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Doctoral Dissertation Defense
Submitted to the Graduate Faculty of Argosy University, Phoenix
Graduate School of Business and Management
In Partial Fulfillment of the Requirements for the Degree of Doctor of Education
Organizational Leadership
By Vincent Bridges
December XX, 2016
A QUALITATIVE STUDY OF CURRICULUM OUTCOMES OF MEDICAL ASSISTING PROGRAMS AT THREE
MIDWESTERN UNITED STATES SCHOOLS
John Opinski, Ph.D, Committee ChairGraduate School of Business & Management
David Blake, Ph.D, Committee MemberGraduate School of Business & Management
Dale Mancini, Ph.D, Department ChairGraduate School of Business & Management
DISSERTATION COMMITTEE MEMBERS
Dissertation Defense Agenda Problem Background Purpose and Importance of the Study Problem Statements Themes and Concepts Research Questions Review of Literature Methodology and Study Design Results and Findings Findings Summary Conclusions and Recommendations Future Research and Summary
Background to the Problem
Increasing number of jobs and future projection. (U.S. Bureau of Labor Statistics, 2012)
Education and Preparedness Training of Medical Assistants
Changing role of the Medical Assistant
Shortage of Primary Care Physicians and Nurse Practitioners
(Bodenheimer, Willard-Grace & Ghorob, 2014) Medical Assistant Expanded
Responsibilities (American Association of Medical Assistants, 2015)
Ascertain the effectiveness of the medical assistant program outcomes for three Midwestern United States schools.
Ensuring Quality Patient Care through quality education and training.
Allow educational institutions to align educational delivery with stakeholder needs.
Continuous effort to ensure competent and confident graduates
Purpose and Importance of Study
Problem Statements Medical assistant graduates are encountering job responsibilities that
are traditionally not a part of their formal didactic education and training, due to the changing medical environment and the requirements of the medical assistants to perform expanded job duties to help ensure quality patient care.
Some medical assistant graduates are not considered strong enough candidates as those who have had additional skill set training as it relates to the expanded job duties and functions.
Patient Centered Medical Home Teams vs Traditional Disease Management
Health Coaching vs Traditional Patient Motivation and Education
Panel Management vs Traditional Quality of Care and Patient Care Outcome Management
Medical Scribing vs Traditional Documentation Process and Patient Interaction
Themes and Concepts
How do the program outcome for the medical assisting program at three Midwestern United States schools meet the needs of its stakeholders?
What program decisions or changes can be made by educational leaders of three Midwestern United States schools, as a result of these study results, to enhance or better meet stakeholder needs that may be identified?
Research Questions
The Role of the Medical Assistant Traditional Expanded
Medical Assistants and Healthcare Quality Diabetes Study – UNITE Health Center Hypertension, Hyperlipidemia & Uncontrolled Type 2 Diabetes Study Colon Rectal Cancer (CRC) Screening Study
Review of Literature
Scope of Practice Varies by State Not addressed by some states Delegation of Duties
Delegation of Duties Exclusions Definition of the M.A’s Scope of Practice (McCarty, 2012) As of 2012 , 11 states passed laws recognizing clinical scope of practice
(McCarty, 2012)
Review of Literature – Continued
Medical Assistants and Meaningful Use of Electronic Medical Records Centers for Medicare and Medicaid Services Initiative Electronic Health Records and Computerized Physician Order Entry
Review of Literature – Continued
Study Methodology: Qualitative Study Study Design: Descriptive Design Data Collection Tool & Design Method: A two page survey with seventeen
open and closed-ended questions. Data Collection Method: Online - Preferred, Email, and Mail Sampling Method: Purposive Sampling to identify appropriate professionals
that have experience hiring medical assistants and understand their job responsibilities, and/or managing their day-to-day administrative and clinical responsibilities.
Methodology and Study Design
The study participants must meet the following criteria to participate: Work(ed) for a medical organization, physician practice, healthcare institution or urgent care;
and, Hire(d) Medical Assistants and understand their job duties and requirements; or,
Manage(d) day-to-day clinical and administrative responsibilities of medical assistants (Present or Recent Past); and, Reside in one of the Midwestern United States, including Oklahoma; and, At least 18 years of age.
The study will seek 20-25 healthcare professionals that meet the study participation requirements to complete the online survey.
Population/Sample
Informed Consent and ConfidentialityConsent Documentation and ProcessInformation and Participant Confidentiality and Security
Population/Sample – Continued
Organization Affiliation EMR/EHR Usage/Type EHR Modules (CPOE) PCMH Team Models Medical Scribing Practices Administrative Functions Clinical Function
Data Collection
Simulation Training Laboratory Analysis Skills Microbiology Proficiency Survey Participants Demographics
Total Number of Participants - 25 Gender Make-Up - Female – 64% and Male 36% Participant Educational Level
Some College – 4%, 1 ParticipantAssociate Degree - 28%, 7 ParticipantsBachelor’s Degree – 40%, 10 ParticipantsMaster’s Degree – 16%, 4 ParticipantsDoctorate Degree – 12%, 3 Participants
Participant Profile
Participant Organizational Affiliation Physician Practice – 36%, 9 Participants Hospital or Free-Standing Clinic – 24%, 6 Participants Urgent Care – 20%, 5 Participants Other – 20%, 5 Participants
Chiropractic Medicine, Dialysis, Medical Employment Partners, and Practice Management Leadership Consultants
Participant Profile - Continued
First Coding Cycle Two Elemental Methods Used:
In-Vivo Coding – Use of words or short phrases from the actual language. These codes are identified by “xxxx”.
