STUDENT HANDBOOK JANUARY 2019 - The UEA Portal
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STUDENT HANDBOOK
JANUARY 2019
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Contents The Course Director’s Welcome ....................................................................... 3 The Physician Associate Course ........................................................................ 4 How the Course is organised ............................................................................ 5 Physician Associate Learning Resources ........................................................... 7 How you will be taught ..................................................................................... 9 Consultation Skills .......................................................................................... 11 Clinical Placements ......................................................................................... 12 How you will be assessed ............................................................................... 15 Plagiarism, collusion and copyright................................................................. 16 Course Progression, and Reassessment.......................................................... 20 School Feedback ............................................................................................. 20 School Management ...................................................................................... 22 What the School expects from you................................................................. 24 Physician Associate student support .............................................................. 26 How to avoid burn-out ................................................................................... 28 2|Page
The Course Director’s Welcome Dear Student Welcome to the UEA Physician Associate course, you are now joining an established and successful course and the expanding and exciting profession in the UK. You will join the successful and enthusiastic first cohort who are all employed as physician associates and have received very positive feedback from their employers. The course will continue to adapt and improve with students at the centre. My door is always open for any engagement and feedback as we work together to continually improve the course. Audrey Gibbs Course Director 3|Page
The Physician Associate Course Physician Associates play a vital role in the future of the NHS, improving the lives of thousands of patients. Once qualified, you will be set for a career as a versatile, dynamic healthcare professional. Working under the supervision of a doctor, you will be in constant contact with patients, making a difference where it counts. The Physician Associate is an indispensable new figure in the structure of UK healthcare. You will support both doctors and patients by providing diagnostic and therapeutic treatment, developing care management strategies, and working with patients’ families. Being a Physician Associate can mean greater contact time with patients than doctors, giving you a pivotal role in their experience of healthcare. Working under the supervision of doctors, Physician Associates are present in every aspect of healthcare. At UEA, you will develop the versatility to become the complete healthcare professional. This course was created as a direct response to new healthcare job opportunities in Norfolk and Suffolk. These opportunities are with local acute hospitals, who have partnered with us to develop the programme, including: Ipswich Hospital, James Paget University Hospital, The Norfolk and Norwich University Hospital, The Queen Elizabeth Hospital King’s Lynn and West Suffolk NHS Foundation Trusts. In other words, the course has been created with your future in mind. Not only this, but the work of Physician Associates is on the increase across the NHS, with recognition from the Royal College of Physicians and legal regulation on the way. 4|Page
How the Course is organised YEAR 1 MODULE 1 (MED-700E)- FOUNDATION SKILLS FOR PHYSICIAN ASSOCIATES This module is about preparing you to study to become PAs. It will equip you with the competence and confidence to practice your basic clinical skills in the workplace which will allow you to efficiently utilise and build on your workplace learning during the remaining course. There will also be knowledge based lectures covering background clinical science and social science as well as some learning theory and aspects of law, ethics and professionalism. Following formative assessment opportunities in the skills laboratory you will be encouraged to practice basic procedural skills in the work place under supervision. MODULE 2 (MED-7001F)- GENERAL MEDICINE This module provides the background learning for the majority of the general medical specialties including cardiology, respiratory, gastroenterology, renal medicine, haematology, endocrinology, dermatology and old age medicine. Clinical placements provide an opportunity to reinforce campus learning and develop and build on clinic skills learnt in module 1. Students who have not yet completed all their summative work based assessments of procedural skills will have further opportunity to demonstrate competence. MODULE 3 – (MED-7002D) - SURGERY This module provides the background learning for the major surgical specialties including vascular surgery, orthopaedics (including rheumatology), urological surgery, obstetrics and gynaecology, ENT and general surgery. Clinical placements provide an opportunity to reinforce campus learning and develop and build on clinical skills learnt in modules 1 and 2. Students who have not yet completed all their summative work based assessments of procedural skills will have further opportunity to demonstrate competence which must be done by the end of this module. Written and practical OSCE examinations at the end of module 3 are blueprinted across the first year (modules 1-3) of the course and passing these will determine that students have made sufficient progress to move to year 2 of the course. YEAR 2 MODULE 4 – MED-7003E) - COMMUNITY MEDICINE and MENTAL HEALTH This placement gives you experience of medical care outside of hospital and of mental health care this includes, primary care, community paediatrics, psychiatry, ophthalmology, neurology, old age medicine and palliative care. You will develop and learn to use clinical and communication skills with patients presenting with a range of undifferentiated conditions. You will develop knowledge and understanding of referral pathways and treatment available within Community Care and also care available and appropriate for patients post-discharge from Acute or Secondary Care establishments. You will learn about the NHS and the different roles health care professionals play in the wider community. 5|Page
