| Course | PA 650 Capstone Project |
|---|---|
| Week | 1 |
| Paper type | Discussion post with two replies |
| Length | About 460 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 650 Week 1
Week 1 Discussion: Initial Post
Three Patients With the Same Back and Three Different Prescriptions: Naproxen Alone, Naproxen With Cyclobenzaprine and Naproxen With Methocarbamol, and the Question My Capstone Will Ask
Two Patients, or Three
On my emergency medicine rotation, three adults came in during one week with the same kind of problem: low back pain for under a week, no trauma, no pain down the leg, normal neurological examinations. A 38-year-old warehouse worker. A 51-year-old teacher. A 29-year-old line cook. None had red flags.
What Each Clinician Did
The first clinician prescribed naproxen alone with advice to keep moving. The second added cyclobenzaprine at bedtime. The third added methocarbamol three times a day. All three are experienced and all three gave clear reasons when I asked: "it does nothing extra," "it helps them sleep" and "the spasm is the pain."
None of the three was wrong by the standard of the day: each choice can be defended, and none of the patients came to harm that I know of. What caught my attention was the confidence behind each choice. The first clinician cited a trial. The second cited patients' sleep. The third cited the mechanism. Three different kinds of reason for three different actions on the same kind of patient suggests the evidence has not settled the question in the minds of the people who use it, or that it has and has not reached them all.
The Group Claim, Stated Out Loud
My claim is that these three patients belong to one group for the purpose of this decision: adults with acute, nontraumatic, nonradicular low back pain being discharged on an NSAID. If that grouping holds, the three prescriptions cannot all be the best choice for the same group. The national guideline allows either an NSAID or a skeletal muscle relaxant for acute low back pain when medication is wanted (Qaseem et al., 2017), but says less about adding one to the other.
I may be wrong about the grouping. If age, job or sleep turns out to change the right answer, the group splits, and the capstone will have to say so.
A Question Naming an Action
Should a clinician add a skeletal muscle relaxant to naproxen for these patients at discharge? That is the action my capstone will examine.
Replies That Test the Grouping
Reply to Aisha: Your three patients with sore throats include one with a positive rapid strep test. Does that patient belong in the same group, or does the test result put them in a different decision?
Reply to Jordan: Your group is "older adults with insomnia," but one of your patients is 66 and another 89. Would the same prescription be considered for both, given what changes with age?
References
Qaseem, A., Wilt, T. J., McLean, R. M., & Forciea, M. A. (2017). Noninvasive treatments for acute, subacute, and chronic low back pain: A clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 166(7), 514-530. https://doi.org/10.7326/M16-2367
PA 650 Week 1 instructions, in plain terms
The opening post of the capstone asks for two or three patients who belong to the same group, each described in a single clause with nothing beyond what makes them members. Then describe what each clinician did, plainly, and the reason each gave if you know it. State the group claim out loud: that these patients share one decision, so the different actions cannot all be the best choice. Close with a question that names a specific action a clinician could take, not a topic. Replies should test whether a classmate's patients really belong to one group, for example by pointing to a test result or an age difference that would change the decision. Cite any guideline that leaves the question open.
How the PA 650 Week 1 example is put together
The patients are a 38-year-old warehouse worker, a 51-year-old teacher and a 29-year-old line cook, each with under a week of back pain, no trauma, no leg pain and a normal neurological examination. The clinicians' choices follow: naproxen alone with advice to keep moving, naproxen with cyclobenzaprine at bedtime and naproxen with methocarbamol three times a day, each with the reason given. The group claim names adults with acute, nontraumatic, nonradicular back pain discharged on an NSAID and cites Qaseem et al. (2017) for allowing either drug class without addressing the combination. The question asks whether to add a skeletal muscle relaxant to naproxen at discharge. Replies ask Aisha whether a positive strep test moves one patient out of her group and Jordan whether patients aged 66 and 89 share one prescribing decision.
Reading the PA 650 Week 1 grading rubric
The post earns most of its points from the group claim. Posts that present several interesting cases without saying why they share one decision lose the largest share. Next, graders deduct for patient descriptions padded with history that has nothing to do with membership. Faculty reward a plain account of what each clinician did and why. The closing question must name an action; a topic such as "muscle relaxants" earns little. Citing a guideline that leaves the question unresolved shows why the capstone is needed. Replies score when they test a classmate's grouping with a specific detail that might split it. Correct any source cited in APA form takes the last share.
Common PA 650 Week 1 mistakes, and how to avoid them
Opening capstone posts most often fall short by describing one memorable case in detail instead of two or three patients who share a decision. Another common problem is a question that names a condition rather than an action, which no study can answer. Some posts also criticize a clinician rather than describing the variation neutrally. If you saw different variation on rotation, such as antibiotics for sinusitis or imaging for headache, send short descriptions of the patients and what each clinician did; a post written for you would state the group claim, record each action and reason, cite the guidance that leaves the gap and end on an action question. Paste classmates' posts for replies that test their groupings.
Get a PA-650 Week 1 example written to your instructions
Send the Week 1 discussion instructions and a sentence about the decision you keep seeing handled two ways, and a custom PA-650 post written to your rubric comes back inside 24-48h, the first one free. Nothing real needs to travel with it; describe the pattern loosely and the writer builds the patients from that.
More PA 650 papers and MPAS samples
- PA 650 Week 2: Question Narrowing Exercise
- PA 650 Week 3: Patient Population Definition
- PA 650 Week 4: Comparison Arm Rationale
- PA 650 Week 5: Strength of Evidence Table
- PA 650 Week 6: Harm and Benefit Balance
- PA 650 Week 7: Bedside Recommendation Statement
- PA 650 Week 8: Clinical Poster Draft
- PA 501 Week 1: Defining the PA Role Post
- PA 648 Week 1: Testable Commitment Post
- PA 502 Week 1: Clinical Question Post
- PA 503 Week 1: First Question Post
PA 650 Week 1 questions, answered
Do the patients have to come from a clinical rotation?
Most sections accept anything you genuinely watched, and a few insist on a rotation. What the week is after is more than one instance of the same decision handled differently, so a rotation week, a shadowing day, or a pattern you have read about in enough detail to describe can all supply it. Check the wording your classroom publishes before you commit to one source.
What if all three clinicians did the same thing?
Then the agreement is worth examining rather than abandoning, because clinicians who all do one thing are sometimes all following a habit nobody has tested. Say that you saw no variation, name what they all did, and ask what evidence would have to exist for that to be right. A post built on uniform practice can work, but it has to argue that the uniformity is the surprise.
How much can the question change after Week 1?
A great deal, and the following week exists partly to change it. What survives from here is usually the group rather than the wording, since the patients you put together are what the rest of the term argues about. Writers who reopen the grouping after the evidence table is built spend two weeks rebuilding rows that no longer apply to anybody.
Where can I find a free PA 650 Week 1 sample paper?
This page holds a complete PA 650 Week 1 capstone post about three back pain patients given three different prescriptions, with replies.
What question does the PA 650 Week 1 sample end with?
Whether a clinician should add a skeletal muscle relaxant to naproxen at discharge for adults with acute, nontraumatic, nonradicular low back pain.