COURSE DESCRIPTION:

All clinical courses require the student to integrate theory and laboratory training in the patient care setting. The focus of this clinical course is application of basic therapeutic techniques and procedures. Topics include medical records, charting, patient history and physical examinations, infection control, patient positioning, vital signs, breath sounds, chest assessment, oxygen therapy, humidity and aerosol therapy, cough techniques, incentive spirometry, and percussion and postural drainage. 

OBJECTIVES:

• Participate actively and effectively in the development of the respiratory care plan.
• Review existing data, collect additional data, and evaluate all data to determine and defend the appropriateness of the prescribed respiratory care plan.
• Select, assemble, assure cleanliness, check for proper function, and correct malfunctions of equipment used in providing respiratory care.
• Initiate, conduct, and modify prescribed therapeutic procedures.
• Maintain patient records and communicate relevant information to other members of the healthcare team in a professional manner.
• Develop professionalism and community service skills.

Assignments: 

Clinical Portfolio:

Each student will compile digital clinical portfolio documenting the learning activities for the semester through our clinical documentation system.

The clinical portfolio consists of: 

1. Timesheet (Completed Hours = 144 hours)
2. Daily log completion (12)
3. Completed competencies (as defined within the syllabus)
4. Daily performance evaluations (12)
5. Preceptor evaluations (12)
6. Clinical site evaluations (1)
7. Professional Credits (as defined within the syllabus)

General Requirements of the Clinical Portfolio:

1. Clocking-in -the student must be clocked in and out for each day in clinic – no exceptions! If a student misses clock in/out submission, the student is required to compete a time exception form within 24 hours of missed punch. Failure to have a complete timesheet could result in scheduled make-up hours of clinical time.
2. Daily logs-Daily logs are used to document the practice of clinical skills of the student. It is vital that these logs are completed every day the student attends clinic. It is the student’s responsibility to ensure that these logs are completed daily – before you leave the clinic. (If attendance is not documented, it will be assumed that the clinic day was not completed). Activities performed during the day may be listed on the log from the list of competencies contained in the clinical portfolio.
3. Daily performance- evaluations-the student will have a daily performance evaluation completed and signed by the clinical preceptor every day when the student is in clinic-no exceptions!  Any category noted as NI will be addressed by the clinical chair.
4. Preceptor evaluations – Students must complete a preceptor evaluation each day of clinical rotation evaluating their assigned preceptor for that day.
5. Site evaluations-You must complete a site evaluation for your assigned clinic site. Due at final check-off.
6. Professional credits – Students will be required to complete a minimum of 20 professional credits as part of their Clinical Practicum I rotation. Examples of professional credits include student involvement in the state and national professional organization as well as community to service. Please refer to the table below. Due at final check-off to Dropbox on D2L.
7. The Director of Clinical Education will review clinical documentation completed on Trajecsys throughout the clinical rotation to ensure adequate progress is made toward clinical practicum objectives. Formal feedback will be provided to each student at a minimum of every two weeks of rotation via Trajecsys.

CLINICAL PORTFOLIO FINAL CHECK-OFF NOVEMBER 22^nd, Midnight.  NO EXCEPTIONS!

Task Analysis:

Each student must complete and submit 3 task analysis papers. The task analysis may be done on any of the commonly ordered modalities assigned for completion during Clinical Practicum I. This assignment may be typed or hand written (scanned for submission), no formal format required. The completed assignment must be turned in via D2L Dropbox by Nov. 8th via D2L Dropbox.

Task Analysis Format:

Patient info: Age, patient diagnosis, area (DO NOT IDENTIFY PT BY NAME)

Therapy type (i.e., oxygen therapy (cannula), aerosol treatment (small volume nebulizer), Bronchial hygiene therapy (PEP, incentive spirometer, IPPB)

Indications:

Contraindications:

Hazards:

Outcomes:

Monitoring:

Performance steps:

competencies:

            GENERAL GUIDELINES ON Competencies:

1. Required competencies are listed in each course syllabus.
2. Prior to being checked-off the student must practice the skills several times.
3. A hospital staff member that has worked with you can fill out competencies. It is your responsibility to make sure the competencies are completed properly and filed under the competency tab in Trajecsys.
4. Student will be responsible for performing any procedure at any time once they have passed the competency for that procedure.
5. It is the student’s responsibility to demonstrate weekly progress in clinical check-offs to their Clinical Coordinator.
6. It is the student’s responsibility to contact the Clinical Coordinator if they are having problems with the competencies.
7. A student must complete the competencies specified in the course syllabus. Failure to complete the required competency may result in an unsuccessful grade in clinical and prevent completion of the program.
8. All competencies must be completed no later than November 22^nd.