MODULE 5 – (MED-7004X) - EMERGENCY MEDICINE (ADULT and CHILD) In this module you will be exposed to specialist healthcare for children and will have a second (senior) exposure to the adult acute admitting services. This module includes hospital paediatrics, emergency medicine, emergency surgery, and old age medicine. It is expected that, under appropriate supervision, you will play a more active role in delivery of health care and be fully integrated into the clinical team. At the end of the second year there is a written and practical skills (OSCE) examination which is blueprinted across the whole 2 year course. Passing these two assessments will be a pre- requisite for sitting the national UKAPA examination http://www.ukiubpae.sgul.ac.uk/the- national-examination-and-re-certification. Once the national exam has been passed graduates are eligible for inclusion on the National Managed Voluntary Register of PAs MODULE 6 – (MED-7005X) - STUDENT SELECTED PLACEMENT WITH HEALTH IMPROVEMENT PROJECT Ensuring patient safety and continuous improvement in health care quality and efficiency are key responsibilities of all health care professionals. This module provides you with the opportunity to apply relevant knowledge and skills to an area that interests you, allowing you to study that area in greater depth. The module will also allow you to demonstrate higher academic skills including synthesis and analysis of evidence as well as real time experience in planning, and executing a clinically relevant health improvement project. You will present your projects verbally part way through the module, allowing you to use the feedback to further develop your work, and to assist with your final write-up. The summative assessment of this module is by way of a written dissertation. National Position on PA training. The course is guided by the national curriculum which can be found here: http://www.fparcp.co.uk/about-fpa/Who-are-physician-associates. Please read this so that you will be well prepared for your national exam. We assume that 100% of you leaving our programme will sit the national exam although legally you can practice without this and without national registration at this time. 100% of the first UEA cohort passed the national exam with very high scores, the UEA average being well above the national average. 6|Page
Physician Associate Learning Resources Please consult your Blackboard site for more resources and term dates Generic Resources Link to Faculty of Physician Associates at the Royal College of Physician; http://www.fparcp.co.uk/ (has links to student resources including recommended iPhone/iPad Apps) Physician Assistant Journals Advance for Physician Assistants: Online Edition monthly, peer-reviewed journal. Internet Journal of Academic Physician Assistants peer-reviewed journal. JAAPA Journal of the American Academy of Physician Assistants monthly, peer-reviewed journal. Journal of Physician Assistant Education quarterly, peer-reviewed publication of the Physician Assistant Education Association. OSCE guides (YouTube) Radiology Masterclass tutorials http://www.radiologymasterclass.co.uk Module 1 Foundation Skills for Physician Associates Recommended reading materials All books listed in each category are held at UEA library on the TALIS system (https://uea.rl.talis.com/index.html) and are available for loan, although loan-periods may vary. Pathology Stevens A., J.S. Lowe, Scott I., Core pathology (2009) Mosby 3rd edition. (This title was part of the British Medical Association Book Awards 2009 - Highly Commended, Basic and Clinical Sciences). Should also have student consult online access. Wilkins, R., & Cross, S. (2011). Oxford Handbook of Medical Sciences, 2nd edition. Oxford: OUP Oxford. Pharmacology Battista E., Horton Szar D., (2012) Crash Course Pharmacology 4th edition Rutter P. (2009) Community pharmacy: symptoms, diagnosis, and treatment, Churchill Livingstone Elsevier **good concise information on drugs which includes basic anatomy, history and examination skills** McGavock H., (c2011) How drugs work: basic pharmacology for healthcare professionals Hugh McGavock, Radcliffe publishing 3rd edition Immunology/ Cancer Biology King J.B., Robins M.W. Cancer biology (2006) Pearson Prentice Hall, 3rd edition which is available as an electronic resource. **Probably more in-depth knowledge with respect to oncogenes and tumour suppressor genes but does concise chapters on what is cancer, epidemiology and principles of cancer treatment** Abbas A.K., Lichtman A. H., Pillai S., Baker D. L., (2014) Basic immunology: functions and disorders of the immune system, 4th edition Elsevier (advantage –small to carry around and concise; disadvantage- more detail than necessary for PA course). Anatomy Tortora, G., & Derrickson, B. (2013). Essentials of anatomy and physiology 9th edition Singapore: Wiley Medical Ethics and Law R. A. Hope, Savulescu J., Hendrick J., (2008) Medical ethics and law, 2nd edition, Churchill Livingstone Health Psychology and Sociology 7|Page
Alder B. (2009) Psychology and sociology applied to medicine: an illustrated colour text 3rd edition, Churchill Livingstone Sarafino E. P., Smith T.W., (c2012) Health psychology; biopsychosocial interactions, John Wiley & Sons Geissler C., Powers H. J., Human nutrition (2011) Churchill Livingstone Elsevier 12th edition Worden J., Grief counselling and grief therapy: A Handbook for the mental health practitioner (4th edition) Clinical Skills Douglas G., Nicol E.F., Robertson C., (2013) Macleod’s clinical examination 13th edition. Churchill Livingstone Hennessey, I., & Japp, A., (2008) The ECG Made Easy, 7th Edition Hampton, Churchill Livingstone Corne J., (2009) Chest X-Ray made Easy 2nd Edition Corne Churchill Livingstone Hennessy I., (2007) Arterial blood gases made easy. Edinburgh: Elsevier Churchill Livingstone. Collier, J. (2008). Oxford handbook of clinical specialties, 8th edition, Clinical specialties. Oxford: Oxford University Press. Communication Skills Silverman J., Kurtz S., Draper J., (2013) Skills for communicating with patients, 3rd edition, Radcliffe Publishing. Critical Appraisal Grenhalgh T., (2014) How to read a paper: The Basics of Evidence-based Medicine, 3rd edition, Blackwell Publishing. Module 2 General Medicine Collier, J. (2008) Oxford handbook of clinical specialties, 8th ed., Clinical specialties. Oxford: Oxford University Press. Ballinger, A. (2012) Essentials of Kumar & Clark's clinical medicine, 5th edition Edinburgh: Saunders See also texts listed under clinical & communication skills Module 3 Surgery Browse, N., & Black, J. (2014). Browse's Introduction to the Symptoms & Signs of Surgical Disease 4th Edition 4th ed. Hoboken: Taylor and Francis. Ellis, H., & Calne, R. (2011) Lecture Notes General Surgery 12th ed. Hoboken: John Wiley & Sons. Luqmani R., Robb J., (2013) Textbook of Orthopaedics, Trauma and Rheumatology, 2nd edition Mosby Magowan B, Owen P, Drife J. (2009) Clinical Obstetrics & Gynaecology, 2nd ed. London: Saunders Elsevier Bullock N. Urology: (2007) An Illustrated Colour Text, 1st edition Churchill Livingstone Module 4 Mental Health/Community Medicine Stephenson, A. (2004). Textbook of General Practice, 2nd edition, Taylor & Francis Simon C., Everitt H., (2014) Oxford handbook of general practice, 3rd edition Oxford University Press. Module 5 Emergency Medicine (adult & child) Turner C., Horton Szar D., (2008) Crash course Neurology 3rd edition Mosby (**Note; this book has a newer edition 2015 but core material will be very comparable). Gawkrodger D., (2012) Dermatology; An illustrated colour text 5th edition Churchill Livingstone Lissauer, T. (2012). Illustrated textbook of paediatrics 4th edition Edinburgh: Mosby. Olver J., Cassidy L., Gurjeet J., (2014) Ophthalmology at a glance 2nd edition, Wiley Blackwell Ludman H., Bradley P., (2012) ABC of ENT 6th edition, Wiley Blackwell Harrison R., Daly L., (2011), A Nurse's Survival Guide to Acute Medical Emergencies 3rd edition 8|Page
