POLICIES & PROCEDURES | Master of Physician Assistant Studies

It is the student’s responsibility to master the instructional objectives and course learning outcomes. Studying only lecture material, only textbook readings, or only using practice exam questions will put the PA student at a disadvantage on the exams.

Each student is expected to adhere to the strict standards of professional ethics regarding testing. Test questions, topics, content, style, or format may not be discussed in advance with current or past students nor discussed with future students following any test. Possession of or access to a written or electronic copy of test/ questions and/or test answers outside of the testing environment is prohibited. These actions constitute cheating; refer to the SAHP handbook section entitled “Academic Misconduct Policy” for more information on academic misconduct.

The purpose of the remediation process is for students to correct prior misunderstandings and to further improve knowledge and/or skills. The following remediation policy applies to all didactic courses, excluding anatomy and physiology, which are not eligible for remediation. The following remediation policy also applies to all didactic courses within the clinical year (Seminar I, II, III; Research I, II, III; Clinical Ethics; Master’s Project) Students are encouraged to utilize this process to identify content areas they do not fully understand.

Metacognition Academic Improvement Plan

A student will complete an academic improvement plan involving meetings every 2-4 weeks with the director of student success, Jennifer Smith for the following circumstances:

• Course average is a C (<80%) after the midterm summative exam (see below)
• Final course grade is a C (<80%)
• Students on academic probation

Once a student meets one of the above criteria, the student will receive a letter of academic concern that will be placed permanently in their student file. The program director will reach out to set up a meeting with the student to review remediation requirements and expectations. It is the responsibility of the student to schedule a meeting with the Director of Student Success within 10 business days of receiving the letter of academic concern. See above paragraph regarding consequences if remediation requirements are not met.

Assessment Procedures

Students are required to bring a laptop on the days of formative assessments, summative exams, and course exams as all will be delivered electronically.  Testing procedures will be modeled after PANCE testing site procedures. Nothing will be allowed in the testing room except for a writing implement, a pocket-less sweatshirt, disposable earplugs, and a laptop computer with charger. Any additional supplies needed to take the test will be provided.

Students are required to download the lockdown browser prior to the first test to ensure assessment security.  It is the student’s responsibility to ensure that their lockdown browser software is current and functional prior to each test. 

Students should arrive 15 minutes prior to the posted assessment time. Students set up their computer and store any prohibited items (examples of prohibited items include outerwear with pockets, drinks, snacks, gum, heaters, cell phones, etc.). Students will then exit the classroom and will be allowed to re-enter at the official start of the test. Students who are late to their respective assessment will be allowed to begin if no one has completed the test and left the room with the exception of practical assessments. no extra time will be given for the test. No one will be allowed to reenter the classroom until authorized by the proctor. 

Students are expected to take care of personal needs prior to assessments.  They will be allowed to use the restroom if an emergency occurs. However, this should be the exception, and not the rule. Any student who leaves the room for personal needs (i.e., to use the restroom) during an assessment will be escorted and/or met by a faculty or staff member at an assigned restroom somewhere in the SAHP building.  No extra time will be allotted on the assessment.

If an electronic assessment is missed, a make-up will be scheduled if the absence is excused. Illness is an excused absence only with prior notification to faculty and a note from a healthcare provider upon returning to class. Please read the PA Program Student Handbook policy on Attendance for a full explanation of criteria for missing an assessment. Make-up assessments will not necessarily match the original exam format. For Midterm and Final Exams only, if the absence is unexcused, retesting parameters will be at the discretion of the Program Director. Unexcused absences for any other graded assessment will result in a grade of zero for that assessment.

1. Formative Assessments
   Approximately every other week, students will have a formative assessment that relates to all material covered in the in the course up to that point. Due to time constraints and to minimize exam fatigue, the weeks immediately preceding the midterm and final exam may not have dedicated formative assessments. See each course syllabus for specific details.
   
   The questions for each formative assessment will consist of multiple choice, matching, fill-in-the blank, and higher-order (case-based) short answer questions. No content-based questions will be answered during the assessments.
   
