Academic Progression Policy

Standard A3.15a, A3.15b, A3.15c & A3.15d

Created:    7/1/2018

Reviewed: 5/13/2020

Effective:   5/13/2020

Purpose

Board of Regents (BOR) Handbook Title 2, Chapter 11 governs dismissals. Program Dismissal Procedures found in Title 2, Chapter 11 of the BOR Handbook.

Failure to adhere to program, UNR Med, and/or UNR expectations or policies may result in remediation, academic monitoring, academic probation and/or dismissal. Probation and dismissal are not to be construed as progressive steps. Probation and/or dismissal may occur if the student engages in "Prohibited Conduct" as set forth in Section 10.2.1 of the NSHE Code (or any successor section of the NSHE Code defining "prohibited conduct"). Probation and/or dismissal may also occur at any time a student is determined to have failed to meet cognitive, academic or behavioral standards outlined in the Essential Functions (Technical Standards), PA Academic Dishonesty (Integrity) Policy, this Academic Progression Policy and the PA Professional Standards of Conduct Policy.

Emergency Removal

In the event of professionalism violations, threat to safety, wellbeing or institutional property or normal operations, students may be subject to immediate removal from program activities by any faculty or program director. Removal proceedings may be imposed consistent with NSHE Code T2 Chapter 10.4.10, or any successor section of the NSHE Code regarding Emergency Removal. The review process will commence immediately and a recommendation of dismissal may be decided and communicated to the UNR Med PA Studies Program Director and Dean of UNR Med for review and further action. (ARC-PA C3.03)

Academic Progression

Academic Progression is a term used by the UNR Med PA Studies Program meaning that a student is maintaining a satisfactory level of academic achievement in each course, semester, and throughout the program, such that they will be able to meet expected graduate competencies, take the Physician Assistant National Certification Examination (PANCE), and enter into clinical practice as a physician assistant.

Monitoring, probation, suspension, and dismissal (all defined below) are not to be construed as progressive steps. Probation, suspension, and/or dismissal may occur if the student engages in "Prohibited Conduct" as set forth in Section 10.2.1 of the NSHE Code (or any successor section of the NSHE Code defining "prohibited conduct"). When the PA Student Progress Committee (SPC) considers progression, it will assess student progress in academic, behavioral, and professional issues. The SPC (see below) will meet regularly to review all aspects of a student's contribution to the program and overall academic progress.

Academic progression in the didactic phase of the UNR Med PA Studies Program is dependent on passing each required course in the semester prior to advancing to the next semester. In the clinical phase, clerkships are not dependent upon each other for progression and this allows for flexibility in specific disciplines and, if approved, delay in starting a clerkship due to hardship or a designated remediation plan. (ARC-PA A3.15c & B4.02)

Students must meet Satisfactory Academic Progress (SAP) standards to be eligible for financial aid. The Office of Student Financial Aid & Scholarship has established guidelines (based on federal regulations) for re-evaluating student progress. This information is available for students to review at: Satisfactory Academic Progress. Responsibility for understanding the financial aid implications of academic progress rests solely on the student. Questions should be directed the Office of Student Financial Aid & Scholarship.

PA Student Progress Committee (SPC)

The SPC is made up of faculty members from the PA Studies Program and may include other members of the University of Nevada, Reno. This committee is charged with regular and consistent monitoring of all PA students, both academically and professionally, throughout their time in the program. Pursuant to this policy, the SPC is also the PA Program's disciplinary committee. The committee, on an as needed basis, reviews students who are identified as "at risk" or needing special attention or resources to support their academic or professional progress. This may include conduct violations, remediation, academic monitoring, or probation (definitions below). The SPC may review and discuss all student educational records with appropriate faculty members and/or preceptors in determining an appropriate course of action for students under review. The SPC may act to protect the students, community or institution at any time.

Request for Student to Appear Before the SPC

1. The SPC may request the appearance of the student to clarify issues being discussed. This notification will be in writing and transmitted in person or through official UNR email. In this communication, the student will be notified of the topic of discussion, proposed action and the reason for the proposed action. The meeting shall take place within fifteen (15) business days after the notice to the student. The student may refuse to appear and may submit evidence on his/her behalf. If the student chooses not to appear, this action will not be a factor in the decision of the SPC. However, it will limit the student's ability to represent themselves.
2. The student may have a representative present at the meeting as support. Students must make a request to the chair to have a representative present. Meetings will not be rescheduled to make accommodations for a representative to be present. The representative participation is limited to giving advice to the student and will not be allowed to speak to the committee.
3. Prior to the SPC meeting, the student may inspect his/her UNR Med PA Studies Program academic file, excluding any contents of the file which the student has waived his or her right to review.
4. The student may request a copy of his/her academic file, excluding those matters mentioned above, at his/her expense. The student may also request a copy of the record of the SPC meeting at his/her expense as it relates to his/her appearance before the SPC.

