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RACP Royal Australasian College of Physicians Exam (FRACP)

Domain 1: Clinical Process

THEME 1.1 – CLINICAL SKILLS

Learning objectives

1.1.1 Elicit the history and obtain other relevant data

1.1.2 Conduct an appropriate physical examination

1.1.3 Synthesise findings from history and physical examination to develop a differential diagnosis and
management plan

1.1.4 Plan and arrange investigations appropriately

THEME 1.2 – PATIENT CARE AND THERAPEUTICS

Learning objectives

1.2.1 Manage general care in the unwell patient

1.2.2 Prescribe appropriate and safe pharmacotherapy

1.2.3 Incorporate health and wellness promotion in clinical practice

1.2.4 Manage patients with surgical problems

1.2.5 Facilitate ongoing care planning

THEME 1.3 – PROCEDURAL SKILLS

Learning objectives*

1.3.1 Prepare patient for procedure

1.3.2 Competently perform procedures relevant to Adult Medicine

1.3.3 Provide care following procedure



Domain 2: Medical Expertise

THEME 2.1 – MANAGEMENT OF ACUTE MEDICAL PROBLEMS

Learning objectives

2.1.1 Recognise and manage the critically ill patient

2.1.2 Manage specific acute medical problems

2.1.3 Communicate with patients and their families/carers in an emergency situation

THEME 2.2 – MANAGE PATIENTS WITH UNDIFFERENTIATED

PRESENTATIONS

Learning objectives

2.2.1 Manage patients with undifferentiated presentations

THEME 2.3 – MANAGE PATIENTS WITH DISORDERS OF ORGAN SYSTEMS

Learning objectives

2.3.1 Manage patients with disorders of the cardiovascular system

2.3.2 Manage patients with endocrine and metabolic disorders

2.3.3 Manage patients with disorders of the gastrointestinal system

2.3.4 Manage patients with non-malignant disorders of the haematological system.

2.3.5 Manage patients with disorders of the immune system

2.3.6 Manage patients with mental health disorders

2.3.7 Manage patients with disorders of the musculoskeletal system

2.3.8 Manage patients with disorders of the neurological system

2.3.9 Manage patients with disorders of the renal and genitourinary systems

2.3.10 Manage patients with disorders of the respiratory and sleep system

2.3.11 Manage patients with skin disorders

THEME 2.4 – MANAGE PATIENTS WITH DEFINED DISEASE PROCESSES

Learning objectives

2.4.1 Manage patients with neoplastic diseases

2.4.2 Manage patients with genetic disorders

2.4.3 Manage patients with infectious diseases

THEME 2.5 – MEDICINE THROUGHOUT THE LIFESPAN/GROWTH AND
DEVELOPMENT

Learning objectives

2.5.1 Manage common presentations in adolescents

2.5.2 Manage common presentations in pregnancy

2.5.3 Manage common problems associated with the menopause

2.5.4 Manage problems in the older patient

2.5.5 Manage patients at the end of life


Royal Australasian College of Physicians Exam (FRACP)
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Question: 485
A 35-year-old man, a victim of a motor vehicle accident, was found to havemassive intracranial haemorrhage on computed
tomography of his brain. He hasbeen in a coma for the last 3 days in the intensive care unit and is currently onventilator support.
After talking to the family members, a decision was made tofollowing regarding brain death testing is correct?
A. Sedative drugs should be administered
B. During apnoea testing, breathing is absent despite an arterial PCO2 of
C. Four-vessel angiography is required to establish intracranial blood flow
D. Upgoing plantar responses excludes a diagnosis of brain death
E. There should be a minimum 2-h observation and mechanical ventilation
Answer: B
Explanation:
The Australian and New Zealand Intensive Care Society (ANZICS) has established clinical guidelines to determine brain death.
These should be carried out by two 426 Intensive care medicine medical practitioners with the requisite knowledge, skills and
experience. Some states in Australia require the medical practitioners to have at least 5 years of working experience and at least
one person being a specialist not involved in organ retrieval. In Australia and New Zealand, whole brain death is required for the
legal determination of death. This contrasts with the United Kingdom, where brain-stem death is the standard. Determination of
brain-stem death requires unresponsive coma, the absence of brain-stem reflexes and the absence of respiratory centre function
in the clinical setting in which these findings are irreversible. In particular, there must be definite clinical or neuro-imaging
evidence of acute brain pathology (e.g. traumatic brain injury, intracranial haemorrhage, hypoxic encephalopathy) consistent with
the irreversible loss of neurological function. Certain preconditions have to be met before brain death testing: Absence of
hypothermia (temperature is >35 C) Adequate blood pressure (e.g. systolic blood pressure >90 mmHg, mean arterial pressure
>60 mmHg in an adult) Sedative drug effects are excluded No severe electrolyte, metabolic or endocrine disturbance Intact
neuromuscular function It is possible to examine the brain-stem reflexes (including at least one ear and one eye) It is possible
to perform apnoea testing. For clinical testing there should be a minimum of 4 h observation and mechanical ventilation during
which the patient has unresponsive coma (Glasgow coma score of 3), with pupils non-reactive to light, an absent cough/tracheal
reflex and no spontaneous breathing efforts. 1. No motor response in the cranial nerve distribution to noxious stimulation of the
face, trunk and four limbs, and no response in the trunk or limbs to noxious stimulation within the cranial nerve distribution 2. No
pupillary responses to light 3. Absence of corneal reflexes 4. Absence of gag (pharyngeal) reflex 5. Absence of cough (tracheal)
reflex 6. No vestibulo-ocular reflexes on ice-cold caloric testing 7. Breathing is absent [despite arterial PCO2 >60 mmHg (8 kPa)
and arterial pH < 7.30] 8. Specify PCO2 in mmHg or kPa and pH at end of apnoea. To determine brain death when clinical
examination cannot be done, the absence of intracranial blood flow needs to be demonstrated by either intraarterial angiography
or another reliable method, but is not a routine part of testing.
Question: 486
Which one of the following should be included in the parenteral nutritionfor critically ill patients?
A. Carbohydrate as glucose of 0.5 g/kg ideal body weight/day
B. Amino acid mixture 0.30.5 g/kg ideal body weight/day
C. Lipid emulsions 12 g/kg ideal body weight/day
D. Weekly multivitamins and trace elements
E. Separate infusions of lipid from amino acid-containing mixtures
Answer: C
Explanation:
In the intensive care unit (ICU), patients have increased metabolic needs related to stress, which are likely to accelerate the
development of malnutrition, a condition associated with poorer clinical outcomes. Therefore, it is recommended that all patients
who are not expected to be on normal nutrition within 3 days should receive parenteral nutrition within 2448 h if enteral nutrition
is contraindicated or if they cannot tolerate enteral nutrition (Singer et al., 2009). The minimal amount of carbohydrate required is
about 2 g/kg of glucose/day. Hyperglycaemia (blood glucose >10 mmol/L) contributes to death in critically ill patients and should
be avoided to prevent infectious complications. Studies have shown conflicting outcomes in ICU patients when blood glucose is
maintained between 4.5 and 6.1 mmol/L. There is a higher incidence of severe hypoglycaemia in patients treated to the tighter
limits, but clear recommendations are lacking. A balanced amino acid mixture of 1.31.5 g/kg ideal body weight/day should be
administered and should include 0.20.4 g/kg/day of L-glutamine. Lipids should be an integral part of parenteral nutrition for
energy and to ensure essential fatty acid provision in long-term ICU patients. Essential fatty acids are not synthesised within the
human body and must be supplied. All parenteral nutrition prescriptions should include a daily dose of multivitamins and of trace
elements. Previously, lipid emulsions were given separately but it is becoming more common for a single solution of glucose,
proteins and lipids to be administered.
Question: 487
Which one of the following is correct concerning patient management aftersuccessful resuscitation for ventricular fibrillation
cardiac arrest?
A. Early post-resuscitation electrocardiography accurately identifies acute
B. Oxygen supplementation should be administered to achieve oxygen saturation
C. Mechanical ventilation should be adjusted to achieve normocarbia
D. Myocardial dysfunction after arrest is usually irreversible
E. Pyrexia after cardiac arrest is self-limiting and does not require
Answer: C
Explanation:
Care after cardiac arrest and return of spontaneous circulation (ROSC) substantially influences patient outcomes (Nolan et al.,
2012). An ABCDE (airway, breathing, circulation, disability and exposure) approach can be used to identify and treat organ
failure. Exposure refers to the need for a comprehensive headto-toe assessment. The inspired oxygen concentration
immediately after ROSC should be adjusted to achieve normal arterial oxygen saturation (9498%) when measured by pulse
oximetry and arterial blood-gas analysis. Ventilation should be adjusted to achieve normocarbia and monitored using the end-tidal
carbon dioxide with waveform capnography and arterial blood gases. In the setting of cardiac arrest, an early post-resuscitation
12-lead electrocardiogram (ECG) is less reliable for diagnosing acute coronary occlusion than in patients without cardiac arrest.
Performing immediate coronary artery angiography in all patients with out-of-hospital cardiac arrest and no obvious non-cardiac
cause of arrest, regardless of ECG changes, is becoming increasingly common. Post-cardiac arrest myocardial dysfunction can
be severe, but usually resolves after 4872 h, but this depends on pre-existing dysfunction. In patients with severe cardiogenic
shock, an intra-aortic balloon pump should be considered. Recovery of brain function can be maximised by using targeted
temperature management, optimising cerebral perfusion, and controlling seizures and blood glucose levels. Pyrexia associated
with systemic inflammatory response is common in the first 48 h after cardiac arrest, and is associated with poor outcome.
Therefore, post-cardiac arrest pyrexia should be actively treated and prevented where possible. Mild hypothermia improves
