PA 616 Week 5 Operative Note Draft Example

Clinical Clerkship - Surgery Chamberlain University Free custom sample in 24 to 48h

This PA 616 Week 5 sample paper drafts the operative note for C.N.'s myotomy, anterior wrap and on-table endoscopy, written as labeled fields. Chamberlain PA 616 (PA-616), Clinical Clerkship - Surgery, asks Master of Physician Assistant Studies (MPAS) students to produce a note that can be read without reading it through. The draft gives incision and closure times, diagnoses, procedure, personnel with the student's role stated once, findings that say what was seen, a description without reasoning, 20 mL blood loss, no specimens or drains and a signature line, and explains why the choice of wrap belongs elsewhere, citing the ACG guideline.

CoursePA 616 Clinical Clerkship - Surgery
Week5
Paper typeOperative note draft
LengthAbout 470 words, 5 pages
FormatAPA 7 student paper
SchoolChamberlain University
ProgramMaster of Physician Assistant Studies (MPAS)
UpdatedOctober 2026

Free sample paper for PA 616 Week 5

1

Operative Note Draft for C.N.: Labeled Fields Found Without Reading, the Shortest Entry That Answers Each Label, My Role Stated Once, No Reasoning in the Account and a Line for the Attending's Signature

Student Name

Chamberlain University

PA 616: Clinical Clerkship - Surgery

Instructor Name

Month Day, Year

What this page is doingThe title describes a field-by-field document with the student's role fixed and room for countersignature, which is what an operative note draft must be.
2

Operative Note Draft for C.N.: Labeled Fields Found Without Reading, the Shortest Entry That Answers Each Label, My Role Stated Once, No Reasoning in the Account and a Line for the Attending's Signature

The Draft

Date and time: April 14, 2026; incision 07:52, closure 09:31.

Preoperative diagnosis: achalasia, type II.

Postoperative diagnosis: same.

Procedure: laparoscopic Heller myotomy with Dor (anterior) fundoplication; intraoperative upper endoscopy.

Surgeon: attending surgeon. Assistant: third-year resident. PA student: camera operation and retraction; present for the entire case.

Anesthesia: general endotracheal, rapid sequence induction.

Indications: two years of trouble swallowing both food and drink, weight loss and type II achalasia on manometry; consent obtained for myotomy and partial fundoplication.

Findings: dilated distal esophagus; thickened muscle at the gastroesophageal junction; no hiatal hernia.

Description: five ports placed. Phrenoesophageal ligament divided; anterior vagus nerve identified and preserved. Myotomy carried 6 centimeters onto the esophagus and 2.5 centimeters onto the stomach, through longitudinal and circular muscle to mucosa. Endoscopy confirmed free passage across the junction; air insufflation under saline showed no leak. Dor fundoplication fixed to both myotomy edges and the crura with interrupted sutures. Ports removed under vision; fascia closed at the 12-millimeter site.

Estimated blood loss: 20 mL.

Specimens: none.

Drains: none.

Complications: none.

Condition: extubated, to recovery in stable condition.

Prepared by: PA student, for review. Attending signature: ______ Date and time: ______

What this page is doingWriting each field as the shortest entry that answers it lets a reader find any detail without reading the whole note.
3

A Label Is Not an Answer

"Findings: as expected" would not answer the label. The findings field says what was seen.

Likewise "Complications: none" is answered only after checking with the surgeon at the end of the case; I did not assume it. "Specimens: none" is confirmed against the circulating nurse's record.

Your Role, Stated Once and Used

My role is stated once, in the personnel field, and the description uses "the myotomy was carried" rather than claiming any step as mine.

No Reasoning in the Account

Why the surgeon chose a Dor rather than a Toupet wrap is not in the note; that discussion belongs in the clinic record. The operative note records what was done, consistent with the partial fundoplication guidance for myotomy (Vaezi et al., 2020).

What this page is doingKeeping reasoning out of the operative account makes the note a factual record that can be relied on later.
4

The Countersignature Line

The draft has no legal standing until the attending reviews, edits and signs it.

The attending changed two entries on review: the gastric extent of the myotomy from 2.5 to 3 centimeters, and the addition of "no mucosal injury identified" to findings. Both changes are visible in the signed version, not edited into my draft silently.

