Physician Assistant Studies

Degrees and Certificates

Courses

PAS-501: Clinically Oriented Anatomy & Dissection

Credits 3

PAS 501: Clinically Oriented Anatomy and Dissection I (3.0 credit hours)

This is the first of three courses focused on gross human anatomy presented in a regional approach. Students learn anatomical terminology and correlate structure with function. Learning objectives in the course align with many of the learning objectives in PAS 531 and 511. Instruction is primarily in lecture and laboratory format with identification of structures on prosected cadavers. These learning experiences enable students to achieve the program’s Didactic Phase Learning Outcomes. Student learning is assessed primarily with multiple-choice question examinations and laboratory practical examinations.

Pre-requisite(s): PAS 506 and PAS 507

PAS-502: Clin Oriented Anat & Dissect II

Credits 4

PAS 502: Clinically Oriented Anatomy and Dissection II (4.0 credit hours)

This is the second of three courses focused on gross human anatomy presented in a regional approach. Students learn anatomical terminology and correlate structure with function. Learning objectives in the course align with many of the learning objectives in PAS 532 and 512. Instruction is primarily in lecture and laboratory format with dissection and identification of structures on cadavers. These learning experiences enable students to achieve the program’s Didactic Phase Learning Outcomes. Student learning is assessed primarily with multiple-choice question examinations and laboratory practical examinations.

Pre-requisite(s): PAS 506, PAS 507, PAS 501, PAS 511, PAS 531, and PAS 541

PAS-503: Clin Oriented Anat & Dissec III

Credits 2

PAS 503: Clinically Oriented Anatomy and Dissection III (2.0 credit hours)

This is the third of three courses focused on gross human anatomy presented in a regional approach. Students learn anatomical terminology and correlate structure with function. Learning objectives in the course align with many of the learning objectives in PAS 532 and 513. Instruction is primarily in lecture and laboratory format with identification of structures on prosected cadavers. These learning experiences enable students to achieve the program’s Didactic Phase Learning Outcomes. Student learning is assessed primarily with multiple-choice question examinations and laboratory practical examinations.

Pre-requisite(s): PAS 506, PAS 507, PAS 501, PAS 502, PAS 511, PAS 512, PAS 531, PAS 532, PAS 541, and PAS 542

PAS-507: Intro Patient Eval, Clin Skill

Credits 5

PAS 507: Introduction to Patient Evaluation and Clinical Skills (5.0 credit hours)

This course provides students with an introduction to the clinical psychomotor skills necessary for evaluating patients and performing common clinical procedures. Students learn how to conduct and document a complete medical history and physical examination. Students are also introduced to the interpersonal and communication skills necessary for the effective exchange of information and collaboration with patients, families, and other health care professionals. Instruction is primarily in lectures, laboratory sessions, and small group activities. These learning experiences enable students to achieve the program’s Didactic Phase Learning Outcomes. Student learning is assessed primarily with multiple-choice question examinations, written assignments, and physical examination and clinical skills practicals.   

Pre-requisite(s): Matriculation into the LMU-SMS-Knoxville PA Program

PAS-511: Patient Asmnt & Clin Skills I

Credits 4

PAS 511: Patient Assessment and Clinical Skills I (4.0 credit hours)

This is the first of three courses focused on patient assessment and clinical skills. Students develop interpersonal communication and clinical decision making skills as they learn how to elicit focused patient histories, perform focused physical examinations, interpret clinical findings, order and interpret diagnostic studies, generate differential diagnosis lists, determine the most likely diagnosis, explain clinical findings and assessments to patients and their families, determine appropriate management options, engage patients and their families to formulate patient-centered management plans, and present and document patient encounters. Students learn the indications, contraindications, and potential complications of common clinical procedures. Students also develop correct techniques for and proper documentation of common clinical procedures. Learning objectives in this course align with many of the learning objectives in PAS 501 and PAS 531. Instruction is primarily in small group discussion, simulated patient encounters, and laboratory format. Procedures are performed on simulated task trainers, human cadavers, and classmates as appropriate. These learning experiences enable students to achieve the program’s Didactic Phase Learning Outcomes. Student learning is assessed primarily with physical examination and clinical skills practicals, written assignments, and simulated patient encounters. 