Churchill Livingstone Elsevier Module 6 Student Selected Placement with Health Improvement Project Harris, M., & Taylor, G. (2013). Medical Statistics Made Easy 2nd Edition 2nd edition London: Scion Publishing. Petrie, A., & Sabin, C. (2012). Medical Statistics at a Glance Workbook 2nd edition Chichester: Wiley. Grenhalgh T., (2014) How to read a paper: The Basics of Evidence-based Medicine, Blackwell Publishing 3rd Edition Panesar S, Carson-Stevens A, Salvilla SA, Sheikh A,. (2014)Patient Safety and Health Care Improvement at a Glance Chichester: Wiley-Blackwell How you will be taught Lectures and Seminars Lectures and seminars are 50 minute teaching sessions that are provided by the PA team, academics from within the Faculty of Medicine and Health Sciences and by senior clinicians from the surrounding general practices and hospitals. A few lectures are delivered to the whole cohort of undergraduate medical students and Physician Associate students studying a particular topic, so there could be up to 200 students in the room. The modules on the medical student course are completely different to those on the PA course and they study subjects in a different order across 5 years, so depending on the topic you may be joining students from different MB BS year groups during your two year course. You will find electronic resources to support these teaching sessions in folders on Blackboard. These include PowerPoint files, MP3s and PDFs that summarise the main points. The documents often give you a reading list to accompany the lecture or seminar. You are strongly advised to read up topics before and after your lectures. Each of you has a different academic background and life experience as well as different learning styles so you will therefore find some areas more challenging than others. The course requires you to be adult learners who can identify and redress your own learning needs. Just turning up at lectures is most unlikely to be sufficient for you to pass our exams and national exams later. Clinical Skills You are fortunate to have access to a state of the art Clinical Skills Resource Area (CSRA) situated adjacent to the Norfolk and Norwich University Hospital in the Bob Champion Research and Education Building (BCRE). You share this facility with the undergraduate medical students and we have provided increasing equipment and staff funding to support this without detriment to them. As your term dates are different we hope there will not be congestion or competition and we have arranged your timetables to fit around each other. There is high fidelity simulation equipment (SIMMAN) which will be used for at least one session per module during your training. There is also a 24-hour-a-day open access to the skills laboratory area at the CSRA which allows you to use the equipment for self- directed practice in your own time providing it is not being used for teaching or OSCEs. The 24hr practice lab can become quite busy in the few days leading up to each medical student OSCE (which occurs on about 30 9|Page
different days throughout the year) but at other times, and especially out of hours, it is often
empty. There is CCTV surveillance in place to ensure that the facilities are used appropriately.
Please see Blackboard for our Clinical Skills 24hr Access Protocol. There are also facilities at
our partner teaching hospitals for use when you are on placement but access is variable.
Professor Lesley Bowker is the Clinical Skills Director for the MB BS and is based in the CSRA.
Other staff at the CSRA include a clinical skills senior nurse (Helen Francis), Senior Technical
Manager (Chris Bligh), a Health Care Assistant (Nicola Browne), four administrators (Rebecca
Ogden, Louise Terrington, Laura Hancock and Caroline Coombs) and the receptionist is Olivia
Kennedy.
The Bob Champion Research and Education Building
Procedural Skills Teaching
In the CSRA you will be taught new procedural skills ranging from basic assessments such as
blood pressure and pulse, to more advanced procedures such as cannulation for intravenous
drips and catheterization. Your training will be overseen by the senior clinical skills nurse
(Helen Francis) but teachers will come from multiple different clinical backgrounds to help
her deliver the sessions. There is the opportunity to practice using mannequins and all
students must attend simulation training in the lab before practicing on patients.
Examination Skills Teaching
You will be expected to attain the same level of competence and confidence in physical
examination skills as a junior doctor. A very basic set of skills is taught in module 1 but this is
built on (spiral curriculum) during modules 2 and 3 and specialized examination skills (e.g.
mental state examination, paediatric examination) are taught in the second year. The sessions
will be in the CSRA and you will practice examination on models as well as each other and
occasionally invited patient volunteers where appropriate.
10 | P a g eAnatomy Teaching
Anatomy will be taught using a combination of workbooks, screencasts, PowerPoints and
seminars. The material is organised to match clinical skills and students will be told which
resources to use for each clinical skill covered within the module.
Consultation Skills
Learning to listen and talk to patients and
colleagues is one of the most important skills a
doctor must acquire. We all know how to listen
and to talk but we rarely have the opportunity to
consider in depth how our individual style of
communicating influences the people we talk
with.
The term ‘communication skills’ in medicine is
used to indicate a range of evidence based
behaviours which are known to impact on a
consultation with an individual patient seeking
advice, or a discussion with a colleague.
In the Physician Associate programme we consider
that the conduct of the consultation is the
fundamental process of all medical practice and
we have adopted the structure and skills-based
model known as the Calgary Cambridge Model,
devised by Silverman, Draper and Kurtz to guide
our understanding and teaching. This model is
patient-centred and proposes that the consultation should address both the bio-medical
aspects of a patient’s presentation, which we call ‘disease’, and the psycho-social aspects,
which we call ‘illness’.