Descriptive Coding – Summarizing in a word or short phrase the basic topic of a passage of qualitative data.
Second Coding Cycle Pattern Coding – Pulls together a lot of material into a more
meaningful unit of analysis. Frequency – How often or seldom a word or short phrase happens.
Data Review and Coding Process
Streamlined Code and Theory Model
(Saldana, 2016)
Four-Step Process Step 1: Identify what was taught by each institution.
(Institution Catalog & Course Description) Step 2: Identify what the stakeholders considered important.
(Participant Survey) Step 3: Apply a frequency pattern to the stakeholder information
and feedback. (Frequency Tables) Step 4: Compare the data in step three to data in step one.
(Review & Analysis)
Coding Process
School Curriculum Outline
What was identified from the data: 10 Category 17 Sub-Category 152 Codes
Code, Sub-Category and Category Totals
Code, Sub-Category, and Category Table
Code Assignment Table – Clinical Codes
Top Three Code Frequency Table Compilation
Stakeholder/Institution Service ReviewSymbol Grading System
✓ Needs Met × Needs Not Met ✶ Needs Partially Met ≠ Unable to Determine
Results and FindingsCodes Affecting All Institutions
Additional Results and FindingsInstitution “A”
The Areas of Review and Recommendation were discussed under the previous slide “Codes Affecting All Institutions”
“No Additional Findings”
Additional Results and FindingsInstitution “B”
Additional Results and FindingsInstitution “C”
Findings Summary
Institution “A” – Eight (8) Significant FindingsInstitution “B” – Ten (10) Significant FindingsInstitution “C” – Nine (9) Significant Findings
Conclusions and RecommendationsRQ1 - How do the program outcome for the medical assisting program at three Midwestern United States schools meet the needs of its stakeholders?
Overall – All institutions are for the most part meeting the expected stakeholder needs, many of the findings were related to some of the expanded duties and enhancement of some of the traditional functions already being taught and are addressed under RQ2.
Conclusions and Recommendations RQ2 - What program decisions or changes can be made by educational leaders of
three Midwestern United States schools, as a result of the evaluation results, to enhance or better meet stakeholder needs that may be identified?
Enhance Critical Thinking (Exams and Didactic Courses) Incorporate learning and Instruction related to PCMH teams Incorporate learning and Instruction related to CPOE Add Complex Medication Management Add Legal Course Related to Pharmacology & Medication Delivery Introduce Complex Medical or Clinical Scenarios to Promote Critical Thinking and
Decision-Making within the Scope of Practice
Phlebotomy Practice Consider incorporating “live sticks” – using student-student practice
Conclusions and Recommendations - CONT Microbiology (Infection Control)
Include Laboratory Component Inoculate Agar Microscopic Microbe Analysis
Incorporate Chain of Infection Model Include Morphology of Bacteria Teach Various Methods to Break Chain of Infection
Conclusions and Recommendations - CONT Laboratory Test
Urinalysis Glucose Hematocrit
Patient Education Disease Management Goals Patient Out-Reach
Survey Larger Population and Sample Add Additional States – Incorporate M.A. Legislation for Specific States and
analyze impact related to current functions and expanded duties. Research Oversight and Regulation Concerns
Sample – Physicians Regarding Auspice and Oversight and include feedback from various boards such as the Board of Medical Examiners, Board of Osteopathic Examiners, and the various Nursing Boards.
Future Research and Summary
American Association of Medical Assistants. (2015). What is a medical assistant. Retrieved 06 17, 215, from American Association of Medical Assistants: http://www.aama-ntl.org/medical-assisting/what-is-a-medical-assistant
Bodenheimer, T., Willard-Grace, R., & Ghorob, A. (2014, 07). Expanding the roles of medical assistants: Who does what in primary care? Journal of the American Medical Association, 174(7), 1025-1026.doi:10.1001/jamaintemmed.2014.1319
McCarty, M. (2012). The lawful scope of practice of medical assistants: 2012 update. Retrieved from American MedTech: http://www.americanmedtech.org/portals/0/pdf/news/scopeofpracticearticle_june%202012.pdf
References
Saldana, J. (2016). Coding manual for qualitative researchers. Los Angeles: Sage Publishing
U.S. Bureau of Labor Statistics. (2012). Occupational outlook handbook: Medical assistants. Retrieved 06 17, 2015, from U.S. Bureau of Labor Statistics: http://www.bls.gov/ooh/healthcare/medical-assistants.htm
References – Continued
Questions?
Q & A