Roles, Competencies, and Performance Criteria
Expected of Graduates from the PCOM Physician Assistant Program
I. Using appropriate interpersonal skills, the graduate will be able to elicit a detailed and accurate history, and perform a comprehensive physical examination under the direction and/or supervision of a licensed physician regardless of the patient's age, sex or presenting health care problem in the following ways:
A. Communicate effectively as a health care professional
1. Interact with patients, families and/or significant others in a manner which provides the desired psychosocial support by:
- respecting individual cultural, religious, and socioeconomic differences;
- recognizing the patient's reaction to his/her illness and disability;
- recognizing the reactions of the patient's family to illness and disability
2. Engage the greatest possible degree of patient motivation and cooperation in treatment.
3. Communicate to the patient the importance of and need for treatment compliance.
4. Function effectively with other members of the health care team in providing appropriate patient care, and appreciating the role of other health care professionals in various health care settings.
5. Effectively communicate the need for a comprehensive and honest sexual, physical, chemical, and/or traumatic history.
B. Elicit the appropriate problem-oriented and/or comprehensive history from patients regardless of age or gender with an attitude of respect and adherence to the concepts of privilege and confidentiality.
1. Obtain a clear, concise chief complaint and history of present illness using open-ended questions, empathic responses, and clarification of verbal and nonverbal clues concerning patient illness or related concerns.
2. Obtain a past history including childhood illnesses, adult medical and surgical problems, injuries, hospitalizations, medication, allergies, tests, hazards, safety issues, immunizations, travel, psychiatric and social disorders.
3. Obtain a psychosocial, residential, occupational, family, and environmental history.
4. Obtain a review of systems and arrange findings into logical groups.
5. Obtain a history of past medical treatment compliance.
C. Perform a comprehensive and/or focused physical examination regardless of the patient's age, gender, or health problem(s), based on historical information.
1. Possess the knowledge of the appropriate use of the instruments for the physical examination.
2. Possess the knowledge to explain the use of instruments for the physical examination.
3. Select the appropriate system or systems to examine for the patient's health concern.
4. Possess the knowledge of selected or indicated universal precaution procedures in the physical examination.
D. Identify, order, perform, and interpret the appropriate diagnostic procedures or studies.
1. Possess the skills required to extrapolate the appropriate studies or procedures to be performed from the historical data and physical exam findings.
2. Possess the knowledge of the risks, expenses, and patient inconvenience as compared to the safety and benefit of various diagnostic studies.
3. Possess the knowledge of the sensitivity, specificity, and predictive values of the diagnostic studies.
4. Possess the skills to provide the patient and their families with informed consent of various studies and procedures.
II. Assess, monitor, and analyze the information database of the patient regardless of their age, gender, or health problem(s).
A. Integrate and synthesize data from the patient history, physical examination, and diagnostic procedures, as well as previous medical records, and record the findings.
1. Possess the skills necessary to organize data from the medical history, physical examination and/or diagnostic studies and develop a database.
2. Possess the skills necessary to accurately record and present data in a logical sequence.
3. Possess the skills necessary to select pertinent data from the medical history, physical examination and diagnostic studies.
4. Differentiate between normal and abnormal information contained in the database, including signs, symptoms and diagnostic values.
B. Develop a preliminary diagnosis and secondary problem list based on the data obtained.
1. Generate a hypothesis upon learning the patient's chief complaint and reevaluate same throughout the history of present illness, past medical history, family history, social history and review of systems.
C. Present the data based in a problem-oriented format and establish a complete problem list.
1. Identify the elements of the problem-oriented format for a primary care problem.
2. Organize the data in the appropriate category of the problem-oriented format.
3. Identify the patient's problems and list them in the specified problem list format.
4. State each problem at the highest level of the problem's resolution.
5. Revise and reassess the problem list to reflect current data.
6. Present the database obtained in the problem-oriented format to the supervising physician in both a written and verbal format.
III. Formulate and document an individual treatment / management plan for a patient regardless of age, gender, or health problem(s) in consultation with a physician.