Pre-requisite(s): PAS 506 and PAS 507

PAS-512: Patient Asmnt & Clin Skills II

Credits 4

PAS 512: Patient Assessment and Clinical Skills II (4.0 credit hours)

This is the second of three courses focused on patient assessment and clinical skills. Students develop interpersonal communication and clinical decision making skills as they learn how to elicit focused patient histories, perform focused physical examinations, interpret clinical findings, order and interpret diagnostic studies, generate differential diagnosis lists, determine the most likely diagnosis, explain clinical findings and assessments to patients and their families, determine appropriate management options, engage patients and their families to formulate patient-centered management plans, and present and document patient encounters. Students learn the indications, contraindications, and potential complications of common clinical procedures. Students also develop correct techniques for and proper documentation of common clinical procedures. Learning objectives in this course align with many of the learning objectives in PAS 502 and PAS 532. Instruction is primarily in small group discussion, simulated patient encounters, and laboratory format. Procedures are performed on simulated task trainers, human cadavers, and classmates as appropriate. These learning experiences enable students to achieve the program’s Didactic Phase Learning Outcomes. Student learning is assessed primarily with physical examination and clinical skills practicals, written assignments, and simulated patient encounters. 

Pre-requisite(s): PAS 506, PAS 507, PAS 501, PAS 511, PAS 531, and PAS 542

PAS-513: Patient Asmnt & Clin Skills III

Credits 3

PAS 513: Patient Assessment and Clinical Skills III (3.0 credit hours)

This is the third of three courses focused on patient assessment and clinical skills. Students develop interpersonal communication and clinical decision making skills as they learn how to elicit focused patient histories, perform focused physical examinations, interpret clinical findings, order and interpret diagnostic studies, generate differential diagnosis lists, determine the most likely diagnosis, explain clinical findings and assessments to patients and their families, determine appropriate management options, engage patients and their families to formulate patient-centered management plans, and present and document patient encounters. Students learn the indications, contraindications, and potential complications of common clinical procedures. Students also develop correct techniques for and proper documentation of common clinical procedures. Learning objectives in this course align with many of the learning objectives in PAS 503 and PAS 533. Instruction is primarily in small group discussion, simulated patient encounters, and laboratory format. Procedures are performed on simulated task trainers, human cadavers, and classmates as appropriate. These learning experiences enable students to achieve the program’s Didactic Phase Learning Outcomes. Student learning is assessed primarily with physical examination and clinical skills practicals, written assignments, and simulated patient encounters. 

Pre-requisite(s): PAS 506, PAS 507, PAS 501, PAS 502, PAS 511, PAS 512, PAS 531, PAS 532, PAS 541, and PAS 542

PAS-531: Prin of Clin Medicine I

Credits 10

PAS 531: Principles of Clinical Medicine I (10.0 credit hours)

This is the first of three courses focused on the evaluation and management of acute, emergent, and chronic presentations of medical and surgical conditions found in pediatric, adult, and geriatric patient populations.  Students learn the epidemiology, etiology, physiology, pathophysiology, clinical presentation, diagnostic evaluation, prevention, and management (acute, longitudinal, pre-/intra-/post-operative, pharmacologic, non-pharmacologic, referral, rehabilitative, palliative/end-of-life) of these conditions.  Students also learn how to generate differential diagnoses and make clinical decisions by linking relevant anatomic, physiologic, and pathophysiologic concepts with clinical presentations and diagnostic study results.    Learning objectives in this course align with many of the learning objectives in PAS 501 and PAS 511.  Instruction is primarily in lectures, small group discussion, and case study format.  These learning experiences enable students to achieve the program’s Didactic Phase Learning Outcomes. Student learning is assessed primarily with multiple-choice question examinations.

Pre-requisite(s): PAS 506 and PAS 507

PAS-532: Prin of Clin Medicine II

Credits 10

PAS 532: Principles of Clinical Medicine II (10.0 credit hours)

This is the second of three courses focused on the evaluation and management of acute, emergent, and chronic presentations of medical and surgical conditions found in pediatric, adult, and geriatric patient populations. Students learn the epidemiology, etiology, physiology, pathophysiology, clinical presentation, diagnostic evaluation, prevention, and management (acute, longitudinal, pre-/intra-/post-operative, pharmacologic, non-pharmacologic, referral, rehabilitative, palliative/end-of-life) of these conditions. Students also learn how to generate differential diagnoses and make clinical decisions by linking relevant anatomic, physiologic, and pathophysiologic concepts with clinical presentations and diagnostic study results. Learning objectives in this course align with many of the learning objectives in PAS 502 and PAS 512. Instruction is primarily in lectures, small group discussion, and case study format. These learning experiences enable students to achieve the program’s Didactic Phase Learning Outcomes. Student learning is assessed primarily with multiple-choice question examinations.