   Questions missed by >25% of students may be included as class wide “remediation objectives” on subsequent exams. Class-wide remediation topics will be posted to Moodle; it is recommended that all students review these remediation topics, as they may be retested.
   
   Retesting of Formative Assessments
   Students who score <75%, our benchmark for competency, on a formative assessment will be required to retest. This retest will consist of at least 25% different questions. If retest score remains below 75%, the student must complete a focused remediation session with the course coordinator, targeting missed concepts. If student fails to attend retest or submit assignment for remediation, they will receive a zero for their formative assessment grade. Students who score between a 75% and 80% must complete a structured self-assessment identifying areas of weakness and an action plan for improvement. Grades will not be adjusted based on remediation or retesting. Students will retain their original exam grade.
    

2. Summative Exams 
   Approximately half-way through the semester, students will have midterm exams that will test all the material covered in the course up that point. At the end of each semester, students will have final exams that will test all material covered in the course. See each course syllabus for specific details. In the spring semester, students will have a written summative exam that tests all information covered during didactic year.
   
   Midterm
   There is no retesting of midterm exams.
   
   If a student scores below 70% on midterm, the student will meet with their advisor and be assigned a remediation activity. These students will receive a letter of concern placed permanently in their student file.
   
   Final
   There are several exams that students must successfully pass with a score of 70% or above to progress in the program. If a student scores below 70% on a final exam, remediation is required. Students will receive topic-specific feedback. Remediation will be assessed based on retesting.
   
   The retest may consist of 30% new questions in a new format. This is limited to final exams during the didactic year. The retest will be scheduled by the faculty before grades are due to the registrar. Failure of both the initial and the retest will result in a failing grade (F) being recorded for the associated course, regardless of other grades earned in that course. Failure to attend or partake in the retest will also result in a failing grade in the course.
    

3. Course Examinations
   Course Exams are administered in courses that do not have formative assessments and summative assessments. The exams are weighted equally throughout the course. If a student makes below a 75% on any of the course examinations, the student may be given a review assignment by the course coordinator based on topics missed. Scores will not be adjusted based on completion of review assignment; however, failure to submit within the given time frame will result in a zero.
    

4. Quizzes
   Quizzes may be administered as a method of assessment depending on the respective course. Quiz grades are final and will not be remediated. If a student is concerned with their score on a particular quiz, they can meet with the course coordinator who can review missed topics with the student.
    

5. Pass Fail Courses
   This policy outlines the general framework for academic remediation within the curriculum. Remediation provides students with structured opportunities to address academic deficiencies and demonstrate required competencies. For courses graded on a pass/fail basis, specific remediation procedures are determined at the course level and can be found in the individual course syllabus.
    

6. All other assessments

   Any other assessments other than what is listed above will not be remediated unless specified otherwise in the course syllabus

Practice Assessment Procedures

This policy only applies to Midterm and Final Standardized Patient Exams. Students must meet competency in all designated areas of the Standardized Patient exam with a score of at least 70% and obtain an overall score of 70% or greater, which is the percentage deemed “passing” for this program before scores are rounded. The areas tested for competency will vary based on progression in the curriculum.

• Summer: CC/HPI, ROS, Other History
• Fall:  CC/HPI, C ROS, Other History, PE
• Spring: CC/HPI, ROS, and Other History PE, and Assessment/Plan

Any area in which competency is not reached will result in required remediation, as outlined in Remediation of SP Exams.

The following materials are the only resources students may bring into the standardized patient:

• Physical diagnosis equipment
• Blank paper provided by the clinical skills exam lab
• Writing implement
• Patient chart (if available)

Discussion of the standardized patient exam material or case is prohibited and is considered cheating by exam compromise. Consequently, doing so will result in a failing grade for the exam. No exam retakes will be offered if a failure grade is earned due to academic misconduct. Refer to the SAHP handbook section entitled “Academic Misconduct Policy” for more information on academic misconduct.

