EVMS School of Health Professions Physician Assistant Program Preceptor Handbook

Transcription

1 EVMS School of Health Professions Physician Assistant Program Preceptor Handbook P age

2 TABLE OF CONTENTS Introduction... 3 Eastern Virginia Medical School... 3 Mission... 3 Vision... 3 Values... 3 Physician Assistant Program... 3 Curriculum... 4 Phase I: Didactic Curriculum... 4 Phase II: Clinical Curriculum... 5 Competencies... 6 Technical Standards... 7 Clinical Year Schedule and Important Dates... 8 Precepting a Physician Assistant Student... 9 Student Supervision Policy... 9 PA Student Documentation/Computer Access (if applicable) Student Service Liability Coverage INTEGRATING THE STUDENT INTO YOUR PRACTICE The One Minute Preceptor Important Phone Numbers and External Links P age

3 INTRODUCTION This booklet is intended to serve as a guide for preceptors for the Master of Physician Assistant Program at Eastern Virginia Medical School (EVMS). This booklet contains information about our program in addition to data that is specific to the preceptor role. The preceptor guides and teaches the student in perfecting skills in history taking, physical examination, effective oral communication, developing diagnoses, assessments and plans. EASTERN VIRGINIA MEDICAL SCHOOL MISSION Eastern Virginia Medical School is an academic health center dedicated to achieving excellence in medical and health professions education, research and patient care. We value creating and fostering a diverse and cohesive faculty, professional staff and student body as the surest way to achieve our mission. Adhering to the highest ethical standards, we will strive to improve the health of our community and to be recognized as a national center of intellectual and clinical strength in medicine. VISION Eastern Virginia Medical School will be recognized as the most community oriented school of medicine and health professions in the United States. VALUES Three core values drive our daily efforts: Excellence: We determine with our stakeholders what is valuable and hold ourselves to high performance standards that fulfill our promises. Collegiality: We serve our community and one another, building strong and mutually supportive relationships. We work as a cooperative, united team to further our purposes of education, research and patient care. Integrity: We strive to maintain the highest ethical standards and accept accountability for all we do and say. PHYSICIAN ASSISTANT PROGRAM Our PA Program is accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC PA). The PA Program is divided into two phases and spans 28 consecutive months (seven semesters). In Phase I, the 15 month pre clinical year incorporates traditional classroom interaction with clinical skills development through the Sentara Center for Simulation and Immersive Learning. In Phase II, the 12 month clinical year, students complete nine clinical field experiences which form the basis of the professional socialization processes for adaptation to the role and functions of a physician assistant. Clinical sites are located throughout the Commonwealth of Virginia and many of our students are also placed outside the Hampton Roads area for some of their supervised practice experiences during their clinical training. 3 P age

4 CURRICULUM PHASE I: DIDACTIC CURRICULUM SEMESTER ONE COURSE NUMBER COURSE NAME CREDITS MPA 5001 Pathophysiology for Health Professions 5 MPA 5061 Clinical Anatomy for Health Professions 5 MPA 5341 Legal and Ethical Issues in Medicine 2 MPA 5081 Introduction to the PA Profession and The Business of Medicine 2 MPA 5142 Psychosocial Elements of Wellness 2 SEMESTER TWO COURSE NUMBER COURSE NAME CREDITS MPA 5112 Clinical Pharmacology I 3 MPA 5132 Clinical Skills and Therapeutics I 4 MPA 5134 Patient Counseling and Education 2 MPA 5162 Introduction to Clinical Medicine I 5 MPA 5091 Clinical Assessment I 3 MPA 5800 Foundations of Interprofessional Practice 0.5 SEMESTER THREE COURSE NUMBER COURSE NAME CREDITS MPA 5213 Clinical Pharmacology II 3 MPA 5234 Clinical Skills and Therapeutics II 4 MPA 5253 Intro to Epidemiology and Evidence Based Medicine 2 MPA 5263 Introduction to Clinical Medicine II 5 MPA 5192 Clinical Assessment II 3 SEMESTER FOUR COURSE NUMBER COURSE NAME CREDITS MPA 5304 Problem Based Clinical Reasoning 4 MPA 5333 Fundamentals of Surgical Patient Care 3 MPA 5294 Clinical Assessment III 3 MPA 5364 Introduction to Clinical Medicine III 5 MPA 5284 Journal Review Seminar 2 MPA 5801 Interprofessional Practice Practicum Total Didactic Program Credits 68 4 P age