outcome after a period of global cerebral hypoxiaischaemia and it also decreases the cerebral oxygen requirements.
Question: 488
Which one of the following statements is true concerning pulmonary arterycatheters?
A. The pulmonary artery wedge pressure is a measure of left atrial
B. The use of pulmonary artery catheters is associated with improved intensive
C. There is an increased incidence of ventricular arrhythmias
D. Left bundle branch block is a common complication
E. The normal pulmonary artery wedge pressure is 2025 mmHg
Answer: A
Explanation:
The following parameters can be measured with a pulmonary arterial catheter: temperature, central venous pressure, right atrial
pressure, right ventricular pressures, pulmonary artery pressures, pulmonary artery occlusion pressure, cardiac output and mixed
venous sampling. The pulmonary artery wedge pressure (PAWP) tracing is obtained by inflating the balloon at the distal tip of the
catheter, allowing the balloon to obstruct blood flow through a branch of the pulmonary artery. This creates a column of blood
between the catheter tip and the left atrium, equilibrating pressure between them so that the pressure at the distal end of the
catheter (the PAWP) is equal to that of the left atrium. The PAWP, which is also known as the pulmonary capillary wedge
pressure or pulmonary artery occlusion pressure, varies from 6 to 15 mmHg, with a mean of 9 mmHg. The PAWP can estimate
the left ventricular end-diastolic pressure (i.e. the left ventricular preload) if there is no obstruction to flow between the left atrium
and left ventricle. A variety of haemodynamic and clinical problems can reduce the reliability of this estimate, including mitral
valve disease, reduced left ventricular compliance and pulmonary disease. In intensive care unit patients, heart failure patients
and patients undergoing high-risk surgery, the use of pulmonary artery catheters has not been shown to improve survival. Right
bundle branch block is a complication of catheter insertion, placing patients with pre-existing left bundle branch block at risk of
complete heart block. Ventricular and supraventricular tachycardias are well-recognised complications.
Question: 489
In adult comatose patients after cardiac arrest, which one of the followingparameters predicts a poor outcome?
A. E. computed tomography (CT) scan showing cerebral infarction
B. Absence of vestibulo-ocular reflexes at 12 h
C. Glasgow coma scale (GCS) of less than 5 at 12 h
D. Presence of myoclonus
E. A computed tomography (CT) scan showing cerebral infarction
Answer: A
Explanation:
It is impossible to predict accurately the degree of neurological recovery during or immediately after a cardiac arrest. The
neurological examination during cardiac arrest is not helpful in predicting outcome and should not be used. Furthermore, there are
no clinical neurological signs that reliably predict poor outcome less than 24 h after cardiac arrest. After cessation of sedation
(and/or induced hypothermia), the probability of awakening decreases with each day of coma. In adult patients who are comatose
after cardiac arrest, and who have not been treated with hypothermia and who do not have confounding factors (such as
hypotension, sedatives or neuromuscular blockers), the absence of both pupillary light and corneal reflex at 72 h or longer reliably
predicts a poor outcome. Absence of vestibulo-ocular reflexes at 24 h or longer and a Glasgow coma motor score of 2 or less at
72 h or longer are less reliable. Other clinical signs, including myoclonus, are not recommended for predicting poor outcome. The
presence of myoclonus status in adults was strongly associated with poor outcome, but rare cases of good neurological recovery
have been described and accurate diagnosis was problematic. There is insufficient evidence that neuro-imaging or blood tests can
accurately predict outcome.
Question: 490
other medical problems included type 2 diabetes, chronic kidney disease (CKD)with serum creatinine of 178 mol/L due to
diabetic nephropathy, hypertensionand anaemia with a haemoglobin of 85 g/L. He was transferred to the intensivecare unit 2 h
after admission because of severe urosepsis (APACHE II score 30)and persistent hypotension (blood pressure 85/50 mmHg)
despite intravenousfluid resuscitation. Which one of the following statements concerning treatmentoptions is correct?
A. Blood should be transfused to maintain a haemoglobin level above
B. High-dose steroids should be administered
C. Patients should be placed in the supine position
D. Blood glucose level should be strictly controlled between 4.5 and
E. There is no clear benefit of colloid over crystalloid fluid resuscitation
Answer: E
Explanation:
There is good evidence that early resuscitation in patients with severe sepsis or septic shock improves outcome (Annane et al.,
2005; Dellinger et al., 2008). Supine body positioning is a risk factor for nosocomial pneumonia in mechanically ventilated patients,
a semi-recumbent position reduces the risk. Studies show that transfusion of blood to critically ill patients to maintain a
haemoglobin level of greater than 100 g/L does not improve outcome. However, a haemoglobin concentration of less than 70 g/L
has become a more widely accepted threshold after the Transfusion Requirements in Critical Care (TRICC) trial. This trial
randomised 838 critically ill patients to either a restrictive transfusion strategy (transfusion threshold of <70 g/L) or a liberal
transfusion strategy (threshold of <100 g/L) and found that the restrictive strategy decreased in-hospital mortality. Whilst
glycaemic control is important, an intensive insulin regimen to keep the level between 4.4 and 6.0 mmol/L has not shown a
beneficial effect on mortality. In critically ill patients, a target blood glucose of 4.46.1 mmol/L increased the incidence of severe
hypoglycaemia, and either increased mortality or had no effect on mortality, when compared to the more permissive blood
glucose ranges of 7.810 mmol/L. Studies do not support the routine use of steroids in septic shock, but some advocate their use
in patients with increasing vasopressor requirements and failure of other therapeutic strategies. There is no clear benefit of colloid
over crystalloid fluid resuscitation, but crystalloid redistributes rapidly into the whole extracellular volume, hence larger volumes
must be given for intravascular resuscitation.
Question: 491
A 60-year-old man presents with sudden onset of palpitations. He is alertbelow. Which one of the following medications is
contraindicated in this patientto correct the rhythm disturbance?
,
A. Amiodarone
B. Lignocaine
C. Verapamil
D. Magnesium
E. Procainamide
Answer: C
Explanation:
All these medications can be useful agents in the treatment of ventricular tachycardia (VT), except for verapamil. Verapamil is
contraindicated in this case because it can cause the blood pressure to fall due to negative inotropic action (RobertsThomson et
al., 2011). The initial management of a patient with sustained monomorphic VT caused by underlying structural heart disease is
determined by the patients symptoms and haemodynamic state. Direct-current cardioversion is warranted for sustained VT,
which produces symptomatic hypotension, pulmonary oedema or myocardial ischemia. Reversible causes of VT, such as
electrolyte imbalances, acute ischaemia, hypoxia and drug toxicities, should be corrected. In patients who are haemodynamically
stable, pharmacological reversion of VT can be attempted. Lignocaine can be useful in VT associated with ischaemia or
myocardial infarction. However, in patients with slow and stable VT, the efficacy of lignocaine is limited. Intravenous
procainamide is an appropriate therapy in these patients, as it rapidly slows and terminates VT. Although procainamide is
successful for acute arrhythmia termination in around 75% of patients with sustained monomorphic VT, its use can be limited by
hypotension, which occurs in approximately 20% of these individuals. Amiodarone is also useful, but its onset of action is slower
than that of lignocaine or procainamide, and the results of acute termination studies have been variable. Transvenous catheter
pace termination, by application of ventricular pacing at a faster rate than the VT (overdrive), can also be performed to treat
sustained VT. The most common form of idiopathic VT is focal VT arising from the right ventricular outflow tract, which
accounts for approximately 6070% of idiopathic VTs. These focal VTs can manifest as recurrent premature ventricular
contractions or paroxysmal monomorphic VT, usually with left bundle branch block morphology and a marked inferior axis.
Patients, who are typically aged 3050 years, often present with palpitations and, occasionally, presyncope. The treatment of
patients with focal VT depends on the frequency and severity of symptoms, as this condition has a benign course in the vast
majority, with a low incidence of sudden cardiac death. Patients with minimal symptoms do not necessarily need treatment. For
those with severe symptoms or those who have developed a tachycardia-mediated cardiomyopathy, the options include
pharmacological therapy or radiofrequency catheter ablation. Acute termination of focal VT can be achieved by vagal
manoeuvres, such as carotid sinus massage.
Question: 492
Which one of the following factors is associated with increased chances ofa successful spontaneous-breathing trial after
prolonged mechanical ventilation?
A. Pneumonia as cause of respiratory failure
B. Chronic heart failure
C. Upper airway stridor at extubation
D. Partial pressure of arterial carbon dioxide of greater than 45 mmHg after
E. Daily interruption of sedative infusion
Answer: E
Explanation:
Approximately 15% of patients in whom mechanical ventilation is discontinued require re-intubation within 48 h (McConville and
Kress, 2012). Rates of extubation failure vary considerably among intensive care units (ICUs). For example, the average rate of
failed extubation in surgical ICUs ranges from 5% to 8%, whereas it is often as high as 17% in medical or neurological ICUs.
Patients who require re-intubation have an increased risk of death, a prolonged hospital stay and a decreased likelihood of
returning home, as compared with patients in whom discontinuation of mechanical ventilation is successful. Risk factors for
unsuccessful discontinuation of mechanical ventilation include: Failure of two or more consecutive spontaneous-breathing trials
