Welcome back! We’re progressing through our list of the most commonly cited Standards by finishing with the two remaining B Standards. The two we are discussing today are both experiencing a surge in incidences, so you’ll definitely want to take note.

B3.03c Language 

Citations for Standard B3.03c are rapidly increasing. In summary, programs must have specific learning outcomes matching the ARC-PA glossary definitions for women’s health, including gynecological and prenatal care.

Standard B3.03c states, “Supervised clinical practice experiences must enable all students to meet the program’s learning outcomes…c) for women’s health (to include prenatal and gynecologic care)”

Here are examples of two observations: 

“The program did not provide evidence that it has defined its supervised clinical practice experience (SCPE) learning outcomes for women’s health to include prenatal and gynecologic technical skills.” (However, I’ll note that in the example provided, the program did have learning outcomes for prenatal care and for gynecologic care, but there was not a sufficient definition for technical skills for either element.) 

"Each of the syllabi in Appendix 17 for the SCPEs including PXX 6XX Women’s Health Rotation, contained a list of 16 technical skills; however, none were specific to prenatal or gynecologic care. At the time of the site visit, the program acknowledged that there were no learning outcomes for technical skills related to prenatal or gynecologic care.”

B3.03c Caveats for Success

• Ensure that the clinical learning outcomes for Women’s Health and gynecology encompass all aspects of the glossary definitions. 

• Look at your list of required technical skills during the clinical year. Ensure these are embedded in specific SCPE syllabi and aligned preceptor evaluations and that a gap analysis process is clearly in place if students cannot obtain competency during this rotation.  

• Using the glossary definition headers for learning outcomes is essential to provide the appropriate context.

• For more information, see my blogs published April 10, 17 and 24, 2024.

Standard B1.03e Language

Citations for Standard B1.03e are on the rise because the Commission’s scrutiny of instructional objectives and learning outcomes now encompasses both didactic and clinical content. The 6th Edition standards will provide more insights. 

Standard B1.03e states, “For each didactic and clinical course (including required and elective rotations), the program must define and publish for students the following detailed information in the syllabi or appendix to the syllabi:

e. Learning outcomes and instructional objectives, in measurable terms that can be assessed, that guide student acquisition of required competencies.”

Standard B1.03e is another multiplier Standard, which can, unfortunately, be replicated in many other Standards. If B1.03e is found noncompliant for clinical year learning outcomes, this multiplies citations to areas such as the B3.03 Standards. 

Let’s look at some sample language we see from the committee:

Findings: “The program did not consistently define and publish learning outcomes and instructional objectives in measurable terms for each didactic and clinical course that would guide student acquisition of the required competencies.”

Comments: “In the application and at the site visit, the single syllabus for all required clinical courses included general and rotation-specific learning outcomes and instructional objectives. However, the learning outcomes were complex and the instructional objectives were broadly written and not defined well enough to guide student acquisition of required competencies.”

B1.03e Caveats for Success:

• Review all learning outcomes and instructional objectives for complex content.

• Search every syllabus in the program for any “and/or” requirements.  “And/ors” can be deadly! If you have any, they automatically say it’s not compliant! How does one evaluate an “and/or” statement?

Let’s review what qualifies as “complex content” that will get your program in trouble.

Here is an example from a syllabus. “Students will apply clinical reasoning and problem-solving abilities to formulate a differential diagnosis for symptoms/conditions commonly used for patients seeking general women’s health, prenatal, and gynecologic care.” Notice how there are multiple concepts here and far too much complexity. This one will be insufficient unless you can somehow have the preceptor evaluation accommodate for that complexity with something like drop-down boxes in the answers.

“Demonstrates appropriate history and physical examination skills required in accordance to each chief complaint or presentation (preventive, emergent, acute, chronic, and rehabilitative patient encounters).” This complex content lists five types of patient encounters, therefore if there is no way to evaluate each type of encounter for each student, the evaluation is insufficient.

Next week…

We’re ending the “top ten” list with two more new additions: Standards E1.03, which pertains to correctly submitting the voluminous documents in the reports required by the ARC-PA, and A3.12, about information that must be current and available on your program’s website. I’ll conclude with some final thoughts on the state of SSRs and changes that may come with the 6th Edition Standards. I hope you’ll join me then.