The Culture of Health Care

2. The Culture of Health Care Health Professionals—The People In Health Care Lecture c This material (Comp 2 Unit 2) was developed by Oregon Health and Science University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC000015. This material was updated in 2016 by Bellevue College under Award Number 90WT0002. This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/.

3. Health Professionals—The People in Health CareLearning Objectives • Define terms used in health care and in health professionals’ education and training, including clinician, patient/consumer, disease, and syndrome. (Lecture a) • Describe the education, training, certification, licensure, and roles of physicians, including those in primary care and other specialties. (Lecture a) • Describe the education, training, certification, licensure, and roles of nurses, advanced practice nurses, licensed practical nurses, medical assistants, and medication aides. (Lecture b) • Describe the education, training, certification, licensure, and roles of physician assistants, pharmacists, therapists, allied health professionals. (Lecture c) • Describe the education, training, certification, licensure, and roles of paramedics, emergency medical technicians, dental professionals, mental health professionals, and social workers. (Lecture c)

4. Physician Assistant • Education • Most PA applicants have bachelor of science degree • Associate’s, bachelor’s, or master’s degree • Training • Preclinical • Clinical • Certification • Required to pass the Physician Assistant National Certifying Exam • Maintaining certification requires continuing medical education and recertifying every six years

5. Physician Assistant Continued • Licensure • In most states, licensure is by a the medical board • Some states have a specific PA board • Roles • Diagnose and treat patients • Prescribing authority • Hospital and nursing home rounds

6. Pharmacy Training Travis NimmoCC-BY

7. Pharmacy • Certification • Six specialty practice areas recognized by the Board of Pharmacy Specialties: • Ambulatory care pharmacy • Nuclear pharmacy • Nutrition support pharmacy • Oncology pharmacy • Pharmacotherapy • Psychiatric pharmacy

8. Pharmacy Continued • Licensure • Varies by state • North America Pharmacy Licensure Exam (NAPLEX) • Multistate Pharmacy Jurisprudence Exam (MPJE) • Some states require a state exam instead of or in addition to the MPJE • Roles • Dispensing, community and hospital based • Consulting, usually hospital based

9. Respiratory Therapy • Education • Usually an associate’s degree, but there are bachelor’s degrees in respiratory therapy • Training • Preclinical • Clinical • Certification: Two levels • Certified Respiratory Therapist Exam (CRT) • Registered Respiratory Therapist Exam (RRT) • Both exams are offered by the National Board of Respiratory Care

10. Respiratory Therapy Continued • Licensure • Required in most states • Successful completion of the CRT exam required • Roles • Respiratory assessment • Patient education • Respiratory treatments and medication • Oxygen administration and ventilator support

11. Physical Therapy • Physical therapy aide • On-the-job training • Not licensed • Physical therapy assistant • Associate’s degree • Licensure varies by state • Physical therapist • Master’s or doctoral degree • Licensure • National Physical Therapy Exam (NPTE) • Other exams or requirements

12. Occupational Therapy • Occupational therapy aide • On-the-job training • Not licensed • Occupational therapy assistant • Associate’s degree or certificate • Certification • Certified Occupational Therapy Assistant (COTA) • Licensure varies by state • Occupational therapist • Master’s or doctoral degree • Certification • Occupational Therapist Registered Exam • Licensure varies by state

13. Radiology Technician/Technologist • Education • Certificate, associate’s degree, bachelor’s degree • Training • Some general studies • Anatomy, physiology, math, physics, radiation technology • Clinical practicums

14. Radiology Technician/Technologist Continued • Certification • Voluntary certification by the American Registry of Radiologic Technologist (ARRT) • Accredited training program and an exam • Licensure • Varies by state, but most require licensure • ARRT certification is often a requirement

15. Radiology Technician/Technologist Continued 2 • Role • Help maintain and calibrate equipment • Position and set controls for x-rays • May specialize in a specific type of radiology such as computed tomography and magnetic resonance imaging

16. EKG Technician • Education • Often on-the-job training • Certificate programs usually consists of a single course • Training • Basic anatomy, physiology, and electrophysiology of the heart • Technical training on how to use the equipment and verify quality of the tracing

17. EKG Technician Continued • Certification • Certification exams are available but generally aren’t required • License • No state license required • Role • At the most basic level, EKG technicians set up the EKG equipment, run the test, evaluate whether it is an accurate recording, and prepare the recording for interpretation

18. Dietetics and Nutrition • Dietetic technician, registered (DTR) • Associate’s degree • Registration Examination for Dietetic Technicians • Variable licensure • Registered dietician (RD) • Bachelor’s degree • Registration Examination for Dieticians • Most states require licensure, certification or registration

19. Requirements for Emergency Medical Technicians (EMTs) and Paramedics 2.2 Table: This work by Travis Nimmo was adapted from MedicOne Medical Response, “Difference between Paramedics and EMTs” (2009), and is licensed under CC-BY

