Learning clinical communication skills outcomes of a program for professional practitioners,the secret law of attraction book in hindi 2013,watch the secret life of the american teenager season 3 episode 18 - You Shoud Know

The Physical Therapist Assistant Program is offered at the Quad-Cities Campus only with clinical practice available throughout a large regional area. Physical therapist assistants (PTAs) provide physical therapy services under the direction and supervision of a licensed physical therapist.
Simulation Exchange newsletter is a product of the VHA SimLEARN National Simulation Center.
The Simulation Learning, Education and Research Network (SimLEARN) is the VHA's program for simulation in health care training. The Jefferson College of Health Sciences Physician Assistant (PA) Program will host information sessions to provide details on our program, the PA profession and how prospective students can apply.
To see Jefferson College of Health Sciences Catalog, with the Physician Assistant section beginning on page 190, click here. The program prepares graduates in generalist, primary care medicine to provide diagnostic and therapeutic medical services under physician supervision. The curriculum, clinical experiences, and rotations emphasize local and regional healthcare through an affiliation with Carilion Medical Center, the largest hospital-clinic network in southwest Virginia. Because of the close working relationship between PAs and physicians, PAs are educated in the medical model designed to complement physician training.  The PA program is a 27-month professional program designed for students with a bachelors degree.
The curriculum is comprised of 14 months of didactic instruction followed by 13 months of supervised clinical practice in the major medical disciplines. Previous occupations: emergency medical technician (EMT), certified nursing assistant (CNA), ED Scribe, medical assistant, physical therapy assistant, military medic, mental health counselor, radiology tech, respiratory therapist and others. To provide a positive learning environment that is conducive to attainment of Student Learning Outcomes. To provide a strong foundation of medical knowledge, clinical skills, and ethical and professional behaviors that will meet the needs of a practicing PA.
To instill an appreciation for lifelong learning skills and the need to provide the most current patient-centered care possible. To provide the skills necessary to communicate and collaborate effectively within a team environment.
To graduate physician assistants who will serve as leaders in their professional lives and will participate in the education of future medical providers. Jefferson College of Health Sciences is accredited by the Commission on Colleges of the Southern Association of Colleges and Schools to award associate, baccalaureate and masters degrees. Essay. The CASPA application includes a written essay, which will be reviewed by our admissions committee.
Healthcare Experience. All successful candidates must have 500 hours of healthcare experience, paid, volunteer, or as a student, prior to enrollment in the PA program. GRE. The Graduate Record Exam (GRE) is required and should have been taken within the last five years. International Students. International students must have their transcripts submitted for independent evaluation of equivalency by an acceptable credentialing evaluation agency. Prerequisite Courses. Applicants must have completed the following prerequisite coursework before beginning the program. Requests for waivers of any of these requirements will be considered on an individual basis, must be made in writing to the program, and must be supported with excellent reasons. Requirements for Accepted StudentsDeposit: An accepted applicant has two weeks after receipt of notification of acceptance to submit a $500 deposit, which is counted toward tuition.
Technical Standards: Students must be able to comply with all of the PA Program’s required Technical Standards.
Contingencies: Applicants will be required to complete all unfinished prerequisites before matriculation, and may be required to complete those prerequisites with a grade of B or higher.
See the Jefferson College of Health Sciences Financial Aid page and Tuition Schedule for current information. Please Note: The Didactic Phase (Classroom) starts in August and goes into the second Academic Year and ends in October of the following year. Program OutcomesBefore graduation, all students must pass a summative evaluation that focuses in the Competencies for the Physician Assistant Profession (medical knowledge, interpersonal and communication skills, patient care, professionalism, practice-based learning and improvement, systems-based practice; full text available here). Integrating clinical reasoning into problem based learning in first and second years of the curriculum in a physiologically relevant and clinically relevant manner. Curricular revision and the use of more contemporary, effective teaching methods such as TBL. Madonna is one of the largest independent rehabilitation hospitals in the country, located in Lincoln, Nebraska. Madonna’s Omaha Campus is currently under construction west of Village Pointe to bring specialized rehabilitation for brain trauma, spinal cord injuries, severe stroke and neurological diseases to the Metro Area. The goal of Madonna’s Brain Injury Rehabilitation Program is to help the people we serve become as independent as possible while establishing a partnership for life that the patient and their family can depend on.