Chronic heart failure Partial pressure of arterial carbon dioxide of greater than 45 mmHg after extubation More than one co-
existing condition other than heart failure Weak cough Upper airway stridor at extubation Age 65 years or older Acute
Physiology and Chronic Health Evaluation (APACHE) II score of greater than 12 on the day of extubation Pneumonia as the
cause of respiratory failure. Treatment approaches include a progressive reduction of ventilator assistance. Increasingly,
tracheostomy is performed in patients who require prolonged weaning. However, the timing of tracheostomy remains
controversial. Potential advantages of tracheostomy include easier airway suctioning and improvements in the patients comfort
and ability to communicate. Although some studies have suggested that early tracheostomy might reduce short-term mortality, the
length of stay in the ICU and the incidence of pneumonia, others have not shown such benefits. A recent meta-analysis led to the
conclusion that there is insufficient evidence to warrant a recommendation for early tracheostomy. Daily interruption of sedative
infusion has been associated with reduction of the duration of mechanical ventilation. Trials of spontaneous breathing assess a
patients ability to breathe while receiving minimal respiratory support. To accomplish this, ventilators are switched from full
respiratory support modes, such as volume-assist control or pressure control, to ventilatory modes, such as pressure support,
continuous positive airway pressure (CPAP) or ventilation with a T-piece (in which there is no positive endexpiratory pressure).
Ideally, a trial of spontaneous breathing is initiated while the patient is awake and not receiving sedative infusions. For a
spontaneous-breathing trial to be successful, a patient must breathe spontaneously with little or no ventilator support for at least
30 min without any of the following: Respiratory rate of more than 35 breaths/min for more than 5 min Oxygen saturation of
less than 90% Heart rate of more than 140 beats/min
Question: 493
A 50-year-old man with cirrhosis due to hepatitis C (from past intravenousdrug use) and refractory ascites is being evaluated for
liver transplantation.His clinical condition is also complicated by porto-pulmonary hypertension.Which one of the following is an
absolute contraindication to orthotopic livertransplantation?
A. A. single hepatocellular carcinoma lesion of 3 cm in diameter
B. Acute kidney injury due to hepatorenal syndrome
C. Not responsive to interferonribavirin treatment
D. Pulmonary artery pressure of 55 mmHg
E. Refractory ascites
Answer: D
Explanation:
The ultimate treatment for cirrhosis and end-stage liver disease is liver transplantation (Schuppan and Afdhal, 2008). Once
decompensation has occurred in all types of liver disease, mortality without transplantation is as high as 85% over 5 years. Porto-
pulmonary hypertension (defined by the co-existence of portal and pulmonary hypertension) is rare, but occurs in up to 1620%
of patients with refractory ascites. The development of porto-pulmonary hypertension seems to be independent of the cause of
portal hypertension. Although most patients with porto-pulmonary hypertension have cirrhosis as the underlying disease, the
syndrome has been described in patients with portal hypertension due to non-hepatic causes, such as portal venous thrombosis in
the absence of chronic hepatic disease. Thus, portal hypertension seems to be the required driving force of pulmonary
hypertension. The mechanisms by which portal hypertension causes pulmonary hypertension remain incompletely understood.
The development of severe pulmonary hypertension in patients who have cirrhosis is an ominous prognostic sign. The condition is
deemed irreversible and a pulmonary artery pressure of more than 40 mmHg precludes liver transplantation. Other absolute
contraindications include: Extrahepatic malignant disease AIDS responding poorly to highly active anti-retroviral therapy
Cholangiocarcinoma Severe uncontrolled systemic infection Multiorgan failure Active substance abuse. The Milan criteria
suggest that the mortality and recurrence of hepatocellular carcinoma is acceptable if liver transplantation is done for either a
single tumour of less than 5 cm in diameter, or no more than three tumours with the largest being less than 3 cm in diameter.
Recurrence of infection with hepatitis C virus is universal following liver transplantation, with an accelerated natural history
compared with hepatitis C infection in immunocompetent patients.
Question: 494
Which one of the above is administered in the management of pulselessventricular tachycardia that persists after three shocks?
A. Adenosine
B. Epinephrine (adrenaline)
C. Amiodarone
D. Atropine
E. Calcium chloride (10%)
F. Flecainide
G. Lignocaine
Answer: C
Explanation:
Amiodarone is an anti-arrhythmic drug with complex pharmacokinetics and pharmacodynamics. It has effects on sodium,
potassium and calcium channels, as well as alpha- and beta-adrenergic blocking properties. Two randomised trials demonstrated
the benefit of amiodarone over conventional care, which included lignocaine in 80% of cases, or routine use of lignocaine for
shock refractory, recurrent ventricular tachycardia (VT) or ventricular fibrillation (VF), for the endpoint of survival to hospital
admission, but not to survival to hospital discharge (Nolan et al., 2012). Additional studies have reported improvement in
defibrillation response when amiodarone is given to patients with VF or haemodynamically unstable VT. In view of the short-term
benefits, amiodarone should be considered for refractory VF or VT. There is little evidence to suggest a survival-to-discharge
advantage with any anti-arrhythmic drug used during resuscitation from out-of-hospital or in-hospital cardiac arrest. Amiodarone
is given intravenously with an initial dose of 300 mg. An additional dose of 150 mg could be considered. This may be followed by
an infusion at a rate of 15 mg/kg over 24 h. Amiodarone is recommended following the third shock; however, in situations where
two or three stacked shocks are given in the first round, amiodarone is not given until two further shocks, with 2 min of
cardiopulmonary resuscitation in between each round, have been given.
Question: 495
Which one of the above is used in the management of torsades de pointes?
A. Adenosine
B. Epinephrine (adrenaline)
C. Amiodarone
D. Atropine
E. Calcium chloride (10%)
F. Flecainide
G. Lignocaine
Answer: H
Explanation:
Magnesium is an electrolyte that is essential for membrane stability. Hypomagnesaemia causes myocardial hyperexcitability,
particularly in the presence of hypokalaemia and digoxin. Compared with placebo, magnesium has not been shown to increase
return of spontaneous circulation (ROSC) or survival for patients in VF in the pre-hospital, intensive care and emergency
department settings. Magnesium should be given for hypomagnesaemia and torsades de pointes, but there is insufficient data for
or against its routine use in cardiac arrest.
Question: 496
Which one of the above should be administered to a patient experiencingpalpitations caused by rapid atrial fibrillation (AF) with
an accessory pathway?
A. Adenosine
B. Epinephrine (adrenaline)
C. Amiodarone
D. Atropine
E. Calcium chloride (10%)
F. Flecainide
G. Lignocaine
Answer: F
Explanation:
The goals of acute drug therapy for rapid atrial fibrillation (AF) with an accessory pathway are prompt control of the ventricular
response and stabilisation of the haemodynamic state (Link, 2012). Treatment of AF with an accessory pathway requires a
parenteral drug with rapid onset of action that lengthens antegrade refractoriness and slows conduction in both the AV node/
HisPurkinje system and the accessory pathway. Treatment is not to differentially block the AV node as this may increase
antegrade conduction down the accessory pathway and accelerate the ventricular rate. Flecainide is effective at slowing
conduction through both normal pathways as well as accessory pathways, and is therefore less prone to diverting conduction
toward the accessory path. It also has greater effect at higher atrial rates. It is a potent inhibitor of sodium channels and
therefore slows conduction. The effect of flecainide can be seen as lengthening of the PR interval and widening of the QRS
complex on the electrocardiogram. Flecainide is also known to be negatively inotropic and may result in bradycardia and
hypotension. Other side effects include visual blurring and oral paraesthesiae. Cardioversion is required for haemodynamically
unstable patients.
Question: 497
Which one of the above should be administered to a patient who developsventricular tachycardia at the onset of his regular
haemodialysis with pre-dialysisbiochemistry showing a potassium level of 7.0 mmol/L (3.44.5 mmol/L)?
A. Adenosine
B. Epinephrine (adrenaline)
C. Amiodarone
D. Atropine
E. Calcium chloride (10%)
F. Flecainide
G. Lignocaine
Answer: E
Explanation:
Calcium is essential for normal muscle and nerve activity. It transiently increases peripheral resistance, myocardial excitability
and contractility. Calcium may have toxic effects on an ischaemic myocardium. Therefore, it is to be given only to patients with
hypocalcaemia, hyperkalaemia or who have overdosed on a calcium antagonist. Randomised controlled trials and observational
studies have demonstrated no survival benefit when calcium was given to in-hospital or out-of- hospital cardiac arrest patients. In
ventricular fibrillation, calcium did not restore spontaneous circulation. Hyperkalaemia raises the resting membrane potential,
causing a narrowing between resting membrane potential and threshold potential for action potential (AP) generation. Calcium
restores this initial narrowing back towards 15 mV by raising the threshold potential to being less negative. APs generated from
less negative voltages are slower since sodium channels in phase 0 are voltage dependent for velocity (Vmax). Calcium restores
Vmax, resulting in improvement in ECG changes within minutes of administration.
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Certification-Board Australasian mock - BingNews https://killexams.com/pass4sure/exam-detail/RACP Search results Certification-Board Australasian mock - BingNews https://killexams.com/pass4sure/exam-detail/RACP https://killexams.com/exam_list/Certification-Board Certification Grievances Appeal Process