Pre-requisite(s): PAS 506, PAS 507, PAS 501, PAS 511, PAS 531, and PAS 541

PAS-533: Prin of Clin Medicine III

Credits 8

PAS 533: Principles of Clinical Medicine III (8.0 credit hours)

This is the third of three courses focused on the evaluation and management of acute, emergent, and chronic presentations of medical and surgical conditions found in pediatric, adult, and geriatric patient populations. Students learn the epidemiology, etiology, physiology, pathophysiology, clinical presentation, diagnostic evaluation, prevention, and management (acute, longitudinal, pre-/intra-/post-operative, pharmacologic, non-pharmacologic, referral, rehabilitative, palliative/end-of-life) of these conditions. Students also learn how to generate differential diagnoses and make clinical decisions by linking relevant anatomic, physiologic, and pathophysiologic concepts with clinical presentations and diagnostic study results. Learning objectives in this course align with many of the learning objectives in PAS 503 and PAS 513. Instruction is primarily in lectures, small group discussion, and case study format. These learning experiences enable students to achieve the program’s Didactic Phase Learning Outcomes. Student learning is assessed primarily with multiple-choice question examinations.

Pre-requisite(s): PAS 506, PAS 507, PAS 501, PAS 502, PAS 511, PAS 512, PAS 531, PAS 532, PAS 541, and PAS 542

PAS-541: Physician Assistant Pract I

Credits 2

PAS 541: Physician Assistant Practice I (2.0 credit hours)

The first of three courses focused on topics relevant to Physician Assistant practice. Instruction covers the historical development of the profession, professional organizations, the PA relationship with the physician and other health care providers, the roles and responsibilities of various health care professionals, the team approach to patient centered care, medical ethics, intellectual honesty, academic integrity, professional conduct, the provision of care to diverse populations, death, dying, and loss, patient response to illness, injury, and stress, and provider wellness. These learning experiences enable students to achieve the program’s Didactic Phase Learning Outcomes. Student learning is assessed primarily with written assignments and/or small group activities.    

Pre-requisite(s): PAS 506 and PAS 507

PAS-542: Physician Assistant Pract II

Credits 2

PAS 542: Physician Assistant Practice II (2.0 credit hours)

This is the second of three courses focused on topics relevant to Physician Assistant practice. Instruction covers methods to search, interpret, and evaluate medical literature, concepts of public health, patient safety, prevention of medical errors, quality improvement, and risk management. These learning experiences enable students to achieve the program’s Didactic Phase Learning Outcomes. Student learning is assessed primarily with written assignments and/or small group activities.

Pre-requisite(s): PAS 506, PAS 507, PAS 501, PAS 511, PAS 531, and PAS 541

PAS-543: Physician Assistant Pract III

Credits 1

PAS 543: Physician Assistant Practice III (1.0 credit hour)

This is the third of three courses focused on topics relevant to Physician Assistant practice. Instruction covers coding and billing, documentation of care, healthcare delivery systems, health policy, credentialing, laws and regulations regarding professional practice and conduct, licensure, and certification, and policies that affect PA practice. These learning experiences enable students to achieve the program’s Didactic Phase Learning Outcomes. Student learning is assessed primarily with written assignments and/or small group activities.

Pre-requisite(s): PAS 506, PAS 507, PAS 501, PAS 502, PAS 511, PAS 512, PAS 531, PAS 532, PAS 541, and PAS 542

PAS-602: Clin Conf/Clin Phase Cum Asmnt

Credits 2

PAS 602: Clinical Conference / Clinical Phase Cumulative Assessment (2.0 credit hours)

This course occurs in the 5th, 6th, and 7th semesters of the program. Students complete scholarly projects, mock summative assessments, and PANCE preparation activities. These learning experiences enable students to achieve the program’s Clinical Phase Learning Outcomes. Student learning is assessed with grading rubrics for scholarly projects and mock summative simulated patient encounters, physical examination skills assessment, and clinical procedures skills assessment and with multiple-choice examinations for the mock summative written examination and PANCE preparation activities.