Madonna Rehabilitation Hospital is one of the only hospitals in the region to be accredited by CARF, the Rehabilitation Accreditation Commission, as a Brain Injury Rehabilitation Program for multiple levels of care, including LTACH, Acute Rehabilitation and Outpatient, multiple services. Family members and other support system for the persons served are provided with structured training on how to interact with and care for their loved one. Recent remodeling of the therapeutic space includes such items as a house with bedroom, kitchen, bath and laundry rooms, a retail store, automobile, riding lawn mower, pickup truck and workshop. As we adjust to the new server, we expect that there will be technical issues in various sections of the site. PTAs help people of all ages who have medical problems, or other health-related conditions that limit their ability to move and perform functional activities in their daily lives. Serving the largest integrated health care system in the world, VHA's SimLEARN provides an ever-growing body of curricula and best practices that improve health care for our nation's Veterans.
It placed second in the Large Company Division at the annual International Meeting on Simulation in Healthcare (IMSH) Jan.
Click here to download the Jefferson College Physician Assistant Program Frequently Asked Questions. Physician assistants provide high-quality, cost-effective healthcare while maintaining patient satisfaction at a level comparable to that of physicians.
Through interprofessional coursework, PA students collaborate with other health professional students to gain skills necessary for future practice. Graduates receive a Master of Science in Physician Assistant degree and are eligible to sit for the PA National Certifying Exam (PANCE). Didactic students spend many hours in class, and still more time studying and preparing presentations; Clinical phase students often work much more than a 40-hour week. Substitutions may be made if all three are not available, but at least one reference should be from someone familiar with you in a work or professional setting. This experience should be in areas with direct patient or client contact, for example, EMT, medical technology, nursing, and phlebotomy. GRE scores are considered along with other applicant factors, and will be required before a candidate is interviewed. Applicants who are selected to be interviewed will be scheduled for an interview session several weeks ahead of time. Decisions are based on applications, overall and prerequisite grades, healthcare experience, essays, GRE scores, references, and interviews. If you have not completed this application, you need to notify the Financial Aid office now so they can process your institutional award.
Our graduates rate the program highly for satisfaction and perception of their clinical competence; employers similarly give our graduates high ratings.
We help people overcome disabling injuries or illness and achieve the highest level of independence. Programming is highly individualized, dependent upon each individual’s functional level and activity tolerance.
Patients who are just emerging from coma (Rancho Level II or higher) may be admitted to our LTACH level of care, while those who have already emerged from coma on ARU, and those with moderate to mild deficits, might be served in our outpatient program. In addition to these specialties, rehabilitation nursing and access to a physician with training in physical medicine and rehabilitation is available 24 hours per day, seven days per week on an inpatient basis. Madonna is the only rehabilitation provider in the region to offer a comprehensive vision program, led by Dr.
Virtual patients (VPs) may support learning processes and be a valuable complement in teaching communication skills, patient-centeredness, clinical reasoning, and reflective thinking. PTAs work in a variety of settings including hospitals, private practices, outpatient clinics, home health, nursing homes, schools, sports facilities, and more.
The use of innovative technologies in a safe learning environment enhances diagnostic, procedural and communication skills to support quality care and the best possible outcomes.
The licensed PA can provide most of the healthcare services performed by medical doctors and is an integral part in healthcare delivery today. Patient contact in fields such as health education, health promotion, and social work may be considered as long as work was in areas of patient or client services.
If you take the GRE before finishing your CASPA application, GRE scores may submitted directly to CASPA with the Designated Institution (DI) code 0597.
Students for whom English is not their primary language are required to submit their TOEFL (Test of English as a Foreign language)score.

Simply meeting the minimum requirements does not guarantee an interview or admission to the program.
Our graduating students have an excellent track record on the national certification Board exam, with a trend toward increasing scores on that exam. Family members are encouraged to be actively involved in therapy and nursing care so they may reinforce learning new skills. All Madonna nurses are specially trained in providing care for patients with brain injury, and several Madonna nurses have specialty training as a Certified Rehabilitation Registered Nurse. The team, consisting of physical, occupational, speech, recreational and respiratory therapists, as well as neuropsychology, social worker, rehabilitation nurse and case manager, work together to meet the complex physical, cognitive, social and emotional needs of persons with brain injury. PTAs may also measure changes in the patient’s performance as a result of the physical therapy provided. However, if you finalize your CASPA application and later take the GRE, scores should be sent directly to Jefferson College using DI Code 5099.
The minimum score accepted for admission is 550 for the paper-based test (equivalent requirements are 80 for internet-based and 215 for computer-based tests). Admission decisions are made after each interview session, and outstanding candidates are accepted within 2 weeks after the interview.
This means that Madonna meets higher standards relating to staff competency, programming, patient and family education, advocacy and outcomes management.