SPC Meeting Process

The student's experience of meeting with the SPC shall be informal, supportive and non-adversarial. The Chair(s) shall preside over the meeting, maintain order and determine relevancy of the information presented to the SPC. The contents of the meeting are to be closed and confidential except as required by law or called by witness in litigation. Students or representatives present may not use recording devices during the meeting. The Chair(s) of the SPC may request the presence of legal counsel at any time to provide advice to the SPC. The student may be present for only that section that requires appearance and discussion and may not remain during deliberations of the SPC. Witnesses invited by the Chair(s) to provide statements or clarification of the situation may only be present while providing their own testimony.

Notification of Outcomes

After the review and, if appropriate, interview with the student, the committee will recommend actions which may include continued monitoring, development of a remediation plan, probation, or dismissal from the program. These definitions are listed below in this document. The committee's requirements will be communicated directly to the student by the Chair(s) of the SPC within fourteen (14) calendar days of the close of the meeting. Absent an appeal, the decision of the SPC is final and binding to all issues.

Appeal Process

The student may appeal the decision of the SPC to the program director. The notice of appeal must be in writing and must be received by the program director within five (5) calendar days of the date on which the SPC's written decision was issued. The student will continue to be enrolled in the PA program during the time of the appeal and, if the student has provided written notice of appeal, pending the decision of the program director. Failure to appeal within the time limit and protocol set forth in this section renders the decision of the SPC final and binding as to all issues. Students may be guided through this process by contacting Rubina Hackbusch, Office of PA Admission and Student Affairs at rubinah@med.unr.edu or by calling (775) 682-7669.

The appeal process commences using the following process:

1. Within five (5) calendar days after the date of the notice of appeal, the following materials will be submitted to the program director by the Chair(s) of the SPC and the student, where appropriate:

1. All materials considered by the SPC during the meeting including the record of the applicable proceedings.
2. The Chair of the SPC and the student shall each submit a written statement of issues to be considered by the program director.
3. The SPC may submit a written summary in support of its decision.
4. Written statements or summaries may not exceed five (5) pages unless the program director approves a request to exceed this page limitation.

2. The program director will provide a written decision to the student's appeal within a reasonable amount of time, not to exceed fourteen (14) calendar days, after the submission of materials.

The student may appeal the decision of the program director to the Dean of UNR Med. The notice of appeal must be in writing and must be received by the UNR Med Dean's office within five (5) calendar days of the date on which the program director's written decision was issued.

The student will continue to be enrolled in the PA program during the time of the appeal and, if the student has provided written notice of appeal, pending the decision of the Dean. Failure to appeal within the time limit and protocol set forth in this section renders the decision of the program director final and binding as to all issues. Students may be guided through this process by contacting Rubina Hackbusch, Office of PA Admission and Student Affairs at rubinah@med.unr.edu or by calling (775) 682-7669.

Academic Monitoring Status

Academic Monitoring ("Monitoring") is a term and official designation used by the UNR Med PA Studies Program when a student's performance is marginal or not fully meeting the expectations supported by the curriculum and policies of the program. The meaning of this term, according to Oxford Dictionary is, "The process of observing students' academic progress in one or more subject over a period of time. It is used by teachers to compare the performance of a particular student to that of his/her classmates and to identify students who are struggling, excelling, or underachieving." This designation is created as a step prior to a student being placed on Academic Probation (see below) which would be recorded on the official transcripts. The student will be asked to appear before the SPC and will receive notification from the committee if he/she is placed in this status.

A student may be placed on monitoring status for academic or behavioral/professionalism reasons. The performance of students on monitoring status will be reviewed by the SPC at regular intervals and at the conclusion of each semester, to establish the overall status of progression in the program. Additionally, the terms of monitoring will be documented in the student file and may include a remediation plan to improve performance in areas of deficiency.

