Download Behavioral Medicine Syllabus

Department of Physician Assistant Studies
Learning. Caring. Serving. Leading.
PAS 642 Behavioral Medicine
1.5 Semester Hours
Course Director:
Diane Duffy, MD
Tracey Tonsor, PA-C
Office
FC 205
FC 207
Phone
336-278-6848
336-278-6852
E-mail
[email protected]
[email protected]
Course Description: The Behavioral Medicine rotation is designed to give students practical experience
in the diagnosis and management of psychiatric patients in the clinical setting. Students will work to
hone their ability to recognize psychiatric diagnoses in both the outpatient and inpatient settings with
the goal of applying their knowledge and skills to the many other disciplines of medicine and clinical
practice.
Course Goals:
1. To apply the medical content and principles of behavioral medicine to the care of patients.
2. To provide opportunities for each student to develop the core PA competencies in a supervised
behavioral health setting.
3. To expose each student to an experienced and competent medical provider role model for the
care of psychiatric patients.
Learning Outcomes:
Upon completion of this course the clinical phase PA students will:
1. Obtain and document an appropriate history relevant to the behavioral health, utilizing all
available information sources, e.g. patient, family, community. (MK, IC, PC; B1.02, B1.03, B2.04,
B2.05, B2.06)
2. Perform and document appropriate physical examinations for the behavioral medicine patients.
(MK, PC; B1.03, B2.07, B2.08)
3. List and describe the common diagnoses in behavioral medicine. Demonstrate understanding of
epidemiology, pathophysiology, and management including cognitive therapies/counseling
strategies in addition to pharmacotherapeutics. (MK, IC; B1.03, B1.07, B2.04, B2.05, B2.07,
B2.08, B2.09, B2.10)
4. Interpret diagnostic tests, including screening questionnaires, laboratory results and imaging
studies. (MK; B1.02, B1.03, B1.07, B2.05, B2.07, B2.08)
5. Generate and implement an appropriate management plan, including treatment, follow-up
plans, patient education and counseling. (MK, IC, PC; B1.07, B2.04, B2.05, B2.09)
6. Discuss the appropriate use of medication related to such issues as: dosage, indications,
contraindications, interactions, complications, metabolism, excretion, and mutagenicity. (MK,
PC; B1.03, B1.07)
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7. Properly perform/assist and document any procedures under the supervision of the preceptor.
(IC, PC; B1.02, B1.03, B2.04, B2.05, B2.07)
Teaching Methodologies: The content of this module will be presented through a variety of methods
that include observation and participation at the clinical site, independent reading and participation in
online activities developed to guide experiential learning.
Accommodations: Students requiring academic accommodations must follow the “Academic Support”
policy in the Elon University DPAS Student Handbook.
Academic Honesty: All Elon PA students acknowledged their commitment to abide by the Elon Honor
Code by signing the Honor Pledge during orientation.
Required Textbooks:
1. All first year required textbooks
2. Specific additional textbooks and resources to be determined through collaboration between
the student and course directors based on elective discipline.
3. Ebert, Michael, Loosen, Peter, Nurcombe, Barry, Leckman, James. Current Diagnosis &
Treatment Psychiatry (current edition). McGraw-Hill/Lange
Other Resources:
1. *Moodle: Please check the course site frequently for new announcements, updated schedules,
assignments and other course communication.
2. Practicing physician assistants, physicians, allied health care providers and laboratory teaching
aids.
Assessment Activities:
Multiple Choice Behavioral Medicine Exam (30%), Preceptor Evaluation (60%), Professionalism (10%).
Grade Scale and Grade Points:
Percentage
89.50-100
85.50-89.49
79.50-85.49
75.50-79.49
69.50-75.49
Below 69.50
There is no rounding of grades.
Letter Grade
A
B+
B
C+
C
U
Grade points
4.0
3.3
3.0
2.3
2.0
0
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Note: For further information regarding academic standing in the Department of Physician Assistant
Studies, please see the Student Handbook.
Grading Criteria:
1. Demonstrate acquisition of a strong medical science knowledge base as demonstrated on the End of
Rotation exam.
2. Demonstrate satisfactory self-directed learning skills, clinical reasoning skills, interpersonal
communication, a commitment to patient-centered care, professionalism and practice-based
learning as evidenced by satisfactory performance on the preceptor evaluation.
3. Demonstrate a commitment to learning and professionalism by actively participating in all clinical
activities and exceeding the professional behavior standards and minimum requirements for clinical
rotations available in the Elon PA Student Handbook.