While most of our patients with brain injury are discharged to a community setting, patients who will need additional time in a more structured, residential setting after discharge are also served. For very low-level patients, weaning them from a mechanical ventilator might be the first part of treatment. Participation in a variety of adaptive sports and recreational outings can be integrated into therapy or just for fun. Both the VP model and the case created using the developed model were validated by a group of 10 experienced primary care physicians and then further improved by a work group of faculty involved in the medical program.
Madonna has the capacity to lock sections of the brain injury rehabilitation unit to provide better security for patients as they emerge from coma and go through this stage of recovery.
Often the need for treatment may not be identified until months after the incident, when academic, vocational, personal or family adjustment difficulties arise.
The VP primary care model is based on Kolb’s learning theories and consists of several learning cycles. Adolescents and children 18 years or younger are admitted to The Alexis Verzal Children’s Rehabilitation Hospital. Madonna is regionally known for its Mild Traumatic Brain Injury services — a comprehensive two-day assessment focusing on medical, physical, cognitive (thinking) and emotional aspects of mild traumatic brain injury. Each learning cycle includes a didactic inventory and then provides the student with a concrete experience (video, pictures, and other material) and preformulated feedback. These children are provided rehabilitation in a dedicated, secure area designed specifically for children and adolescents.
The students’ learning process was visualized by requiring the students to expose their clinical reasoning and reflections in-action in every learning cycle. As a national expert in this area, Madonna offers an opportunity for persons who have previously received services to return for a re-evaluation to determine if there are any further needs.
Content analysis of the focus group interviews showed good acceptance of the model by students. The VP was regarded as an intermediate learning activity and a complement to both the theoretical and the clinical part of the education, filling out gaps in clinical knowledge.
The content of the VP case was regarded as authentic and the students appreciated the immediate feedback. Virtual patients (VPs) are currently introduced into many health care programs worldwide but are still sparsely used in medical school curricula [3]. Designing a VP is a delicate process, and the production of learning objects for multimedia consumes both time and resources [4]. Doctors in primary care often use strategies in clinical reasoning that are not always explicitly taught, and few studies have explored how these skills are acquired [8].
Examples are an important part of clinical reasoning, and VPs have something to contribute here as a complement to the real-life clinical practice.
Primary care, with its complexity and its structure as an educational arena for students, may gain from a blended learning structure where virtual patients may help the student be introduced to learning situations similar to those they encounter during their clinical placements in primary care.Learning in Primary CareThe same learning theories that are applicable for learning in primary care are also applicable for virtual patients. Education in primary care has a holistic perspective on patient care, and the learning is based on theories of adult learning and self-directed learning.
During a clinical placement in primary care, the students meet patients with a wide variety of medical problems and have a strong internal motivation to learn from these patients. Adults learn most effectively when they do things in a real-life setting and have active roles in a meaningful context [10,11]. Students’ learning is an active process where the starting point is their pre-understanding [12]. The virtual learning experience is very similar to what may happen in real clinical practice. A virtual patient may be described as an approximation to reality and is often experienced as very authentic by learners.
The knowledge the students gain from the virtual patient can be directly applied to real patients that they meet at the primary health care centre. This kind of reflection may be useful as a tool for meaningful learning, and reflections are best done in an authentic context [13].
The primary care placements of medical students are only about 1 week per semester, and the students change primary health care centres three to four times during the study program.Modeling of the Virtual Patient Primary Care ModelA reference group of 10 experienced primary care teachers from the Centre for Family Medicine were involved in developing the new model of VP for primary care with the aim of embedding communication skills, clinical reasoning, and reflection in the model.
The group of teachers met on several occasions and explored different current systems for VPs. The VP system (Open Tufts University Sciences Knowledgebase, OpenTUSK) was chosen after consensus in the reference group.
The decision was based on the possibilities this system offered from a pedagogical family medicine perspective.
All teachers were involved in creating the VP case material about the patient with multiple diagnoses. This tool allows open-ended questions and free-text answers that may promote students’ own reflections and make it possible to adapt the learning with the VP case to how diagnostic decision making takes place in a primary care context. Videos are already widely used in primary care education, and the students are trained in analyzing videotaped consultations as a part of their education in primary care.
The preformulated comments from teachers after the free text provided possibilities to give students insight into experienced family doctors’ clinical reasoning.
