Standards of Capacity for Matriculation, Promotion, and Graduationat the Physician Assistant Program of the University of North Dakota School of Medicine & Health Sciences

• Overview

The Physician Assistant Program of the University of North Dakota School of Medicine and Health Sciences (UNDSMHS) has a responsibility to society to graduate the best possible future Physician Assistants.  All graduates of the Program must have knowledge, skills, and capacities to function in a wide variety of clinical situations and to render a wide spectrum of patient care.  These standards (academic and capacity) are designed to ensure the graduation of capable, well-rounded future clinicians.

Historically, physician assistant education in the United States has been structured as a broad general training which is intended to produce “undifferentiated physician assistants.”  The University of North Dakota Physician Assistant Program’s (UND PA Program) Academic Standards and Standards of Capacity are intended to support that model.  Whereas a truly undifferentiated PA may not be achievable, the standards attempt to insure that graduates of the Program possess the background to pursue virtually any area of clinical medicine.  Thus all students must meet both the Academic Standards and the Standards of Capacity to matriculate, progress through the curriculum, and meet the requirements for graduation from the University of North Dakota Physician Assistant Program.

Academic Standards:

Demonstrates mastery in various disciplines, before matriculation and after; as judged by faculty members, examinations, and other measurements of performance. Once a student matriculates at the UND PA Program, levels of mastery are required in six broad areas of competency.

These six areas of competency are:

• Medical/Scientific Knowledge
• Clinical Skills
• Ethics and Professionalism
• Interpersonal and Communication Skills
• Lifelong Learning
• Health Care Systems-based Practice and Improvement

Academic Standards are addressed in detail in the UND Physician Assistant Student Policy and Procedures Manual (http://www.med.und.nodak.edu/physicianassistant/) and in the syllabus for each course. Any student who has specific questions about performance requirements in a course should speak with the Course Master (individual course instructor).

• Standards of Capacity (formerly referred to as technical standards):

The essential aptitudes and abilities that allow PA students (and practicing PA’s) to perform in the vast array of requisite ways summarized by the six areas of competency above. 

Without the ability to demonstrate the essential capacities, students cannot fulfill the requirements of all the courses within the UND PA Program.  Meeting these Standards of Capacity is required for: a) matriculation (insomuch as the abilities can reasonably be determined before matriculation), b) advancement toward candidacy, and c) graduation.

The listed capacities are essential in meeting the core competencies as defined by the University of North Dakota Physician Assistant Program “Student Performance Goals and Objectives” (http://www.med.und.nodak.edu/physicianassistant)

Students enrolled in the UND PA Program must have capacities in five broad areas:

1. Perception/Observation
2. Communication
3. Motor/Tactile Function
4. Cognition
5. Professionalism

A. Perception/Observation

Students must be able to perceive, by the use of senses and mental abilities, the presentation of information through:

• Small group discussions and presentations
• Large-group lectures
• On-line lectures
• One-on-one interactions
• Demonstrations
• Laboratory experiences
• Patient encounters (at a distance and close at hand)
• Diagnostic findings
• Procedures
• Written material
• Audiovisual material

Students’ diagnostic skills will be lessened without the functional use of the senses of equilibrium, smell, hearing, and taste. Additionally, they must have sufficient exteroceptive sense (touch, pain, and temperature), sufficient proprioceptive sense (position, pressure, movement, stereognosis, and vibratory) and sufficient motor function to permit them to carry out theses functions.

B. Communication

Students must be able to skillfully communicate, both orally and in writing (in English) with faculty members, the healthcare team, patients, families, and other students, in order to:

• Elicit information
• Convey information
• Clarify information
• Create rapport
• Develop therapeutic relationships
• Work collaboratively

Students must be able to speak, hear, and observe patients in order to elicit information, describe changes in mood, and perceive nonverbal communications. Students must be able to communicate effectively and sensitively with patients, including speech, reading and writing.

C. Motor/Tactile Function

Students must have sufficient motor function and tactile ability to:

• Attend and participate in classes, groups, and activities which are part of the curriculum
• Examine patients (including observation, auscultation, palpation, percussion, and other diagnostic maneuvers)
• Conduct basic laboratory procedures and tests
• Perform diagnostic procedures
• Provide patient care appropriate to the circumstances
• Function in a wide variety of patient care venues
• Perform in a reasonably independent and competent way in potentially high speed/high demand environments

Students must demonstrate coordination of both gross and fine muscular movements, equilibrium, and functional use of the senses of touch and vision.

D. Cognition

Students must be able to demonstrate higher-level cognitive abilities, which include:

• Rational thought
• Measurement
• Calculation
• Visual-spatial comprehension
• Conceptualization
• Analysis
• Synthesis
• Organization
• Representation (oral, written, diagrammatic, three dimensional)
• Memory
• Application
• Clinical reasoning
• Ethical reasoning
• Sound judgment

Students must possess the above abilities to reach diagnostic and therapeutic judgments. They must also be able to comprehend three-dimensional relationships and the spatial relationships of structures.

E. Professionalism

Students must consistently demonstrate the core attributes of professionalism.  UNDSMHS has defined the following behaviors as indicators of professionalism (http://ome.med.und.nodak.edu/curric/professionalismpage.htm):

• Commitment to Excellence
• Honesty and Integrity
• Respect for Others
• Empathy and Compassion
• Professional Responsibility
• Social Responsibility
• Altruism

Students must possess the emotional health necessary for full utilization of their intellectual abilities, the exercise of sound judgment, the prompt completion of responsibilities attendant to the diagnosis and care of patients, and the development of mature, sensitive, and effective relationships with patients and co-workers. Students must be able to tolerate physically taxing workloads and to function effectively under stress. They must be able to adapt to changing environments, to display flexibility and to learn to function in the face of uncertainties inherent in the clinical problems of many patients. They must have a high level of compassion for others, motivation to serve, integrity, and a consciousness of social values and possess sufficient interpersonal skills to interact positively with people from all levels of society, all ethnic backgrounds, and all belief systems. 

•  Students with Disabilities

It is the experience of the UND Physician Assistant Program that students with disabilities (as defined by Section 504 of the Rehabilitation Act and the Americans with Disabilities Act) are qualified to study and practice as a PA with the use of reasonable accommodations.  To be qualified for admission to the UND PA Program, individuals must be able to meet the Program’s Academic Standards and Standards of Capacity, with or without reasonable accommodation.  Accommodation is viewed as a means of assisting students with disabilities to meet essential standards by providing them with an equal opportunity to participate in all aspects of each course.  (Reasonable accommodation is not intended to guarantee that students will be successful in meeting course requirements.)

Students needing clarification are encouraged to contact the UND PA Program Director or Disability Support Services. Disability Support Services assessments are confidential and it is the students responsibility to submit written documentation to the PA Program Director in a timely manner.             

              Disability Support Service

              Room 190 McCannel Hall

2891 2nd Ave. N. - Stop 9040

              Grand Forks, ND 58202-9040

              701-777-3425 Voice/TDD

              Fax 701-777-4170

dss@und.nodak.edu

C. The Use of Auxiliary Aids and Intermediaries

Students with documented disabilities are provided with accommodations at the Program, which may include involvement of an intermediary or auxiliary aid.  No disability can be reasonably accommodated with an aid or intermediary that provides cognitive support, substitutes for essential clinical skills, or supplements clinical and ethical judgment.  Thus, accommodations cannot eliminate essential program elements or fundamentally alter the PA Program curriculum.