Students will report to the SP Lab at their designated time. The required portion(s) of the SP to be performed will depend on the current semester and associated course (Patient Evaluation, Physical Diagnosis, Clinical Medicine II, Preceptorship). During this exercise, the student will interview a patient, obtain a pertinent history, perform an appropriate physical exam including interpretation of visual or auditory findings, develop a differential diagnosis, make an appropriate diagnosis, order/interpret lab and imaging studies, and/or provide a treatment plan for the patient. Interpretation of diagnostic materials such as labs, ECG, and radiographs are required during the patient encounter with the student’s interpretation verbalized to the patient. Physical exam findings may be presented in written, picture, audio, or video format.

Standardized Patient Exam checklists are not available for review. Students will be provided feedback by faculty on the SP Exams. This feedback will include how they performed on each area assessed for competency, to include areas of strength and areas for improvement, and feedback from faculty on professionalism. Similar feedback will be provided if a student fails and is required to retest for the final SP Exam.

The SP encounter is graded using a specific checklist of history, physical exam, lab/radiology interpretation, differential diagnosis, diagnosis, and treatment items that should be observed by the faculty grader during the student’s patient encounter and on the written SOAP note. Full credit will not be awarded for examinations done incorrectly or with nonfunctioning equipment (i.e., otoscope/ophthalmoscope must be turned on). Treatment plans may include specific medication names, but dosages are not required.

A student can not earn more than a maximum grade 80% (B) on the SP if they score < 70% in two or more sections, regardless of earned grade (i.e. if a student’s overall score is an 85% but in 2 sections the score is < 70%, the student will not earn more than an 80%).

A student will earn an automatic maximum grade of 60% (D) on the SP if any of the following are observed:

• Faculty observing obvious inability to use patient evaluation equipment
  • For example, using an otoscope to do a funduscopic exam
• Treatment plan that will cause harm to the patient
  • For example, discharging a patient home with an acute MI on ECG
  • For example, prescribing a contraindicated medication that will cause a patient harm

Grades for the SP exams will be rounded up to the nearest 5^th percentile. If a retest is required, students will receive their original grade rounded to the nearest 5^th percentile.

Midterm SP

Individualized remediation will be required for students who score <70% in one or more sections on the midterm SP.

Final SP

If a student scores < 70% on one section of the final SP (HPI, ROS, PMH, PE, A/P, documentation, and professionalism), they will be tasked with completing a remediation assignment based on topics missed. If a student scores < 70% in more than one section, the student will have to retest the encounter on another day.

If the student still scores <70% in more than one section on the final SP retest, the student will go before the Student Progress and Professionalism committee for further steps.

The simulated patient activities are scored using a specific checklist of history, physical exam, lab/radiology interpretation, differential diagnosis, diagnosis, and/or treatment items that should be observed by a peer or faculty grader during the student’s patient encounter and on the written SOAP note. Students must earn 75% or greater in each section pass the assessment. Full credit will not be awarded for examinations done incorrectly or with nonfunctioning equipment (e.g.., otoscope/ophthalmoscope must be turned on). Treatment plans may include specific medication names, but dosages are not required. During the first half of each semester, students will engage in a debriefing session with faculty or peers on the graded skills after completing their SOAP note.

The following materials are the only resources students may bring into the simulated patient activities and clinic day:

• Physical diagnosis equipment
• Blank paper provided by faculty
• Writing implement
• Patient chart (if available)

Discussion of the graded skills assessment case prior to or during the assessment is prohibited and is considered cheating. It will result in a failing grade for the assessment. No assessment retests will be offered if a failing grade is earned due to academic misconduct. Refer to the SAHP handbook section entitled “Student Conduct, Dismissal, & Appeals” for more information on academic misconduct.

Grades for Simulated Patients activities will not be rounded – students will keep their original grade. However, grades for clinic day assessment will be rounded to the nearest 5^th percentile. If retesting is required, students will receive their original grade rounded to the nearest 5^th percentile after completing the retest.