Once a clinical skill has been mastered, it is the responsibility of the student to have their preceptor verify these skills by completing the documentation in Trajecsys.

            A competency must be completed for the following skills:

      1. Handwashing

      2. Isolation Procedures

      3. Vital Signs

      4. Oxygen Therapy (Use of at least one oxygen delivery device)

      5. Aerosol and Humidity Therapy (Use of at least one device)

      6. Aerosol Drug Administration (Metered Dose Inhalers, Dry Powder 

   Inhalers and Small Volume Nebulizer)

      7. Incentive Spirometry

      8. Intermittent Positive Pressure Breathing (or EZ-pap)*

      9. Chest Physiotherapy

     10. Mucous Clearance Adjuncts

     11. CPR (completed during Summer II, copy of card uploaded to Castlebranch)

            Competencies will be evaluated as follows:

CASE STUDY:

Following the format outlined here, each student will submit a word document case study. All attempts will be made to let you work on your case study during clinical time, however, it may be necessary for you to remain at the clinical site for some additional time to complete the case study. Case studies will be graded on their neatness, completeness and student’s ability to interpret and analyze data. A rubric is available on D2L for reference.

Case Study Format:

The following outline should be followed exactly for the case studies. Include all titles and subject headings. Case studies are to be turned in on or before midnight Sunday, November 29^th via the assignment drop box on D2L.

Patient Data

1. Name: initials only
2. Age
3. Sex

Admitting data (include date of admission)

1. admitting chief complaint
2. pertinent history-medical, family, social/occupational
3. current differential or working diagnosis

Present chest examination (a and b to be done by student, info may also be retrieved from the H&P)

1. observations of setting and general appearance
2. inspection, auscultation, percussion and palpitation
3. radiologic

Vitals signs (one set to be done by the student) Get at least three sets of vital signs (include dates);

Present, admitting, and one set of intermediate values. Comment specifically on any measures that are not normal.

1. heart rate/rhythm
2. ventilatory status
3. blood pressure
4. temperature

Any lines or tubes (Art. Line, chest tube, etc.)

Clinical laboratory data. Where possible get at least three sets of clinical laboratory data; present, admitting, and one set of intermediate values (dates should be provided for all clinical lab data). Comment specifically on any measures that are not normal.

1. red blood cells
2. hemoglobin/hematocrit
3. white blood cells
4. blood gases (including 02 content Fi02 and ventilatory data and interpretation of acid-base status and oxygenation for each blood gas)
5. platelets
6. clotting studies (clotting time, PT, PTT)
7. Serum electrolytes (relate abnormal to ABG’s)
8. Sputum culture and sensitivity
9. Blood urea nitrogen (BUN)
10. Creatinine
11. Glucose
12. Urinalysis

Pertinent medications (medications associated with admitting diagnosis as well as any pulmonary medications)-include for each; synopsis of PDR (or other drug book) sections for 1. Description, 2. Indications and usage (specific to this case), 3. Precautions, 4. Adverse reactions, 5. Dosage and administration.

1. respiratory
2. cardiovascular
3. antibiotic
4. other-analgesics, antacids, anticoagulants, antihistamines, decongestants, anti-inflammatory, antipyretics, diuretics, narcotics

Evaluation of major organ systems other than drugs

1. heart
2. neurological
3. liver
4. kidneys
5. GI

Major diagnostic procedures and results (listed by date)

Rationale for initial treatment

Major complications since admission (include dates)

Rationale for current treatment (applied to present illness)

Rationale for current respiratory care

Reasonable short term plan for the patient

At the end of the clinical rotation, the students will present their case study on Thursday, December 3^rd via Zoom. Your presentation should be no longer than 20 minutes and you should prepare based on the criteria below. These presentations will be evaluated and each participant will be awarded professional credits.