If an ISA CAP® or CCST® applicant feels he/she was wrongly denied certification, original or renewal, from the CAP or CCST program, then he/she has the right to appeal.

Appeals Procedures

All appeals shall be in writing.

  1. The notice of appeal must be delivered to the Certification Board, addressed to the attention of the ISA Executive Director, by the close of business on the 21st day after the receipt date of the notice of denied certification.
  2. The appeal should include the date the notice of denied certification was received and must state the reasons the applicant believes the denied certification was in error.
  3. The appeal should indicate whether or not the applicant requests a hearing.
    1. If a hearing is requested, the applicant must explain why a hearing is needed, identify the issues to be resolved at a hearing, list names of prospective witnesses, and identify documentation and other evidence to be introduced at the hearing before the Board.
  4. The Chair of the Certification Board will select a three-member panel of the Board to become the Review Panel, one of whom shall be appointed Chair and will be the final vote in the event of a tie during the ruling.

Procedures

The Review Panel will review the appeal and any request for a hearing. The Review Panel will grant a hearing in connection with the appeal, if requested.

Hearing

  1. The Chair of the Review Panel will determine the time and location of the hearing within 90 days after determination that a hearing is warranted and will notify the applicant within the first 21 days. The applicant will be notified of the hearing time and location at least 20 days prior to the time determined for the hearing.
  2. The applicant may be represented by counsel or represent him/herself at the hearing. The applicant may offer witnesses and documents and may cross-examine any witness.
  3. The Review Panel may consider any evidence it deems relevant without regard to strict application of legal rules of evidence.
  4. The applicant is urged to submit a written brief (four copies) 10 days prior to the hearing to the Certification Board, addressed to the attention of the ISA Executive Director, for distribution to the panel in support of his/her position. However, written briefs are not required.