5 PHASE II: CLINICAL CURRICULUM SEMESTER FIVE COURSE NUMBER COURSE NAME CREDITS MPA 5465 Introduction to Clinical Practice (1 week) 1 MPA 5705 Supervised Practice in Family Medicine (5 weeks) 3 MPA 5715 Supervised Practice in Pediatric Medicine (5 weeks) 3 MPA 5725 Supervised Practice in General Internal Medicine (5 weeks) 3 SEMESTER SIX COURSE NUMBER COURSE NAME CREDITS MPA 5735 Supervised Practice in Emergency Medicine (5 weeks) 3 MPA 5745 Supervised Practice in General Surgery (5 weeks) 3 MPA 5755 Supervised Practice in Women s Health (5 weeks) 3 SEMESTER SEVEN COURSE NUMBER COURSE NAME CREDITS MPA 5785 Supervised Practice in Psychiatry and Behavioral Health (5 weeks) 3 MPA 5790 Supervised Practice in Elective I (5 weeks) 3 MPA 5795 Supervised Practice in Elective II (5 weeks) 3 MPA 5807 Service Learning Practicum (semesters 5, 6, and 7) 1 MPA 5837 PANCE Review Seminar (throughout the clinical year) 1 MPA 5900 Senior Seminar 5 MPA 5802 Interprofessional Practice (semester 5, 6, & 7) 1 Total Clinical Program Credits 31 TOTAL PROGRAM CREDITS 99 5 P age

6 COMPETENCIES The following are skills and /or principles in which students have been instructed as part of their didactic curriculum. Students will encounter most of the following, but some may develop competency in the following areas: History and Physical Examination Adult, Pediatric, Obstetric, Geriatric Laboratory Method Skills Arterial Blood Gas Collection Blood Cholesterol Determinations Blood Glucose Determinations Capillary Blood Collection Complete Blood Counts Blood smear preps Differential count Hemoglobin Microhematocrit Red and White Blood Cell Count Erythrocyte Sedimentation Rates Fecal Analysis Assessing Occult Blood in Feces Collection of Feces Specimen Phlebotomy Serologic Procedures Blood typing Mono test Pregnancy testing Rheumatoid arthritis test Slide preparation for KOH, Saline & Gram Stain Universal Precautions Urinalysis Chemical Macro/Microscopic Analysis Collection Urine Specimen Sterile Technique Gowning Gloving Hand washing Scrubbing Wound Management Wound Cultures/Dressings Evaluation and Management of Burns Packing Medications Drug Administration Oral, Intradermal, Intravenous Drug Dose Calculations Interpreting Drug Sensitivity Data Writing Prescriptions Radiology Introductory Principles Interpretation of Films Normal vs. Abnormal Chest Films Abdominal Films Musculoskeletal Films Tubes, Lines, and Drains Central Venous Catheterization Chest Tube Insertion/Removal Male and Female Urinary Catheterization Nasogastric Intubation Removal of Tubes and Lines Chest tubes CVP lines Penrose/Jackson Pratt Drains Suturing and Knot Tying Instrument Tie One and Two Handed Tie Simple Continuous/Interrupted Vertical/Horizontal Mattress Vertical/Horizontal Mattress Subcutaneous/Subcuticular Other Procedures Ear Irrigation Electrocardiograms Performance of EKG Interpretation of EKG Nasal Packing Ocular Foreign Body Removal Splinting and Casting Sedation 6 P age

