Surgical Technology Program

Surgical Technology Program

Fall 2016 Application

Application Deadline is June 13, 2016

Return Application To:

Diana Montoya, Department Chair

Surgical Technology Program

PCC-SMC Campus

1008 Minnequa Ave

Suite #2333

Pueblo, CO 81004

Welcome students and thank you for choosing Surgical Technology as your career path.

Surgical technologists are allied health professionals, who are an integral part of the team of medical practitioners

providing surgical care to patients. Surgical technologists work under the supervision of a surgeon to facilitate the safe and effective conduct of invasive surgical procedures, ensuring that the operating room environment is safe, that equipment functions properly, and that the operative procedure is conducted under conditions that maximize patient safety. Surgical technologists possess expertise in the theory and application of sterile and aseptic technique and combine the knowledge of human anatomy, surgical procedures, and surgical tools and technologies to facilitate a physician's performance of invasive therapeutic and diagnostic procedures (AST, 2014).

Surgical technology is one of the fastest growing professions in the country. At PCC, the Surgical Technology Program prepares you for a career in a variety of settings including hospital surgery departments, obstetric departments, cardiac catheterization labs, ambulatory surgery centers and central processing. A Surgical Technologist is a vital member of the operating room team and requires extensive commitment and special qualities for those who practice in this profession. As an experienced surgical technologist, you can choose to specialize in such areas as General, OB/GYN, Endoscopy,

Ophthalmology, Otorhinolaryngology, Oral and Maxillofacial, Plastic and Reconstructive, Genitourinary, Orthopedic,

Cardiothoracic, Peripheral Vascular, or Neurological Surgery. With experience, you can also choose to advance to the role of a certified surgical first assistant (CSFA).

You have completed pre-requisite courses to increase your understanding of human anatomy and physiology, microbiology, medical terminology, and the process and treatment of diseases which is necessary to enter into the Surgical Technology Program.

Upon acceptance into the Surgical Technology Program, you will gain classroom and hands-on experience in the cognitive (knowledge), psychomotor (skills), and affective behavior learning domains. The Curriculum includes topics like the principles of patient preparation and care, preparing the operating room, creating and maintaining a sterile field, scrubbing, gowning, and gloving, draping the surgical patient and equipment, and providing effective surgical case management before, during, and after surgery. Throughout the learning experience you will also discover how to apply hemostasis, how to load and use sutures, needles, and stapling devices, how to handle specimens, and understand surgical pharmacology and anesthesia including calculating and preparing controlled medications and drugs appropriately. Additionally, you will learn how to apply wound care and dressing applications and utilize the principles of asepsis. You will be taught how to handle sharps safely, pass surgical instrumentation, supplies, and equipment during surgical procedures, perform surgical counts, execute room turnover and terminal cleaning processes, and carry out the necessary skills needed to process and sterilize instrumentation and supplies competently. Finally, you will receive extensive clinical experience working with surgeons and staff within a real operating room environment.

So… if you are punctual and can demonstrate consistent attendance, you’re able to work quickly and accurately, pay attention to details, prioritize and work well under pressure; you are a good candidate for the Surgical Technology Program. And… if you are able to problem solve and show a willingness to learn and cope with change, can communicate effectively and work both independently and as a team member; you are a good candidate for the Surgical Technology Program. Please proceed with the application process. I look forward to meeting you soon.

Diana L Montoya

Diana L. Montoya, CST- BSHCM

Department Chair of Surgical Technology

Pueblo Community College I 900 W. Orman Avenue, Suite #MT172 I Pueblo, CO 81004 719-549-3279 I [email protected]

APPLICATION FOR ADMISSION TO THE SURGICAL TECHNOLOGY PROGRAM

Student Application Check List:

I wish to be considered as a candidate for admission into the Surgical Technology Program

I have attached the Surgical Technology Course Curriculum Schedule Acknowledgement Page I have previously obtained a degree: Associates _____ Bachelors _____ None__________ Full name of your degree:_____________________________________________________ Year Completed:____________________________________________________________

I have completed all the required Bio pre-requisites within the last 5 years: BIO201, BIO202, BIO204, BIO116 and HPR178 at a C or above: If completing a prerequisite course in the summer semester, please make a note below.You may still apply for the program.

