surgical technology - flathead valley community college · surgical technology application packet...
TRANSCRIPT
Revised: August 17th, 2018
Surgical Technology
Application Packet
For spring 2019
Application Deadline: October 5, 2018
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Dear Applicant,
Flathead Valley Community College is very excited that you are interested in our Surgical
Technology Program! All of our Healthcare Programs here are exceptional, but I am positive
that you have chosen the best one to apply to (okay I might be a little biased). Our Surgical
Technology Program is challenging, I’m not going to sugarcoat it for you. However, it is also
very exciting and prepares you for employment in a wide variety of settings.
As a Certified Surgical Technologist (CST), you will be directly involved in patient care. You
will be part of a team effort in the operating room by getting the instruments, supplies and
equipment ready to assist the surgeon and nurses in giving the best care and outcome for your
surgical patient.
It will be your responsibility to make the most out of this program. It will require that you do a
substantial amount of studying and practicing outside of the class and clinical rotations in order
to be successful. You will need to be able to multi-task, stand or sit for long periods of time,
have good hand-eye coordination, distinguish colors and changes in variation, see objects 20
inches to more than 20 feet away, hear activities/commands given within 20 feet, cope with
unexpected situations and emotions, complete forms accurately, read lists, tables and schedules,
accurately recall information, interpret information, detect odors, provide emotional support to
others, sustain repetitive movements, and apply knowledge from one situation to another.
During the course of this program, it is our goal to provide you with a solid foundation of
professionalism, dedication, integrity and mutual respect between instructors and students.
This program is accredited, which means upon completion of the coursework, you will be
eligible to sit for the national certifying exam. Graduates find a sense of pride in their
certification, as they have accomplished a challenging period in their life that has helped shape
them as a professional.
Thank you for applying to the program! Surgical Technology is one of the fastest growing
professions not only here in the Flathead Valley, but also nationwide. I look forward to meeting
with you and would be happy to answer any questions you may have.
Sincerely,
Patty Lincoln, AAS, CST
Program Director for Surgical Technology
406-756-4414
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Our Program
The Flathead Valley Community College Surgical Technology Associate in Applied Science
(AAS) degree is a 70-credit program designed to develop skills in all phases of operating room
procedures and techniques, including clinical experience in the operating room.
In addition to operating room techniques, surgical procedures, surgical instruments and
equipment, students study surgical microbiology, surgical pharmacology, medical terminology,
anatomy and physiology, asepsis (sterile technique), preparation of the patient for surgery and
the physical conditions that make it necessary for a person to have surgery.
A new class of ST students begins each year in January. A maximum of 8 students are accepted
each year with 2 put on a wait list. If the number of qualified applicants exceeds available
spaces, not all qualified applicants will be accepted.
Program Application Deadline
Applications may be obtained via the FVCC Surgical Technology website or picked up in the
Program Directors office, BC 123A anytime and must be returned no later than the first Friday in
October for spring admission. Once applicants have met all the program criteria, selected
students will be interviewed by Surgical Technology faculty, objectively assessed on a rubric,
and then notified of their admission status into the program by mid-November.
Applicants should be sure to obtain the most current information and application packet for the
Surgical Technology Program either from the FVCC website, Program Director’s office or from
the FVCC Admissions and Records Office. Please be sure to use the most current application as
updates are made for each application session.
Program Accreditation and Approvals
The Surgical Technology Program is accredited by the Commission on Accreditation of Allied
Health Education Programs (www.caahep.org) upon the recommendation of the Accreditation
Review Committee on Education in Surgical Technology and Surgical Assisting (ARC/STSA)
(arcstsa.org).
Upon successful completion of the Surgical Technology Program, students will sit for the national
certification exam as administered through the National Board of Surgical Technology and Surgical
Assisting (www.nbstsa.org)
Demands of the Profession The Surgical Technology student should have the maturity, individual motivation, conscience, good
interpersonal skills, and manual dexterity combined with a solid academic science background to
assume the professional responsibilities of the Surgical Technologist. Demands include but are not
limited to:
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Assist in lifting and positioning patients weighing as much as 350+ pounds, repeatedly lift trays
of instruments weighing 25 pounds, stand, bend, stoop, and/or sit for long periods of time in one
location with minimum or no breaks, refrain from nourishment or restroom breaks for periods up
to 6 hours, maneuver large pieces of surgical equipment.