Deposition

  1. If the applicant or Review Panel desires to take a deposition prior to the hearing of any voluntary witnesses who cannot attend the hearing, the deposition of a witness may be applied for in writing to the Chair of the Review Panel together with a written consent signed by the potential witness that he or she will give a deposition for one party and a statement to the effect that the witness cannot attend the hearing along with the reason for such unavailability.
  2. The party seeking to take the deposition of a witness shall state in detail as to what the witness is expected to testify.
  3. If the Chair of the Review Panel is satisfied that such deposition from a possible witness will be relevant to the issue in question before the Panel, then the Chair will authorize the taking of the deposition. The Chair will also designate a member of the Panel to be present at the deposition.
  4. The deposition may be taken orally or by video. Any refusal of the taking of the deposition by the Chair shall be reviewed by the Panel at the request of the applicant.
  5. The party requesting the deposition will pay for the cost connected with taking the deposition.

The applicant will be notified of the result of the Review Panel within 30 days of the meeting.

Final Review

  1. If the Review Panel makes a decision adverse to the applicant, the applicant may appeal to the full Certification Board for a final review by the close of business on the 21st day after the notice of decision is issued. Such appeal shall follow the same procedures as the initial appeal to the extent possible with the Chair of the Board serving as the Chair of the Final Review Panel. The Chair will once again select a three-member panel, one of whom shall be himself, to become the Review Panel, and the final vote in the event of a tie during the ruling shall be his.
  2. If the applicant does not petition the Board for review or request a hearing before the Board regarding the recommendation of rejection of the application within the time allowed by these rules, the original decision by the Review Panel shall stand.
Mon, 03 Jul 2023 20:58:00 -0500 en text/html https://www.isa.org/certification/certification-testing/certification-grievances-appeal-process
Online Pharmacy Technician Certification Course

Requirements for pharmacy technicians vary by state, but most require certification, registration or licensure. Earning your certification from the Pharmacy Technician Certification Board (PTCB) provides a valuable, industry-recognized credential that meets most states’ requirements.

Sun, 27 Mar 2022 10:32:00 -0500 en text/html https://www.utsa.edu/pace/online/pharmacy-technician-certification-training.html
How to become a PADI wreck diver: The step-by-step guide No result found, try new keyword!We humans have always been fascinated with shipwrecks. From finding hidden treasures to making new discoveries, a lot of the advances in scuba diving were motivated ... Fri, 05 Jan 2024 01:45:06 -0600 en-us text/html https://www.msn.com/ New Cardiology Certification Board: What's the Plan?

The proposal by the major cardiovascular societies in the US to form a new board of cardiovascular medicine to manage initial and ongoing certification of cardiologists represents something of a revolution in the field of continuing medical education and assessment of competency. 

Five US cardiovascular societies — the American College of Cardiology (ACC), the American Heart Association (AHA), the Heart Failure Society of America (HFSA), the Heart Rhythm Society (HRS), and the Society for Cardiovascular Angiography &amp; Interventions (SCAI) — have now joined forces to propose a new professional certification board for cardiovascular medicine, to be known as the American Board of Cardiovascular Medicine (ABCVM)

The ABCVM would be independent of the American Board of Internal Medicine (ABIM), the current organization providing maintenance of certification for cardiologists as well as many other internal medicine subspecialties. The ABIM's maintenance of certification process has been widely criticized for many years and has been described as "needlessly burdensome and expensive." 

The ABCVM is hoping to offer a more appropriate and supportive approach, according to Jeffrey Kuvin, MD, a trustee of the ACC, who has been heading up the working group to develop this plan. 

Kuvin, who is chair of the cardiology at Northwell Health, Manhasset, New York, a l arge academic healthcare system, explained that maintenance of certification has been a topic of discussion across the cardiovascular community for many years, and the ACC has a working group focused on the next steps for evaluation of competency, which he chairs.

"The topic of evaluation of competence has been on the mind of the ACC for many years and hence a work group was developed to focus on this," Kuvin noted. "A lot of evolution of the concepts and next steps have been drawn out of this working group. And now other cardiovascular societies have joined to show unification across the house of cardiology and that this is indeed the way that the cardiovascular profession should move." 

"Time to Separate from Internal Medicine"

The general concept behind the new cardiology board is to separate cardiology from the ABIM. 

"This is rooted from the concept that cardiology has evolved so much over the last few decades into such a large multidimensional specialty that it really does demarcate itself from internal medicine, and as such, it deserves a separate board governed by cardiologists with collaboration across the entirely of cardiology," Kuvin said. 

Cardiology has had significant growth and expansion of technology, tools, medications, and the approach to patients in many specialities and subspecialties, he added. "We have defined training programs in many different areas within cardiology; we have our own guidelines, our own competency statements, and in many cases, cardiology exists as its own department outside of medicine in many institutions. It's just time to separate cardiology from the umbrella of internal medicine." 

The new cardiology board would be separate from, and not report to, the ABIM; rather, it would report directly to the American Board of Medical Specialties (ABMS), the only recognized medical certification body in the US. 

What Are the Proposed Changes

Under the present system, managed by the ABIM, clinicians must undergo two stages of certification to be a cardiologist. First, they have to pass the initial certification exam in general cardiology, and then exams in one of four subspecialties if they plan to enter one of these, including interventional cardiology, electrophysiology, advanced heart failure or adult congenital heart disease

Next, clinicians enter the maintenance of certification phase, which can take three different forms: 1) taking another recertification exam every 10 years; 2) the collaborative maintenance pathway — a collaboration between ACC and ABIM, which includes evaluation, learning and a certified exam each year; or 3) longitudinal knowledge and assessment — in which the program interacts with the clinician on an ongoing basis, sending secured questions regularly. 

All three of these pathways for maintenance of certification involve high stakes questions and a set bar for passing or failing. 

Under the proposed new cardiology board, an initial certification exam would still be required after fellowship training, but the maintenance of certification process would be completely restructured, with the new approach taking the form of continuous learning and assessment of competency. 

"This is an iterative process, but we envision with a new American Board of Cardiovascular Medicine, we will pick up where the ABIM left off," Kuvin notes. "That includes an initial certifying examination for the five areas that already exist under the ABIM system but with the opportunities to expand that to further specialties as well."

He points out that there are several areas in cardiology that are currently not represented by these five areas that warrant some discussion, including multimodality imaging, vascular heart disease, and cardio-oncology. 

"At present, everybody has to pass the general cardiology exam and then some may wish to further train and get certified in one of the other four other specific areas. But one topic that has been discussed over many years is how do we maintain competency in the areas in which clinicians practice over their lifetime as a cardiologist," Kuvin commented. 

He said the proposed cardiology board would like to adhere to some basic principles that are fundamental to the practice of medicine. 

"We want to make sure that we are practicing medicine so that our patients derive the most benefit from seeing a cardiologist," he said. "We also want to make sure, however, that this is a supportive process, supporting cardiologists to learn what they know and more importantly what they don't know; to identify knowledge gaps in specific area; to help the cardiologist fill those knowledge gaps; to acknowledge those gaps have been filled; and then move on to another area of interest. This will be the focus of this new and improved model of continuous competency."

The proposed new board also says it wants to make sure this is appropriate to the area in which the clinician is practicing.

"To take a closed book certified exam every 10 years on the world of cardiology as happens at the current time – or the assessments conducted in the other two pathways – is often meaningless to the cardiologist," Kuvin says. "All three current pathways involve high stakes questions that are often irrelevant to one’s clinical practice." 

Lifelong Learning

"The crux of the changes we are proposing will be away from the focus of passing a test towards a model of helping the individual with their competency, with continuous learning and evaluation of competency to help the clinician fill in their knowledge gaps," he explains.

He described the new approach as "lifelong learning," adding that, instead of it being "a punitive pass/fail environment with no feedback, which causes a lot of discontent among clinicians," it will be a supportive process, where a clinician will be helped in filling their knowledge gaps. 

