RA Procedures II

Course Details

Course Number: RADS 5253  Fall 2010

Location: Bridwell Hall

Classroom Number: 204

Days & Times:

Hybrid Course- Internet and On campus Requirements

On Campus requirements TBA



Course Attachments

RADS RA Procedures IIFall2010   RADS 5253 RA II Syallabus.pdf

Textbooks

Fundamentals of diagnostic radiology (3nd ed.).
Brant, W.E. & Helms, C.A. (2006)
  ISBN: 9780781761352

Clinical radiology: The essentials (3rd ed.)
Daffner, R.H. (2007).
  ISBN: 9780781799683

Textbook of Uroradiology (4th ed.)
Dunnick, N.R., Sandler, C.M., Newhouse, J.H., & Amis, E.S. (2008).
  ISBN: 978-0-7817-6750-7

Gastrointestinal radiology: The requisites (3rd e
Halpert, R.D. (2006).
  ISBN: 0323032214

Manual of GI fluoroscopy.
Javors, B.R. (1996).
  ISBN: 0865776075

MSU Faculty Member
Vicki Sanders MSRS, RRA, RT(R)(CV)   
view Profile »

Course Objectives• Describe the basic concepts of reviewing radiographic images of the noncontrast abdomen, GI, and GU systems. • Identify indications for appropriate abdomen, GI, and GU imaging procedures. • Radiographically identify common abdomen, GI, and GU pathologies.