ENG121: Grade:_______ BIO201: Grade:_______ BIO202: Grade:_______ BIO204: Grade:_______

BIO116: Grade:_______ or BIO216 Grade: _______ HPR178: Grade: _______

I have attached copies of “Unofficial” transcript(s) from every prior school listed on my application.

If we do not receive a transcript for each school listed, your application will not continue through the application process.

I have attached the “Essential Functions” Acknowledgement Page

I have researched the Association of Surgical Technologists website (www.AST.org) and have attached a copy of the Surgical Technologist Job Description for a Scrub Surgical Technologist, Second Circulating Surgical Technologist, and Second Assistant Surgical Technologist (one document).

I have attached two (2) Letters of Recommendation forms from a non-related acquaintance

Each letter is to be placed “in a sealed envelope and the recommender’s name is signed across the seal” according to the instructions found within the application. Please do not submit more than 2 recommendations.

I have attached the Work / Volunteer History Form Demographic Information: (please print or type all information)

Name _______________________________________________ S#_________________________________ Current Address __________________________________________________________________________

Street City State Zip

Phone: (Home) _____________________________ (Student E-mail)__________________________________ (Cell) ______________________________ (Personal E-mail)__________________________________

It is the student's responsibility to see that all the application materials have been received and an

advising appointment has been arranged with the Program Chair if needed.

How do I apply?

1. Complete the Surgical Technology Program Application Packet by the due date

2. Please note if you are completing a prerequisite course in the summer semester – you may still

apply for the program pending completion of that course with a C.

What Should I Expect After I Apply?

1. The Surgical Technology Program’s Admission Committee will review your application.

You will

be notified by phone on June 13, 2016 if you are eligible for an interview

. ** Please make sure

you have included a correct contact phone number and are available to take the call. We will try

contacting applicants up to two times.

2.

Interviews will be scheduled on Monday, June 20, 2016 and Tuesday, June 21, 2016.

All

Interviews are conducted in person and NO telephone interviews will be permitted. Applicants

are responsible for all expenses incurred.

If Chosen, What Should I Expect After I Interview?

1. Following your interview, you will be notified via an official email based on a “Conditionally

Acceptance” into the Surgical Technology Program.

2. Within the “Conditionally Accepted” letter, you will be given information with definitive

deadlines to complete a background check and a drug screen, purchase Surgical Technology

Program Scrubs, jacket, and hat, and review a current copy of the Surgical Technology Program

Handbook in preparation for Orientation. Please do not do the background check or drug screen

prior to conditional acceptance notification due to test time sensitivity. During the Fall and

Spring semester, you will be required to obtain specific immunizations and take a current CPR

Certification course at your cost.

3. You must return the “Conditional Acceptance” form by the date indicated in the letter to

“reserve” your place for the Fall 2016 term.

What Happens If I Am Not Conditionally Accepted?

1. An alternate list will be established once the Surgical Technology Program is full. Candidates will be

notified as vacancies occur up through the first week of Fall semester classes.

2. Students must apply annually for admission to the Surgical Technology Program – including any

student placed on an alternate list who did not receive final acceptance.

3. It is the student’s responsibility to keep applications current and complete as outlined above.

4. Students must keep their own copies of their application in order to reactivate for future

consideration as the Surgical Technology Department shreds all copies of applications following the

start of the fall semester.

The Surgical Technology Program has a selective admissions policy due to lab space and the limited

number of clinical sites available to the program. A maximum of sixteen (16) applicants will be chosen for

the Fall Semester 2016. A list of alternates will be maintained and students will be notified of any vacancy

up through the first week of Fall Semester classes. Final admission of all applicants will be awarded at the

discretion of the Surgical Technology Admissions Committee.

ASSOCIATE of APPLIED SCIENCE in SURGICAL TECHNOLOGY – 71 Credits

Entrance Requirements: This is a limited-entry admission program. Students must complete prerequisite courses within the last 5 years with a “C” or higher

to be admitted to the Surgical Technology program. Students who complete the departmental application process will have their qualifications reviewed by the program’s admission committee. Applicants not accepted for a given year who wish to be considered for a subsequent term must reapply.