A. Consult with a supervising physician as appropriate.
1. Possess the knowledge of primary care treatment modalities and health risk interventions.
2. Possess the knowledge of desired and adverse effects of these treatment modalities and interventions.
3. Determine any or all additional information needed for assessment and management of the respective problem.
4. Develop and discuss the treatment / management plan for the patient's respective problem(s) with the supervising physician.
5. Consult with and involve other health care professionals in the design of the treatment / management plan, in order to maximize patient care.
6. Incorporate community and other resources when developing a treatment / management plan for the patient.
7. Report communicable or infectious diseases to the appropriate local, state, national or global health department or agency as required.
8. Describe the health status and diagnosis to the patient and/or the patient's family using terminology understandable to them, or using an appropriated facilitator to translate for them.
IV. Provide health education service to the patient, his/her family members or significant others, the public, or other health care providers.
A. Assess the health belief status of the patient concerning his/her health problem(s) and health knowledge base.
1. Determine the information needs of the patient.
2. Determine the patient's perception of barriers that offer resistance to the care of the patient.
3. Elicit the patient's understanding of the relationship between a specific disease process and the antecedent behaviors.
B. Provide education and counseling to patient and his/her family or significant others regardless of their health care problem(s).
1. Educate regarding the signs and symptoms of their illness.
2. Educate regarding the reasons for performing diagnostic studies and procedures, and counsel regarding the best options for the patient.
3. Educate regarding the meaning of the diagnosis.
4. Counsel patient and family members or significant others on the rationale and effects of treatment as well as prognosis.
5. Educate regarding health promotion and disease prevention.
V. Implement, monitor and modify the treatment / management plan for the patient regardless of age, gender, or health problem(s).
A. Using the information obtained from the medical history, physical examination, laboratory studies and other sources, carry out the management plan.
1. Administer medications in the appropriate manner, i.e. oral versus parenteral.
2. Perform clinical skills dictated by the situation such as performing Pap smears, placing nasogastric tubes, intubating, and obtaining throat cultures.
3. Perform minor surgical therapies or interventions
4. Initiate emergency treatment.
B. Monitor the progress of the patient, as well as the implementation of the treatment / management plan.
C. Modify the plan when appropriate.
VI. Manage life-threatening emergencies in the absence of a physician.
A. Recognize signs and symptoms of life-threatening emergencies.
1. Possess the skills necessary to recognize the signs and symptoms of life-threatening emergencies
2. Possess the knowledge of the limits of personal and professional abilities.
B. Take appropriate action to sustain life.
1. Possess the knowledge of life-sustaining measures.
2. Possess the skills of life-sustaining emergency measures such as BCLS and ACLS.
3. Perform life-sustaining emergency measures such as BCLS and ACLS.
4. Appropriately record and report to other health care professionals upon stabilization of the patient.
C. Initiate emergency treatment.
1. Possess the knowledge of emergency treatment.
2. Possess the skills of emergency treatment.
3. Provide treatment of emergency problems within the framework of one's personal and professional limits, as well as one's certified or documented abilities.
4. Appropriately record and report any action taken to other health care professionals upon stabilization of the patient.
VII. Promote and maintain professional competency and life long learning.
A. Maintain the ethical code of the PA profession, with respect for the diversity of patient values and beliefs.
1. Act in a humane, caring, understanding and considerate manner.
2. Respect the privacy of the patient-PA relationship.
3. Be aware of limitations; seek help and advice when needed.
B. Develop skills for life-long learning with appropriate use of the medical resources.
1. Engage in periodic review of professional skills (self assessment)
2. Devise a program of CME activities based upon perceived needs
3. Acquire knowledge and skills essential to incorporating into practice proven evaluation/treatment modalities, prevention interventions, and compliance techniques.
4. Understand and appreciate the role of the Internet in fostering life-long learning skills.
5. Recognize advantages and opportunities afforded to the PA by membership and participation in local, state and regional medical organizations.
6. Recognize the importance of obtaining and continuing national certification and recertification provided by the NCCPA.
7. Promote ongoing acceptance and understanding of the PA's role within local, regional, and national communities.
C. Practice collegially with other health care professionals.
1. Refer problems beyond one's competency.
2. Seek and accept constructive criticism concerning one's performance and judgment.