Over the two years you will learn a range of different skills, which not only enhance the
likelihood of a favourable outcome to the consultation, but can also be applied to
communication in other situations, such as referring patients to colleagues or talking to
relatives or other caregivers. When you graduate, we want you to be competent in a number
of areas including the following:
• establishing and maintaining trusting, respectful relationships
• listening to patients, relatives/caregivers/partners, and to other healthcare
professionals
• explaining, and providing patients and others with well-timed and understandable
information
• negotiating mutually acceptable outcomes
• recording, storing and managing clinical information
• presenting information clearly in written, electronic and oral forms, and
11 | P a g ecommunicating ideas and arguments effectively
From the very beginning of your course of study, you will start to work toward these objectives.
You will have the opportunity to role-play with trained actors in a small group setting; receive
feedback; and reflect upon your own developing style and learning needs.
Clinical Placements
During placement you will be allocated to a hospital HUB, each hub consists of two main
hospitals.
• Southern hub = Ipswich and West Suffolk Hospitals
• Eastern hub = James Paget University Hospital and Norfolk and Norwich University
Hospital
• Western hub = Queen Elizabeth Hospital, Kings Lynn and Norfolk and Norwich University
Hospital
It is anticipated you will do all your attachments in all modules across the two years (including your
Health Improvement Project) within your hospital HUB which will allow you to be recognised and
‘get comfortable’ within the setting as well as plan your housing, travel etc. We also hope to
arrange for your primary care experiences (mainly in module 4) to be geographically within the
HUBs. Each student will spend some time in both of their hospitals but the exact rotational
arrangement will be determined locally and will depend on capacity and specialties available. At
least 8 weeks will be spent in the second hospital, usually in the second part of the first year. In
general your module 1 hospital will be your primary hospital base.
There will be a variety of different learning opportunities with the volume and type varying
according to the specialty and the hospital. However most learning will be delivered using an
apprenticeship model in which students are attached to a medical team. This will introduce you
to working as part of a multi-disciplinary team and will give you direct experience of how different
healthcare professionals interact in the clinical setting. You will gain a good understanding of how
good communication and a mutual understanding of roles can enhance patient care.
All hospitals will provide one half day case-based seminar per week in which PA students meet
together with the learning facilitator (LF) to present a case each. The LF will be helping you present
and interpret your case as well as overseeing the teaching you provide to your fellow students on
topics that arise from the case. If you have to be absent (eg sick leave) you should inform both
the UEA placement hub and your placement team (usually your LF or their administrative support
team).
There may be other learning opportunities offered by hospitals including;
• bedside teaching
• skills revision sessions
• simulation teaching
• joining other existing undergraduate and postgraduate/departmental teaching e.g. grand
rounds
12 | P a g eHowever, you should be aware that in the majority of clinical sessions that you attend your role will be more observational and education is not the main aim. In these, you will pick up a lot of ‘informal’ learning about each specialty. You will maximise this learning by asking questions as well as identifying your own knowledge gaps for looking up later. Examples include going to outpatients, endoscopy, theatre, or following a specialist nurse, physiotherapist or a consultant ward round. Try to think of one topic per session that you will go away and read about or revise afterwards. All sessions in secondary care are compulsory, the times will be determined by the hospital team, and may include hours between 8am – 6pm and occasional after hour work at weekends or overnight. These will be important learning opportunities out of hours and we would also encourage you to take some further evening and weekend opportunities. It is a priority to take the opportunity to go to clerk patients (taking a history and a full examination constitutes a ‘clerking’) on the ward(s) you are attached to whenever you have free-time. This is a key part of your learning in every module and will pay dividends in exams. Many patients will be grateful to have someone to talk to and will often give you information about their condition that you won’t find in a textbook. However, always remember to ask the nurse in charge of the patient if it is all right for you to talk to them and ensure you get the patient’s consent. The more effort you put in when you are on placement the more opportunities you will receive, and the more enjoyment you will gain, as well as undoubtedly learning invaluable skills. Clinical Concerns You may very occasionally encounter events during your clinical training that upset you, or which you feel uncomfortable about in some respect. You should seek guidance from the clinician you are with at the time, or another clinician later about your concerns. You may also seek guidance from your UEA adviser, your learning facilitator on placement, or the Course Director (Audrey Gibbs, a.gibbs@uea.ac.uk) if you feel that there is a specific concern that you are unclear who else to raise it with. Speaking Up/Raising a Concern For any concerns you have while on placement or at any time during the programme, regarding any aspect of your course or patient safety we expect you to be aware of and follow the guidelines in our ‘Speaking Up’ policy and to use the concern form if necessary. The full policy and concern form will be found in the PA blackboard module and should be read as soon as possible. Dress Code for Clinical Placement The practice of clinical medicine relies on mutual respect and confidence. Your appearance will affect your working relationship with patients and fellow professionals and may also have infection control implications. Therefore in general, your clothing should be smart and clean at all times whilst you are in the hospital or in GP surgery. We recommend you wear the sort of clothes you would wear to an interview and have the appearance that you would expect from others who are treating your parents or loved ones. Remember most of your patients will be the same age as your grandparents. 13 | P a g e
We recommend you come appropriately dressed to EVERY day during placement even if you
think you only have a seminar or procedural session in the CSRA that doesn’t involve patients.
You may well be seen by patients and clinicians visiting the department and inappropriate
dress can be seen as quite unprofessional and even disrespectful by clinicians. It will also
allow you flexibility to visit the ward or if there is a last minute change in your timetable.
All students must wear an identification badge and show their face for the purposes of
recognition by patients, teachers and other staff. Patients and teachers must be able to
identify students to verify that they are genuine. Showing one’s face also makes it easier for
patients who are hard of hearing to hear you and/or lip read, and an important part of
communication includes facial expression.
