Physician Assistant Professional Organizations and Roles
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Questions and Answers

Which organization is responsible for certifying physician assistants?

  • ARC-PA
  • AAPA
  • PAEA
  • NCCPA (correct)

    • What defines the level of supervision required for a physician assistant in Kentucky?

  • Dependent on the patient's condition
  • No supervision is required
  • Always requires the physician to be present
  • Regulated by individual state licensing boards (correct)

    • What is typically seen as a counterproductive aspect of physician assistants' supervision?

  • PAs cannot prescribe medications
  • Supervision requires constant physician presence
  • PAs take over all physician tasks
  • Physicians must cosign charts (correct)

    • What is the role of PAEA in relation to physician assistant education?

    <p>Supports PA education</p> Signup and view all the answers

    In the Hierarchy of Natural systems, what does the 'bio' level encompass?

    <p>Nervous system and tissue</p> Signup and view all the answers

    What is one misconception about the supervision of physician assistants?

    <p>Physicians must always be available</p> Signup and view all the answers

    What are the primary components of the patient's hierarchy of systems?

    <p>Social, psycho, and bio</p> Signup and view all the answers

    Which of the following does not describe full prescriptive authority for PAs?

    <p>Requires physician oversight in all cases</p> Signup and view all the answers

    What should be assumed about a patient's sexual practices if they identify as gay?

    <p>They may have multiple partners.</p> Signup and view all the answers

    Which of the following should be asked to determine the risk of STDs in a patient?

    <p>How many partners have you had in the last 6 months?</p> Signup and view all the answers

    What is an example of a focusing skill during a patient interview?

    <p>Echoing the patient's words</p> Signup and view all the answers

    Why is it important to ask about the types of sexual activity a patient engages in?

    <p>To assess potential risks for scrotum dermatitis.</p> Signup and view all the answers

    What aspect should a healthcare professional consider when discussing hazardous sexual activity?

    <p>The use of drugs or alcohol during sexual encounters.</p> Signup and view all the answers

    What is the primary basic need of individuals with Obsessive-Compulsive Personality?

    <p>Control</p> Signup and view all the answers

    Which behavior is characteristic of the Histrionic Personality type?

    <p>Impulsive and overly dramatic</p> Signup and view all the answers

    How should a provider respond to a patient exhibiting Narcissistic Personality traits?

    <p>Acknowledge their unique accomplishments</p> Signup and view all the answers

    What is a common dysfunctional behavior of individuals with Obsessive-Compulsive Personality?

    <p>Excessive hand washing</p> Signup and view all the answers

    What is a recommended strategy when dealing with a patient who has Histrionic Personality?

    <p>Provide small, non-suggestive compliments</p> Signup and view all the answers

    What is a defining characteristic of Paranoid Personality?

    <p>Suspicions and hypervigilance</p> Signup and view all the answers

    Which behavior should be avoided when responding to someone with Obsessive-Compulsive Personality?

    <p>Becoming overly involved</p> Signup and view all the answers

    Which trait is commonly associated with Narcissistic Personality in terms of interaction with medical professionals?

    <p>Minimizing provider knowledge</p> Signup and view all the answers

    How should professionals balance the need for control when working with clients with Obsessive-Compulsive Personality?

    <p>Set strict limits on detailed information</p> Signup and view all the answers

    What is often a consequence of the impulsivity seen in Histrionic Personality?

    <p>Strained relationships</p> Signup and view all the answers

    What is the primary focus of the assessment phase in a behavior change plan?

    <p>Evaluating the patient's confidence and barriers</p> Signup and view all the answers

    Which stage of change best aligns with a patient who is actively engaging in changing their behavior?

    <p>Action</p> Signup and view all the answers

    When developing a plan with a patient, what is a crucial step to ensure both parties understand the treatment strategy?

    <p>Obtaining explicit agreement on the treatment plan</p> Signup and view all the answers

    What should be assessed to understand a patient's readiness to change their behavior?

    <p>Their perception of the behavior</p> Signup and view all the answers

    What is the purpose of scheduling regular follow-ups with the patient?

    <p>To review progress and address concerns</p> Signup and view all the answers

    What is an important factor when attempting to assist a patient in identifying barriers to change?

    <p>Allowing the patient to identify barriers themselves</p> Signup and view all the answers

    In the SPIKES model, what does the 'E' represent?

    <p>Empathy</p> Signup and view all the answers

    What key aspect should be addressed when giving knowledge to the patient in the SPIKES model?

    <p>Delivering information in a clear and understandable manner</p> Signup and view all the answers

    What is important about the physical setup when collecting a sexual history from a patient?