Adapt to frequent changes in the work environment (from calm to extremely stressful),
concentrate and attend to detail amidst a variety of environmental distractions, process
information accurately, thoroughly, and quickly, carry out complex sequences of instructions,
prioritize tasks quickly, demonstrate sufficient peripheral vision to function while in the sterile
surgical environment, demonstrate positive coping skills in a stressful environment, learn and
apply new information regarding new procedures on an on-going basis, demonstrate prior
learning, demonstrate critical thinking skills, demonstrate professional behaviors and
accountability and manipulate and account for placement of very fine (11-0) suture with needle
holder (finer than a strand of hair).
Disability Statement
Upon admission, a candidate who requests accommodations due to a disability may be asked to
provide documentation of his or her disability for the purpose of determining appropriate and
reasonable accommodations. To continue in the curriculum, the candidate must be able to
perform all of the essential functions. Request for accommodations should be directed to Tracy
Sullivan, Disability Services Coordinator at 406-756-3376.
Class Schedule & Clinical Rotations
Surgical Technology course work is offered days only. Students should be available M-F from
8:00 am - 5:00 pm.
During clinical rotations, students are expected to work the schedule they are assigned by the
FVCC Clinical Coordinator which could vary according to patient care and student needs.
Weekend and evening call shifts will be required during a student’s last clinical rotation. Clinical
sites are local (within a 100-mile radius of FVCC).
Program Curriculum
Pre-Surgical Technology Courses
These classes must be completed, or be currently enrolled in to apply.
AHMS 144 Medical Terminology 3 Credits
AHST 101 Introduction to Surgical Technology 3 Credits
BIOH 201NL* Human Anatomy & Physiology I 4 Credits
BIOH 211NL* Human Anatomy & Physiology II 4 Credits
COMX 115 Interpersonal Relations/Communication 3 Credits
Or
COMX 111C Introduction to Public Speaking 3 Credits
M 120* Mathematics w/ Healthcare Application 3 Credits
PSYX 100A Introduction to Psychology 4 Credits
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WRIT 101W* College Writing 3 Credits
27 Total Semester Credits
Spring Semester AHST 116* Surgical Techniques I w/ Lab 6 Credits
AHST 201* Surgical Procedures I 4 Credits
BIOM 250NL* Microbiology for Health Sciences 4 Credits
14 Total Semester Credits
Fall Semester AHST 202* Surgical Procedures II 5 Credits
AHST 216* Surgical Techniques II 3 Credits
AHST 250* Surgical Clinical I 4 Credits
BIOH 113* Human Form & Function II 4 Credits
16 Total Semester Credits
Spring Semester AHST 207* Professional Development & Leadership 3 Credits
AHST 255* Advanced Surgical Clinical 10 Credits
13 Total Semester Credits
70 Total Program Credits *Indicates prerequisite and/or corequisite needed. **Students must earn a grade of C (2.0) or higher in all Pre-Surgical Technology classes with an overall GPA of at
least a 2.75.
Students are presumed to possess basic computer skills with the use of word processing and presentation software and the ability to use the internet and send/receive email. Students should enroll in the CAPP 131 computer class if they need introductory coursework in a computer class.
Program Costs
Costs are subject to change. Costs listed are estimates only. Costs include specific technical
courses and requirements after formal acceptance into the Surgical Technology program. It does
not include costs associated with obtaining pre-requisite courses and/or courses taken during the
Surgical Technology program that are for a “second degree”. Transportation costs, room and
board, relocation costs to the Flathead Valley for class and other locations for clinical
experiences are not included in the below costs. Uniform, textbooks, background check, CPR,
immunizations, etc. are all estimations from area facilities. There may be other costs not included
in this list.