20. Dental Health • Dental Assistant • Education • On the Job • Certificate • Associate’s degree • Certification • Certified Dental Assistant Exam • Licensure • Varies by state • Dental Hygienist • Education • Associate’s degree • Bachelor’s degree • Licensure • National Dental Hygiene Board Exam • State clinical board

21. Dentist • Education • Doctor dental surgery (DDS) or doctor of dental medicine (DMD) • 4 years of college • 4 years of dental school • Training • Preclinical • Clinical

22. Dentist Continued • Licensure • Dental school • Written National Board Dental Examinations • Additional written and practical examinations vary by state • Role • General preventive, restorative, and periodontal care

23. Mental Health ProfessionalsRoles and Training 2.3 Table: Mental Health Professionals Roles and Training

24. Social Workers • Education • Bachelor’s degree in social work (BSW) • Master’s degree or master’s of social work (MSW) • Training • BSW focuses on direct service • MSW more clinical and supervisory training • Licensure • All states and the District of Columbia require licensure, certification, or registration

25. Social Workers Continued • Roles • BSW • Direct service • Case management • Health, housing, relationships, disability • MSW • Counseling • Case management • Supervisory • May specialize in certain areas such as mental health, substance abuse, rehabilitation

26. Case Manager • Education • Varies greatly to include on-the-job training, associate or certificate programs, nursing degrees, and social service degrees • Training • May include additional training specific for case management • Certification • Certification of case managers is available in specific fields but generally are not required

27. Case Manager Continued • Licensure • Depending on education and training • Role • A case manager is required to assess a client’s problems and mobilize resources to enable the client to function at his or her best level

28. Two Examples of Other Roles • Health information management (HIM) professionals manage the patient’s medical record for clinical, financial, and legal uses • Biomedical engineers apply engineering principles in the design, development, and maintenance of IT systems and medical device equipment

29. Health Professionals—The People in Health Care Summary – Lecture c • This lecture discussed the education, training, certification, licensure, and roles for physician assistants; pharmacists; respiratory, physical and occupation therapists and technicians; and nutrition and dietary personnel • Training and roles of paramedics and EMTs, dental health professionals, mental health professionals, social workers, and case managers were also reviewed

30. Health Professionals—The People in Health Care Summary • Terminology used in health care and in the education of health professionals was reviewed • Education, training, certification, licensure, and roles of physicians, nursing personnel, and others, including common specialties and subspecialties, were discussed • The unit looked at health care roles in specific work settings, specialty areas, and nonclinical fields

31. Health Professionals—The People in Health CareReferences – Lecture c References AHIMA (American Health Information Management Association).(2016). Certification. Retrieved from http://www.ahima.org/certification American Board of Medical Specialties. (2016). Board certification and maintenance of certification. Retrieved from http://www.abms.org/board-certification American Medical Association. (2016). Obtaining a medical license. Retrieved from http://www.ama-assn.org/ama/pub/education-careers/becoming-physician/medical-licensure.page American Medical Association. (2016). Requirements for becoming a physician. Retrieved from http://www.ama-assn.org/ama/pub/education-careers/becoming-physician.page Explore Health careers.org. (2016). Career explorer. Retrieved from http://explorehealthcareers.org/en/home HRSA (Health Resources and Services Administration Health Workforce). (2016). Health workforce research. Retrieved from https://bhw.hrsa.gov/health-workforce-analysis/research MedlinePlus. (2014). Health occupations. Retrieved from https://www.nlm.nih.gov/medlineplus/healthoccupations.html MedlinePlus. (2012). Medical dictionary. Retrieved from http://www.nlm.nih.gov/medlineplus/mplusdictionary.html National Association of Advisors for the Health Professions. (2013). Health professions links. Retrieved from http://www.naahp.org/PublicResources/HealthProfessionsLinks.aspx

32. Health Professionals—The People in Health CareReferences – Lecture c Continued National Registry of Emergency Medical Technicians. (2016). National EMS certification. Retrieved from http://www.nremt.org NIH MedlinePlus. (2011). Life works: Explore health and medical science careers.NIH MedlinePlus. Summer. Retrieved from https://medlineplus.gov/magazine/issues/summer11/articles/summer11pg24-25.html U.S. Bureau of Labor Statistics. (2016). Biomedical engineers. In U.S. Department of Labor, Occupational outlook handbook, 2016–17 edition. Retrieved from http://www.bls.gov/ooh/architecture-and-engineering/biomedical-engineers.htm U.S. News and World Report. (2016). Best health care jobs. Retrieved from http://money.usnews.com/careers/best-jobs/rankings/best-healthcare-jobs Charts, Tables, Figures 2.2 Table: Travis Nimmo, adapted from MedicOne Medical Response, “Difference between Paramedics and EMTs” (2009), and licensed under CC-BY. 2.3 Table: Mental Health Professionals Roles and Training Images Slide 5: Pharmacy Training. CC-BY by Travis Nimmo.

33. The Culture of Health CareHealth Professionals—The People in Health CareLecture c This material was developed by Oregon Health & Science University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC000015. This material was updated in 2016 by Bellevue College under Award Number 90WT0002.