What this page is doingRecording the attending's edits openly shows how the draft and the final note differ, which is part of learning the format.
5

References

Vaezi, M. F., Pandolfino, J. E., Yadlapati, R. H., Greer, K. B., & Kavitt, R. T. (2020). ACG clinical guidelines: Diagnosis and management of achalasia. American Journal of Gastroenterology, 115(9), 1393-1411. https://doi.org/10.14309/ajg.0000000000000731

PA 616 Week 5 instructions, in plain terms

The fifth week asks for an operative note draft laid out as a column of labeled fields with short entries, not as paragraphs. Each entry should be the shortest form that answers its label: a date and time, names with roles, a finding stated rather than "as expected." State your own role once, in the personnel field, and keep it consistent in the description. Keep reasoning out of the account; the operative note records what was done, while the reasons belong in clinic or consent notes. End with a countersignature line for the attending, since the draft has no standing until signed. If your site dictates operative notes, the same fields structure the dictation. Fields with no answer should say "none" rather than be left blank. Cite guidance where a field depends on it.

How the PA 616 Week 5 example is put together

The draft lists date and incision and closure times, preoperative and postoperative diagnosis of type II achalasia, the procedure with intraoperative endoscopy, the attending as surgeon, the third-year resident as assistant and the student's role on camera and retraction. Anesthesia, indications and findings follow: a dilated distal esophagus, thickened muscle and no hiatal hernia. The description covers five ports, ligament division, the anterior vagus kept intact, the muscle divided 6 centimeters up the esophagus and 2.5 onto the stomach, endoscopy with no leak, a Dor wrap and closure. Blood loss is 20 mL, with no specimens, drains or complications. A signature line ends the draft. Sections explain answering each label, stating the role once and leaving the reason for the wrap to the clinic record, citing Vaezi et al. (2020).

PA 616 Week 5 rubric: what full points look like

Operative note drafts lose the most when written as narrative paragraphs, which makes key fields hard to find. Next comes vague entries such as "findings: as expected" or "complications: none apparent" that do not answer the label. Graders deduct when the student's role is overstated or inconsistent. Faculty reward labeled fields, the shortest accurate entry for each and a description free of reasoning. A countersignature line shows understanding of the draft's status. Accuracy of procedural details is checked. Citation of guidance where relevant, in APA form, completes the rubric.

PA 616 Week 5 help from the desk

Operative note drafts most often go wrong by telling the story of the case, including why each step was done. Another common problem is the student describing steps as their own when they assisted. Some drafts also leave fields blank. If your case was a different operation, send the procedure, the personnel and what was found and done; a draft prepared for you would set out labeled fields, give the shortest accurate entry for each, state your role once, keep reasoning out and end with a signature line. If your site uses a dictation template, the fields would follow its order.

Get a PA-616 Week 5 example written to your instructions

Attach whichever note format your section works from, together with the week's instructions and the case you were given. A custom PA-616 draft is written to those field names and comes back inside 24-48h, the first free. The operation in the sample never happened, which is what lets it be handed over: it shows a format and evidences nothing.

Request this week free All PA-616 weeks Finished samples

More PA 616 papers and MPAS samples

PA 616 Week 5 questions, answered

My site dictates these rather than typing them. Does that change the assignment?

Not much, because what is marked is the content of each field and not the medium. A dictated note runs through the same set in the same order, and a transcript of one reads as a labeled document once the labels are typed back in. Where your section asks for a dictation, write it as spoken field headings followed by their entries.

How long should the account of the operation be?

Shorter than students write it. Most formats want the work described at a level a colleague could picture without being taught anything, which in practice is a paragraph rather than a page. Length here tends to arrive as explanation, and explanation is the one thing the field does not want. If your section states a word count, that count wins over any of this.

What goes in a field my case has no answer for?

Write that there is none, in the field, rather than deleting the heading. A format keeps its shape across every case it covers, so a heading with none recorded under it is a complete answer and a heading that has vanished is not. Deleted fields are also the version a countersigning clinician sends back, which is the practical reason the habit matters.

Where can I find a free PA 616 Week 5 sample paper?

This page holds a full PA 616 Week 5 operative note draft for a laparoscopic Heller myotomy in labeled fields with a signature line.

Why is the reason for the Dor wrap not in the PA 616 Week 5 sample note?

The operative note records what was done; the reasoning behind choosing the wrap belongs in the clinic or consent record.