The following guidance is in line with the Hospital Dress Code used for doctors in all the
teaching Trusts. It would also generally apply in Primary Care, with the exception of the ‘bare
below the elbow’ policy.
On the ward, in clinics and during an OSCE, certain jewellery items may be worn eg a wedding
band and any other jewellery or piercings worn for religious or cultural reasons such as a Sikh
bracelet (Kara) or nose piercing. What you wear should not impede effective hand hygiene,
and should not unintentionally come into contact with patients during direct patient care
activity. Where students wish to cover their forearms or wear a bracelet when not engaged
in patient care, you should ensure that your sleeves or bracelets can be pushed up the arm
and secured in place for hand washing and direct patient care activity. We recommend
students speak with their clinical placement supervisor to ensure that the wearing of any such
jewellery would not contravene Trust infection control guidelines in any other situation, such
as theatre. We would expect your request to be considered fairly and on a case-by-case basis.
In general, students should be clean and smartly dressed. Therefore the following
are not permitted in settings in which a student is interacting with patients, service users and
professionals:
• T-shirts or shirts with visual logo branding, slogans or images that could be deemed
unsuitable to the setting.
• Wrist watches or fashion jewellery, including body jewellery (except simple stud
earrings, wedding bands or items of cultural or religious significance, as described
above)
• Ties – for cross- infection reasons, the wearing of ties is not permitted however a bow
tie may be worn.
• Revealing clothing – please consider the setting and activities that are undertaken in
such a setting. Inappropriate clothing could include very short skirts, low cut tops, or
tops that expose your midriff.
• Open-toed shoes, sandals or trainers – footwear should be well fitted with a low heel.
• Clothing that covers most of the face i.e. peaked caps and hoods
• The Niqab is also an example of unacceptable clothing when interacting with patients,
service users and professionals as it covers the face; however the Hijab (only obscuring
the hair and the top of the head) is acceptable. This applies not only in clinical settings
14 | P a g ebut also in educational elements of the programme where communication skills are
relevant, such as some types of group work and role-play exercises.
• Excessive makeup, nail polish, nail extensions, extremes of hairstyles – if you have long
hair please ensure that it is tied back. Avoid ‘designer stubble’.
• Strong odours, perfumes or aftershaves.
• The following would be considered examples of good practice:
• Clean, tidy and well-kept appearance in accordance with the dress code of the Medical
School.
• When on NHS premises such as a hospital Trust or a Primary Care Trust, a community
setting such as a GP practice, or in the homes of patients and service users, students
should dress according to both the University’s and the appropriate local guidelines
and regulations.
• Clothing that maintains the NHS ‘bare below the elbow’ policy, where appropriate
• Wearing of correct identification passes/badges as issued by the University/Trusts.
Bags and Coats
There are lockers/cloakrooms for you to use at the back of the CSRA (and at the peripheral
hospitals). Please bring your own padlock if you intend to leave valuable although we can loan
you a padlock on a sign-in single day basis if you forget. Do not take bags and coats into the
rooms or the ward areas – it is untidy, reduces space and can be a trip hazard.
Primary Care and OSCE Examinations
You are expected to follow the same dress code as Secondary Care, but remember you will be
involved in interacting with patients (including manual handling) so bear this in mind and make
sure the clothes you are wearing are comfortable and don’t restrict your movement.
Clinical (OSCE) Examinations
You are expected to follow the same dress code as Clinical Placement, but remember you will
be involved in interacting with patients (including manual handling) so bear this in mind and
make sure the clothes you are wearing are comfortable and do not restrict your movement.
How you will be assessed
Please note, this is an initial overview and you will be provided with more detail on arrival.
Objective Structured Clinical Examination (OSCE)
At the end of year 1 and year 2 your clinical skills will be tested with a multiple station OSCE.
The format of each station will vary, but might include:
• taking part of a patient’s history (e.g. taking a history from a person who has fallen over)
• examining one or more aspects of a patient (e.g. examining a patient’s knee)
• interpreting an investigation (e.g. looking at an X-ray of the arm)
• performing a practical or clinical skill (e.g. taking blood pressure)
• formulating a management plan and discussing with a patient (e.g. discussing insulin with
a newly diagnosed diabetic)
15 | P a g eIn most stations there will be a single examiner and, depending on which station it is, there might be a patient or actor present. Occasionally there will be an observer, moderator or external examiner present. My Progress Portfolio We will be using an electronic portfolio for monitoring your progress (curricular coverage), attendance and delivering assessment during your clinical placements. We hope this will provide a really useful way of conveniently monitoring your own progress. You will require either an Android or Apple smart phone with data. There are several types of assessment that use this online software including; 1. Procedural skills competency sign offs (summative x 2 for each skill required) 2. Placement tutor reports which will also contain reports on attendance 3. Case presentation signoffs (formative but compulsory) with feedback given on your weekly case presentations Please refer to the Faculty of Heath Confidentiality policy on the Physician Associate blackboard site. Following up your patients’ management and progress is a key part of your learning. You will discover how patients progress, how diagnoses change over time or when new information is obtained, how problems are solved, and how some patients go on to suffer complications (e.g. hospital acquired infection, pulmonary embolus etc). You can follow up patients by seeing them again, by reading their medical records (e.g. discharge summaries) or by asking the clinical staff about their progress. End of Year Written Exam This will comprise one (or two) Single Best Answer papers that test your knowledge of topics you have learnt about during the first year (end of year one) or the whole course (end of year 2). Module 6: Health Improvement Project (MSc only) This will be assessed through coursework and will include a dissertation to be submitted towards the end of year 2. Plagiarism, collusion and copyright Whatever you have heard or learned about these topics before, you must make sure to learn the UEA rules, whether they are similar or different to what you know. Students all too often get into trouble by not doing this. Definitions of plagiarism (the unacknowledged use of another person's work) and collusion (a form of plagiarism, involving unauthorised co- operation between at least two people) are expanded in the UEA policy document on these topics. The policy can be found on the Dean of Students’ Office (DoS) website here: http://www.uea.ac.uk/plagiarism and you will also find here a wealth of useful information 16 | P a g e