Course ExpectationsCourse Overview: This course prepares the radiologist assistant for clinical medical imaging procedures involving patient preparation, fluoroscopy, and filming for gastrointestinal and genitourinary systems. Students complete reading and writing assignments, take online quizzes, participate in classroom and online discussions, do research, participate in hands-on laboratory experiences, and make presentations. Students also participate in rigorous in-class image reviews to demonstrate their understanding of the course content. Grading / Evaluation: Class Participation 10% WebCT Open Book Module Quizzes 20% Presentations 20% In-Class Image Review 30% Comprehensive Closed Book Final Exam 20% A = 90 = 100 B = 80 – 89 C = 70 – 79 D = 60 – 69 F = Below 60 The last opportunity to drop this course with a grade of “W” is 4:00pm October 18,2010. Refer to the Undergraduate Bulletin for details about receiving a grade of “Incomplete” in a course. In an emergency or extenuating circumstance, a student may request a grade of “Incomplete” in a course before grades are submitted. If the instructor grants the “Incomplete,” the student has until thirty (30) days after the beginning of the next long semester to complete the course requirements. If the student does not complete the course requirements within the deadline, the grade of “Incomplete” will automatically convert into a grade of “F.” Communication with Instructor: Contact information for the instructor is listed at the beginning of this syllabus. Email is the preferred mode of communication. It is critical that students report all email changes immediately to the instructor. The instructor will respond or at least acknowledge email messages from students within a maximum of five (5) business days when MSU is in session. Beyond standard university holidays and breaks, the instructor will notify students of any extended periods of time when email contact is not practical (professional meetings, etc) CLASS ACTIVITIES AND ASSIGNMENTS Students can proceed through the course content at their own pace within the boundaries set by the Course Schedule and the MSU Academic Calendar. Quizzes may not be posted until the due dates. See the Course Schedule for specific information about activities and due dates. Participation – 10% Students must participate in class activities, projects, and discussions. Students complete most course requirements by working independently from the instructor and classmates. Evidence of class participation includes: responding to emails, taking quizzes and the final exam on or before the scheduled deadlines, participating in online discussions, and submitting the assignments in a timely manner. Students should participate in the online discussions at least once every other week throughout the semester. Discussion topics can be posted by students or by the instructor. WebCT Open Book Module Quizzes - 20% Module 1: Upper GI Procedures Module 2: Lower GI Procedures Module 3: Abdomen & Urinary Procedures Module 4: Comprehensive Review of All Previous Procedures in THIS course Each module has a quiz. Students should complete the reading assignments before attempting the open book module quizzes. See the separate Reading Assignments link on WebCT. See the Course Schedule at the end of this syllabus for specific information about module quiz due dates. When a student has reviewed a module and is ready for the quiz, he or she will log on to WebCT and receive a customized timed module quiz consisting of randomized multiple choice questions. Students may take quizzes ahead of schedule but MUST complete them by the scheduled deadlines on the Course Schedule at the end of this syllabus. The information covered during seminar days will be included on the module quizzes. It is important to know the module content before attempting the module quizzes because they are timed. Students who do not complete module quizzes before the deadlines listed on the Course Schedule at the end of this syllabus will have points deducted from their Class Participation grade. Quiz scores will be available through WebCT after they have been graded. If students have technical difficulties during a quiz, they should use the “Help” link at the top toolbar in WebCT, contact the MSU Information Systems Support Staff, and send an email to the course instructor explaining what happened. If a student finds a faulty quiz test item or believes that a quiz question has been scored incorrectly, he or she should send an email to the course instructor (donna.wright@mwsu.edu) that includes the following:  Module Quiz Number (I –IV)  Question Stem  Answer Scored as Correct by the Computer  Answer the Student Thinks Should be Correct  Rationale Supporting Why the Student’s Answer is Correct  Page numbers must be included when referencing the textbook in a rationale For example, a student can not send the message “I think question number ten is wrong on quiz four” because each student gets a quiz of randomly generated test items. The instructor has to know the question stem to find the question in the database. After reviewing the case, if the course instructor thinks a revision is justified, the student’s quiz score will be revised to reflect the additional points and the test bank will be updated. It may take several weeks for the student to receive a response because the instructor works on batches of questions for a particular quiz at a time. Presentation – 20% Students will teach their classmates about specific topics related to GI / GU imaging procedures during the second set of seminar classes. Students should email the instructor to claim one of the following topics (first come – first serve). Students are encouraged to use textbooks and captured images, and Internet or other external resources in their PowerPoint presentations. Students should provide handouts for their classmates, including an APA format Reference List. The sources of graphics used in the PowerPoint presentation should be cited on the slides. Students will have one hour for presentations. Students should NOT read their presentations to the group. Presentations should be INTERACTIVE to engage