2018-2019 Admissions Packet

Dear Prospective Surgical Technology Student,

Congratulations on your decision to pursue the Surgical Technology Program at Washburn Tech. This packet will

help guide you through the application process.

The Washburn Tech Surgical Technology program is available in a full-time, day time format that begins every

August. 14 students are accepted to this program every academic year. This 53 credit hour curriculum is

designed to provide graduates with the knowledge, skills, attitudes, and abilities needed to practice safely and

effectively as an entry level Surgical Technologist with the eligibility to take the National Certification Exam for

Surgical Techs.

Students learn to apply basic surgical skills along with the understanding of how these affect the surgical patient.

The surgical tech should be one with a strong sense of responsibility, a stable temperament, a concern for order,

considerable patience and one who pays attention to details. The surgical tech’s job will require heavy lifting,

good manual dexterity, and physical stamina as the surgical tech may be standing for long periods of time. The

surgical tech must be keenly sensitive to the surgical patients’ needs and be able to work effectively under

stress.

Please review the content of this packet to get an overview of the admissions process. This is information that is

critical for a successful application-please read the entire packet carefully. Additionally, please make sure that

your contact information is up-to-date with Washburn Tech as we frequently communicate with prospective

students via phone, mail and e-mail.

All requirements on the enclosed checklist must be completed prior to being considered for selection into the

program. To check the status of your file, call the Admissions Office at 785-670-2200. Thank you for considering

Washburn Tech for your educational needs.

Sincerely,

Kristi Mick, CST

Surgical Technology Director/Instructor

Washburn Institute of Technology (Washburn Tech) prohibits discrimination on the basis of race, color, sex, religion, age, national origin, ancestry, disability, marital or parental status, sexual orientation/gender identity, genetic information or other non-merit reasons, in programs and activities, admissions, educational programs or activities and employment, as required by applicable laws and regulations. The follow person has been designated to handle inquiries regarding the non-discrimination policies: Dr. Pamela Foster, Equal Opportunity Director, Washburn University, 1700 SW College Ave., Topeka, Kansas 66621, 785.670.1509, eodirector@washburn.edu.

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Pre-Admission Checklist

The following pre-admission requirements must be completed for a student to be considered for the

selection process.

DEADLINE: March 1st

It is the applicant’s responsibility to provide the required documentation by the deadline, and verify

that it has been received. In order to ensure an equitable process, a scoring rubric based upon

academic performance in prerequisites, assessment scores and references are used during selection.

____

Apply to Washburn Tech. Applications are submitted online at www.washburntech.edu.

____

Take Workkeys assessment* (Students who have qualifying COMPASS, SAT or ACT scores within

the last 5 years, may use those. Students who have completed a college level English or Math

class can possibly use their grades in lieu of testing depending on the letter grade. See an

Admissions Counselor for details.)

____

Submit official high school or GED transcripts

____ Complete prerequisite coursework

Anatomy and Physiology-must be at least 6 credit hours and within last 5 years with lab

____ Submit all official college transcripts to Washburn Tech. *Prerequiste coursework taken at another institution must be accepted by Student Records Administrator

____

Submit three references, using the Reference Release form included in this packet, from a current or previous employer, preferably in the healthcare field or health care instructors. References from family members and friends are not acceptable.

____

Apply to the Washburn Tech Surgical Technology program and submit written interview

questions. (Application is in this packet.)

____

Set up interview with Surgical Technology Director/Instructor, Kristi Mick.

E-mail preferred: kristina.mick@washburn.edu

Please submit all documentation prior to scheduling.

Program Information

Program and prerequisite courses require students to have knowledge of and access to computers.

Students will be required to submit homework online using Microsoft Word, download information and

use e-mail. Laptops are not required in the classroom.

While Anatomy & Physiology is the only required prerequisite, other recommended prior course work

to enhance a student’s success and ability to articulate include:

Medical Terminology

Pharmacology

Microbiology

CNA certification

Previous work in the health field is highly recommended.

Prerequisite courses are available to take at Washburn Tech and Washburn University, including

Certified Nurses Aide classes. In order to enroll in prerequisites, you must have an application on file

and meet with a Recruiter or Advisor. CNA courses run through our continuing education program and

offered on a regular basis. For more information about CNA class availability, contact Teresa Vasquez

at 785-670-3353.