on avoiding plagiarism. Avoiding plagiarism and collusion is what we all have to do! The UEA policy on plagiarism and collusion applies to work of all types submitted for formative as well as summative assessment, including, for example, your health improvement project. Please check guidance specific to different tasks for what is expected for each. What you submit needs to be a result of your own effort and representing your own ideas and under- standing. Using the ideas of others is normal in academic work, but you just need to acknowledge the source/s clearly by citing them specifically. If you use their words you need to show this by using quotation marks, as well as the citation. See the separate piece in the Handbook on Referencing. This is also available in the Blackboard folder [MB BS General Information (All Years) > UEA MB BS Regulations, Policies & Forms > Plagiarism and Referencing]. The policy states that the University takes a serious attitude towards plagiarism and collusion, because “students who plagiarise or collude threaten the values and beliefs that underpin academic work and devalue the integrity of the University’s awards.” (p.1). These offences include self-plagiarism, which is undeclared re-submission for assessment of one’s own previously assessed or published work. They are considered a fitness to practise issue for medical students, because of the expectations of probity for doctors and medical students (1). You are expected to familiarise yourself with the principles and definitions explained in the UEA policy document, and to use resources provided by UEA, including those on the DoS web pages cited above, to help you to develop good academic practice and to avoid committing plagiarism and collusion. Working in groups is encouraged and required in MED because learning can be enriched deeply by sharing ideas with others. What you share should be in a form that needs digestion and evaluation by your peer: this is what learning is about. It is risky and unhelpful to share work with other students in a form that could be submitted for individual assessment, as the provider could also be accused of collusion. All work of students in the MB BS and all taught post-graduate courses that is suspected of containing plagiarised material may be submitted to the text-matching softwares ‘Turnitin’, or ‘SafeAssign’, to establish the extent of the offence and to help identify sources. More information about text-matching software is available from the DoS website at the address given above. Even if not required to submit an assignment electronically, you must keep electronic copies of your assessments as submitted (in Word/Powerpoint and in pdf format), in case you are required to produce them for checking with text-matching software. It is also advisable to keep copies (electronic or paper) of working drafts of assignments in order to show your ownership of the work, if you are asked to. MED will soon be a pilot school in the university for screening student coursework on submission for matched text, as is done in many other universities. We are also plan to pilot 17 | P a g e
students’ own use of text-matching software on their work before submission, to help them learn the skill of academic writing without plagiarism. More information will be available later in the year, on Blackboard and by email. Copyright law and sharing electronic resources A separate but related issue to plagiarism, pertinent especially to use of electronic resources, is that copying and pasting sources of electronic origin (e.g. images, diagrams and text on websites), is very likely to infringe copyright of the authors. This is true even if the source is acknowledged thus avoiding plagiarising it. Terms and conditions of many resources readily available on the internet often state that their use is free for personal use, but that copying, sharing or redistribution is not allowed, even for educational purposes. Posting on Blackboard, or emailing copies, are forms of redistribution and sharing. Websites popular for PBL work and PDF files of journal articles are included in this. The Terms and Conditions of use should always be checked before copying. The UEA’s copyright expert recommends that best practice to avoid infringing copyright is to share or post a link to the resource (pers. comm., Dave Palmer, UEA Library, March 2009). The electronic link allows each user to read and download or process the item as the copyright terms and UEA’s license allow. Source 1. General Medical Council, Medical Schools' Council. Medical students: professional values and fitness to practise. 2016. [Accessed 28/09/17]. Available from: http://www.gmc-uk.org/education/undergraduate/professional_behaviour.asp. This is considered a fitness to practise issue for medical students, because of the expectations of probity for doctors and medical students (1). 18 | P a g e
A student’s guide to preparing for OSCEs The key to success in OSCEs is to be systematic and to practice, practice, practice. It is very easy to miss easy marks just because it’s not second nature. The best way to practice is to put together a mark sheet of everything you think you need to do in each station including washing your hands and greeting the patient etc. then get together with friends and practice till you are perfect. A student’s guide to preparing for the End of Year Written Exam All students find the written exam daunting because of the body of knowledge students are expected to know. The key is to focus on the important bits and start early. At the end of each week take the time to look over the learning objectives for the week and those for the lectures and see if you would be able to answer them as a short answer question. If not, try going through the seminars related to that objective and make notes on them. You will find that for the single best answer (SBA) paper a lot of the knowledge you will acquire simply by paying attention in seminars and teaching in Clinical Practice. There are some useful books of questions, but remember some UEA SBAs are in a unique style so make sure you have a look at practice questions on Blackboard to get an idea from them. How assessment results are given The way in which assessment results are given back to students is constantly evolving and varies with different assessments. OSCEs Results are posted on E:vision. A breakdown of your marks for each station will be sent to you and directly to your adviser End of Year Written Exam Results are posted on E:vision. A breakdown of your marks will be sent to you, your adviser, and your learning facilitator via email. To access results on E:vision: go to the portal and click on the e:vision tab, half way down the right hand side there is box called Student records – click on student view, then under 19 | P a g e
assessment and award details click on provisional marks this year.
These results are an essential part of your student held record and should form a part of your
meetings with your adviser.
Course Progression, and Reassessment
In order to progress to the next year of the course you have to pass all assessments, currently
you are permitted two attempts (a first sit and a reassessment).
The reassessment fee is currently £70 per module. https://portal.uea.ac.uk/learning-and-
teaching/students/assessment/results
Please note that if you fail any summative component of our course twice, you will be withdrawn
from our course.