Pre-requisite(s): Successful completion of all Didactic Phase courses (PAS 506, PAS 507, PAS 501, PAS 502, PAS 503, PAS 511, PAS 512, PAS 513, PAS 531, PAS 532, PAS 533, PAS 541, PAS 542, and PAS 543) and the Didactic Phase Cumulative Assessment (written examination, simulated patient encounter, physical examination skills assessment, and clinical procedures skills assessment).

PAS-611: Family Medicine

Credits 4

PAS 611: Family Medicine (4.0 credit hours)

This required 4-week supervised clinical practice experience under the supervision of the clinical site preceptor is designed to provide students with exposure to adult and elderly patients presenting for acute, chronic, and preventive encounters in family medicine. Students apply knowledge and skills learned during the Didactic phase of the program to novel patient encounters in the outpatient setting from initial presentation through ongoing follow-up. These learning experiences enable students to achieve the program’s Clinical Phase Learning Outcomes. Student learning is assessed primarily with the clinical preceptor evaluation of student performance and a multiple-choice examination.

Pre-requisite(s): Successful completion of all Didactic Phase courses (PAS 506, PAS 507, PAS 501, PAS 502, PAS 503, PAS 511, PAS 512, PAS 513, PAS 531, PAS 532, PAS 533, PAS 541, PAS 542, and PAS 543) and the Didactic Phase Cumulative Assessment (written examination, simulated patient encounter, physical examination skills assessment, and clinical procedures skills assessment).

PAS-621: Hospital Medicine

Credits 4

PAS 621: Hospital Medicine (4.0 credit hours)

This required 4-week supervised clinical practice experience under the supervision of the clinical site preceptor is designed to provide students with exposure to adult and elderly patients admitted to the hospital for acute conditions and exacerbations of chronic conditions. Students apply knowledge and skills learned during the Didactic phase of the program to novel patient encounters in the inpatient setting from admission through discharge. These learning experiences enable students to achieve the program’s Clinical Phase Learning Outcomes. Student learning is assessed primarily with the clinical preceptor evaluation of student performance and a multiple-choice examination.

Pre-requisite(s): Successful completion of all Didactic Phase courses (PAS 506, PAS 507, PAS 501, PAS 502, PAS 503, PAS 511, PAS 512, PAS 513, PAS 531, PAS 532, PAS 533, PAS 541, PAS 542, and PAS 543) and the Didactic Phase Cumulative Assessment (written examination, simulated patient encounter, physical examination skills assessment, and clinical procedures skills assessment).

PAS-622: Outpatient Medicine

Credits 4

PAS 622: Outpatient Medicine (4.0 credit hours)

This required 4-week supervised clinical practice experience under the supervision of the clinical site preceptor is designed to provide students with exposure to adult and elderly patients presenting for acute, chronic, and preventive encounters in family or internal medicine. Students apply knowledge and skills learned during the Didactic phase of the program to novel patient encounters in the outpatient setting from initial presentation through ongoing follow-up. These learning experiences enable students to achieve the program’s Clinical Phase Learning Outcomes. Student learning is assessed primarily with the clinical preceptor evaluation of student performance and a multiple-choice examination.

Pre-requisite(s): Successful completion of all Didactic Phase courses (PAS 506, PAS 507, PAS 501, PAS 502, PAS 503, PAS 511, PAS 512, PAS 513, PAS 531, PAS 532, PAS 533, PAS 541, PAS 542, and PAS 543) and the Didactic Phase Cumulative Assessment (written examination, simulated patient encounter, physical examination skills assessment, and clinical procedures skills assessment).

PAS-631: Behavioral Medicine

Credits 4

PAS 631: Behavioral Medicine (4.0 credit hours)

This required 4-week supervised clinical practice experience under the supervision of the clinical site preceptor is designed to provide students with exposure to adult patients seeking care for acute and chronic behavioral and mental health conditions. Students apply knowledge and skills learned during the Didactic phase of the program to novel patient encounters in the outpatient setting from initial presentation through ongoing follow-up. These learning experiences enable students to achieve the program’s Clinical Phase Learning Outcomes. Student learning is assessed primarily with the clinical preceptor evaluation of student performance and a multiple-choice examination.