"I think this would be a welcome change not just for cardiology but across medical specialties," Kuvin said. 

He also pointed out the ABMS itself is considering a continuous competency approach, and the proposed new cardiology board aims to work with the ABMS to make sure that their goals of continuous competency assessment are matched. 

"The world has changed. The ability to access information has changed. It is no longer imperative for a clinician to have every piece of knowledge in their brain, but rather to know how to get knowledge and to incorporate that knowledge into clinical practice," Kuvin noted. "Competency should not involve knowledge alone as in a closed book exam. It is more about understanding the world that we live in, how to synthesize information, where we need to improve knowledge and how to do that." 

Kuvin acknowledged that asking clinicians questions is a very helpful tool to identify their knowledge base and their knowledge gaps. "But we believe the clinician needs to be given resources – that could be a conference, an article, a simulation - to fill that knowledge gap. Then we could ask clinicians some different questions and if they get those right then we have provided a service." 

Tactile skills for cardiologists needing to perform procedures – such as interventionalists or electrophysiologists may be incorporated by simulation in a technology-based scenario.

On how often these assessments would take place, Kuvin said that hadn't been decided for sure. 

"We certainly do not think an assessment every 10 years is appropriate. We envision, instead of an episodic model, it will be rather a lifelong journey of education and competency. This will involve frequent contact and making sure knowledge gaps are being filled. There are criteria being set out by the ABMS that there should be a certain number of touch points with individuals on an annual as well as a 5-year basis to make sure cardiologists are staying within specific guardrails. The exact nature of these is yet to be determined," he said. 

Kuvin added that it was not known yet what sort of hours would be required but added that "this will not be a significant time burden."

What is the Timeframe?

The application to the ABMS for a separate cardiology board is still ongoing and has not yet received formal acceptance. Representatives from the five US cardiovascular societies are in the initial stages of formulating a transition board. 

"The submission to the ABMS will take time for them to review. This could take up to a year or so," Kuvin estimates. 

This is the first time the ABMS has entertained the concept of a new board in many years, he noted. "It will be a paradigm shift for the whole country. I think that cardiology is really at the forefront and in a position where we can actually do this. If cardiovascular medicine is granted a new board, I think this will help change the approach of how physicians are assessed in terms of continuous competency not just in cardiology but across all specialties of medicine."

He added: "We are confident that we can work within the construct of the ABMS guidelines that have been revised to be much more holistic in the approach of continuous competence across the board. This includes thinking beyond rote medical knowledge and thinking about the clinician as a whole and their abilities to communicate, act professionally, work within a complex medical system, utilize medical resources effectively. These all have to be part of continuous competence."

How Much Will This Cost?

Noting that the ABIM has received criticism over the costs of the certification process, Kuvin said they intend to make this "as lean a machine as possible with the focus on reducing the financial [burden] as well as the time burden for cardiologists. It is very important that this is not cumbersome, that it is woven into clinical practice, and that it is not costly." 

But he pointed out that building a new board will have significant costs. 

"We have to think about developing initial board certification examinations as well as changing the paradigm on continuous certification," he said. "This will take some up-front costs, and our society partners have decided that they are willing to provide some start-up funds for this. We anticipate the initial certification will remain somewhat similar in price, but the cost of ongoing continuous competency assessment will be significantly reduced compared to today's models."

Kuvin said the collaboration of the five participating US cardiovascular societies was unprecedented. But he noted that while the transition board is beginning with representatives of these individual societies, it will ultimately be independent from these societies and have its own board of directors. 

He suggested that other societies representing other parts of cardiology are also interested. "Cardiology has recognized how important this is," he said. "Everybody is excited about this."

Thu, 07 Dec 2023 08:53:00 -0600 en text/html https://www.medscape.com/viewarticle/new-cardiology-certification-board-what-s-plan-2023a1000umq
National Board Certification FAQs

Should I take EDCI 5515 or EDCI 5959 credits?

EDCI 5515 credits should be taken if you want to use the National Board Certification toward your Master's degree in Curriculum &amp; Instruction. EDCI 5959 credits are for continuing education only and will NOT be accepted on your Program of Study for the Master's degree in C&amp;I. 

Will there be classes offered to help me proceed through the National Board Certification process?

Yes, a series of seminars and workshops are offered through the Wyoming National Board Certification Initiative each semester. Information about these seminars and workshops is posted and updated on the Wyoming NBC website. Graduate level Curriculum and Instruction credit is available for these seminars (courses listed as EDCI 5515). These courses are designed to support teachers as they grow as professionals and simultaneously proceed through the Board Certification process and the UW Master’s program.  

Where will the classes be offered?

The classes are offered around the state of Wyoming to allow participation across the state. Dates and locations for upcoming seminars and workshops can be found on the Wyoming NBC website. Participants enroll in the courses through UW Outreach Credit Programs (toll free phone number: 1-800-448-7801). Up to 9 total credit hours of the seminars can be taken by enrolled graduate students. Up to 9 total seminar/workshop credit hours may be applied as electives in the Curriculum and Instruction Master’s program.  

Who will teach these classes?

The seminars are taught by Barbara Maguire, a Nationally Board Certified teacher and expert in the NBC process.

How many times can I take the NBC class?

Graduate students/National Board Candidates can enroll in the seminars as many times as necessary/desired. For those seeking graduate degrees, up to 9 credits can be applied to the Curriculum and Instruction Master’s degree program as elective hours dependent upon the student’s committee approval.

What about tuition?

Students will pay regular graduate tuition for the seminar classes. View the current UW fee schedule

Will I need to complete a Thesis or Plan B paper to finish my C&amp;I degree? No, the NBC Portfolios will be accepted in Lieu of a Plan B Paper for teachers pursuing NBC Certification and a UW Master’s degree simultaneously. This acceptance is dependent upon committee approval (not acceptance by the National Board). An agreement to utilize this procedure and maintain portfolio confidentiality has been reached between UW and the NBPTS (National Board for Professional Teaching Standards). The NBC portfolio must be submitted and defended (in a meeting with the student’s graduate committee) prior to initial submission to the NBPTS.  The committee’s portfolio copies will be destroyed after the defense.

Note: The Rubric for Assessment of the presentation  is provided below.

If I am already a National Board Certified teacher, can I apply my NBC work retroactively to a graduate degree?

No, the program is designed for those working on National Board Certification and a C&amp;I Master’s degree simultaneously.

How do I apply for a UW Curriculum and Instruction Graduate Program?

 The graduate application and other information can be found here.

What if I have Additional Questions?

 If you have additional questions, please contact the UW Department of Curriculum and Instruction (curriculum@uwyo.edu; 307-766-6371).

Assessment Checklist for National Board Certification (NBC)

Portfolio &amp; Presentation 

Committee members will evaluate the following areas and will determine if the student/NBC candidate accomplished each of these aims/activities at a level sufficient to warrant the substitution of the NBC portfolio and presentation for the Plan B requirement. S/U (Satisfactory/Unsatisfactory) will be assigned  for each area, and an overall evaluation of “S” must be achieved for portfolio to serve in lieu of the Plan B paper.  