Full-time program

• Students are accepted once a year (August)

• Instructional hours--Monday-Friday 8:00am-2:55pm

• Clinical hours vary-could be as early at 6am

• Times for all programs are subject to change

Surgical Technology Course Requirements

Course Number Course Name Credit Hours

Prerequisites

HCT 132 & 133 Anatomy and Physiology 6

Prerequisite Total 6

Semester 1

SUR 105 Intro to Surgical Technology 4

SUR 110 Microbiology (can be transferred in) 2

SUR 120 Medical Terminology for Surgical Tech 3

SUR 135 Principles & Practices of ST 5

SUR 145 Principles & Practices of ST Lab 3

SUR 155 Surgical Procedures I 4

SUR 175 ST Clinical I 3

Semester 1 Total 24

Semester 2

SUR 250 Surgical Pharmacology 2

SUR 245 Surgical Procedures II 5

SUR 265 Surgical Procedures III 5

SUR 270 ST Clinical II 4

SUR 285 ST Clinical III 6

SUR 295 ST Certification Review 1

Semester 2 Total 23

Program Total 53

Note: English as Second Language applicants will be considered for the program when they pass the

TOFEL exam and the entrance exams in Reading for Information and applied Math at the required

levels for entrance into the program. College level English is encouraged for ESL students, although

not required.

Acceptance Process

In order to ensure an equitable process, a scoring rubric based upon academic performance in prerequisites, assessment scores, references and the interview are used during selection. From there,

the top applicants will be selected. Additional points are added to the rubric for completion of

recommended coursework, CNA licensure and health field experience. Applicants will be notified in writing of their acceptance, or placement on the alternate list. (NOTE: Only applicants who have met

all deadlines and have a complete file receive this communication.) Applicants must respond in

writing, indicating their plan to accept or decline enrollment in the Surgical Technology program by

the date designated in the notification letter. In addition, an enrollment fee of $50 must be paid when

accepting a seat in the program. Failure to respond by the established deadline will result in forfeiture

of a seat in the Surgical Technology Program.

Reapplication Process

Applicants who are not selected for admission must reapply for the next class by the application deadline. Applicant will need to submit an application to the Practical Nursing program. Professional references must be within 2 years of submission.

Student Responsibilities upon Entrance of Program

• Background Check—Washburn Tech requires a background check prior to starting classes. If

your background check provides adverse information that may prohibit your ability to attend

clinicals, become employed or licensed, you may not be able to start and/or complete the

Surgical Technology program.

• Physical exam—A physical examination must be completed before entering the program and

must have been obtained within three months prior to starting the program. Students who are accepted into the program will receive a physical examination worksheet for their doctor.

• Current immunizations are required.

• MMR documentation (titer date or first and second dates required) • Tetanus (Good for 10 years)

• Diptheria (Good for 10 years)

• Pertussis vaccine (Good for 10 years) • Current negative TB skin test

• Hepatitis B series or titer

• Varicella (chicken pox) titer or vaccination—

o WE WILL NOT ACCEPT HISTORY OF CHICKENPOX

• CPR for the Healthcare Provider or for the Professional Rescuer (CPR – Health Care Providers

course offered at Washburn Tech)

• Proof of insurance coverage (Washburn University has plans available.)

5724 SW Huntoon Topeka, KS 66604 Fax: 785-273-7080

Email: tech-info@washburn.edu

Surgical Technology Applicant Reference Statement

To The Applicant: Please request reference statements from three persons who have recent knowledge about your qualifications. On the first page of each reference form, fill in your name and give to the references. Request your reference send directly to the Admissions Office at Washburn Institute of Technology. Please print your name_____________________________________________________________ (Last) (First) (Middle) The Family Educational Rights and Privacy Act and its amendments guarantee student access to their educational records. Students may, however, waive their right to access to references. The choice of the applicant regarding this reference is to be indicated below. Please circle your response: I do / do not waive my right to inspect the contents of the following reference. Signature______________________________________

To the Reference: The above named person is applying for admission to the Surgical Technology program at Washburn Tech and has given your name as a reference. Please give us a candid assessment of this applicant regarding their suitability for our program. How long and in what capacity have you known the applicant?______________________________

Please describe the nature of professional relationship (employer, licensed colleague, supervisor, etc.) __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ (over)

Please carefully assess the applicant in the following areas. In making your assessment, compare the applicant to other individuals you have known who have similar levels of experience and education.

Assessment Area Superior Good Average Poor Unknown

Intellectual ability

Motivation

Self-reliance

Oral communication skills

Written communication skills

Ability to analyze a problem and format a solution

Cooperativeness

Creativity/innovation

Leadership

Reliability

Integrity

Cultural sensitivity

Overall assessment of the applicant as to their ability to complete the Surgical Technology program:

Highly Recommend

Recommend

Recommend with reservation

Not recommend Comments: Name__________________________________________ Date____________________________ Signature_______________________________________ Position_________________________ Organization_____________________________________ Phone___________________________ E-mail______________________________________________________________________________ Please submit directly to Admissions Office. Fax: 785-273-7080 Email: tech-info@washburn.edu

5724 SW Huntoon Topeka, KS 66604 Fax: 785-273-7080

Email: tech-info@washburn.edu

Surgical Technology Applicant Reference Statement

To The Applicant: Please request reference statements from three persons who have recent knowledge about your qualifications. On the first page of each reference form, fill in your name and give to the references. Request your reference send directly to the Admissions Office at Washburn Institute of Technology. Please print your name_____________________________________________________________ (Last) (First) (Middle) The Family Educational Rights and Privacy Act and its amendments guarantee student access to their educational records. Students may, however, waive their right to access to references. The choice of the applicant regarding this reference is to be indicated below. Please circle your response: I do / do not waive my right to inspect the contents of the following reference. Signature______________________________________