For your presentation, you will present the following information in narrative form (in your own words):

1. Patient data (Age, gender)

2. Admitting data, chief complaint

3. Pertinent History-medical, family, social/Occupational

4. Working Diagnosis (give description of disease)

5. Any pertinent issues with labs or x-rays

6. Any pertinent treatment and outcomes (medications, medical interventions such as CPR, ventilator, etc.)

7. Length of Stay, summary of outcomes and prognosis, plan of care

Presentations will be graded on content, professionalism, and ability to answer questions about your case study presentation.

PROFESSIONAL CREDITS:

In an effort to develop professionalism and promote community service within the respiratory profession, each student is required to complete professional credits each clinical practicum. Students are required to participate in suggested activities throughout the semester and are awarded professional credits assigned to each activity. Examples of activities along with point value are listed below.  Additional meaningful caveats may also be considered with the approval of the faculty. Failure to complete professional credits will result in an “Incomplete” grade for the clinical practicum and students will not be allowed to progress within the curriculum until completion. All professional credits must be submitted as a Word Document (example posted to D2L under resources).

Clinical Affective Evaluation:

Each student will be evaluated by the Clinical Chair (with input from clinical preceptors) on their performance during their clinical rotation. Feedback will be provided to each student as part of their final grade.

The evaluation includes:

1. professional appearance
2. attendance
3. arrive on time and prepared
4. dependability
5. can function as part of the healthcare team
6. friendly and helpful within the department
7. accepts supervision, seeks feedback
8. appropriate and courteous with patients 
9. conducts self in a professional/ethical manner
10. communicates effectively, use appropriate language
11. can prioritize and use effective time management
12. self-directed and manages work responsibly
13. self-confident, uses good judgment

participates in educational activities that enhance clinical performance

Grade Items and Grade Determination:

Approximate Grading Scale:

A:  90-100

B:  80-89

C:  75-79

D:  70-74

F:   69 and below

Attendance and Participation:

Attendance at clinical sites is an essential component of the student’s clinical education. The student must be in their assigned area of rotation and prepared for instruction at the scheduled time for that rotation. Each student is required to document their clinical hours utilizing our clinical documentation software, Trajecsys. Hours are reviewed and verified each week by the Clinical Chair and/or assigned faculty. Each student will complete, 12, 12 hours shifts for a total of 144 hours of clinical time with additional hours noted for orientation and case study presentations. Every student is required to make-up any missed clinical time.

Additional information and policies in reference to clinical attendance is published in the Respiratory Care Program Student Handbook.

Missed Clinic Day Policy:

If a student is unable to complete scheduled hours at their clinical site for their scheduled shift (i.e. illness, etc.), it is his/her responsibility to report the intended absence to the clinical site and the Director of Clinical Education prior to the time of the Practicum. When reporting an absence to the Director of Clinical Education, please call (940) 397-4546 and leave message or contact the Director of Clinical Education directly utilizing direct messaging through the Group Me app. When reporting the absence to a clinical site, have the hospital operator page the Respiratory Charge Therapist currently on shift. Leave a message with the charge therapist. Make-up days will be required for all unexcused clinical absences. Make-up time is made up in double-time.

Please note, calls to report an absence must be made at least one hour prior to scheduled time for the Practicum. An absence not reported by this procedure will be recorded on the Clinical Incident Form as outlines in the Respiratory Care Program Student Handbook. The Director of Clinical Education may take extenuating circumstances into account. An adverse decision, as a result of missed clinic time or failure to report missed hours timely, may be appealed to the Program Director.

Additional information and policies in reference to clinical attendance is published in the Respiratory Care Program Student Handbook.

Tardiness Policy:

 It is equally important that a student be punctual to the clinical site. In order for the student to obtain maximum benefit from the Clinical Practicum, they must be present for the report given at the change of shift. Late is defined as arriving at the clinical site fifteen minutes past the scheduled time for the Practicum. However, if a student arrives later than thirty minutes past the scheduled time for the Practicum, he/she may not be allowed to stay for that clinical day. If a student must be late for clinical it is their responsibility to contact the site prior to the scheduled time for Practicum.

After contacting appropriate person within the specified time, the student must be present within one hour of scheduled time for the Practicum. Depending on the area of rotation and the circumstances, an alternative assignment may be made. If a student is habitually late the instructor and/or the Clinical Director will counsel them.

If the student does not report tardiness to the appropriate person, an absence will be recorded. The Director of Clinical Education will take extenuating circumstances into account. Every two days a student is late, an unexcused absence will be recorded.