______ Overall evaluation of the portfolio and presentation as suitable substitutes for Plan B

paper/project and defense

Presentation of NBC Portfolio to Master’s Committee:

______Student provides a brief overview of National Board Certification process and portfolio

______Student describes process of working on the portfolio (including connections to C&amp;I courses

taken, time commitment, assessments and data analysis, and reflections)

______ Student presents at least one explicit connection between the portfolio documentation and

his/her C&amp;I Master’s Degree coursework (e.g. assessment strategy learned in literacy specific

course was used to evaluate student work included in NBC portfolio), and explains ways processes informed each other

_____ Student describes challenges, pleasures, difficulties associated with the NBC process

_____Student summarizes learning derived from portfolio process and completion

 

 More information on National Board Certification:

Visit our Course Schedule page to view projected MA core and emphasis course offerings

Sun, 12 Nov 2023 09:24:00 -0600 en text/html https://www.uwyo.edu/ste/masters-degrees/national-board-certification-faq.html
Three MISD teachers receive National Board Certification No result found, try new keyword!“I’m so glad I did this.” Obtaining National Board Certification challenges teachers to hone their practice, demonstrate their professional knowledge, and reinforce their dedication to ... Fri, 15 Dec 2023 08:36:00 -0600 en-us text/html https://www.msn.com/ Five ECISD teachers get National Board certification

ODESSA, Texas — Five teachers got a big surprise Monday, all for doing what they love, educating students.

In 2023, Ector County Independent School District awarded five teachers with the National Board for Professional Teaching Standards Certification with a check of $3,000.

What this means is the teachers selected demonstrated a deep understanding of their students, content knowledge, use of data, assessments and teaching practice.

NewsWest 9 spoke with one of the recipients to hear how the National Board Standards not only improved their work, but introduced new skills.

"The National Board makes you focus on explaining things and writing things down and showing and writing kind of what you're doing already," Odessa College Tech Teacher Shelly Wagner said. "So it hyper-focuses you on the little decisions you make every day and it seems automatic sometimes when teachers are teaching in the classroom and it comes easy, people from the outside walk in and see you teaching and 'Oh wow, that looks fun,' but there's a lot of thought process behind it and National Board makes you focus on that thought process and really hone in to make your decisions better."

Mon, 11 Dec 2023 21:51:00 -0600 en-US text/html https://www.newswest9.com/article/news/education/five-ecisd-teachers-get-national-board-certification/513-9b6b7764-279a-4c2c-b504-bcd4b9d4af5e
How to Become an ABA Therapist

Drexel University School of Education

Building a career in Applied Behavior Analysis (ABA) therapy is an opportunity to make a life-changing difference in the lives of those with behavioral, developmental, or intellectual issues. ABA therapy can be very challenging but is also rewarding work that can improve behaviors and daily skills of those in need of intervention, work that is meaningful to the individuals receiving the supports as well as their parents. Pursuing advanced education in ABA therapy is critical, as it provides the rigorous coursework, practical training, and certification requirements necessary for a successful and effective career in the field.

What is ABA Therapy?

Applied Behavior Analysis (ABA) therapy is a category of therapy that employs evidence-based tools and practices to treat individuals diagnosed with behavioral and developmental disorders. While ABA therapy is most commonly associated with the treatment of children with autism, other applications of ABA therapy include ADHD, traumatic brain injury, dementia, and other developmental issues. Treatment strategies within ABA therapy use positive reinforcement practices to improve the social, learning, communication, life-management, and other functional skills of individuals with behavioral disorders. Research demonstrates that consistent participation in ABA therapy is an effective means to address these needs.

What Does an ABA Therapist Do?

ABA therapists assess their individuals ‘behavioral issues, or behavior reduction. Then they will work on skill acquisition. One way a therapist may approach skill acquisition will be to break down targeted behaviors into smaller steps and reward patients for improving a targeted behavior or skill. ABA therapists also monitor progress, document the effectiveness of treatment strategies, and work with parents, teachers, clinicians, and other stakeholders on strategies for maintaining desired behaviors. The goal of the ABA therapist is to help the individual develop the behavioral and practical skills for independence in their personal and professional lives.

ABA therapists practice across a range of settings, but education and healthcare are the most common industries for the profession. In school and classroom settings, ABA therapists collaborate with teachers and administrators to develop individualized and school-wide positive behavior support plans for addressing student behavior challenges. Working with students diagnosed with autism is common in this setting. ABA therapists serve an important role in healthcare settings, such as hospitals, clinics, and private practices, where they may work with patients with significant behavioral challenges, addiction issues, or those recovering from a traumatic brain injury or living with dementia, who need to improve specific behaviors and skills to enhance functions within daily life. Across professional settings, ABA therapists typically work under the supervision of a board certified behavior analyst (BCBA), who has obtained higher levels of training and certification.

ABA Therapy Education Requirements

Those interested in becoming an independent practicing ABA therapist must earn a bachelor’s degree, and in most cases a master’s degree. At the undergraduate level, a bachelor’s degree in psychology, sociology, education, or other behavioral science most closely aligns with the skills required of an ABA therapist. While a bachelor’s degree may provide the qualifications for some assistant-level positions, most careers in ABA therapy require a master’s degree and BCBA certification.

5 Steps to Become an ABA Therapist: Qualifications and Education Requirements

Below are the five main requirements for becoming a licensed and board-certified ABA therapist.

1. Obtain an Undergraduate Degree

Earning a bachelor’s degree is the first step in becoming an ABA therapist. Many of those interested in pursuing a career in ABA therapy will earn a bachelor’s degree in psychology or special education, as the field explores issues of human behavior, developmental disorders, and mental health conditions that directly apply to the practice of ABA therapy. Undergraduate degrees in education are also common. We encourage you to visit the School of Education’s undergraduate degrees webpage to learn more about our academic offerings.

2. Obtain a Graduate Degree

Graduate-level coursework provides the skills and training necessary for most professional positions in the field of ABA therapy, and a master’s degree is required for board certification. A behavior analyst degree, like Drexel’s MS in Applied Behavior Analysis, provides the course sequence necessary to the take the Board Certified Behavior Analyst® examination. ABAI-verified graduate programs provide critical supervision by experienced ABA therapists that help students meet the requirements for the profession.

3. Gain Relevant Experience

The BACB requires 1,500-2,000 hours of experience in the field as part of the requirements to become a licensed board certified behavior analyst and practice ABA therapy. A majority of states in the U.S. also have strict requirements regarding field experience. Many states require 1,000+ hours of hands-on clinical experience, supervised by a qualified BCBA or instructor who has also completed the requirements outlined by their state for the licensed practice of ABA therapy. Not all states adhere to the same fieldwork requirements, so individuals should consult with their state’s licensing board. Students in Drexel's MS in Applied Behavior Analysis program complete field experience hours as part of the program.

4. Become Licensed and Certified

License and certification requirements will vary from state to state. Some states do not require a license, some require BCBA certification for licensure, and many employers require a license and BCBA certification, even if the employer’s state does not. Individuals should visit the APBA Licensure and Other Regulation of ABA Practitioners page to learn about the requirements of their state and work closely with their state’s licensing board when they reach this stage. Generally, aspiring ABA therapists who meet the standards set by the Behavior Analyst Certification Board (BACB) and who obtain BCBA certification will fulfill most of the qualifications for a license to practice in the field. Drexel’s MS in Applied Behavior Analysis and Applied Behavior Analysis certificate program provide students with the coursework needed for the BCBA certification exam.

5. Maintain Licensure

A BACB license for the practice of ABA therapy must be renewed every two years. License renewal requirements vary from state to state but include several steps in common, including continuing education coursework, adherence to the BACB code of ethics, and other self-reported requirements. Individuals should consult with their state’s licensing board to learn more about the requirements and application process for license renewal.

How Long Does It Take to Become an ABA Therapist?

Aspiring ABA therapists should expect to devote a minimum of six years to education and practical training. Typically, four years is spent earning a bachelor’s degree in a relevant field and two years earning a master’s degree and becoming certified. Students in Drexel’s two-year MS in Applied Behavior Analysis program complete the required coursework during the course of the program. For those with master’s degrees, Drexel offers a 12-to-21-month ABA certificate program that provides the necessary coursework for BACB certification.