    <p>Maintaining a private and neutral environment</p> Signup and view all the answers

    What is an appropriate next step after advising a patient about behavior change?

    <p>Set collaborative goals with the patient</p> Signup and view all the answers

    Which emotional symptoms are commonly associated with stress?

    <p>Fearful</p> Signup and view all the answers

    What is the primary focus of the Biomedical model?

    <p>Defeating the disease</p> Signup and view all the answers

    What calculation is used to determine pack years for smokers?

    <p>Cigarettes divided by 20, then multiplied by years</p> Signup and view all the answers

    Which history component focuses on what the patient currently suffers from?

    <p>Chief Complaint (CC)</p> Signup and view all the answers

    During which part of the interview process does the clinician center the conversation?

    <p>End</p> Signup and view all the answers

    What is a major barrier to communication in patient-centered interviewing?

    <p>Cultural competency</p> Signup and view all the answers

    What is the goal of open-ended interviewing?

    <p>To encourage patients to express their thoughts freely</p> Signup and view all the answers

    How many problems do most patients wish to discuss in a visit?

    <p>3 to 4</p> Signup and view all the answers

    What cognitive symptoms may indicate an individual is experiencing stress?

    <p>Memory loss</p> Signup and view all the answers

    Which part of the interview is crucial for transitioning to the middle of the session?

    <p>All the above</p> Signup and view all the answers

    Study Notes

    Professional Organizations

    • The American Academy of Physician Assistants (AAPA) is a professional society for PAs
    • The National Commission on Certification of Physician Assistants (NCCPA) is the certifying agent for PAs
    • The Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) accredits PA programs
    • The Physician Assistant Education Association (PAEA) supports PA education

    Supervision of PAs

    • PAs are legally and professionally bound to their supervising physicians, although the physician does not have to be present at all times
    • States typically specify the level and extent of supervision needed in practice
    • Supervision is typically a positive aspect of healthcare, as it increases productivity

    Patient Hierarchy of Systems

    • The Hierarchy of Natural systems breaks down a patient’s experience into three categories:
      • Social: Culture and Community
      • Psycho: Behavior and Personal experience
      • Bio: Nervous System, tissues, cells and organelles

    Full Prescriptive Authority

    • The ability to prescribe medication without the oversight or signature of a physician

    Responses to Injury, Illness and Stress

    • Cognitive: Low Concentration, Confusion, Disorientation, Inattention, Indecision, Memory Loss, Unwanted Memory
    • Emotional: Overwhelmed, Depressed, Numb, Volatile, Fearful, Anxious, Uncertain
    • Physical: Nausea, Dizziness, GI Problems, Tachycardia, Tremors, Headache, Fatigue, Insomnia, Pain, Teeth Grinding
    • Behavioral: Irritability, Withdrawal, Argumentative, Inappropriate humor, Appetite change, Sexual desire/function, Substance use, Suspicious

    The Biomedical vs Biopsychosocial Model

    • Biomedical: Focuses on defeating the disease itself, treats illness as a problem to be solved through a simple equation, ignores other reasons someone may have for visiting a provider (e.g. anxiety about the disease)
    • Biopsychosocial: Explains how patients with the same disease can have very different experiences and require individualized treatment plans, emphasizes the importance of the provider-patient relationship in treating the whole person, differentiates between the biological disease and the experience of illness

    Patient-Centered Interviewing Techniques

    • Middle Interview Transition: Summarize the interview thus far, check for accuracy of understanding, inform the patient that the interview style will change to focus on the patient and ensure they are ready
    • Common Interview Challenges: Special-needs patients, Personality challenges, Cultural competency, Different types of patient visits

    Calculating Pack Years

    • Pack Years = ( cigarettes smoked per day / 20 ) x number of years smoking

    Parts of the Medical History

    • Chief Complaint (CC): The reason the patient is seeking medical attention
    • History of Present Illness (HPI): A detailed description of the patient's current symptoms, using LOCATES to guide the narrative
    • Past Medical History (PMH): Includes the patient's history of other diseases, injuries, or health conditions
    • Social History (SH): Includes information about the patient's lifestyle, including occupation, education, marital status, habits, and social support.
    • Family History (FH): Includes information about the patient's family's health history.
    • Surgical History (SxH): Includes information about the patient's past surgeries.
    • Medications (Med): Includes information about the medications the patient is currently taking
    • Review of Systems (ROS): A comprehensive review of all body systems to identify any additional symptoms the patient may have.
    • Allergies (Ax): Includes any allergies the patient has.