Summary of Criteria for Placement on Academic Monitoring

The student WILL be placed on Academic Monitoring status if any of the following occur:

• The student fails (<70%) two (2) exams in any one (1) course in the same semester in the didactic phase. 
• The student fails three (3) exams in one (1) semester during the didactic phase.   
• The student fails two (2) End of Rotation Examinations during the clinical phase.
• The student fails to adhere to the PA policy on Professional Standards of Conduct at any time.
• The Student's cumulative GPA falls below 3.0.
• Verbal or written reports and/or evaluations from academic faculty, clinical preceptors, designees, or staff indicate that a student is not adhering to course requirements or not achieving learning outcomes.

The SPC MAY consider placing a student on Academic Monitoring status for the following:

• Any combination of examination failures in different didactic courses in the same semester. 
• An identified pattern of failure to meet assignment deadlines as required in all courses.
• Failure to adhere to the UNR Med PA Studies Program policies on Professional Standards of Conduct as documented by faculty or designee (i.e. preceptors or instructors).
• Failure to adhere to any program policies and procedures as defined in the UNR Med PA Studies Program Student Handbook.

Academic Probation

Academic probation ("Probation") is an academic status designed by the SPC to alert students that their academic, professional, or behavioral performance is failing to meet minimum standards, placing them at risk for program dismissal. The performance and progress of students on Probation will be reviewed by the SPC monthly and at the conclusion of each semester. The terms of Probation will be documented in the educational record and may include a remediation plan, required meetings with faculty advisor, repeating or review of part or all the curriculum, personal counseling or tutoring, and other cognitive evaluations or approaches to encourage satisfactory performance. Students placed on Probation have failed to meet minimum academic or professional standards; as such, Probation status may be documented in the student's official UNR transcript, and may be reportable to professional state licensing boards. Students may not be on Probation, for any reason, for more than two (2) semesters throughout the program or they may be recommended for dismissal.

Student Restrictions while on Probation

Students on Probation are not permitted to serve in elected leadership positions, participate in admissions applicant interviews, and may be subject to additional restrictions as determined by the SPC. Students on Probation are not considered to be in "good academic standing" until Probation status has been lifted by the SPC. Students may not graduate while on Probation.

Criteria for Placement on Academic Probation

The student will be placed on Academic Probation if the student's Cumulative GPA falls below 2.0.

Remediation

Remediation is the opportunity to correct unsatisfactory performance, progress and/or professional conduct in the program. Remediation may be offered by the SPC to further assess/evaluate a student and to support the student in meeting the learning objectives of the course.

Remediation may also begin when a student is placed on Academic Monitoring or Probation. The student may be offered a remediation plan (see below). Remediation is not automatic or guaranteed.

A Remediation Plan is designed to notify faculty and learners of program expectations established to provide the greatest opportunity to achieve success in meeting the learning outcomes of a course when an initial attempt of the assessment indicates the student has been unsuccessful. The plan will be developed by the Academic Coordinator or Clinical Director with the assistance of the course director. The plan will be presented and reviewed by the SPC. The components of the plan will include: 1) required activities, assignments and assessments to be successfully completed; 2) the final date of submission of materials in support of the remediation plan; and 3) signatures of the students and the faculty reviewer or SPC Chair(s). Failure to fulfill all the terms of a remediation plan may result in dismissal from the program. Student remediation progress will be monitored by the course director and the SPC. (Diagram) (ARC-PA A3.15c & B4.02)

Deceleration

Deceleration is the loss of a PA student from an entering cohort, who remains matriculated in the PA program. The UNR Med PA Studies curriculum is designed to be delivered and completed on a full-time basis. The program does not offer deceleration or option to complete the curriculum on a part-time basis.

Withdrawal

Students are required to submit written notification to the program director if they choose to withdraw from the program voluntarily. The date the program receives the written withdrawal notification becomes the official withdrawal date. (ARC-PA A3.15d)

In summary, the SPC may recommend dismissal in the following cases:

• Meeting criteria to be placed on Academic Probation for a third semester at any time in the program.
• Failure of two (2) courses anytime during enrollment in the program.
• Violation of the Professional Standards of Conduct Policy.
• Violation of the Academic Dishonesty (Integrity) Policy.