7 TECHNICAL STANDARDS The Accreditation Review Commission on Education for the Physician Assistant (ARC PA) requires all Physician Assistant (PA) programs to publish technical standards for admission, defined as physical, cognitive and behavioral abilities required for satisfactory completion of all aspects of the curriculum and for entry into the profession. The technical standards for admission establish the expectations and abilities considered essential for students admitted to the EVMS PA Program in order to achieve the level of competency required for graduation and the practice of medicine. Applicants to the program must possess independent ability, aptitude, and skills in the following areas observation, communication, critical reasoning, motor & sensory functions, and behavioral & social attributes as outlined below. It is expected in this technology age that students also have sufficient computer skills and are comfortable with electronic communication and media to successfully and professionally function as a student physician assistant. OBSERVATION SKILLS Demonstrate sufficient attention and accuracy in observation skills (visual, auditory, and tactile) in the lecture hall, laboratory, patient s bedside, and outpatient settings. COMMUNICATION SKILLS Demonstrate effective verbal & non verbal communication skills with other students, faculty, patients, and healthcare providers from different social & cultural backgrounds, varying degrees and types of infirmities, and varying cultures, and personalities. CRITICAL REASONING SKILLS Demonstrate critical reasoning skills required to undertake the full curriculum, achieve the level of competency required by the faculty, and meet the demands of total patient care. These skills include, but are not limited to, intellectual, conceptual, integrative, and quantitative abilities. MOTOR AND SENSORY FUNCTION Demonstrate sufficient motor and sensory function to perform typical functions of physician assistants, including, but not limited to, physical examinations, treatment interventions, and general care of patients. BEHAVIORAL AND SOCIAL ATTRIBUTES Demonstrate the behavioral and social attributes vital to participation in a professional program and service as a practicing professional physician assistant. Physician Assistant applicant must be prepared to independently meet the technical standards, with or without reasonable accommodation, in order to complete the program and indicate such ability prior to their matriculation into the program. These technical standards also serve as pre requisites for continuation, promotion, and graduation from the PA Program. 7 P age

8 CLINICAL YEAR SCHEDULE AND IMPORTANT DATES Schedule for Clinical Year MPA 5465 Introduction to Clinical Practice 1 wk April 30-May 4, 2018 Semester 5 - Summer 5XXX SCP1 5 wks May 7, 2018-June 7, XXX SCP2 5 wks June 11, 2018-July 13, 2018 Return-to-Campus #1 1 wk July 16, 2018-July 20, XXX SCP3 5 wks July 23, 2018-August 23, 2018 Semester Break 1 wk August 27, 2018-September 3, 2018 Semester 6 - Fall 5XXX SCP4 5 wks September 4, 2018-October 5, 2018 Return-to-Campus #2 1 wk October 8, 2018-October 12, XXX SCP5 5 wks October 15, 2018-November 15, XXX SCP6 5 wks November 19, 2018-December 20, 2018 Thanksgiving Holiday 11/22-23 Semester Break 1 wk December 24, 2018-January 4, 2019 Semester 7 - Spring Return-to-Campus #3 (MPA 5807) 1 wk January 7-11, XXX SCP7 5 wks January 14, 2019-February 14, XXX SCP 8 5 wks February 18, 2019-March 22, 2019 Return-to-Campus #4 1 wk March 25-29, XXX SCP9 5 wks April 1, 2019-May 2, 2019 Final Exam Week 1 wk May 6-May 10, 2019 GRADUATION Saturday, May 18, P age

9 PRECEPTING A PHYSICIAN ASSISTANT STUDENT STUDENT SUPERVISION POLICY PURPOSE The Eastern Virginia Medical School PA program recognizes that student supervision and supervised clinical practice (SCP) rotations require time and careful consideration. The goal of this policy is to provide guidelines for student supervision to promote an excellent learning experience for the student and overall good experience for the precepting provider(s). The purpose is to also provide specific guidelines for the supervision of physician assistant students and to clarify the roles and responsibilities of the designated provider(s) engaged in the education program. This policy also provides guidelines to ensure the safety and proper care of patients in the educational environment. SCOPE This policy applies to all licensed medical providers who are involved in the education, observation, assessment and supervision of physician assistant students. DEFINITIONS Designated Preceptor (DP): The immediate supervisor(s) of the PA student can be an MD, DO, PA, or nurse practitioner. The provider must be licensed in the appropriate state and meet a minimum requirement of two years of experience. Physician Assistant (PA) Student: A student in good standing in the EVMS PA Program, having completed the didactic curriculum and meeting the technical standards for advancement to SCPs. Clinical Director (CD): A designated individual in the EVMS PA Program with a supervisory role regarding the student policies, student placements, student performance and the acting liaison for the DP regarding clinical experiences. Clinical Educator (CE): A designated individual in the EVMS PA Program with the role of scheduling students, communicating with DP, and reviewing student performance regarding clinical experiences. PRINCIPLES This policy is based on the following principles: The central focus of the SCP experience is to learn the appropriate care of the patient in an acceptable educational environment for the student. The autonomy, personal dignity and responsibility of the patient, student, and DP(s) must be recognized and respected. This will improve the patient care and the student s overall educational experience. 9 P age