PREREQUISITES Prerequisite Courses for Program Admission

GENERAL EDUCATION PRE-REQUISITES 20

SS95+ ENG 121 English Composition I 3

BIO 111, RC 80+, SS 95+,EA 61+ (CHE 101 is highly recommended)

BIO 201*Ŧ

Human Anatomy and Physiology I 4

BIO 111 EA 61+, and ENG 121 (CHE 101 is

highly recommended) BIO 202*Ŧ Human Anatomy and Physiology II 4

BIO 201 or 202, ENG 121, and EA 61+ BIO 204*Ŧ Microbiology 4

See College Catalog HPR 178 Ŧ Medical Terminology 2

RC80+, SS95+, EA61+ BIO 116*Ŧ Introduction to Human Disease 3

*Within five (5) years of application - Ŧ Must be completed prior to final admission

CORE REQUIREMENTS – 1ST YEAR (27 Credits)

Semester 1 - Fall 15

Program Admittance STE 102 Introduction to Surgical Technology 4

Program Admittance STE 103 Introduction to Surgical Technology Lab 4

Program Admittance STE 130 Surgical Instruments, Supplies, & Equipment I 3

Program Admittance STE 140 Surgical Case Studies I 2

Program Admittance STE 106 Surgical Anesthesia & Pharmacology Care 2

Semester 2 - Spring 13

STE 100 STE 111 Surgical Procedures & Case Management 4

STE 102 STE 112 Surgical Procedures & Case Management Lab 4

STE 130 STE 131 Surgical Instruments, Supplies, & Equipment II 3

STE 140 STE 141 Surgical Case Studies II 2

Summer Special 8 Week Session 5

STE 111, STE112, STE 131, STE 141 & STE106 STE 281 Surgical Technology Internship I 5

CORE REQUIREMENTS – 2ND YEAR (24 Credits)

Semester 3 – Fall 9

STE 281 STE 282 Surgical Technology Internship II 6

STE 281 STE 279 CST Exam Review Course 3

Semester 4 – Spring 9

STE 282, STE 279 STE 283 Surgical Technology Internship III 6

STE 282, STE 279 STE 289 Surgical Technology Capstone 3

I have reviewed and addressed all my questions and concerns regarding the Surgical Technology Program and I acknowledge that I agree to the Curriculum Schedule for the Surgical Technology Program.

________________________________ __________________________ ______________________

SURGICAL TECHNOLOGY

ESSENTIAL FUNCTIONS

ESSENTIAL FUNCTION DEFINITION

Age specific To serve all demographic patients

Critical Thinking Critical thinking ability for safe and effective practice Mental/Emotional

Requirements

Ability to use positive coping skills to manage stress appropriately. To make decisions and judgments under pressure. To handle multiple priorities and demonstrate calm and effective responses, especially in emergency situations

Interpersonal Skills Interpersonal abilities sufficient to interact with physicians, staff, faculty, individuals, families, and patients from a variety of social, emotional, cultural and intellectual backgrounds Communication Ability Communicate and understand fluent English both verbally and in writing

Physical Endurance Remain continuously on task for several hours with the majority of time standing, bending, or sitting for long periods of time in one location with minimal/no breaks. Refrain from

nourishment or rest room breaks for periods up to 8 hours. Work days, nights, weekends and call. Able to lift up to 50 lbs. and assist with and/or lift, move, position, and manipulate, with or without assistive devices, the patient who is unconscious

Mobility Physical abilities sufficient to move and maneuver in small spaces without assistive devices. Demonstrates a full range of motion; manual and finger dexterity, and hand-eye coordination Motor Skills Gross and fine motor abilities sufficient to manipulate instruments, supplies, and equipment

with speed, dexterity, and good eye-hand coordination while providing safe and effective patient care with a variety of modalities

Hearing Ability Auditory ability sufficient to monitor and assess the surgeon and surgical team’s concerns, hear and understand muffled communication without visualization of the communicator’s mouth/lips and within 20 feet. Hear activation/warning signals on equipment

Visual Ability Normal or corrected visual ability sufficient for observation of a patient and surgical procedure. Demonstrate sufficient visual and tactile ability to load a fine (10-0) suture onto needles and needle holders with/without corrective lenses and while wearing safety glasses Olfactory Ability Olfactory senses (smell) sufficient to detect odors to maintain environmental and patient

safety and address patient needs Professional Attitude and

Demeanor

Ability to present professional appearance and implement measures to maintain own physical and mental health, and emotional stability. Ability to demonstrate emotional health required for the utilization of intellectual abilities and exercise good judgment.