The structure of the case was visualized in the program VUE, and the case was written in a text document before it was entered in OpenTUSK.Representation of the Virtual Patient Primary Care Model as a Formative Learning ActivityExperience-based education in communication skills is one of the responsibilities of the primary care part of the medical study program at KI and one of the most important learning outcomes of the primary care part of the program. A Danish patient-doctor communication model (PRACTICAL) is applied when giving feedback on patient encounters [15]. PRACTICAL has further developed the core aspects of patient-centeredness and does not only stress the importance of taking into account the patient’s ideas, concerns, and expectations, but has six more relevant aspects related to different parts of the patient encounter. The training in communication skills has a clear progression through the study program in medicine. During the first semesters, the students have training in early clinical contact and have focus on the patient’s agenda.
From the third semester, they also train the doctor’s part of the patient encounter with specific questions a doctor needs to ask the patients in order to get the correct diagnosis. At later stages, the students practice how to involve the patient in decision making and how to build a common ground for shared understanding and follow-up. How to motivate the patient and how to mobilize the patient’s internal capacities is an important part of that training. The same strategy in communication training was adapted to the virtual patient environment (see Figure 1). The communication, physical examination, and clinical reasoning were highlighted in the VP model through teachers’ comments and embedded hyperlinks.
To visualize and enhance the learning process, a cycle for self-directed learning was constructed (see Figure 2). The VP case learning outcomes are in alignment with the learning objectives of the study program in medicine.Screenshots of the first learning cycle of gathering information are presented in Figures 3 to 6 with answers written by one student who performed the VP case.
View this figureEvaluation of the Virtual Patient Primary Care ModelAll final-semester students at the KI medical program were invited to participate in a pilot session of the VP model. In general, the questions were open-ended and students were asked to formulate their answers in free text. At the beginning of the first learning cycle, the student was requested to plan the patient encounter. The patient encounter was then introduced through a film showing the information gathering, followed by preformulated teachers’ comments that were given as feedback to the student.
The VP continued with iterated cycles (physical examination, preliminary diagnosis, explanation and planning, and closing session).
Students finished the case by a final reflection about their educational outcome during the VP encounter.

The iterative reflective writing parts could be reread and revised throughout the VP and resubmitted several times. After the VP was finalized, no further alterations could be made, and all written content was displayed on the screen.Characteristics of the Primary Care Virtual Patient Model as a Learning ActivityThe VP case was designed based on an authentic patient story that was modified in order to hide the identity of the patient and to highlight the intended learning outcomes of the activity. Reflections were designed to be part of every learning cycle (see Figure 2).Films and other material from the patient encounter were embedded in the VP case. Video films were produced in an authentic clinical setting with a family doctor and a standardized patient.
The films were based on manuscripts in which the intention was to show good communication and clinical skills.
The camera viewed both the family doctor and the patient simultaneously in order to visualize the interaction in all parts of the patient encounter. The content of the VP case was created in congruence with the Calgary-Cambridge Guides [14] and the PRACTICAL [15] training model in communication skills. The comments were written as a short text (100-150 words) following each part of the encounter. The content analysis of the three group interviews resulted in the following themes.Evaluation of the Virtual Patient Primary Care ModelThe Learning ProcessStudents reported that they had had a generally positive learning experience working with the VP. They felt that the VP-model supported self-directed learning as it could activate students and stimulate reflection. The opportunity not only to read text, but also to actually see the doctor’s actions on films, enriched the learning experience. The students quite liked the fact that they received immediate feedback to their answers and reflections.
However, they also saw some potential to develop the model by more comprehensive information on the goals and intended learning outcomes.
They appreciated that the VP dealt with common conditions that they rarely met on hospital wards.
The tutors’ comments were very relevant and gave the students deepened medical knowledge. The comments also worked well as feedback, though they were general and not individualized to the answer from each student.
Students wanted more emphasis on the most important and potentially dangerous conditions when reflecting on differential diagnoses. They also wanted information on how comprehensive the answers they were expected to write should be.
They also pointed out some minor incongruencies in the content.The Status of the Virtual Patient Model in Clinical Education in Primary CareStudents described it as being a very good complement to the theoretical part of the course and the clinical placement, as it gave an opportunity to fill out gaps in their clinical experience. Working with the VP gave also a welcome opportunity to meaningful learning when no other organized activities were available. Students saw a great flexibility in the VP model that, with some adaptation, could be used in teaching on all levels of the medical program in primary health care, for example, to teach about typical medical cases. The video film about the clinical examination could be shortened, as it contained some redundant information.DiscussionPrincipal FindingsWe present the preliminary results from a new model for virtual patients based on the learning theories applicable to primary care as a learning environment for medical students. The model has embedded communication training and a funnel of clinical reasoning through the case. Reflection-in-action embedded through the case is emphasized and ends with a reflection-on-action.
The features that make this VP model suitable for primary care education include the way the model works with open-ended questions, allows free-text answers, and enables the visualization of communication and clinical reasoning processes in a family medicine context.Our evaluation with student interviews shows this to be a promising model.