10 Joint decision making and exchange of information should occur daily between the DP(s) and the PA student. Provide an opportunity to obtain hands on experience and be involved in the delivery of diverse medical care must be provided, to allow PA students to prepare for future practice. Appropriate supervision must be maintained and based upon student performance and ability (See below: Supervision of the PA student). The PA student s ability to ask questions, obtain information, examine, diagnose, manage and treat patients during this experience will increase preparedness for future clinical practice. Ability to demonstrate cultural competency through interaction with patients. POLICY Role of the Designated Preceptor The role of DP will be given to an individual licensed as an MD, DO, PA, or NP with at least 2 years of clinical experience and a current state medical license. The provider must also be credentialed in the facilities where they are providing specialty care or performing diagnostic and therapeutic procedures. Multiple preceptors may be designated for one student s experience, but each must meet these criteria. Identification of the Physician Assistant (PA) Student The PA student will wear an identification badge with a visible student designation at all times. The PA student will also introduce himself/herself as a student to all patients, hospital staff and others. Respecting Patient Rights and Consent to Treatment The DP and PA student are obligated to inform the patient of the educational nature of the patient care, the student status of the PA student trainee, and the option to refuse student involvement. The patient must give informed consent for student involvement. When a patient is incapable of giving informed consent, consent should be obtained from the appropriate substitute decision maker. For emergent situations, the facilities protocols for consent will apply. Supervision of the PA Student Although the supervising preceptor may not be with the student during every shift, it is important to clearly assign students to another MD, DO, PA or NP who will serve as the student s preceptor for any given time interval. In the case where supervision is not available, students may be instructed to complete an assignment or may spend time with ancillary staff (radiology, laboratory services, physical therapy, etc.). The preceptor should be aware of the student s assigned activities at all times. Appropriate supervision of the PA student is expected at all times during the clinical experience. The DP can provide direct supervision of technical skills with gradually increased autonomy in accordance with the PA student s demonstrated level of expertise. However, every patient must be seen and every procedure must be evaluated prior to patient discharge. No PA student will be allowed to see, treat or discharge a patient without evaluation by the DP. 10 P age

11 PA STUDENT DOCUMENTATION/COMPUTER ACCESS (IF APPLICABLE) In facilities with electronic medical records, computer access is to be provided for the PA student to review appropriate patient information, including but not limited to history, physical exam, lab reports, ancillary testing and consultations. If allowed by the DP, practice and/or facility, PA students may enter information in the medical record. All medical entries must be identified as student and must include the PA student s signature with the designation PA S. PA student entries are for educational and student evaluation purposes only and cannot be used in lieu of any required DP documentation. All entries must be countersigned by the DP, which indicates that the DP verifies the content as being accurate and appropriate, and a separate entry provided by the DP. Preceptors are required to document the services they provide as well as review and edit all student documentation. Although student documentation may be limited for reimbursement purposes, students notes are legal and are contributory to the medical record. Moreover, writing a succinct note that communicates effectively is a critical skill that the PA student should develop. The introduction of EMRs presents obstacles for students if they lack a password or are not fully trained in the use of one particular institution s EMR system. In these cases, students are encouraged to hand write note for review by the preceptor whenever possible for feedback. You are strongly encouraged to follow these guidelines for all patient encounters. Department of Health and Human Services Centers for Medicare and Medicaid Services Evaluation and Management Documentation Provide by Students Any contribution and participation of a student to the performance of a billable service must be performed in the physical presence of a teaching physician or resident in a service that meets teaching physician billing requirements. Students may document services in the medical record. However, the teaching physician must verify in the medical record all student documentation or findings, including history, physical exam and/or medical decision making. The teaching physician must personally perform (or re perform) the physical exam and medical decision making activities of the E/M service being billed, but may verify any student documentation of them in the medical record, rather than re documenting this work. For more information visit: and Guidance/Guidance/Transmittals/2018Downloads/R3971CP.pdf Students may transmit prescribing information for the preceptor, but the preceptor must sign all prescriptions. More specifically, the student s name should not appear on the prescription. For sites that use electronic prescriptions, the preceptor MUST log into the system under his/her own password and personally sign and send the electronic prescription. These guidelines must not be violated by the student or the preceptor. 11 P age

