions materials, official transcript, pertinent evaluations and correspondence, summative evaluation, and copies of communication with licensing agencies, credentialing agencies and potential employers. The Program serves as the graduate’s point of contact for information/documentation and verification required by institutions, state medical boards and employers.

Stanford Medicine Resources:

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