The students found working with the primary care VP to be active and meaningful with a sense of authenticity. Realistic video clips were used, which was seen as an important part of the VP case design.
Other studies have also shown that patient videos can add value to virtual educational tools, such as Adams and colleagues who advocate for the creation of a whole library of videos used as VPs in a primary care context [17]. An adaptation of the VP model as described by Hansen and colleagues [18], for example, as an app for mobile device, could facilitate the implementation of the present virtual patient concept.For the students, it is important that they find the activity understandable, valuable, and meaningful [11,19].
The VP activity is designed to be self-instructed and easy to use so that students can take responsibility for their own education and learning process in line with the theories of self-directed learning [19]. One important learning activity by the students throughout the VP case is how they formulate the questions and problems related to each loop in their own words. For a student’s ability to apply concepts to solve new problems, active learning with multiple examples can have major effects [20]. VPs may offer students multiple examples and visualize how family doctors reason—something that is often considered as tacit knowledge. During the clinical placements, the students may then practice their knowledge from the VP case in real patient encounters so there is no long transfer process of knowledge. The integration of theory and practice should promote the students’ individual construction of meaningful learning that is readily available without a long process of transfer from a theoretical context to a clinical environment.
In alignment with Mitchell and colleagues [21], our findings show that the virtual patient model presents an effective learning environment, where education in patient-centered communication and counseling skills are facilitated.The student is guided to work with critical reflection during the case. This is a way for the student to act and think professionally as an integrated part of the formative learning throughout the case. The iterated self-regulated learning cycles, one of the essential parts of the VP model were inspired by Kolb’s learning cycle.
For learning to occur, the student has to proceed through all stages of the cycle, which is based on a continuous flow of actions: Doing, Observing, Thinking, and Doing again are repeated. In our learning cycles, the student started out by planning their actions in the current VP section (doing), followed by a concrete experience via multimedia where they were prompted to reflective observation (observing), and after having read the preformulated feedback, wrote down their reflections (thinking). The student could also return to their text and revise it (doing again).For learning to occur, the student has to proceed through all stages of the cycle. The feedback focused on the main ways of reasoning in primary health care to guide students to the next step.StrengthsThe starting point and emphasis of our model has been the primary care medical education. In our model, we have embedded ways to promote meaningful, deep learning for the students, such as reflection, clinical reasoning, and deepened subject knowledge.
The chosen tool for creating the VP is especially suitable for primary care because it allows both open-ended questions and free-text answers, and the use of video clips. This also makes it possible to visualize the tacit clinical reasoning processes of family doctors. They are given relevant questions related to a case that resembles the patients in their practice at the primary health care centre. We have inserted a step in each cycle where students have to reflect and write down their thoughts, which could take time.
This is still doable but can be regarded as a time limit for an effective learning activity.In the chosen prototype VP system, there is no synchronous interaction between the student and a tutor. This was inherent in the otherwise best technical solution we found, but also one of our concerns when we started the project.
Surprisingly, all the students participating in the pilot test reported that they perceived the feedback as natural, as from a real tutor. The integrated learning cycle, within the VP model, can easily be adapted, not only to medical education, but also to various other health care professional educations and for interprofessional use. The VP model design enables the insertion of VP cases in various professional settings and for different learning outcomes. The content of the VP cases can be reused, repurposed, and shared in different educational contexts. A wider implication and dissemination of the present VP model could be facilitated by use of Web-based platforms such as suggested in the mEducator project [22,23]. The VP model might also serve as a tool for international collaboration and shared understanding in health care education in culturally disparate structures.ConclusionsWe have built a new VP model for primary care education with a patient-centered approach that was congruent with the Calgary Cambridge Guides and contained embedded communication training by allowing the student to act and think professionally and then reflect upon a visual presentation of the different parts of the patient encounter handled by an experienced family doctor.
The model contained iterated learning cycles with a didactic inventory, a concrete virtual experience assisted by multimedia, preformulated feedback from experienced teachers, and the student’s reflections in free text.
Pilot testing showed good acceptance by students who regarded the VP case as authentic, and the model supporting their self-directed learning and reflective thinking. The use of virtual patients to assess the clinical skills and reasoning of medical students: initial insights on student acceptance. Enhancement of medical interns' levels of clinical skills competence and self-confidence levels via video iPods: pilot randomized controlled trial. Marrying content and process in clinical method teaching: enhancing the Calgary-Cambridge guides. P-R-A-C-T-I-C-A-L: a step-by-step model for conducting the consultation in general practice. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness.

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