It is equally important that all students remain at their clinical site for the entire designated time. If the student must leave early for any reason, the student must call the Clinical Director. Students may be required to make up any missed hours.

Leaving the clinical site for any reason and not communicating with the preceptor and the Clinical Director is grounds for dismissal from the program.

It is also required that all students communicate with their assigned preceptor any time they leave their area for any reason (lunch, break, work on case studies, etc.)

Inclement Weather:

 In cases of bad weather (i.e. winter weather) or severe weather (i.e. severe thunderstorm warnings, tornadoes), the student must use their own judgment when deciding whether or not to attend clinical practicum. The student will inform the clinical instructor as soon as possible. Absences secondary to bad and/or severe weather may be excused at the discretion of the Clinical Director.  If public schools in your clinical area (i.e. school-district surrounding your hospital assignment) are canceled, your absence will be excused. No make-up time is required for excused absences secondary to inclement weather.

Note: You may not submit a paper for a grade in this class that already has been (or will be) submitted for a grade in another course, unless you obtain the explicit written permission of me and the other instructor involved in advance.

Plagiarism is the use of someone else's thoughts, words, ideas, or lines of argument in your own work without appropriate documentation (a parenthetical citation at the end and a listing in "Works Cited")-whether you use that material in a quote, paraphrase, or summary. It is a theft of intellectual property and will not be tolerated, whether intentional or not.

Student Honor Creed

As an MSU Student, I pledge not to lie, cheat, steal, or help anyone else do so."

As students at MSU, we recognize that any great society must be composed of empowered, responsible citizens. We also recognize universities play an important role in helping mold these responsible citizens. We believe students themselves play an important part in developing responsible citizenship by maintaining a community where integrity and honorable character are the norm, not the exception.

Thus, We, the Students of Midwestern State University, resolve to uphold the honor of the University by affirming our commitment to complete academic honesty. We resolve not only to be honest but also to hold our peers accountable for complete honesty in all university matters.

We consider it dishonest to ask for, give, or receive help in examinations or quizzes, to use any unauthorized material in examinations, or to present, as one's own, work or ideas which are not entirely one's own. We recognize that any instructor has the right to expect that all student work is honest, original work. We accept and acknowledge that responsibility for lying, cheating, stealing, plagiarism, and other forms of academic dishonesty fundamentally rests within each individual student.

We expect of ourselves academic integrity, personal professionalism, and ethical character. We appreciate steps taken by University officials to protect the honor of the University against any who would disgrace the MSU student body by violating the spirit of this creed.

Written and adopted by the 2002-2003 MSU Student Senate.

The Americans with Disabilities Act (ADA) is a federal anti-discrimination statute that provides comprehensive civil rights protection for persons with disabilities. Among other things, this legislation requires that all students with disabilities be guaranteed a learning environment that provides for reasonable accommodation of their disabilities. If you believe you have a disability requiring an accommodation, please contact the Disability Support Services in Room 168 of the Clark Student Center, (940) 397-4140.

The professor considers this classroom to be a place where you will be treated with respect as a human being - regardless of gender, race, ethnicity, national origin, religious affiliation, sexual orientation, political beliefs, age, or ability. Additionally, diversity of thought is appreciated and encouraged, provided you can agree to disagree. It is the professor's expectation that ALL students consider the classroom a safe environment.

All instructors in the Department have voicemail in their offices and MSUTexas e-mail addresses. Make sure you add your instructor's phone number and e-mail address to both email and cell phone lists of contacts.

All students seeking a Bachelor's degree from Midwestern State University must satisfy a writing proficiency requirement once they've 1) passed the 6 hours of Communication Core and 2) earned 60 hours. Students may meet this requirement in one of three ways: by passing the Writing Proficiency Exam, passing two Writing Intensive Courses (only one can be in the core), or passing English 2113. If you have any questions about the exam, visit the Writing Proficiency Office website at https://msutexas.edu/academics/wpr, or call 397-4131.

Senate Bill 11 passed by the 84th Texas Legislature allows licensed handgun holders to carry concealed handguns on campus, effective August 1, 2016. Areas excluded from concealed carry are appropriately marked, in accordance with state law. For more information regarding campus carry, please refer to the University’s webpage at https://msutexas.edu/campus-carry/rules-policies.

If you have questions or concerns, please contact MSU Chief of Police at police@msutexas.edu.