Repeat of a year
In the following circumstances you would normally be required to repeat a year rather than
have a formal approved break and simply re-sit the examinations the following year:
• upheld appeals following a fail at reassessment
• a fail at a delayed first sit taken during the reassessment period
Requests not to repeat a year will be considered on a case by case basis but would normally
only be agreed in exceptional circumstances.
School Feedback
Throughout your course you will have many opportunities to gain feedback on how you are
doing. Much of this will be informal on a day-to-day basis. Take note of this informal feedback
as it is as crucial to you as any written feedback on your assessments.
We expect you to keep all your feedback together, as part of your student held record. This is
an important record of your progress through our course. It will also help you reflect on your
strengths and weaknesses as you progress through the Physicians Associate course. Feedback
will enable you to identify which topics and/or learning outcomes you need to study and
strengthen your understanding of. You should also go through this feedback with your adviser,
either on a termly basis, but certainly at least once a year.
Student feedback/evaluation
It is very important for you to be able to have input into how the Physician Associate
programme develops, and we really value this. There are a number of feedback mechanisms;
please also refer to the Student representation guide on Blackboard.
20 | P a g eCourse Evaluation All our students are asked to provide feedback at the end of each module (End of Module Evaluation). Whilst end of module evaluations are voluntary, they are really important to the course and so you are strongly encouraged to complete these evaluation forms. Clearly, we cannot get a valid overview of student opinion unless we get a majority of students responding to feedback requests, and it is only through these means that we can really see where changes need to be made. Occasionally, there are other ad hoc requests to provide feedback during the year if staff need feedback about a particular aspect of the course urgently or in particular detail. You can also provide feedback at any time during the year, without prompting, using the ‘Student in-year evaluation form’ which can be found in the Physician Associate Coursewide Evaluations folder (see below). Please take evaluation seriously and spend time on it, consider positive as well as negative aspects of your experience to comment on. Try to be specific, and comment in such a way that it is clear why something is particularly good (or less so). Please do not be rude about staff or unprofessional, as they do receive these comments. We take your views very seriously and try to respond to your views by improving/changing things wherever we can. The central UEA student handbook which contains information about all key UEA policies and guidance can be found on the UEA Portal: https://www.uea.ac.uk/learningandteaching/getting-started/handbooks Useful information is also available on the “All FMH PG students on taught programmes” Blackboard Organisation which you will have access to via the Portal Home tab, once you have completed your registration. 21 | P a g e
Module Leads
YEAR 1
MED-7000E Foundation Skills for Diane Bool d.bool@uea.ac.uk
Physician Associates
MED-7001F General Medicine Bob James r.james2@uea.ac.uk
MED-7002D Surgery Toni Alderton t.alderton@uea.ac.uk
YEAR 2
MED-7003E Community Medicine and Mark Bilby m.bilby@uea.ac.uk
Mental Health
MED-7004X Emergency Toni Alderton t.alderton@uea.ac.uk
Medicine (Adult
and Child)
MED-7005X Student Selected Audrey Gibbs a.gibbs@uea.ac.uk
Placement with Health
Improvement Project
School Management
Within the Medical School itself, our administrative team is led by Colin Bryant (School
Manager). Colin ensures support for the delivery of teaching activity by the School.
Administrative staff
The administrative staff that support your teaching are based in the Learning & Teaching
Service (LTS) Hub on the ground floor of the Elizabeth Fry Building (opposite the MED building).
Your placements team on campus are based in the ZICER Hub.
To distinguish this from your placement HUBs (e.g. the Hospitals) this is often referred to as
the EFRY or ZICER Hub. Staff are there to help if you have any questions. The MED PGT team
should be your first point of contact and will try to answer your question or refer you to
someone who can.
Learning & Teaching Service (Elizabeth Fry Hub) – Campus teaching & student queries
All enquiries should be sent to this email address which is constantly monitored:
med_pgt.hub@uea.ac.uk
Manager
Jean Whiting j.m.whiting@uea.ac.uk 01603 592801
22 | P a g eCoordinator (LTS)
Sarah Wright S.Wright@uea.ac.uk (01603) 591531
Team Leader:
Caroline Frosdick C.Frosdick@uea.ac.uk (01603) 593074
Administrative Assistants:
PA Course
Year 1 Robin Lubach (01603) 597613
Year 2 Faye Thurston (01603) 591764
Other MED PGT courses
Julie Loughridge (01603) 591722
Faye Thurston (01603) 591764
Learning & Teaching Service (ZICER Hub) - Placements
All enquiries should be sent to this email address which is constantly monitored:
pa.placements@uea.ac.uk
Manager
Becky Fitt r.fitt@uea.ac.uk (01603) 591157
Coordinator (LTS)
Sally Barber Sally.barber@uea.ac.uk (01603) 593579
Team Leader:
Katie Vaughan katie.vaughan@uea.ac.uk (01603) 597063
Administrative Assistants:
PA Course
TBC pa.placements@uea.ac.uk (01603) 592381
Clinical Placement administrative teams
Each hospital also has administrative staff responsible for putting together your timetable.
General enquiries about placements can also be sent to pa.placements@uea.ac.uk.