12 Responsibilities of the Designated Preceptor Orientation to the site The DP is responsible for reviewing and following all policies relating to PA student supervision. This includes conversation with the PA student to clarify any policies in question prior to allowing the PA student to participate. The preceptor should communicate his/her expectations of the student during the rotation, to include: hours/schedule, interaction with staff, participation in rounds and conferences, oral presentations, written documentation, assignments, site specific documentation guidelines, and any additional topics the preceptor feels necessary. Expectations Supervise, demonstrate, teach and observe clinical activities in order to aid in the development of clinical skills and ensure proper patient care. Increase levels of responsibility, in clinical assessment and management as appropriate to the student s experience. Audit and co sign charts to evaluate the student s progress notes, history and physical examinations, assessments and treatment plans for accuracy and completeness. Meet regularly with the PA student to discuss his or her assessment, management and documentation of patient care. Provide direct supervision of technical skills with gradually decreased supervision as PA student exhibits level of expertise. However, every patient must be seen and every procedure evaluated prior to patient discharge. Ensure that all policies are distributed to and followed by any other DPs involved in the PA s training. Spend a few minutes each week in a candid summary discussion with the student as to whether each is meeting the other s needs and expectations, and what changes need to made in the roles and relationships. Provide timely feedback to the student and the program regarding student performance. Final Evaluation The DP is responsible for thoroughly and thoughtfully completing an evaluation at the completion of the rotation. These are completed in E*Value (our web based evaluation program) and should be completed in a timely fashion. Any performance or professionalism concerns prior to the evaluation completion should be directly discussed with the CD or CE. The provider should participate in the evaluation of clinical skills and medical knowledge base through the following mechanisms: Direct supervision, observation, and teaching in the clinical setting Evaluation of oral and written presentations Assigned readings and research to promote further learning Preceptors should inform students about their strengths as well as provide opportunities to improve upon weaknesses. The evaluation should also reflect the student s knowledge and skills as well as improvement throughout the rotation. It should also assess progress in comparison to other students at the same level. Ensure that the PA student has the appropriate knowledge, skills and judgment to perform the delegated act such that patients are not put in jeopardy. Feedback to program The DP is asked to provide all requested feedback to the PA Program in a timely fashion. Feedback is encouraged at all times and should be directed to the CD or CE. Expected progression of PA student PA students are trained to take detailed histories, perform physical examinations, give oral presentations of 12 P age

13 findings, and develop differential diagnoses. As the year continues, they should be able to more effectively develop an appropriate assessment and plan, though this will involve discussion with the preceptor. If the preceptor deems it necessary, students initially may observe patient encounters. By the end of the first week, students should actively participate in evaluating patients. As the preceptor feels more comfortable with the student s skills and abilities, the student should be allowed to: Progressively increase supervised autonomy Perform and interpret common lab results and diagnostics. Educate and counsel patients across the lifespan regarding health related issues. Attend clinical rotations as scheduled in addition to grand rounds, lectures, and conferences, if available to them. Demonstrate emotional resilience and stability, adaptability, and flexibility during the clinical year. Professional Relationships It is expected that DPs involved in the education of PA students will: Maintain an ethical approach to the care of patients, colleagues and all involved in the experience. Maintain a professional relationship with the PA student at all times. Avoid exploiting the power differential that is inherent in the relationship. Avoid situations involving potential conflicts of interest, and not intimidating or harassing the PA students emotionally, physically or sexually. Reporting Responsibilities PA students are required to conform to the highest standards of ethical and professional conduct. These include, but are not limited to: respect, flexibility, academic integrity, cultural competency, accountability, honesty, and trustworthiness. It is expected that any DP involved in the education of a PA student will report to the CD, CE or institution any behavior(s) suggestive of incompetence, incapacity, unprofessionalism, or ethically questionable regarding interactions with patient, supervisors and/or colleagues. STUDENT SERVICE Students enrolled in the PA program cannot substitute for practicing physician assistants or provide unsupervised services common to a certified physician assistant while at a learning or employment site. Students are not staff and therefore employee policies do not apply, nor may the student earn a salary for their services as a physician assistant student or work in the PA program in any other capacity. Students credentialed as other non PA professionals cannot substitute as staff in that capacity while in the role of the physician assistant student. Students are not employees of the hospital or clinics and, therefore, work entirely under the preceptor s supervision. Students are not to substitute for paid clinicians, clerical staff, or other workers at the clinical sites. LIABILITY COVERAGE All clinical phase student are covered by EVMS liability insurance. EVMS liability will not cover any student: Assuming a role outside the assigned clinical rotation 13 P age