the interest of their classmates. Presentation Topics • Post-Operative Gut Changes including Bariatric Surgeries – options, procedures, effects on imaging procedures, prognoses, complications, etc) • Drug Considerations - (FDA / DEA / controlled substances, names, actions, contraindications, typical doses, affects on procedures) – Common GI drugs (anti-reflux agents, glucagon, cholecystokinin), GU drugs, Vascular drugs (platelet inhibitors, TPA), Anti-Inflammatory drugs (aspirin, NSAIDS, corticosteroids), Endocrine drugs (insulin, glucagon, levothyroxine thyroid hormone replacement, etc) • Contrast Reactions – current rates, characteristics of iodine-based contrasts, patient considerations (hydration, renal status, diseases of concern, incompatible meds, premeds to reduce reactions, what should be done during reaction - MD perspective (BLS, ACLS, meds), etc • Pediatric GI / GU Considerations – (foreign objects, malformation / atresia, hypertrophic pyloric stenosis, intussusception, Hirschsprung, UTI, etc.) In-Class Image Review – 30% Students will participate in a “hot seat” for image observation during seminar classes. Various faculty members will display randomly selected images and the students will describe what they observe on those images. Radiographs will primarily focus on the abdomen, GI, and GU systems, but may include chest images as a review. By this time in the RA curriculum, students MUST demonstrate competence during in-class image reviews. Students who perform at lower than a grade level of B on the image review will have to repeat the image review. Students who do not achieve a minimum of grade level B on the repeated review, will not successfully complete this course, and will not continue in the RA Program. Comprehensive Closed Book Final Exam - 20% The comprehensive proctored closed-book final exam includes material from all of the courses taken so far in the RA curriculum. Each student must have a proctor and test site approved by the course instructor at least three working days before taking the exam. Typically acceptable proctor sites and candidates include:  College or University Testing Centers  Texas Computer-based Testing Collaborative (In Texas Only) (www.tcbtc.org/locations.html )  Officials at military base education offices The exam site must have reliable Internet connections and should have at least two Internet browsers available (Netscape Navigator and Microsoft Explorer). Sites with extensive firewalls and high security mechanisms may not work for testing. Please test to be sure you can connect to WebCT before committing to a proctor site. High speed connections are more desirable than traditional phone line connections. The site must support an independent phone line in addition to the computer connection so that calls can be made while the student is connected online. The proctor must have moderate computer expertise including the ability and authorization to reboot the remote computer. The student is responsible for any fees proctors charge for their services. Even if someone has served as a proctor in previous courses, he or she will not be accepted as a proctor for this course if he or she does not meet these criteria. Proctor emails will only be sent to commercial or educational email addresses. Proctor approval is at the discretion of the course instructor. The proctor form is available in .pdf format from WebCT. The proctor forms for this course have been redesigned so please use the appropriate proctor forms. Students should review the form and get the proctor information ahead of time. Students should then open the Adobe PDF file and type the required information in the boxes on the forms. Students should print the forms and have the proctor sign the forms. The students should then fax the forms to the course instructor (Fax Number 940-397-4845). Each student can set his/her exam appointment anytime between 9am and 9pm. It is better to take the exam during normal working hours to be sure that MSU Technical Support will be available. The course instructor will provide the examination password to the proctor by email. The instructor may be available by phone and email during the exam time in case there are technical difficulties with the electronic version of the exam. If there are any problems during the exam, the proctor should call the course instructor (Toll Free 866-575-4305, Direct 940-397-4615, Cell 940-781-8477) If the instructor is not available, contact MSU Technical Support through MSU WebCT, and send an email to the instructor explaining what happened. The exam may have to be rescheduled. 2010 TENTATIVE COURSE SCHEDULE Dates Activity August 21 MSU Fall Session Classes Start Sept 10 (12:00pm – 9:00 pm) – Sept 13 (8:00 am-9:00 pm) On-Campus Seminar Classes In-Class Image Review September 29 Module 1 Quiz October 20 Module 2 Quiz November 10 Module 3 Quiz December 1 Module 4 Quiz Dec 3 (6:00 pm-11:00 pm) – Dec 7 (8:00 pm-9:00 pm) On-Campus Seminar Classes In-Class Image Review December 6-8 Comprehensive Closed Book Final Exam Suggested Reading for RA Procedures II Authors Chaps Content Pages Module I Javors General Principles 1 - 20 Daffner 2 Contrast 41 - 48 Daffner 8 GI Imaging (UGI sections) 287 - 340 Halpert 1 - 3 Esophagus --- Small Bowel 1 - 147 Javors 1-2 Pharyngeal & Esophageal Exams 21-60 Javors 3-4 UGI Exams 61-110 Brant & Helms 29 - 30 Esophagus, Stomach 798 - 831 Power point on Course Homepage Esophagus and UGI Module II Brant & Helms 27 - 28 Biliary, Pancreas, Spleen 7 - 797 Halpert 4 - 6 Pancreas, Liver / Spleen, Biliary 148 - 260 Halpert 7 Colon & Rectum 261 - 325 Daffner 8 GI Imaging (LGI sections) 287 - 340 Javors 5-8 Small bowel Colon Exams 111-190 Brant & Helms 31 - 32 Small Bowel, Colon 832 - 864 Powerpoint on class homepage Small Bowel, Colon, Pediatric GI Module III Brant & Helms 26 Abdomen & Pelvis 733-755 Daffner 7 Abdominal Radiographs 232-267 Daffner 2 Contrast 41 - 48 Daffner 9 Urinary Tract Imaging 635 - 733 Powerpoint on class homepage GU Exams and Pediatric GU Brant & Helms 33 - 35 Genitourinary Tract 867 - 923 Dunnick et al 1-16, 18, 20 Textbook of Uroradiology Module IV Comprehensive Chest, Plain Abdomen, GI, GU

