| Course | PA 614 Clinical Clerkship - Emergency Medicine |
|---|---|
| Week | 1 |
| Paper type | Discussion post with two replies |
| Length | About 480 words |
| Format | Discussion post with APA 7 citations |
| School | Chamberlain University |
| Program | Master of Physician Assistant Studies (MPAS) |
| Updated | October 2026 |
Free sample paper for PA 614 Week 1
Week 1 Discussion: Initial Post
Every Line I Write in the Emergency Department Is Read First by the Clinician Who Takes Over at Seven: One Line From My Chest Pain Note, Read Two Ways, and the Repair
The Claim, Stated Early
Writing on this rotation has its reader built in, and that reader is neither me nor my supervising attending. It is the clinician who arrives at 07:00 and inherits whatever is still in the department. Every line I write should be judged by whether that person, who never met the patient, can act on it.
One Line, Two Readings
On my first night shift I wrote, for a 58-year-old with chest pain: "Troponin negative, likely discharge." At 07:00 the oncoming physician assistant read it as: both troponins are back and normal, the patient can go. What I meant was: the first high-sensitivity troponin, drawn at 01:10, is below the limit; the second, due at 04:10, is pending; if it is also below the limit and unchanged, the HEART score of 3 supports discharge. The second troponin had been delayed by a clotted sample and was redrawn at 05:20. "Negative" without a time and a number described a result that did not yet exist.
The oncoming PA did nothing wrong. The line was written in a way that let a reasonable reader conclude the workup was finished. If the second troponin had come back raised, a discharge order written on the strength of my line would have sent home a patient having a heart attack. Nothing in my wording would have stopped it.
The Repair, Written Out
"hs-troponin T at 01:10: 5 ng/L. Second draw at 05:20 (first sample clotted), result expected about 06:30. HEART score 3 (low risk). Under the department's chest pain pathway, if the second value is also below the assay's 99th percentile limit and has risen by less than 3 ng/L, discharge with outpatient stress testing; if not, call cardiology."
The repaired line is longer, but every added word answers a question the next reader would otherwise have to ask: which troponin, when, what number, what is still pending, when it is due and what each result means.
Support Where It Is Asked For
The HEART score was validated prospectively in emergency department chest pain patients, with low scores carrying a low rate of major adverse cardiac events at six weeks (Backus et al., 2013), so naming the score tells the next reader what kind of decision is being made, not just what the troponin was.
Replies That Disagree Usefully
Reply to Nadia: You say the attending is the reader who matters. By 07:00 your attending has gone home. Who reads your note then?
Reply to Ben: You write that short notes are best on nights. Was your short note short because it was clear, or because it left out the time of the second test?
References
Backus, B., Six, A., Kelder, J., Bosschaert, M., Mast, E., Mosterd, A., Veldkamp, R., Wardeh, A., Tio, R., Braam, R., Monnink, S., van Tooren, R., Mast, T., van den Akker, F., Cramer, M., Poldervaart, J., Hoes, A., & Doevendans, P. (2013). A prospective validation of the HEART score for chest pain patients at the emergency department. International Journal of Cardiology, 168(3), 2153-2158. https://doi.org/10.1016/j.ijcard.2013.01.255
What the PA 614 Week 1 assignment asks for
The opening discussion of the emergency medicine clerkship asks for a short argument with a side already chosen, usually about writing on this rotation. State the claim early. Then take one line from your own documentation and show it read two ways: what you meant and what a reader could take it to mean. Write out the repair in full. Use a source only where the claim needs support, for example to show why a named tool or score tells a reader more than a word. Replies should disagree usefully, testing a classmate's position against how the shift actually runs. Keep the post short; most sections want a few paragraphs. If your section asks for replies in the same week, both should be specific rather than general praise.
Inside the PA 614 Week 1 example
The post claims that the reader of an emergency note is the clinician arriving at 07:00. It quotes the line "Troponin negative, likely discharge" from a 58-year-old's chart, describes the oncoming PA reading it as two normal results, and explains that only the 01:10 troponin was back while the second draw had clotted and been repeated at 05:20. The repair gives the first value with its time, the second draw and its expected time, the HEART score of 3 and the pathway thresholds for discharge or a cardiology call. Backus et al. (2013) supports naming the score. Replies ask Nadia who reads her note after her attending leaves and Ben whether his short note was short because it was clear or because it left out the time of a test.
Reading the PA 614 Week 1 grading rubric
Most points in this post depend on one real line from the writer's documentation. A post that argues about writing in general, with no line and no repair, loses the largest share. Next, graders look for both readings of the line set out plainly. The repair must be written out in full; describing how it could be improved is not enough. Faculty reward a claim stated early and sustained. Sources score when they support a specific point rather than decorate the post. Replies are graded on whether they disagree usefully, using the shift's structure to test the claim. Brevity is checked, and APA form for any source completes the rubric.
PA 614 Week 1 help from the desk
The weakest opening posts in this clerkship describe how busy the emergency department is without examining any piece of writing. Another common problem is a repair described in general terms, such as "I should be clearer," rather than written out. Some posts also cite a guideline that does not bear on the claim. If you have your own note line that was misread, or your section frames the claim differently, send the line and the context; we would build the post around that line: the claim first, both readings, write the repair in full and support it only where needed. Paste classmates' posts for replies that disagree with a reason drawn from the shift itself.
Get a PA-614 Week 1 example written to your instructions
Send your section's instructions and the rubric, plus the post length and reply count it sets, and a custom PA-614 Week 1 post is written to them and returned inside 24-48h, the first one free. Discussion samples are built for a single submission with no chance to revise it afterward.
More PA 614 papers and MPAS samples
- PA 614 Week 2: Shift Sign-out Brief
- PA 614 Week 3: Pending Results Note
- PA 614 Week 4: Medical Decision Making Paragraph
- PA 614 Week 5: Interrupted Encounter Write-up
- PA 614 Week 6: Patient Callback Note
- PA 614 Week 7: Shift Documentation Audit
- PA 614 Week 8: End of Shift Summary
- PA 612 Week 1: Inpatient Day Count Post
- PA 610 Week 1: Family Medicine Difference Post
- PA 608 Week 1: Score Report Figure Post
- PA 604 Week 1: Outside-Support Habit Post
PA 614 Week 1 questions, answered
How long should the post be?
Shorter than the written assignments and usually fixed by the section, commonly a few hundred words with a citation or two. Where nothing is stated, the example runs to the length a grader can read without scrolling twice, because a post that outruns the box is rarely rewarded for it. Send whatever limit your classroom publishes and the post is cut to fit it.
Do I need a source for a post about writing?
Most sections want at least one, and professional documentation standards are the usual place they come from. The example cites whatever category the assignment names rather than reaching for clinical literature, which tends to score poorly here because it answers a different question. Send the citation style your classroom uses and the count it expects.
What if my section wants replies in the same week?
Say so and the request covers both. Replies in this course are usually marked on whether they add a second reading rather than on courtesy, and they are short. A sample comes with the post and one or two replies written against it, so the difference in register between the two is visible rather than described.
Where can I find a free PA 614 Week 1 sample paper?
This page carries a full PA 614 Week 1 post showing one emergency chart line read two ways, with the repair and two replies.
What line is repaired in the PA 614 Week 1 sample?
"Troponin negative, likely discharge," rewritten with the first value and time, the pending second draw, the HEART score and the pathway thresholds.