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Estimated Program Costs
In-District Out-of-District Out-of-State
Program: Spring Semester – 14 credits Course Tuition and Fees $2,404.00 $3,090.00 $5,974.00
Course Lab Fees2 $225.00 $225.00 $225.00
Textbooks (approximate cost) $794.00 $794.00 $794.00
Uniform¹ $210.00 $210.00 $210.00
Immunizations (This price varies depending on facility) $200.00 $200.00 $200.00
BLS Healthcare Provider (CPR) $10.00 $10.00 $10.00
Background Check & Compliance Tracker $87.00 $87.00 $87.00
Program: Fall Semester – 16 credits
Course Tuition and Fees $2,404.00 $3,090.00 $5,974.00
Course Lab Fees² $322.00 $322.00 $322.00
Program: Spring Semester – 13 credits
Course Tuition and Fees $2,235.50 $2,872.50 $5,550.50
Course Lab Fees2 $30.00 $30.00 $30.00
Total Program Tuition and Fees $8,921.50 $10,930.50 $19,376.50
¹ The uniform price is going to vary based on the dealer you choose. The uniform consists of: 2 - Plain Black Scrub Pants, 2 - Plain
Black Scrub Tops, 1 - Plain Black Scrub Jacket, 1 - Pair of Operating Room Shoes (Non-marking athletic shoes or close-toed "Dansko's") and 2 - Surgical Technology Patches (purchased in the college Bookstore). Patches are to be sewn on the right sleeve of scrub tops.
² Course Lab Fees encompass costs for laboratory supplies, NBSTSA Certification Exam, Exam Review Book and AST membership for 1 year.
Based on the published FVCC 2018-2019 Tuition and Fee Schedule at:
https://www.fvcc.edu/pay-for-college/tuition-fees/
Admission Guidelines and Criteria
Surgical Technology applicants must complete the Flathead Valley Community College
Application for Admission (degree seeking) and follow the steps for enrolling at FVCC.
Admission to FVCC does not guarantee acceptance into the Surgical Technology Program.
Students entering FVCC with the intent to become a Surgical Technology Program student may
declare an Associate of Science in Surgical Technology upon admission, but are not accepted
into the Surgical Technology Program until after a formal application, interview and selection
process occurs. All candidates who meet application requirements will be considered for
acceptance.
Page 1-6 can be kept for information for students. Pages 7-15 should be submitted with application materials and
students should make a copy of these pages as well for their own records.
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FVCC Surgical Technology Application 2018-2019
Please return your completed and signed application by October, 5th 2018 with all requested
materials in a sealed envelope to the following address:
FVCC Admissions Office/Surgical Technology Program
777 Grandview Drive
Kalispell, MT 59901
All applications will be date stamped upon receipt. Contact information will be entered into the
tracking system. It is the individual’s responsibility to contact the Surgical Technology Program
Director with changes in address or phone number.
Please carefully read the application and review it for completeness before signing. It is
recommended to organize your application in a way that allows for easy identification and
review of content (separate tabs and/or table of contents are both very helpful for ease of content
review). DO NOT rush the application process; incomplete applications will be denied.
AN INCOMPLETE AND/OR UNSIGNED APPLICATION WILL NOT BE PROCESSED.
Please Print
______________________________________________________________________________ Last Name First Name MI DOB Student ID #
______________________________________________________________________________
Mailing Address **Notification of acceptance/non-acceptance will be sent to this address**
______________________________________________________________________________ City State Zip Telephone Number Email
*PLEASE INCLUDE EACH REQUIREMENT BELOW AND INITIAL EACH ITEM
SIGN YOUR NAME ONCE COMPLETED
I have applied to Flathead Valley Community College Admissions Office as a degree
seeking student with all records required on file.
I understand that I will be notified by mid-November whether or not I have received
placement in the Surgical Technology Program for spring 2019. Students will need to respond to
the FVCC Surgical Technology Program Director in writing of their choice (email or letter) to
accept or decline admission into the program. Students who are put on the waiting list will be
offered a placement assignment if and only if an opening occurs. The wait list is maintained only
until the first week of spring 2019. Students who are not accepted may reapply for placement into
a following year program during the open application process.
I understand that all placements in the Flathead Valley Community College Surgical
Technology Program are dependent upon sufficient financial, faculty and clinical resources.