Environment Safety Ability to recognize and protect self, patients and others from environmental risks and hazards Health Safety Be free of reportable communicable diseases and chemical abuse. Demonstrate immunity to

rubella, tuberculosis, and hepatitis B, or be vaccinated against these diseases, or be willing to sign a waiver or release of liability with regard to these diseases

ACKNOWLEDGEMENT OF ESSENTIAL FUNCTIONS

All students in the Surgical Technology Program must be able to perform these essential functions with or without reasonable accommodations. Examples of activities are not all inclusive.

______ I have read and I understand the Essential Functions Standards specific to Surgical Technology. ______ I have the ability to meet the Physical Performance Standards as specified

LETTER OF RECOMMENDATION

** Please sign your name across the sealed flap of the envelope **

I, _____________________ (applicant’s name, printed), am requesting ____________________ (recommender’s name, printed) complete this form of recommendation of me and send it to the address indicated. I understand that your candid evaluation of me is being sought and the form will remain confidential.

CONFIDENTIAL – I hereby waive my right of access to your confidential recommendation and understand that this

recommendation will be held in confidence.

Applicant’s Signature ____________________________ Date _________________________

Number of years knowing the applicant: ________________

Please rate the following skills for the applicant from 1-3: 1) – Below Average 2) – Average 3) – Above Average

____ Integrity/ moral character/ ethical ____ Ability to work as a team player ____ Problem-solving skills ____ Initiative

____ Maturity/ Judgment ____ Responsible attitude

____ Dependability ____ Ability to work independently

How well do you know this applicant? _____ Very Well _____ Fairly Well _____ Slightly In what capacity have you known this applicant? _____________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Please provide a summary of your recommendation for this applicant:

_____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________

Compared to all the persons I could recommend, I would rate this person in the: ___(top 1%) ___(top 5%) ___(top 10%) ___(top 25%) ___(top 50%) ___ (other)

May we contact you with questions? _______ yes _______ no

Signature: ___________________________________ Date: _____________________________________ Position/Title: ______________________ Telephone __________________ E-mail: _____________________ Address: _________________________________________________________________________________

LETTER OF RECOMMENDATION

** Please sign your name across the sealed flap of the envelope **

I, _____________________ (applicant’s name, printed), am requesting ____________________ (recommender’s name, printed) complete this form of recommendation of me and send it to the address indicated. I understand that your candid evaluation of me is being sought and the form will remain confidential.

CONFIDENTIAL – I hereby waive my right of access to your confidential recommendation and understand that this

recommendation will be held in confidence.

Applicant’s Signature ____________________________ Date _________________________

Number of years knowing the applicant: ________________

Please rate the following skills for the applicant from 1-3: 1) – Below Average 2) – Average 3) – Above Average

____ Integrity/ moral character/ ethical ____ Ability to work as a team player ____ Problem-solving skills ____ Initiative

____ Maturity/ Judgment ____ Responsible attitude

____ Dependability ____ Ability to work independently

How well do you know this applicant? _____ Very Well _____ Fairly Well _____ Slightly In what capacity have you known this applicant? _____________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Please provide a summary of your recommendation for this applicant:

_____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________

Compared to all the persons I could recommend, I would rate this person in the: ___(top 1%) ___(top 5%) ___(top 10%) ___(top 25%) ___(top 50%) ___ (other)

May we contact you with questions? _______ yes _______ no

Signature: ___________________________________ Date: _____________________________________ Position/Title: ______________________ Telephone __________________ E-mail: _____________________ Address: _________________________________________________________________________________

WORK / VOLUNTEER HISTORY FORM

Surgical Technology Program

Last First MI Maiden

Permanent Address:

Street City State Zip Telephone

Identification (S#) Are you a Colorado Resident? ________

Email address: _____________________________________________________________________________

Please provide the employer's name, address, length of employment, and type of work. The Admissions

Committee is especially interested in work and volunteer experiences that are health, education and/or surgical technology related.

Employer Address Type of Work or Volunteer Job Duties Dates of Employment Supervisor: Phone: Supervisor: Phone: Supervisor: Phone: Supervisor: Phone:

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