Readmission

A student dismissed from the UNR Med PA Studies Program will not be granted readmission (ARC-PA A3.15d)

Program Completion

The maximum time to complete the UNR Med PA Studies Program is 4 years from the time of matriculation. (ARC-PA A3.15b)

Grading

Minimum Grade Point Average (GPA)

Students must maintain a GPA of 2.0 (passing for pass/fail courses) or above to continue in "Good Standing" in the PA Studies Program. However, students must have a cumulative GPA of 3.0 to be eligible to graduate. Students with a cumulative grade point average in the PA Studies Program below 3.0 will be placed on Monitoring Status. (ARC-PA A3.15a)

Letter Grade	Grade Point	Percentage
A	4.0	90-100%
B	3.0	80-89%
C	2.0	70-79%
F	0	<70%

Pass/Fail - PAS 600-Anatomy, PAS 610-Physiology, and PAS-620 Basic Science in Clinical Medicine are graded Pass/Fail

Incomplete Course and/or Grades

The grade of Incomplete ("I") is an option given by the course director when the required assignments and activities need to be finished beyond the expected course duration. An "I" is given when a student is performing passing work, but for some uncontrollable reason, they are unable to complete a final portion of their course requirements during the scheduled instructional period. An "I" mark is excluded from the grade-point average computation. Non-attendance, poor performance, or student requests are not acceptable reasons for issuance of the "I" mark. Students must complete the course work by the end of the next regular semester, Fall or Spring, to be issued a grade, or it will be recorded as an "F" or "Fail".

Course directors may choose not to assign a grade if a remediation plan is in place. This results in a Not Reported or "NR" designation. This would allow for additional work such as remediation to be completed.The course director must assign a grade for the course by the end of the following semester or it will automatically be assigned an "F" or "Fail".

Students will sign an agreement, created and signed by the course director, with a detailed plan on the course work needing to be completed and the timeline for completion. The course director will review the agreement criteria with the student for clarification.

During the clinical phase, a student can have one (1) "Incomplete Course" on record and still be able to enroll in another course. For example: a student completes the clinical clerkship experience but has not passed the End of Rotation examination and needs to retest. If a student has two (2) "incomplete courses" during the clinical phase, he/she will not be allowed to enroll into another course until the longest running "incomplete" course requirements are fulfilled.

Program Progression

Didactic Phase Progression

Failure of an examination or course grade is generally defined as achieving below a 70% or Fail(See Grading). Students found to be acting out of integrity during an examination or evaluation by violating the Academic Dishonesty (Integrity) Policy or being disruptive in the classroom may result in receiving a failure of the examination/assignment with a grade of ZERO (0) and must meet with the SPC to review and discuss further actions.

Didactic Phase Examination Failures

1. First failure of an examination in one (1) course, one (1) semester:

a. A notification is sent to the student from the course director and a copy is sent to the student's advisor.
b. The student must meet with his/her advisor.
c. The student must meet with the course director to review the examination.
d. Examination grade remains the same.
e. If the exam counts for ≥ 50% of the course grade, the student may be required to meet with the SPC.

2. Second failure of an examination in the same course in the same semester:

a. A notification is sent to the student from the course director and a copy is sent to the student's advisor.
b. The student must meet with his/her advisor.
c. The student must meet with the course director to review the examination.
d. The student is immediately placed on Academic Monitoring.
e. The student will be required to meet with the SPC.
f. Examination grade remains the same.

3. Second failure of an examination in same semester but a different course:

a. A notification will be sent to the student and advisor from the course director.
b. The student must meet with his/her advisor.
c. The student must meet with the course director to review the examination.
d. Examination grade remains the same.

4. Third (or more) failure of an examination in one (1) semester in any combination of course(s):

a. See steps 3. a, b, c, and d.
b. The student must meet with the SPC to determine action(s) to be taken.

Failure to Meet Didactic Course Requirements

1. Initial failure to thr meet minimum required criteria to successfully pass a course with an offer of remediation:

a. The student will be placed on Academic Monitoring status.
b. The student's initial course grade will be "NR" or not recorded.
c. The student must meet with the SPC for the development of a Remediation Plan outlining the steps for successful course remediation.
d. Failure of successful remediation will result in a recommendation of dismissal from the program.

2. Failure of two (2) courses at any time in the program may result in the recommendation of dismissal from the program.

a. Initial failure to meet the minimum required criteria to successfully pass any two (2) courses in the same semester may result in dismissal from the program.
b. Initial failure to meet the minimum criteria required to successfully pass any course in the program, even with successful remediation, will count as a "first" failed course.
c. A subsequent failure of a different course while continuing in the program, is considered "two (2) failed courses" and the student may be dismissed.