Pre-requisite(s):  Successful completion of all Didactic Phase courses (PAS 506, PAS 507, PAS 501, PAS 502, PAS 503, PAS 511, PAS 512, PAS 513, PAS 531, PAS 532, PAS 533, PAS 541, PAS 542, and PAS 543) and the Didactic Phase Cumulative Assessment (written examination, simulated patient encounter, physical examination skills assessment, and clinical procedures skills assessment).

PAS-641: Pediatric Medicine

Credits 4

PAS 641: Pediatric Medicine (4.0 credit hours)

This required 4-week supervised clinical practice experience under the supervision of the clinical site preceptor is designed to provide students with exposure to infants, children, and adolescents brought for acute, chronic, and preventive encounters. Students apply knowledge and skills learned during the Didactic phase of the program to novel patient encounters in the outpatient setting from initial presentation through ongoing follow-up. These learning experiences enable students to achieve the program’s Clinical Phase Learning Outcomes. Student learning is assessed primarily with the clinical preceptor evaluation of student performance and a multiple-choice examination.

Pre-requisite(s): Successful completion of all Didactic Phase courses (PAS 506, PAS 507, PAS 501, PAS 502, PAS 503, PAS 511, PAS 512, PAS 513, PAS 531, PAS 532, PAS 533, PAS 541, PAS 542, and PAS 543) and the Didactic Phase Cumulative Assessment (written examination, simulated patient encounter, physical examination skills assessment, and clinical procedures skills assessment).

PAS-651: Women's Health

Credits 4

PAS 651: Women’s Health (4.0 credit hours)

This required 4-week supervised clinical practice experience under the supervision of the clinical site preceptor is designed to provide students with exposure to adult patients presenting for acute, chronic, and preventive encounters in women’s health. Students apply knowledge and skills learned during the Didactic phase of the program to novel patient encounters in the outpatient setting from initial presentation through ongoing follow-up. These learning experiences enable students to achieve the program’s Clinical Phase Learning Outcomes. Student learning is assessed primarily with the clinical preceptor evaluation of student performance and a multiple-choice examination.

Pre-requisite(s): Successful completion of all Didactic Phase courses (PAS 506, PAS 507, PAS 501, PAS 502, PAS 503, PAS 511, PAS 512, PAS 513, PAS 531, PAS 532, PAS 533, PAS 541, PAS 542, and PAS 543) and the Didactic Phase Cumulative Assessment (written examination, simulated patient encounter, physical examination skills assessment, and clinical procedures skills assessment).

PAS-661: Emergency Medicine

Credits 4

PAS 661: Emergency Medicine (4.0 credit hours)

This required 4-week supervised clinical practice experience under the supervision of the clinical site preceptor is designed to provide students with exposure to adult and elderly patients presenting to the emergency department for acute and emergent encounters and exacerbations of chronic conditions. Students apply knowledge and skills learned during the Didactic phase of the program to novel patient encounters in the emergency department. These learning experiences enable students to achieve the program’s Clinical Phase Learning Outcomes. Student learning is assessed primarily with the clinical preceptor evaluation of student performance and a multiple-choice examination.

Pre-requisite(s): Successful completion of all Didactic Phase courses (PAS 506, PAS 507, PAS 501, PAS 502, PAS 503, PAS 511, PAS 512, PAS 513, PAS 531, PAS 532, PAS 533, PAS 541, PAS 542, and PAS 543) and the Didactic Phase Cumulative Assessment (written examination, simulated patient encounter, physical examination skills assessment, and clinical procedures skills assessment).

PAS-671: Orthopedics

Credits 4

PAS 671: Orthopedics (4.0 credit hours)

This required 4-week supervised clinical practice experience under the supervision of the clinical site preceptor is designed to provide students with exposure to adult patients requiring orthopedic care for acute and chronic encounters. Students apply knowledge and skills learned during the Didactic phase of the program to novel patient encounters in the outpatient setting from initial presentation through ongoing follow-up. These learning experiences enable students to achieve the program’s Clinical Phase Learning Outcomes. Student learning is assessed primarily with the clinical preceptor evaluation of student performance and a multiple-choice examination.