To the Reference: The above named person is applying for admission to the Surgical Technology program at Washburn Tech and has given your name as a reference. Please give us a candid assessment of this applicant regarding their suitability for our program. How long and in what capacity have you known the applicant?______________________________

Please describe the nature of professional relationship (employer, licensed colleague, supervisor, etc.) __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ (over)

Please carefully assess the applicant in the following areas. In making your assessment, compare the applicant to other individuals you have known who have similar levels of experience and education.

Assessment Area Superior Good Average Poor Unknown

Intellectual ability

Motivation

Self-reliance

Oral communication skills

Written communication skills

Ability to analyze a problem and format a solution

Cooperativeness

Creativity/innovation

Leadership

Reliability

Integrity

Cultural sensitivity

Overall assessment of the applicant as to their ability to complete the Surgical Technology program:

Highly Recommend

Recommend

Recommend with reservation

Not recommend Comments: Name____________________________________________ Date____________________________ Signature_________________________________________ Position_________________________ Organization______________________________________ Phone___________________________ E-mail______________________________________________________________________________ Please submit directly to Admissions Office. Fax: 785-273-7080 Email: tech-info@washburn.edu

5724 SW Huntoon Topeka, KS 66604 Fax: 785-273-7080

Email: tech-info@washburn.edu

Surgical Technology Applicant Reference Statement

To The Applicant: Please request reference statements from three persons who have recent knowledge about your qualifications. On the first page of each reference form, fill in your name and give to the references. Request your reference send directly to the Admissions Office at Washburn Institute of Technology. Please print your name_____________________________________________________________ (Last) (First) (Middle) The Family Educational Rights and Privacy Act and its amendments guarantee student access to their educational records. Students may, however, waive their right to access to references. The choice of the applicant regarding this reference is to be indicated below. Please circle your response: I do / do not waive my right to inspect the contents of the following reference. Signature______________________________________

To the Reference: The above named person is applying for admission to the Surgical Technology program at Washburn Tech and has given your name as a reference. Please give us a candid assessment of this applicant regarding their suitability for our program. How long and in what capacity have you known the applicant?______________________________

Please describe the nature of professional relationship (employer, licensed colleague, supervisor, etc.) __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ (over)

Please carefully assess the applicant in the following areas. In making your assessment, compare the applicant to other individuals you have known who have similar levels of experience and education.

Assessment Area Superior Good Average Poor Unknown

Intellectual ability

Motivation

Self-reliance

Oral communication skills

Written communication skills

Ability to analyze a problem and format a solution

Cooperativeness

Creativity/innovation

Leadership

Reliability

Integrity

Cultural sensitivity

Overall assessment of the applicant as to their ability to complete the Surgical Technology program:

Highly Recommend

Recommend

Recommend with reservation

Not recommend Comments: Name____________________________________________ Date____________________________ Signature_________________________________________ Position_________________________ Organization______________________________________ Phone___________________________ E-mail______________________________________________________________________________ Please submit directly to Admissions Office. Fax: 785-273-7080 Email: tech-info@washburn.edu

Washburn Tech Surgical Technology Program Application Note: You MUST apply online to the college prior to submitting this application.

Submit application and interview questions to Washburn Tech’s Admissions Office.

Name_______________________________________________________________________________

(First) (Middle) (Last)

Date_____________________________ Phone_______________________________________

Admission File DUE DATES: March 1st for August admission

Prerequisite Information

Please indicate course number and college you took your prerequisites/coursework at.

Prerequisite Course Number College Year taken Grade

Anatomy & Physiology

Related Course Course Number College Year taken Grade

Microbiology*

Medical Terminology*

Pharmacology*

All official transcripts must be submitted to Washburn Tech prior to the deadline.

Check if you have the following:

o CNA License*

o Health care experience* *Not required for admission but recommended and will provide applicant additional points on admission rubric.

References

Please list all individuals from whom we will receive references.

1.________________________________________

2.________________________________________

3.________________________________________

Student Signature______________________________ Date_________________________

Assessment Scores

Circle one: Test Score College Course

Reading

Math

Written Interview Questions

Please answer the following questions. Please type these questions if possible. Questions need to be

submitted along with the application, or your file will not be considered.

1. What influenced your decision to apply to the Washburn Tech Surgical Technology Program?

2. Describe your understanding of the role of a Surgical Technician.

3. What participation in personal, school, community or work activities have you had which demonstrate leadership ability? Briefly discuss the importance to you of these experiences.

4. What strengths do you have that will allow you to make a difference as a surg tech?

5. How do you propose to provide for any commitments you may have as well as meet the demands of the surg tech program?