Final Exam12/6/2010  TBA

Submission Format PolicyCLASS ACTIVITIES AND ASSIGNMENTS Students can proceed through the course content at their own pace within the boundaries set by the Course Schedule and the MSU Academic Calendar. Quizzes may not be posted until the due dates. See the Course Schedule for specific information about activities and due dates. Participation – 10% Students must participate in class activities, projects, and discussions. Students complete most course requirements by working independently from the instructor and classmates. Evidence of class participation includes: responding to emails, taking quizzes and the final exam on or before the scheduled deadlines, participating in online discussions, and submitting the assignments in a timely manner. Students should participate in the online discussions at least once every other week throughout the semester. Discussion topics can be posted by students or by the instructor. WebCT Open Book Module Quizzes - 20% Module 1: Upper GI Procedures Module 2: Lower GI Procedures Module 3: Abdomen & Urinary Procedures Module 4: Comprehensive Review of All Previous Procedures in THIS course Each module has a quiz. Students should complete the reading assignments before attempting the open book module quizzes. See the separate Reading Assignments link on WebCT. See the Course Schedule at the end of this syllabus for specific information about module quiz due dates. When a student has reviewed a module and is ready for the quiz, he or she will log on to WebCT and receive a customized timed module quiz consisting of randomized multiple choice questions. Students may take quizzes ahead of schedule but MUST complete them by the scheduled deadlines on the Course Schedule at the end of this syllabus. The information covered during seminar days will be included on the module quizzes. It is important to know the module content before attempting the module quizzes because they are timed. Students who do not complete module quizzes before the deadlines listed on the Course Schedule at the end of this syllabus will have points deducted from their Class Participation grade. Quiz scores will be available through WebCT after they have been graded. If students have technical difficulties during a quiz, they should use the “Help” link at the top toolbar in WebCT, contact the MSU Information Systems Support Staff, and send an email to the course instructor explaining what happened. If a student finds a faulty quiz test item or believes that a quiz question has been scored incorrectly, he or she should send an email to the course instructor (donna.wright@mwsu.edu) that includes the following:  Module Quiz Number (I –IV)  Question Stem  Answer Scored as Correct by the Computer  Answer the Student Thinks Should be Correct  Rationale Supporting Why the Student’s Answer is Correct  Page numbers must be included when referencing the textbook in a rationale For example, a student can not send the message “I think question number ten is wrong on quiz four” because each student gets a quiz of randomly generated test items. The instructor has to know the question stem to find the question in the database. After reviewing the case, if the course instructor thinks a revision is justified, the student’s quiz score will be revised to reflect the additional points and the test bank will be updated. It may take several weeks for the student to receive a response because the instructor works on batches of questions for a particular quiz at a time. Presentation – 20% Students will teach their classmates about specific topics related to GI / GU imaging procedures during the second set of seminar classes. Students should email the instructor to claim one of the following topics (first come – first serve). Students are encouraged to use textbooks and captured images, and Internet or other external resources in their PowerPoint presentations. Students should provide handouts for their classmates, including an APA format Reference List. The sources of graphics used in the PowerPoint presentation should be cited on the slides. Students will have one hour for presentations. Students should NOT read their presentations to the group. Presentations should be INTERACTIVE to engage the interest of their classmates. Presentation Topics • Post-Operative Gut Changes including Bariatric Surgeries – options, procedures, effects on imaging procedures, prognoses, complications, etc) • Drug Considerations - (FDA / DEA / controlled substances, names, actions, contraindications, typical doses, affects on procedures) – Common GI drugs (anti-reflux agents, glucagon, cholecystokinin), GU drugs, Vascular drugs (platelet inhibitors, TPA), Anti-Inflammatory drugs (aspirin, NSAIDS, corticosteroids), Endocrine drugs (insulin, glucagon, levothyroxine thyroid hormone replacement, etc) • Contrast Reactions – current rates, characteristics of iodine-based contrasts, patient considerations (hydration, renal status, diseases of concern, incompatible meds, premeds to reduce reactions, what should be done during reaction - MD perspective (BLS, ACLS, meds), etc • Pediatric GI / GU Considerations – (foreign objects, malformation / atresia, hypertrophic pyloric stenosis, intussusception, Hirschsprung, UTI, etc.) In-Class Image Review – 30% Students will participate in a “hot seat” for image observation during seminar classes. Various faculty members will display randomly selected images and the students will describe what they observe on those images. Radiographs will primarily focus on the abdomen, GI, and GU systems, but may include chest images as a review. By this time in the RA curriculum, students MUST demonstrate competence during in-class image reviews. Students who perform at lower than a grade level of B on the image review will have to repeat the image review. Students who do not achieve a minimum of grade level B on the repeated review, will not successfully complete this course, and will not continue in the RA Program. Comprehensive Closed Book Final Exam - 20% The comprehensive proctored closed-book final exam includes material from all of the courses taken so far in the RA curriculum. Each student must have a proctor and test site approved by the course instructor at least three working days before taking the exam. Typically acceptable proctor sites and candidates include:  College or University Testing Centers  Texas Computer-based Testing Collaborative (In Texas Only) (www.tcbtc.org/locations.html )  Officials at military base education offices The exam site must have reliable Internet connections and should have at least two Internet browsers available (Netscape Navigator and Microsoft Explorer). Sites with extensive firewalls and high security mechanisms may not work for testing. Please test to be sure you can connect to WebCT before committing to a proctor site. High speed connections are more desirable than traditional phone line connections. The site must support an independent phone line in addition to the computer connection so that calls can be made while the student is connected online. The proctor must have moderate computer expertise including the ability and authorization to reboot the remote computer. The student is responsible for any fees proctors charge for their services. Even if someone has served as a proctor in previous courses, he or she will not be accepted as a proctor for this course if he or she does not meet these criteria. Proctor emails will only be sent to commercial or educational email addresses. Proctor approval is at the discretion of the course instructor. The proctor form is available in .pdf format from WebCT. The proctor forms for this course have been redesigned so please use the appropriate proctor forms. Students should review the form and get the proctor information ahead of time. Students should then open the Adobe PDF file and type the required information in the boxes on the forms. Students should print the forms and have the proctor sign the forms. The students should then fax the forms to the course instructor (Fax Number 940-397-4845). Each student can set his/her exam appointment anytime between 9am and 9pm. It is better to take the exam during normal working hours to be sure that MSU Technical Support will be available. The course instructor will provide the examination password to the proctor by email. The instructor may be available by phone and email during the exam time in case there are technical difficulties with the electronic version of the exam. If there are any problems during the exam, the proctor should call the course instructor (Toll Free 866-575-4305, Direct 940-397-4615, Cell 940-781-8477) If the instructor is not available, contact MSU Technical Support through MSU WebCT, and send an email to the instructor explaining what happened. The exam may have to be rescheduled.