Who Title Email Phone
number
Norfolk and Norwich University Hospital NHS Trust (NNUH)
Rebecca Ogden Administrative rebecca.ogden@nnuh.nhs.uk 01603
Team Leader 286619
Richard Smith Placement richard.smith@nnuh.nhs.uk 01603
Coordinator 286790
Fran Harlow Learning fran.harlow@nnuh.nhs.uk 01603
23 | P a g eFacilitator 287100
Graeme Carlile Learning graeme.carlile@nnuh.nus.uk 01603
Facilitator 286710
James Paget University Hospital NHS Trust (JPUH)
Dr R Ganepola Learning
Facilitator
Jade Rogers Administrator Jade.rogers@jpaget.nhs.uk
The Queen Elizabeth Hospital (QEH)
Dawn Bould Administrator Dawn.bould@qehkl.nhs.uk 01553
613136
Imran Riaz Learning Imran.riaz@qehkl 01553
Facilitator 613077
Angelo Giubileo Learning Angelo.gublio@qehkl.nhs.uk 01553
Facilitator 613394
Ipswich
Kay Wilson Administrator Kay.wilson@ipswichhospital.nhs.uk 01473
702525
Justin Brown Learning Justin.brown@ipswichhospital.nhs.uk
Facilitator
David Learning
Hodgkinson Facilitator
West Suffolk Hospital (WSH)
TBC Learning 01284
Facilitator 713000
What the School expects from you
The UEA Physician Associate course leads to a professional qualification, and all our students
need to develop themselves as professionals whilst undertaking the course.
It is impossible to specify all the ways in which a professional code of conduct can be violated:
you must interpret the principles and make your own judgements, as will staff.
The following examples indicate areas where courses have encountered problems and which
students should be careful about. (Please read our Professionalism and attendance guidance
which will be made available for you on blackboard.
As a student on the UEA PA Masters course you are expected to: Comply with the spirit and
principles set out by the General Medical Council. Although these relate to doctors and
medical students the interaction you will have with patients is very similar and you should
consider them a guide particularly those in ‘Duties of a Doctor’ and ‘Medical Students:
professional values and fitness to practise’.
24 | P a g eEnsure patient safety and wellbeing in every way you can e.g.
• Be on time for clinical sessions ensure the patient is still willing to see you, check if
there is anything you can help them with (e.g. pass on relevant information to staff)
• Be safe for practice – clean hands and clothes, healthy, not under influence of
drugs/alcohol, preventive immunisations in place, follow occupational health advice.
• Do not exceed the limits of your competence.
• Do not develop personal relationships with patients – do not arrange to see them out
of the NHS setting or without tutor knowledge and do not exchange personal details.
• Maintain confidentiality, while sharing essential information for patient safety.
Be honest and truthful in all areas of your interaction with staff, students and patients e.g.
• Declare any special needs or health problems that need to be known to staff to ensure
student and/or patient safety (e.g. an infectious illness, occupational hazard,
addiction, mental health).
• Do not plagiarise or cite other people’s work without due attribution to them (brief
notes about referencing and plagiarism are provided earlier in this handbook).
• Never falsify others’ signatures or ask others to sign for you.
• Ensure staff and patients know that you are a PA student and not a doctor, and declare
any limit to your competence.
Be responsible about all formal requirements of the University e.g.
• Submit assessments and other compulsory paperwork by the deadline given.
• Attend all teaching OR complete the absence record.
• For Primary and Secondary Care, always ensure staff know if you are going to be absent
or late and complete the absence record.
• Complete the annual declaration and student-held record promptly and fully.
• Abide by and comply with the University regulations. This includes checking your email
and pigeon holes at least every 48 hours.
• All email correspondence with the University and medical school should be using your
UEA email address.
Be respectful of the needs and efforts of others e.g.
• Support peers and any staff members involved in your teaching and learning. Be polite
and appreciative when staff and patients have put aside time and effort to arrange
learning and assessment.
• Should criticism be necessary, do this with due consideration and focus on how to
resolve the problem, rather than being rude or aggressive to the person.
• Ensure that patients are given due time and attention, that you make their comfort and
safety your first priority, and thank them for their involvement with your learning.
• Avoid late arrival, chatting, telephone and social networking use during teaching and
assessment sessions.
• Always consider the safety of other clinical staff (e.g. safe sharp disposal, ensuring you
leave clinical areas and teaching areas clean and tidy etc.)
25 | P a g eSeek help when needed – it is your responsibility to be proactive about issues which may
undermine your performance e.g.
• Declare extenuating circumstances BEFORE formal assessments.
• Meet with your Personal Adviser regularly (the recommended number of meetings
expected for PA students is two times per year), including consulting on progress.
Consider your own reputation and that of the School and University when you are outside
the campus or NHS setting e.g.
• Dress appropriately when working as a PA student.
• Breaking confidentiality, drinking to excess, voicing unjustifiable criticisms of others not
present to defend themselves, having major rows in public settings with other
students, criminal acts such as stealing or illegal drug use or illegal drug dealing are all
examples which can bring both you and the School into disrepute.
We would recommend that you refer to teaching staff, particularly on placement, by their title
and second name, until you are invited to use their first name.
For students undertaking paid work, it must not occur in timetabled sessions. You must limit
this so that it does not detract from the private study required to support course work, or
from time you also need to relax. You should judge how much is manageable according to
your progress on the course, but we anticipate that it would be very unusual to manage more
than 8 hours of paid work per week. Similarly, participation in extra-curricular activities should
be guided by your course progress.
NB: an absolute minimum of 10-15 hours private study per week is expected by the course.
Physician Associate student support
Personal Adviser
Each student will be appointed a personal advisor, in addition to their academic advisor. A
student’s Adviser will offer advice and guidance to support the student’s academic, personal
and professional development. This will include helping the student to reflect upon and benefit
from the feedback they receive on their work. The Adviser helps students reflect on their
academic and professional development at each stage of their course so that by the time they
successfully complete their degree, students not only have the skills, knowledge and
experience to secure the next opportunity in their career, but are also able to articulate this to
prospective employers, or to Universities if they wish to go on to further study. Students may
also choose to speak to their Advisers about personal issues affecting their studies or their
welfare. The Adviser will be open and receptive to offering initial support, but will also be
knowledgeable about the professional services provided by the Dean of Students’ Office and
the Student Union Advice Centre and will refer students to these services whenever
appropriate. Advisers will be assigned by the course director.
Supporting students with disability
The Student Support Service offer a range of services for students. This includes services for
students with physical disability, health related conditions or specific learning disability, such
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