While simulated patient activities will not be remediated, if a student scores < 75% on one section of clinic day (HPI, ROS, PMH, PE, A/P, documentation, and professionalism), they will be tasked with completing a remediation assignment based on topics missed. If a student scores < 75% in more than one section, the student will have to complete another clinic day encounter which may or may not be the same complaint as the original encounter.

Didactic Performance Indicators

Faculty research indicates that students who perform significantly below average in key areas of the didactic curriculum are more likely to score in the bottom 25% on the PANCE compared to their cohort.

Based on annual PANCE performance analysis (which may vary slightly each year):

Students in the bottom 10% in 2 of 3 identified academic areas are required to complete mandatory remediation, which includes:

• Student will set up an initial meeting with the Director of Student Success, Jennifer Smith, to assess study habits, metacognition, and academic needs within 10 business days of receiving remediation notification.
• Development of a personalized remediation plan, created in collaboration with the Director of Student Success.
• Student will set up one check-in with designated PA faculty to briefly review the plan and ensure alignment with academic expectations.
• A final update submitted by the student to faculty upon completion of the remediation plan, summarizing actions taken and outcomes.

Clinical Performance Indicators

Based on clinical year benchmarks:

Students who fail any EOR exam (excluding elective and wellness rotations) must complete mandatory remediation, which includes:

• Student will set up an initial meeting with clinical faculty to review performance and expectations.
• Student will participate in follow-up sessions with the Director of Student Success to address study skills and create a focused remediation plan.
• A brief faculty review of the plan to ensure appropriateness.
• Student is required to submit of a completion summary to faculty outlining the steps taken and areas improved.

1. Preceptor Evaluation of student on rotation or preceptorship
   1. Score of “1 = Unacceptable” on any item results in failure of the preceptorship and will be required to repeat rotation/preceptorship
   2. Score of “2 = Weak” triggers focused remediation. Multiple “2” scores will be reviewed by the Student Progress and Professionalism Committee.
   3. Score of “Not Observed” on a technical or clinical skills will result in remediation and reassessment of that skill.
2. Clinical Encounter/Procedure Logs on rotation or preceptorship
   1. Students must document at least 20 patient encounters for each rotation and at least 40 patient encounters for the preceptorship.
   2. If the minimums are not met, the student will undergo remediation
   3. Failure to submit signed, accurate logs results in failure of the rotation or preceptorship
3. Mid-term Standardized Patient
   1. Must achieve a competency of >/=70% overall and in each component:
      1. History of Present Illness
      2. Review of Systems
      3. Past Medical History
      4. Physical Exam
      5. Assessment and Plan
      6. Documentation
      7. Professionalism
   2. If a student does not meet competency in every section and overall, they will perform remediation.

1. Final-Standardized Patient
   1. Must achieve a competency of >/=70% overall and in each component:
      1. History of Present Illness
      2. Review of Systems
      3. Past Medical History
      4. Physical Exam
      5. Assessment and Plan
      6. Documentation
      7. Professionalism
   2. If a student does not meet competency in one section but meets competency overall, they will perform focused remediation
   3. If a student does not meet competency overall or in two or more sections, they will perform remediation and be required to retest to demonstrate competency.
2. End of Curriculum Exam
   1. Student must meet or exceed the passing scaled score (currently 1458.5).
   2. If the student fails to meet the passing scaled score:
      1. A personalized remediation plan is created with the DCE.
      2. Re-test required.
      3. Failure of retest results in failure of the preceptorship
3. Skills Check-off
   1. Student must pass each station with ≥70%
   2. Failure to do so will result in:
      1. Remediation of the skill(s) and reassessment skill and reassess
      2. Failure after remediation results in failure of the preceptorship.
4. Reflective Essay Series Part 3
   1. Student must achieve ≥70% on Part 3 of the Reflect Essay Series as well as meet with their faculty advisor.
   2. Failure to do so will result in:
      1. Focused remediation with faculty advisor