Instructional Objectives:
Behavioral Medicine Objectives:
1. History
a. Elicit a history and medical review of symptoms that may present as psychiatric disease
b. Develop a risk factors profile
c. Develop skills that will enable recognition of normal and deviation from normal
d. Evaluate suicidal risk
2. Perform and interpret the results of a complete mental status examination including:
a. Appearance and behavior
b. Thought process and perceptions
i. Coherency and relevance
ii. Thought content
iii. Perception
c. Cognitive factors
i. Orientation
1. Attention and concentration
2. Memory
3. Information and vocabulary
4. Abstract reasoning
5. Judgment
6. Perception and coordination
3. Perform problem-focused physical examination, recognizing and interpreting pertinent physical
examination findings.
4. Determine a differential diagnosis based upon historical information, physical examination
findings, and laboratory and diagnostic study findings.
5. Interview an adolescent patient, using the HEADSS method, to ask sensitive questions about
lifestyle choices that affect health and safety (e.g. sexuality, drug, tobacco and alcohol use) and
give appropriate counseling.
6. Describe and discuss the assessment and management of psychiatric emergencies (e.g. suicide,
acute psychosis, drug overdose, violent behavior).
7. Discuss conflicting ethical principles related to the care of the psychiatric/geriatric patient.
8. Discuss the legal process and implications of committing a patient to a psychiatric hospital/longterm care facility.
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9. Describe and discuss public health issues related to psychiatry/geriatrics, such as:
a. Epidemiology of mental health problems
b. Mental health problems of the homeless
c. Access to care
d. Rural vs. urban location
e. Cultural influences
f. Socioeconomic environment
g. Risk-taking behaviors (e.g. substance abuse)
h. Spouse/child/elder abuse
i. Epidemiology of adolescent suicide
j. Geriatric considerations and aging of the population
10. Discuss the appropriate use of medications in the psychiatric/geriatric patient related to such
issues as dosage, indications, contraindications, interactions, complications, metabolism and
excretion.
11. Select a clinical intervention plan that is consistent with the working diagnosis. Identify
appropriate monitoring for patients after interventions, including checking for compliance,
adverse events, and effectiveness. Select a plan that considers the cost, efficacy, possible
adverse reactions, contraindications, and drug interactions for medications selected.
12. Recognize appropriate counseling and patient and family education related to clinical
interventions.
13. Identify proper referral strategies for patients to other services for clinical intervention as
appropriate.
14. Select non-pharmacologic modalities, such as counseling, to integrate into patient management
plans.
15. Describe the following common psychiatric/geriatric problems, including pathophysiology,
diagnosis, treatment and follow-up:
TOPIC LIST
Mood Disorders
Major depressive disorder
Bipolar disorder
Cyclothymia/dysthymia
Adjustment disorder
Anxiety Disorders
Generalized anxiety disorder
Panic disorder
Post-traumatic stress
Disorder
Phobic disorders
Personality Disorders
Antisocial
Avoidant
Borderline
Dependent
Histrionic/Narcissistic
Obsessive compulsive
Paranoid
Schizoid
Schizophrenia and
Psychotic Disorders
Schizophrenia
Delusional disorder
Schizoaffective disorder
Schizophreniform disorder
Schizotypal
Paraphilias and Sexual Dysfunction
Hypoactive sexual desire disorder
Sexual aversion disorder
Exhibitionism
Fetishism
Pedophilia
Sexual masochism
Voyeurism
Eating Disorders
Anorexia nervosa
Bulimia nervosa
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Substance Abuse Related
Disorders
Alcohol Abuse/dependence
Drug abuse/dependence
Tobacco Abuse/Dependence
Attention Deficit Disorder and
Disruptive Behavior
Disorders
Attention deficit hyperactivity
Disorder
Conduct disorder
Oppositional defiant disorder
Somatoform/Fictitious
Disorders
Somatization disorder
Hypochondriasis
Body dysmorphic disorder
Factitious disorder
Malingering
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Behavioral Medicine
Successful completion of the Behavioral Medicine rotation will be evidenced by:
1. Completion of the 3 week Behavioral Medicine rotation.
2. Documentation in the Typhon database of a minimum of 25 patient encounters over the course of
the rotation.
3. Evaluation and treatment or self-study of the diagnoses listed in the Topic List of the Behavioral
Medicine syllabus.
4. Completion of appropriate deliverable for Clinical Year Seminar (may include admit history and
physical, discharge summary or SOAP note).
5. Have achieved a passing grade (69.5% or greater) for the course from the following assessments:
a. End of Rotation exam
b. Preceptor Evaluation
c. Professional Assessment Tool
6. Contacting Clinical Education Team at any point in rotation to discuss concerns regarding the ability
to achieve the above.
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