14 Shadowing outside of their assigned clinical rotation for job interview or interest only purposes Participating in clinical activity outside of the DPs credentialed hospital INTEGRATING THE STUDENT INTO YOUR PRACTICE A placement letter with the student s picture will be sent to prior to the placement. Students are expected to be present for all activities as assigned by the preceptor. In general, students are advised to follow the preceptors schedule. If you attend noon conferences at a local hospital, the student can be asked to attend them as well. Other activities may be assigned to further the educational experience. Please discuss expectations and scheduling on the first day. Introduce the student to staff and inform them of each staff member s responsibilities. Preceptors are often concerned that a student will slow them down. While this may happen in the beginning, there are some things you can do to minimize or eliminate this. Ask the student to write down questions so they may ask them all at once rather than asking as they go along. Once you are comfortable with the student s history and physical examination and skills, utilize the student to perform tasks/skills they ve been introduced to. For example, patient education (i.e. use of an inhaler, wound care management, etc.). Rather than reviewing all aspects of each patient encounter with the student, choose smaller segments. For instance, the first patient with hypertension seen by the student, focus on the history. The second patient, focus on the physical exam and follow up. The third focus on treatment plan, and the fourth discuss diagnostic work up. Students can be assigned reading during down time or have them review lab work for the patients coming in the following day. Have the student conduct education sessions with patients you have seen. This can be done while you move on to the next patient. You can have the student explain a medication or instruct the patient on a diabetic diet etc. It is acceptable to ask the student to read on a topic and be prepared to discuss. It will add to the educational process if you can link this topic to one of your patients. You can ask the student to research a patient s diagnosis and most current treatment for the condition/disease for a particular upcoming appointment. Make sure the student is aware of your preferences regarding patient charting. If the student is unable to write in the chart/emr, have them write a separate SOAP note, to be reviewed later. Be very clear with the student exactly how much time you expect them to take with each patient. This time may start out length, but expectations of improvement should be shared. Students may not initiate a patient encounter without permission from the preceptor or their designee. It is acceptable to ask the student to arrive at the hospital at 0600, perform a follow up visit on all patients, gather and evaluate labs and write notes prior to your arrival. Be prepared to present the patients when I arrive at Students in this case are functioning under your direction. HOWEVER, students may not initiate any 14 P age

15 treatment plan or diagnostic work up unless it has been approved by the preceptor or their designee and the preceptor has also evaluated the patient. Patients may not to leave the facility without being seen by the preceptor or their designee. THE ONE MINUTE PRECEPTOR The One Minute Preceptor is a five step technique which can be used in a variety of clinical settings. This technique encourages critical thinking and can assess where the student is in the clinical reasoning process. It also reminds preceptors to provide feedback. Following a student s patient presentation, follow this technique: STEP ONE: GET A COMMITMENT What do you think is the diagnosis? What is your treatment plan? What test(s) would you order? Avoid prompting the student or discussing the likely diagnosis or treatment plan at this point. STEP TWO: PROBE FOR SUPPORTING EVIDENCE What helped you rule out? Why would you order that lab test/use that medication? STEP THREE: REINFORCE WHAT WAS DONE RIGHT Include specific behaviors/knowledge that showed student understanding and preparedness. STEP FOUR: CORRECT MISTAKES Include in the discussion where the student may need improvement, along with guidance that is specific to any incorrect decisions or behaviors. Describe what was wrong and how to avoid errors in the future. STEP FIVE: TEACH GENERAL RULES Find a practical teaching point (or two) that can be applied to other clinical situations. 15 P age

16 IMPORTANT PHONE NUMBERS AND EXTERNAL LINKS PHONE NUMBERS Angela Conrad, MPA, PA C Associate Professor/Clinical Director ConradAM@evms.edu Shannon Morris, MPA, PA C Assistant Professor/Clinical Educator MorrisSM@evms.edu Tiffany Smith Clinical Coordinator smithtl@evms.edu Elise DeWitt Clinical Coordinator dewittee@emvs.edu EXTERNAL LINKS The following links may be useful in learning more about the PA Profession: The American Academy of Physician Assistants The Virginia Academy of Physician Assistants The Physician Assistant Education Association Physician Assistant Education Association. Preceptor Orientation Handbook: Tips, Tools, and Guidance for Physician Assistant Preceptors. Accessed December 6, P age