Clinical Phase Progression

The grading policy for each clerkship is outlined in the specific course syllabus. The following criteria for progression pertain to the clinical phase which is, by design, an opportunity for students to demonstrate competency outside of the focus of medical knowledge. Therefore, the assessments and evaluations of the students will be performed at different intervals, in a variety of settings and by a variety of evaluators. The following guidelines and expectations are created for the program to monitor the ongoing progress of each student.

End of Rotation Examinations (EOR exam) Failures

1. Failure of one to two EOR exams

a. The student is notified in writing by the course director of the failure and a copy is sent to the student's advisor.
b. Student must meet with his/her advisor regarding circumstances surrounding the failure.
c. The student will not receive a grade or will be given "Incomplete" grade for that course until a successful retest is completed.
d. The student may retest once within thirty (30) days. The course director will provide the EOR exam retest. The student will be required to come to campus to take the retest.
e. Successful passing of the retest will result in a grade of "Pass".
f. Unsuccessful passing of the retest will result in a "Fail" of the course, requiring a repeat of the course. If the course was an elective or primary care selective, the Director of Clinical Education will determine the discipline for the course.
g. The student will be placed on Academic Monitoring status.

2. Failure of three EOR exams (includes initial and retests)

a. The student is notified in writing by the course director(s) of the failure and copies are sent to the student's advisor.
b. The student must meet with the SPC.
c. The student will continue on Academic Monitoring status.
c. The student will will be given an Incomplete ("I") grade for that course until completed.
d. The student will be offered a retest (one [1] time) within thirty (30) days as in 1.d above.
e. Successful completion of the retest will result in a grade of "Pass".
f. Failure of retest (4th failure) will result in the next level of intervention noted below.

3. Failure of four EOR exams (total at any time in the clinical phase including retests):

a. The student is notified in writing by the course director(s) of the failure and copies are sent to the student's advisor.
b. The student will continue Academic Monitoring status.
c. The student will be required to meet with the SPC to determine further disposition in the program and/or offer of remediation.
d. All subsequent EOR Exams must be passed or the student will be dismissed from the program for failure to progress academically.

Failure to Meet Passing Criteria of a Clerkship (Course)

A student who initially fails to meet the requirements to successfully pass a Clerkship for any reason will automatically be placed on Academic Monitoring.

Additionally:

1. Not Recorded "NR" will be recorded on the transcript.
2. The student must meet with the SPC.
3. The SPC will complete a full review of the overall performance of the student.

Preceptor Evaluation of Student Performance

Preceptors are required to evaluate student performance during a clerkship. This gives the program feedback regarding students' achievement of learning outcomes and program graduate competencies. A student evaluation by a preceptor indicating an overall score of 70% or below will be considered a failure of the clerkship despite any other credit for activities such as reflection assignments, paperwork submitted, professionalism points or other activities as assigned. The purpose of the clinical phase is to expand on medical knowledge, patient care, interprofessional communication, teamwork, and skills necessary to become a PA. If competencies in these areas are not demonstrated, the student will receive a failure.

The student will meet with the SPC prior to any determination of disposition to discuss the circumstances surrounding this failing grade. This failure could result in a delay in progression or graduation due to remediation, or potential dismissal from the program. The SPC will determine the disposition of the student based on all available information in the educational record as well as an interview with the student.

Dismissal from a Clinical Site

If a student is asked/told to leave a clerkship assignment and/or site by the preceptor or administrator of a facility for the rest of the clerkship, the student must immediately notify the Director of Clinical Education (DCE) or designee in person or by telephone. If the DCE is notified by the preceptor or administrative staff from the site that the student will not be welcomed back to complete their assigned clinical experience for academic, professional or behavioral reasons, the student will be required to meet with the SPC.

Examination/Evaluation Challenge

A student who has a test question challenge in a graded examination must submit an official challenge form supplied by the program. The forms will be accepted 24 hours after test grades are released. The student must be prepared with a minimum of two (2) peer-reviewed resources to support the alternative answer. The course director will respond to the review request within five (5) business days with a decision. Course directors may choose to meet with the student for further discussion.

Grade Appeal

Grades submitted to the Registrar are considered final. Any appeal of a grade needs to be processed through the Office of PA Admission and Student Affairs by contacting Rubina Hackbusch at rubinah@med.unr.edu or by calling (775) 682-7669.

Rev. 5/13/21