| Course | PA 628 Clinical Clerkship: Elective II |
|---|---|
| Week | 5 |
| Paper type | Feedback follow-up memo |
| Length | About 390 words, 4 pages |
| Format | Memo with APA 7 citations |
| School | Chamberlain University |
| Program | Master of Physician Assistant Studies (MPAS) |
| Updated | October 2026 |
Free sample paper for PA 628 Week 5
Memorandum
To: Faculty advisor
From: PA student
Date: November 20, 2026
Re: Feedback carried from the nephrology elective into the endocrinology elective, and whether the change held
Where the Comment Came From
End-of-rotation evaluation, nephrology elective, October 30, 2026, written comment from the attending.
The Comment, Condensed
"Your plans list drug changes but rarely say what result would make you reverse them."
The Change, Described as Behavior
Every medication change I propose now carries a reversal condition in the same line, for example: "Increase basal insulin from 20 to 22 units; reduce back to 20 if any fasting reading is below 80."
The rule is simple to state and harder to follow: no plan line is complete until it names the result that would undo it. I check each note against that rule before presenting.
The Occasion It Was Tested
November 12, endocrinology clinic. Patient with type 2 diabetes and an eGFR of 38 on basal insulin. I proposed: "Increase glargine from 24 to 26 units; reduce if fasting glucose falls below 90 on two mornings, given reduced kidney clearance of insulin." The attending accepted the plan and kept the reversal line in the note. Lower kidney function raises the risk of hypoglycemia with insulin, a point the kidney and diabetes guideline emphasizes (Rossing et al., 2022), which is why the threshold was set higher than usual.
What Is Still Open
The change is consistent for drug doses but not yet for non-drug plans, such as referrals: I still write "refer to dietitian" without saying what would make the referral unnecessary. I will apply the same rule to every plan line for the rest of the rotation and ask the endocrinology preceptor to check five notes on November 27.
Why It Matters
A plan with a reversal condition can be safely acted on by someone else, which matters when the next visit is with a different clinician.
It also makes my own reasoning visible to the preceptor, who can see at a glance what I expected to happen and judge whether the threshold is safe. In nephrology the attending had to ask me for that reasoning out loud; now it is on the page. The comment cost the preceptor one sentence to write and has changed every note I have written since.
References
Rossing, P., Caramori, M. L., Chan, J. C. N., Heerspink, H. J. L., Hurst, C., Khunti, K., Liew, A., Michos, E. D., Navaneethan, S. D., Olowu, W. A., Sadusky, T., Tandon, N., Tuttle, K. R., Wanner, C., Wilkens, K. G., Zoungas, S., & de Boer, I. H. (2022). KDIGO 2022 clinical practice guideline for diabetes management in chronic kidney disease. Kidney International, 102(5S), S1-S127. https://doi.org/10.1016/j.kint.2022.06.008
Reading the PA 628 Week 5 instructions
Week 5 wants a brief memo rather than an essay. Open by naming the source of the feedback in a clause: when, from whom by role and in what form. Give the comment, condensed but close to its original words. Describe the change as behavior you can show, not as an attitude. Point to a dated occasion when the change was tested on the new rotation and what happened. Say what is still open. If the earlier feedback was entirely positive, carry over the strongest point and show it holding. If you disagreed with the comment, say so and still describe what you did with it. Cite guidance where the test case depends on it.
How this PA 628 Week 5 example is built
The memo is addressed to the faculty advisor on November 20, 2026. The source is the nephrology attending's end-of-rotation comment of October 30. The condensed comment says plans listed drug changes without reversal conditions. The change is a reversal condition in the same line as every medication change, with an example. The test is dated November 12: a glargine increase from 24 to 26 units with a reversal threshold set higher because of reduced kidney clearance, accepted by the attending, citing Rossing et al. (2022). The open section admits referrals still lack reversal conditions and sets a check of five notes on November 27. A last section explains why the habit matters for handoffs.
Where the points sit in the PA 628 Week 5 rubric
Carryover memos are judged on the line from comment to behavior. A memo that restates the comment and promises to improve, with no dated test, earns little. The source should be named precisely and the comment kept close to its original words. The change must be behavior someone else can see in a note. A dated occasion on the new rotation is the core evidence. Admitting what is still open earns credit rather than costing it. Brevity is expected. Any guidance the test case relies on should be cited in APA form. A reversal condition shown in a real note, with the attending's response, is stronger evidence than any description of intent.
PA 628 Week 5 help from the desk
Feedback carryover memos often stop at gratitude for the comment and a general plan to do better. Another weak spot is a test that cannot be checked, with no date or patient. Some memos also claim the change is complete when it applies only in part. If your feedback was different, send the comment and when it was given; we would name the source, condense the comment, describe the change as behavior, point to a dated test on the new rotation and say what remains open. If you disagreed with the feedback, the memo would say so and show what you did with it.
Get a PA-628 Week 5 example written to your instructions
Send the memo instructions, the rubric rows and the comments you are answering, and a custom example written to them comes back inside 24-48h, the first one free. The record underneath stays yours: the hours, the entries describing patients you saw, and any assessment a supervising clinician signed are yours to file, and the desk writes only the document that responds to them.
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PA 628 Week 5 questions, answered
What if the feedback from the earlier block was entirely positive?
Then the memo works from the smallest qualification in it, and most feedback contains one: a suggestion to ask sooner, to commit to an assessment before checking, to say less when presenting. Write that as the item. A memo reporting nothing but praise has no work to show, and a row asking what changed then finds nothing to mark.
Should the memo quote the comment word for word?
A short quotation of the point usually works best, with the rest summarized. Long quotation spends the word count on somebody else's writing and can carry identifying detail along with it. Where a comment was spoken rather than written, say so and give the substance, because a reader marks how it was answered and not how accurately it was transcribed.
What if I disagreed with the feedback?
Say so, and say what was done anyway. A memo recording the disagreement, the reasoning on both sides and the behavior adopted while the question stayed open marks better than silent agreement, which reads as compliance rather than as thought. What loses points is a disagreement used to explain why nothing was altered at all.
Where can I find a free PA 628 Week 5 sample paper?
This page holds a complete PA 628 Week 5 feedback carryover memo tracing one preceptor comment into a tested change.
When was the change tested in the PA 628 Week 5 sample?
On November 12, when a glargine increase was proposed with a reversal threshold set higher because of reduced kidney clearance.