Clinical Phase Attendance Policy

Physician Assistant Studies

Effective Date: 7/1/2017

Statement of Expectations

Attendance at an assigned clinical site is mandatory due to the scheduled time offered by our outside Community Faculty (CF) also called "preceptors". These clinicians are extending their knowledge, practice site, staff and time as a learning opportunity. Regular, consistent attendance is respectful and illustrates motivation. It is also a component of professionalism. Preceptors are asked to indicate if there is any missing time on the Final Evaluation of the Student after each Clerkship.   

Schedules

Students are expected to follow the schedule provided by the preceptor and be in daily attendance throughout each rotation unless prior arrangements have been made with their preceptor and the course director. Students are required to submit schedules during the first week of the clerkship. Part time jobs, extracurricular activities, or lack of pet or childcare are NOT acceptable excuses for tardiness or absences. Missing more than 3 days in one clerkship may result in scheduling additional time to meet the required hours as determined by the course director and/or the Student Progress Committee (SPC). Additional time requirements may result in a delay in the final grade and therefore completion of the program and possibly graduation.  

Punctuality

The student will be consistently present and on time as scheduled by the preceptor. This often means leaving 15 -30 extra minutes to allow for delays in travel. The student should be willing to stay late to complete assignments or, if extra help is required, the student should be willing to remain at the site past the assigned hour to participate in clinical learning, if the activity is within reason. If the scheduled hours are changed and other responsibilities outside of the clinic have been previously arranged, the student must communicate with the preceptor and course director of the inability to adjust to the new schedule due to personal conflict. The overall understanding of the schedule is that flexibility is an important part of professional behavior in the clinical phase and in one's career as a PA. Consistent or habitual lateness will be considered unprofessional behavior and will be reflected in grading and/or referred to the SPC.   

Clinical Hours

Student clinical training will ideally be a minimum of 40 hours per week plus any on-call nights/weekends as scheduled by the preceptor. The option of being on call may vary depending on site-specific requirements of the practice and the program encourages learners to take on this opportunity as much as possible to maximize the clinical learning experience.  

Scheduled hours may vary between day, evening and nights in some practices. Shift work reflects the real-life situation of a practicing PA and may be required to work during holidays. If the schedule given by the preceptor results in the average hours not meeting the minimum, the student is responsible for communicating that with the course director. Logging activities will be monitored closely and any situation that illustrates less than minimal hours in the clinical assignment will be addressed by the clinical team. Students may be given an incomplete grade for the course until such hours are made up in a clinical setting, if required. Conversely, the UNR Med policy prohibits students from working more than 80 hours a week and/or greater than 16 hours in a 24-hour period. For every 6 days worked students will be allowed at least one day off. These days may be averaged over a maximum four-week period.  

If the schedule provided by the preceptor exceeds these requirements, the student must contact the course director and explain the situation. Students should always be thoughtful of patients when it comes to sleep and rest. If a student feels they are putting a patient in danger due to lack of sleep, they must notify the preceptor immediately and contact the course director if necessary.   

Health Restrictions

A student must immediately notify the course director and the preceptor of any significant change in his/her health status (serious injury, prolonged illness or other health-related needs) that impact the ability to progress in the rotation. The program will work with the student to determine if any restrictions or modifications of the student's rotation are necessary. If accommodations cannot be made, the issue will be referred to the SPC or Program Director for further evaluation and recommendations. This may include applying for a Medical Leave of Absence. The student is required to submit a written statement from a licensed physician, PA or APRN detailing any necessary restrictions and/or confirmation of the student's ability to continue with the program requirements. The details do not have to indicate a diagnosis or treatment plan other than the ability to indicate the safety of the student returning to the clinical site.  

Examples of Types of Absences:

1. Preceptor Directed Absence

If a preceptor instructs a student to be absent from an assigned site outside of the initial schedule, the student must notify the clinical team immediately upon notification that they will not be at the site or the preceptor will be unable to supervise. This communication should be direct to a live person or can be through email or texting the course director. If the preceptor directs the student to not come back to the facility at all, then an immediate notification to the course director is expected.

2. Excused Absence Process

Students are responsible for prompt and consistent communication regarding any absence from the clinical site.

  • Students may only be excused in cases of a family emergency, personal illness, or injury.
  • Absences due to illness of longer than two consecutive days will require medical clearance and a letter from a medical provider to excuse the absence and/or return to the clinical site. Medical clearance must be completed by a licensed physician, PA or APRN and submitted to the Program Administrative Assistant or DCE. This letter of ability to return to the school (clinic) cannot be issued by a family/faculty member. This letter should not contain information regarding the nature of the illness but simply a notice that it is safe to return to school.
  • The final determination of "true emergency" will be at the discretion of the course director, the Program Director and/or the SPC.
  • The student MUST notify the course director or clinical staff the night before or before 8:00 AM the day of the absence by calling and leaving a message. The student must do this for every day that they are absent. Sending a message through a classmate is NOT acceptable. Students should follow up with an email as well.
  • The student is responsible for contacting the clinical site/preceptor if an absence is necessary. The program will not contact the preceptor or site for the student unless there are extenuating circumstances. Failure to notify the site will be considered unprofessional behavior.
  • If you have a request for time away from your clinical assignment for Religious Observation and Practice, submit a request, 30 days ahead of the requested time off. UNR Med PA Studies Program follows NSHE policy and it can be found here: https://www.unr.edu/administrative-manual/3000-3999-students/3020-class-absence-policy.
3. Unexcused Absences
  • Being absent on the day of a test without prior or immediate communication with the course director or other program faculty or staff will be considered an unexcused absence. Students will receive a grade of zero for any evaluation/assessment activity for that time period unless documentation can be provided that explains why the absence should be excused. (e.g. Provider note)
  • Any expenses that may result from an unexcused absence will not be refunded. Any extra expenses required to re-create an assessment or evaluation experience will be the responsibility of the student if given the opportunity to perform the activity.
  • Child or pet care or vehicle inoperability are not excused reasons to miss assigned time at the clinical site. Students are expected to have back up plans set up ahead of time. Missed time must be made up as necessary if possible.
4. Extended Absences or Missing Days

Students may not miss more than a total of 6 days total in a clinical phase for any reason other than program sponsored/approved activities. The SPC will address this issue and additional clinical time may be assigned to make up for time for being absent from the rotations. Often, there is an opportunity to make up the missed time at the site after communicating with the preceptor. This made-up time must be approved by the course director and will be considered in evaluating the total time at the site in terms of the need to make-up the time.

Students absent for 7 days or more in succession may need to request a Medical Leave of Absence using the Leave of Absence Request Form in Exxat. This may delay the expected graduation if it is approved. In the clinical phase, an extra week or rotation in a clinic is easier to provide compared to the didactic phase.

5. Anticipated Professional Time

The program faculty may approve time away from the clinical training to attend specific conferences or other professional activities where the student would be attending on behalf of the program or student organization. This must be requested and approved as an anticipated, excused absence and will not be counted in the 6 days a year of absences. Students anticipating job interviews MUST request time away from the clinical site if appropriate. If the student can arrange for an interview on days out of the clinic, that is optimal. There may only be two days excused for interviews in the year.

6. Clerkship Assessment Days

Students anticipating missing days coming back to campus for capstone activities must contact the course director for permission not to attend. These days are full of activities that are often not able to be replicated such as OSCE or simulation labs. The process for excused absences needs to be followed with the course director.

Rev. 6/21/19