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Please list college/universities you have attended:
Name of Institution Dates of Attendance (month/year) Degrees earned (if applicable)
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
I have submitted transcripts from all colleges/universities listed above (including FVCC
classes). If official copies of transcripts are on file in the FVCC Admission Office, photocopies
are acceptable to include with this application. These are available to download and print from
your Student Portal. Official transcripts must be on file in the FVCC registrar’s office for transfer
of credit to be considered.
I have evaluated my transcript(s) and academic standing and I am confident that I can
complete or have completed, with a grade of “C” or higher, all of the required prerequisite courses
for the Surgical Technology Program placement by the end of fall 2018. My selective GPA in
these courses is at least 2.75 (on 4.0 scale).
All prerequisite courses must be completed within 15 years with exception of Human
Anatomy and Physiology I & II.
Completion of Human Anatomy and Physiology I & II must be within five (5) years of
admission date and must contain a lab component. Unless approved by the program
director.
Credits are accepted for prerequisites only if a letter grade appears on the official college
transcript. If a college grade is not assigned to the course, the course needs to be
completed prior to being able to start the Surgical Technology program.
The highest grade will be used for courses that have been taken more than once.
Students who have taken a higher level course than the prerequisite course requirement
may utilize the grade for that course for admission purposes, if the grade is higher than
that of the required course and approved by the Program Director.
The FVCC Surgical Technology program assumes that students applying for the program
have had experience with basic computer skills and keyboarding. Students are
responsible for obtaining these skills independently if they do not meet this technical
requirement.
I have provided proof of current professional certifications (if applicable) such as Certified
Nursing Assistant (C.N.A), Emergency Medical Technician, Certified Medical Assistant, etc.
Professional certifications will need to be approved by the program director as related to the health
profession prior to submission.
I have included my completed Surgical Observation Form. To schedule an observation,
students must contact Patricia Lincoln at [email protected] or call 406-756-4414 to coordinate a
time to observe one surgery.
I have included my Biographical Essay (no more than 3 pages, double spaced, minimum
of 11-point font). Applicants will be graded upon the following content areas:
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Content Includes: 1) Interests/goals in pursuing a career as a Surgical Technologist, 2)
Experiences in any health care field or in your life which directly relates to your knowledge
of and interest in Surgical Technology; can be employment or volunteer experience 3)
Personal strengths which will allow you to function effectively as a CST, and 4) List 5
reasons why you won’t quit.
Structure - spelling, grammar, punctuation & outline
Composition - theme, thought process, & expression
I have included my two Professional Recommendation forms which are unopened, sealed
in a standard letter-size envelope, and signed across the seal by the person who completed the
recommendation form.
I understand that upon withdrawal from the program for any reason, re-entry into the
program is not guaranteed.
I understand an objective point procedure using a rubric will be utilized to determine if I
am selected for an interview. Application and interview performance will determine final
placement into the program.
IMPORTANT: I understand that my final admission to the program is contingent upon
completing a successful criminal background check and all immunizations required for clinical
rotations be facility partners.
After initial acceptance in the program, during the first spring semester students will be
given instructions for creating a CastleBranch account. Cost is $87.00 and responsibility
of the student.
Through CastleBranch a criminal background check will be conducted. Clinical facilities
require backgrounds check for security purposes on individuals who provide services
within the facility and especially those who supervise care and render treatment. Clinical
rotations are an essential part of the program. Students who cannot participate in clinical
rotation due to criminal or other adverse activities that are revealed in a background check
are unable to fulfill the requirements of the program. This decision is made solely by the
healthcare facility partner and not Flathead Valley Community College.
CastleBranch will prompt students to submit ALL of the following required immunizations
and documents for clinical rotations:
o 2 MMR’s or Titers
o Hep B Titer with Positive results (titers are done after receiving three doses of vaccine
to check for immunity). If negative must have booster followed by another titer.