    Number of Issues Patients Discuss

    • Most patients want to discuss 3-4 issues on their clinic visit

    Clinician-Centered parts of the Visit

    • Middle and End sections tend to be clinician-centered, focusing on provider-directed activities like the physical examination and discussion of treatment plans

    Open-Ended Interviewing

    • Goal: To encourage the patient to provide detailed and comprehensive information by asking open-ended questions that can't be answered with a simple “yes” or “no”.

    How to respond to patients with personality challenges:

    • Obsessive-Compulsive Personality:
      • Basic Need: Control
      • Presentation: Spectrum, ranging from orderly and punctual to tidy and conservative, often overly concerned with right and wrong
      • Dysfunction: Obsessive thoughts and compulsive behaviors that interfere with daily life
      • Response: Give the patient as much control as possible, compliment their preparedness, provide detailed information where appropriate
    • Histrionic Personality:
      • Basic Need: Emotional connection with others
      • Presentation: Spectrum, often perceived as charming and attractive, can be romantic and appealing at inappropriate times.
      • Dysfunction: Impulsivity and overly dramatic behavior, use of sexual proclivity to connect with others.
      • Response: Calmly and firmly deny seductive behaviors, provide short and non-suggestive compliments, focus on the patient’s health rather than appearance
    • Narcissistic Personality:
      • Basic Need: Overcome low self-esteem
      • Presentation: Spectrum, overopinionated and self-confident
      • Dysfunction: Exaggerated self-confidence, belief in their own superior intellect, patronize healthcare providers.
      • Response: Acknowledge the patient’s accomplishments, demonstrate expertise by discussing journals or texts, develop patience, and avoid feeling threatened.
    • Paranoid Personality:
      • Basic Need: Fear of own faults, suspicious of others
      • Presentation: Spectrum, suspicious of newcomers, very aware of anything out of the ordinary
      • Dysfunction: Hypervigilance
      • Response: Remain calm and respectful, avoid arguing or challenging the patient's beliefs, focus on building trust

    5 A’s

    • Ask about a behavior
    • Assess readiness to change
    • Advise the patient on changing
    • Agree on the plan of action
    • Assist the patient with their plan
    • Stages of Change:
      • Precontemplation: I’m not ready
      • Contemplation: I’m thinking about it
      • Preparation: I’m ready to change
      • Action: I’m changing!
      • Maintenance: I’ve been changed for a while
      • Termination: I’m so changed it’s not change anymore

    SPIKES Model for Delivering Bad News

    • Set up the interview
    • Perception: Assess the patient's understanding
    • Invite the patient to share their thoughts and feelings
    • Knowledge: Share the information with the patient
    • Emotions: Address their emotions with empathy
    • Strategy: Set goals for the future

    Tips for Taking a Sexual History

    • Private space: Ensure privacy and make the patient feel comfortable
    • Fully clothed patient: Respect the patient's modesty
    • No barriers: Sit at the same level as the patient
    • Open and nonjudgmental: Let the patient know that you are approachable and nonjudgemental
    • Special Circumstances: Children require informed consent from parents or guardians, you may need to meet with them separately when discussing sexual health in a closed room.
    • Sexual Practices: Be clear, direct, and use lay terms when asking about specific sexual behaviors, address questions directly and avoid making assumptions about orientation, practices, or preferences
    • Sexual Timing: Inquire about the number of partners within a specific timeframe to provide a more accurate picture of the patient's risk factors
    • Sexual Behavior: Be clear and direct when discussing sexual practices
    • Hazardous Sexual Activity: Acknowledge the presence of risky behaviors without judgment

    LOCATES History:

    • Location: Where is the pain or symptom located?
    • Onset: When did the symptom first begin?
    • Characteristic: What does the symptom feel like (e.g. burning, stabbing, throbbing)?
    • Alleviate/Aggravate: What makes the symptom better, and what makes it worse?
    • Time: How long does the symptom last? How often does it occur?
    • Environment: Where was the patient when the symptom began?
    • Severity: How severe is the symptom on a scale of 1-10?

    Focusing and Non-Focusing Open-Ended Skills

    • Non-Focusing Skills
      • Silence, non-verbal communication (like nodding or leaning forward), neutral utterances ("okay," "I see")
    • Focusing Skills
      • Echoing: Repeating back what the patient said to encourage them to elaborate
      • Open-ended questions: Asking questions that cannot be answered with a simple yes or no.
      • Summarizing: Summarizing key points to ensure understanding and create a shared understanding of the patient's account

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    Description

    Explore the vital role and functions of professional organizations in the field of Physician Assistants (PAs). This quiz covers the supervision of PAs and the hierarchical structure of patient care systems, focused on social, psychological, and biological aspects. Test your knowledge on the key organizations and the dynamics of PA practice.

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