Note: You may not submit a paper for a grade in this class that already has been (or will be) submitted for a grade in another course, unless you obtain the explicit written permission of me and the other instructor involved in advance.

Late Paper PolicyN/A

Plagiarism Policy Plagiarism is the use of someone else's thoughts, words, ideas, or lines of argument in your own work without appropriate documentation (a parenthetical citation at the end and a listing in "Works Cited")-whether you use that material in a quote, paraphrase, or summary. It is a theft of intellectual property and will not be tolerated, whether intentional or not.

Student Honor Creed

As an MSU Student, I pledge not to lie, cheat, steal, or help anyone else do so."

As students at MSU, we recognize that any great society must be composed of empowered, responsible citizens. We also recognize universities play an important role in helping mold these responsible citizens. We believe students themselves play an important part in developing responsible citizenship by maintaining a community where integrity and honorable character are the norm, not the exception. Thus, We, the Students of Midwestern State University, resolve to uphold the honor of the University by affirming our commitment to complete academic honesty. We resolve not only to be honest but also to hold our peers accountable for complete honesty in all university matters. We consider it dishonest to ask for, give, or receive help in examinations or quizzes, to use any unauthorized material in examinations, or to present, as one's own, work or ideas which are not entirely one's own. We recognize that any instructor has the right to expect that all student work is honest, original work. We accept and acknowledge that responsibility for lying, cheating, stealing, plagiarism, and other forms of academic dishonesty fundamentally rests within each individual student. We expect of ourselves academic integrity, personal professionalism, and ethical character. We appreciate steps taken by University officials to protect the honor of the University against any who would disgrace the MSU student body by violating the spirit of this creed. Written and adopted by the 2002-2003 MSU Student Senate.

Students with Disabilities The Americans with Disabilities Act (ADA) is a federal anti-discrimination statute that provides comprehensive civil rights protection for persons with disabilities. Among other things, this legislation requires that all students with disabilities be guaranteed a learning environment that provides for reasonable accommodation of their disabilities. If you believe you have a disability requiring an accommodation, please contact the Disability Support Services in Room 168 of the Clark Student Center, 397-4140.

Safe Zones Statement The professor considers this classroom to be a place where you will be treated with respect as a human being - regardless of gender, race, ethnicity, national origin, religious affiliation, sexual orientation, political beliefs, age, or ability. Additionally, diversity of thought is appreciated and encouraged, provided you can agree to disagree. It is the professor's expectation that ALL students consider the classroom a safe environment.

Contacting your Instructor All instructors in the Department have voicemail in their offices and MWSU e-mail addresses. Make sure you add your instructor's phone number and e-mail address to both email and cell phone lists of contacts.