Students can choose to sign a declination form.
o 2 Varicella vaccines or Titer. Official physician documented history of chickenpox
may also be accepted.
o Tdap – Must be current within the last 10 years. Cannot be Dtap, TD, or any other
combination.
o Flu shot during flu season (usually starts in October). This is not optional.
o Record of two negative TB skin tests within the last 12 months. After first test is read
the second must be read within 7-21days. If not completed properly in this timeframe,
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the two steps must be redone. The other option is to have a Quantiferon TB blood test
done within the last 12 months. Results must be negative.
o Proof of current (infant through adult) Basic Life Support (BLS) Healthcare Provider
CPR certification that will not expire prior to completion of program.
o Students taking more than 6 credits have the option to utilize the Student Health
Clinic and can contact them at 406-756-4331 for information on costs, billing, and
appointments.
Once background and immunizations are complete, students will be given further
instructions for reading through policies, procedures, and orientation manual of facility
partners where clinical rotations will be completed. Students will have to submit their
contact information to the facility and upload a photo in order to receive an access badge
to be permitted into surgeries.
I have retained a copy of this application for my records (it is my responsibility to
make my own copy).
Student Signature _________________________________________Date__________________
Printed Name of Applicant _______________________________________________________
* Any discrepancies in application criteria must be discussed and signed off with the Program Director
prior to assumption of meeting admission criteria.
If you have any questions regarding the Surgical Technology Admission process or forms, please contact
Patricia Lincoln at (406)-756-4414 or [email protected]
Application Deadline: October 5th, 2018
NO LATE APPLICATIONS WILL BE ACCEPTED
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Surgical Technology Observation Form
Student Name_______________________________________ Date__________________
Surgeon Name ______________________________________
Surgical Procedure_____________________________________________
What type of surgery is it?
Describe what you observed before the procedure:
Describe what you observed during the procedure? What was the Surgical Tech doing?
Describe what you observed after the procedure:
Student Signature_______________________________________________________Date_______________
Hospital Staff Signature__________________________________________________Date_______________
Circle One
Orthopedic
Obstetrics/Gynecology
Neurosurgery
General
Cardio/Thoracic
Ear, Nose and Throat
Ophthalmic
Urologic
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Professional Reference for Surgical Technology Program Applicant
Name of applicant _______________________________________ Date_________
The above named applicant is a candidate for admission to the Flathead Valley Community
College Surgical Technology Program. Please answer the following questions to the best of your
ability and submit the reference to the applicant in a signed and sealed envelope. After sealing
the envelope please sign your name across the seal to ensure confidentiality. Feel free to use
additional paper if you require extra space.
1. How long have you known the applicant and in what capacity?
2. Describe the applicant’s ability to perform effectively in stressful and emergency situations.
Please give an example.
3. Describe the applicant’s ability to perform effectively and harmoniously as a team member.
4. Describe the applicant’s leadership qualities.
5. Do you endorse this applicant as a suitable candidate for this program? Please comment
6. Do you have any other information you feel would be relevant to an employer (program)?
Printed Name: ____________________________________________ Date: ____________
Signature: _______________________________________________
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Professional Reference from an Academic Instructor
Name of Applicant _____________________________Date_________
The above named applicant is a candidate for admission to the FVCC Surgical Technology
Program. Please answer to the best of your ability and submit the reference to the applicant in a
signed and sealed envelope. After sealing the envelope please sign your name across the seal to
ensure confidentiality. Please feel free to use additional paper if you require extra space.
1. Would you describe this student as someone who works best as part of a team or
independently?_______________________________________________________________
___________________________________________________________________________
___________________________________________________________________________.
2. How would rate this student’s communication skills?________________________________
___________________________________________________________________________
___________________________________________________________________________.
3. Does this student get along with their classmates and instructors?______________________
___________________________________________________________________________
___________________________________________________________________________.
4. Comment on this student’s attendance and punctuality:_______________________________
___________________________________________________________________________
___________________________________________________________________________.
5. How well does this student manage under pressure or stressful situations?________________
___________________________________________________________________________
___________________________________________________________________________.
6. Is this student easily distracted or discouraged?_____________________________________
___________________________________________________________________________
___________________________________________________________________________.
7. Do you think this student will be a good candidate for the Surgical Technology Program?
___________________________________________________________________________
___________________________________________________________________________.
8. How would you rate this student overall on a scale from 1-10 (10 being the highest)?
1 2 3 4 5 6 7 8 9 10
Printed Name:____________________________________________
Signature:_______________________________________________