Skills Needed to be an ABA Therapist

Individuals with behavioral issues and disorders are all unique, so the methodologies of ABA therapy are not one-size-fits all. Successful ABA therapists possess the skills and exhibit the qualities that lead to individualized, compassionate, and holistic care for the individuals they treat.

  • Active listening and observation: In order to develop an effective treatment plan, ABA therapists must carefully observe patient behaviors, actively listen to input from parents, teachers and other caregivers, and pay close attention to both verbal and non-verbal cues.
  • Critical and creative thinking: Because the needs of every patient are different, an ABA therapist must be able to evaluate each case to determine a customized plan of treatment. ABA therapists often have to think creatively and outside-of-the-box to develop effective interventions and ways of communicating with their patients.
  • Adaptability: Patient circumstances are all unique, and treatment plans may need to change over time, so ABA therapists must be able to adapt and be flexible to meet patients’ evolving needs.
  • Communication: ABA therapists use communications skills not only to interact personally with patients, parents, teachers, and other stakeholders, but also to effectively explain intervention strategies and deliver treatment updates on a regular basis.
  • Empathy: Successful ABA therapists exhibit empathy and compassion in their work with patients and the individuals in their patients’ lives. Developing this critical skill is key to helping patients feel respected and understood.
  • Detail-oriented work ethic: Following the protocols of the profession and documenting behavioral assessments, treatment plans, and patient outcomes require that an ABA therapist exercise a detail-oriented work ethic.

What is the Expected Salary for an ABA Therapist?

The average salary for an ABA therapist in the U.S. is $42,088 per year, according to Glassdoor. Salaries may vary based on education level, regional location, years of experience, and industry. ABA therapists hold a wide range of professional roles – from behavior analysis consultants to program coordinators to clinical directors. Because ABA therapists can build a career in so many different fields, there is an equally wide range of earnings potential.

Becoming an ABA Therapist with the Help of Drexel University’s School of Education

A master’s degree is required to become a board certified behavior analyst (BCBA).

For those without a master’s degree, Drexel’s Master of Science (MS) in Applied Behavior Analysis (ABA) equips students with the skills and knowledge they need for a successful career in the ABA profession. Within the master’s program, students take the required courses before they take the Behavior Analyst Certification Board (BACB) exam. For those with a master’s degree not in ABA, Drexel offers a certificate in Applied Behavior Analysis that provides the ABAI-verified coursework necessary for taking the BACB exam.

Interested in becoming an ABA Therapist? Take the first step by applying or requesting more information about our ABA programs.

Fri, 03 Feb 2023 10:38:00 -0600 en text/html https://drexel.edu/soe/resources/career-path/how-to-aba-therapist/
New police board revokes certification for six officers in first meeting

Dec. 13—During their first time meeting as a group Wednesday, members of a newly formed state police board revoked the certification of six officers — and one law enforcement communication worker — from around the state.

The board also issued certification suspensions — from 30 hours to 180 days — to eight officers or dispatchers and dismissed four disciplinary cases.

They were the first steps in a process that could shape law enforcement statewide for years to come — changes that could include the overhaul of rules that govern law enforcement policies, discipline and training.

In the short term, Wednesday's moves cut down some of the backlog in disciplinary cases for the Law Enforcement Certification Board, a product of state legislation earlier this year that split the former Law Enforcement Academy Board into two different groups that each oversee different functions of the state's police academy program.

The other newly formed body — the Standards and Training Council — met in recent weeks to begin its review of police training around the state.

One of the actions the board took Wednesday was a temporary suspension of certification for Brad Lunsford, a Las Cruces police officer who recently was indicted on a voluntary manslaughter charge after he was accused of shooting and killing a man.

The board requested the academy's staff to expedite an investigation into Lunsford's disciplinary case.

Board members voted on the disciplinary cases after spending more than three hours in private discussions. The closed session also included discussion of four pending court appeals challenging suspensions or revocations by the former board, as well as one pending lawsuit from an Albuquerque Police Department officer whose certification-by-waiver was rejected by the former board in recent years.

The new certification board is made up of sheriffs and police chiefs from around the state as well as civil rights attorneys and academics.

Board member and attorney Joseph Walsh called the new board structure "effectively a new paradigm that's trying to be implemented to hopefully be a model for law enforcement."

He added the new board structure can bring "true accountability."

The board began a process to hire a CEO for the academy Wednesday with the approval of a job description to be posted for recruiting. Members expressed hope the position would be filled in six months to a year.

A CEO will act as the "enforcement mechanism" of the board's directives at the academy, Walsh said, and make business decisions such as hiring and firing.

Until the position is filled, the board authorized academy director Sonya Chavez to make decisions.

Chavez, who began in the position Oct. 30, previously served as the U.S. Marshal of New Mexico. Before that, she worked as a special agent in the FBI.

"What we're involved in I think is going to be monumental for law enforcement in New Mexico," Chavez told the board Wednesday.

The board's misconduct investigations and hearings are still conducted according to administrative rules set decades ago for the former board, which was for years led by the state Attorney General.

On Wednesday, board members voted to form a four-member working group to draft changes to the rules.

The two members tasked with drafting changes to the rules for the board's disciplinary actions are public defender Julie Ball and Cody Rogers, a Las Cruces-based attorney. Rule changes pertaining to certification qualifications were assigned to be reviewed and redrafted by John Soloman, a criminal justice program director at Central New Mexico Community College, and Carly Lea Huffman, a training coordinator at the Bernalillo County Emergency Communications Center.

The rulemaking process is expected to generate new administrative rules for the board to be in place by the end of 2024.

Wed, 13 Dec 2023 10:01:00 -0600 en-US text/html https://news.yahoo.com/police-board-revokes-certification-six-043300563.html
Changes in Board Certification Could Improve Vascular Surgery Training

Certification and Accreditation

Certification in vascular surgery (VS) in the United States is currently the responsibility of the American Board of Surgery (ABS), which is also responsible for certification in general surgery (GS). The ABS is one of 24 certifying boards that are members of the American Board of Medical Specialties (ABMS). As such, it is responsible for certifying those surgeons who are found to be qualified after meeting specific training requirements and completing an examination process. Certification in VS is specifically overseen by the Vascular Surgery Board (VSB), a component board of the ABS. Details of the ABS and VSB structure can be found on their Web site ( www.absurgery.org ). It should be noted that the ABS is responsible for certification of individuals and is not responsible for hospital credentialing or surgeon reimbursement.

Accreditation of VS training programs in the United States is the responsibility of the Accreditation Council for Graduate Medical Education (ACGME), which develops accreditation standards and reviews accredited programs for compliance. In VS and GS, this is done by the Residency Review Committee for Surgery (RRC-S), one of 26 specialty-specific review committees of the ACGME. Details of the ACGME and RRC-Surgery structures can be found on their Web site ( www.acgme.org ). It should be noted that the RRC-S is responsible for establishing minimal training requirements in VS training programs but is not responsible for individual surgeon certification. However, surgeons seeking certification by an ABMS board must successfully complete an ACGME-accredited residency training program.

Currently, VS is a specialty board of the ABS, such that primary certification in GS is required before a secondary certificate in VS can be obtained. Similarly, completion of an ACGME-accredited residency program in GS is a prerequisite for VS training in an ACGME-accredited program. However, recertification in GS is not required to maintain certification in VS.

Fri, 22 Dec 2023 10:00:00 -0600 en text/html https://www.medscape.com/viewarticle/498511




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