Pre-requisite(s): Successful completion of all Didactic Phase courses (PAS 506, PAS 507, PAS 501, PAS 502, PAS 503, PAS 511, PAS 512, PAS 513, PAS 531, PAS 532, PAS 533, PAS 541, PAS 542, and PAS 543) and the Didactic Phase Cumulative Assessment (written examination, simulated patient encounter, physical examination skills assessment, and clinical procedures skills assessment).

PAS-681: Surgery

Credits 4

PAS 681: Surgery (4.0 credit hours)

This required 4-week supervised clinical practice experience under the supervision of the clinical site preceptor is designed to provide students with exposure to adult patients requiring surgical care for acute, chronic, and emergent encounters. Students apply knowledge and skills learned during the Didactic phase of the program to novel patient encounters in surgical practice. These learning experiences enable students to achieve the program’s Clinical Phase Learning Outcomes. Student learning is assessed primarily with the clinical preceptor evaluation of student performance and a multiple-choice examination.

Pre-requisite(s): Successful completion of all Didactic Phase courses (PAS 506, PAS 507, PAS 501, PAS 502, PAS 503, PAS 511, PAS 512, PAS 513, PAS 531, PAS 532, PAS 533, PAS 541, PAS 542, and PAS 543) and the Didactic Phase Cumulative Assessment (written examination, simulated patient encounter, physical examination skills assessment, and clinical procedures skills assessment).

PAS-691: Selective I

Credits 4

PAS 691/692/693: Selective I/II/III:  Surgery / Medicine (4.0 credit hours)

This required 4-week supervised clinical practice experience under the supervision of the clinical site preceptor is designed to provide students with the opportunity to select a SCPE in a surgery or medicine discipline of interest. Students apply knowledge and skills learned during the Didactic phase of the program to novel patient encounters. These learning experiences enable students to achieve the program’s Clinical Phase Learning Outcomes. Student learning is assessed primarily with the clinical preceptor evaluation of student performance, an assignment, and a presentation.

Pre-requisite(s): Successful completion of all Didactic Phase courses (PAS 506, PAS 507, PAS 501, PAS 502, PAS 503, PAS 511, PAS 512, PAS 513, PAS 531, PAS 532, PAS 533, PAS 541, PAS 542, and PAS 543) and the Didactic Phase Cumulative Assessment (written examination, simulated patient encounter, physical examination skills assessment, and clinical procedures skills assessment).

PAS-692: Selective II

Credits 4

PAS 691/692/693: Selective I/II/III:  Surgery / Medicine (4.0 credit hours)

This required 4-week supervised clinical practice experience under the supervision of the clinical site preceptor is designed to provide students with the opportunity to select a SCPE in a surgery or medicine discipline of interest. Students apply knowledge and skills learned during the Didactic phase of the program to novel patient encounters. These learning experiences enable students to achieve the program’s Clinical Phase Learning Outcomes. Student learning is assessed primarily with the clinical preceptor evaluation of student performance, an assignment, and a presentation.

Pre-requisite(s): Successful completion of all Didactic Phase courses (PAS 506, PAS 507, PAS 501, PAS 502, PAS 503, PAS 511, PAS 512, PAS 513, PAS 531, PAS 532, PAS 533, PAS 541, PAS 542, and PAS 543) and the Didactic Phase Cumulative Assessment (written examination, simulated patient encounter, physical examination skills assessment, and clinical procedures skills assessment).

PAS-693: Selective III

Credits 4

PAS 691/692/693: Selective I/II/III:  Surgery / Medicine (4.0 credit hours)

This required 4-week supervised clinical practice experience under the supervision of the clinical site preceptor is designed to provide students with the opportunity to select a SCPE in a surgery or medicine discipline of interest. Students apply knowledge and skills learned during the Didactic phase of the program to novel patient encounters. These learning experiences enable students to achieve the program’s Clinical Phase Learning Outcomes. Student learning is assessed primarily with the clinical preceptor evaluation of student performance, an assignment, and a presentation.

Pre-requisite(s): Successful completion of all Didactic Phase courses (PAS 506, PAS 507, PAS 501, PAS 502, PAS 503, PAS 511, PAS 512, PAS 513, PAS 531, PAS 532, PAS 533, PAS 541, PAS 542, and PAS 543) and the Didactic Phase Cumulative Assessment (written examination, simulated patient encounter, physical examination skills assessment, and clinical procedures skills assessment).