Attendance RequirementsThis is a hybrid distance education course. Because of the unique distance learning format for this program, students must be present and on-time for the on-campus seminar to receive a passing grade. There are no exceptions to this policy. Students who are tardy for class risk a grade reduction or dismissal from the class. Because students and instructors in this program do not regularly interact in a traditional classroom setting, electronic communication is essential. Students must be vigilant in checking email and logging onto WebCT to insure that messages from the instructor are received in a timely manner.

Other PoliciesMethodology / Teaching Strategies: Independent reading assignments, written assignments, Internet searches, online quizzes, classroom discussion, clinical laboratory skills, online discussions, and presentations are used in this course. Special Needs: In accordance with Section 504 of the Federal Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990, Midwestern State University endeavors to make reasonable adjustments in its policies, practices, services, and facilities to ensure equal opportunity for qualified persons with disabilities to participate in all educational programs and activities. The Office of Disability Services (ODS) provides information and assistance, arranges accommodations, and serves as a liaison for students, instructors, and staff. The ODS has assistive devices such as books on tape, recorders, and adaptive software which can be loaned to qualified individuals. A student/employee who seeks accommodations on the basis of disability must register with the Office of Disability Services in the Counseling Center, Clark Student Center Room 108. Documentation of disability from a competent professional is required. Individuals with grievances related to discrimination or lack of accommodation on the basis of a disability are encouraged to resolve the problem directly with the area involved. If the matter remains unresolved, advice and/or assistance will be provided by the Office of Disability Services for resolution. The grievance procedure may be found in the Student Handbook and Activities Calendar. The director of the Counseling Center services as the ADA Coordinator may be contacted at (940) 397-4618, TDD (940) 397-4515, or 3410 Taft Blvd., Clark Student Center Room 108. Administrative Process: Unresolved issues related to this course should be first addressed between the student and the course instructor. If there is no resolution, students must follow this sequence: Department Chair – Dr. Donna Wright (940-397-4571) College Dean – Dr. Susan Sportsman (940-397-4594) Dean of Students – Dail Neely (940-397-6273) Conduct / Honesty / Honor System: RADS 5353 adheres to the MSU code of Conduct. In particular, academic dishonesty, however small, creates a breach in academic integrity. A student's participation in this course comes with the expectation that his/her work will be completed in full observance of the MSU code of Student Conduct. A student should consult the Student Handbook for answers to any questions about the code. Students are encouraged to take full advantage of many resources available including Internet sites, handouts, other textbooks and journals, faculty, and peers. This interactive collegial learning environment is conducive to life-long learning. Specific components of RADS 5353 are designed to represent the efforts of each student individually and are NOT to be shared. These components include the written assignments submitted for a grade. When students submit their efforts for grading, they are attesting they abided by this rule. Quizzes and exams are not to be copied in any form or shared in any form. Cheating includes, but is not limited to, (1) use of any unauthorized assistance in taking quizzes, tests, or examinations; (2) dependence upon the aid of sources beyond those authorized by the instructor in writing papers, preparing reports, solving problems, or completing other assignments; or (3) the acquisition of tests or other academic materials belonging to the university faculty or staff without permission. Plagiarism includes, but is not limited to, the use of, by paraphrase or direct quotation without correct recognition, the published or unpublished works of another person. The use of materials generated by agencies engaged in "selling" term papers is also plagiarism. By enrolling in this course, the student expressly grants MSU a “limited right” in all intellectual property created by the student for the purpose of this course. The “limited right” shall include but shall not be limited to the right to reproduce the student’s work product in order to verify originality and authenticity, and for educational purposes. Specifically, faculty may submit student papers and assignments to an external agency to detect plagiarism. Academic dishonesty (cheating, plagiarism, etc.) will not be tolerated in this class. If a student is found to have committed academic dishonesty, a grade of zero (0) will be given for the quiz, assignment, etc. Cases may also be referred to the Dean of Students for possible dismissal from the university.

Writing Proficiency Requirement All students seeking a Bachelor's degree from Midwestern State University must satisfy a writing proficiency requirement once they've 1) passed English 1113 and English 1123 and 2) earned 60 hours. You may meet this requirement by passing either the Writing Proficiency Exam or English 2113. Please keep in mind that, once you've earned over 90 hours, you lose the opportunity to take the $25 exam and have no option but to enroll in the three-credit hour course. If you have any questions about the exam, visit the Writing Proficiency Office website at http://academics.mwsu.edu/wpr, or call 397-4131.