What LP did you do?
Juravinski Hospital Intensive Care Unit
How did you go about contacting and arranging the LP?
My preceptor is a tutor for the Med students; I was recommended to shadow this person by some Med students, and obtained his contact information from them. I reached out via email, explained that I was a first year Physician Assistant Student from McMaster looking to do an LP, and indicated the general time line I was looking to shadow him. He replied back with his availability, and we went from there!
What were the two main things you learned from the LP?
1. How the ICU functions both as its own department, and with the rest of the hospital. I had the opportunity to follow the ICU routine from handover to rounds (note taking and orders) to procedures to family meetings. I was also able to attend a new patient consult, and learn how (and why) the ICU becomes involved in inpatient care.
2. The details around ventilation and the “go-to” ICU antibiotics. I hadn’t really spent much time thinking or learning about this on my own, and since both of these things were a big part of each patient’s care, it was a great opportunity to learn more about them!
What did you wish you knew beforehand to help you in your LP?
All the short forms and “nicknames” the staff had for diseases, procedures, and medications! On the first day, I found it hard to follow along with the fast-paced rounds with all the jargon flying around. However, all team members were open to chatting about things afterwards, and I found looking stuff up on my own before I came in the next time to be helpful.
How has this experience helped you clinically, in class and/or in career decision-making?
The first thing that struck me was how each bed seemed to be a different MF1 case. It was very interesting and helpful to see these cases in real-life.
This placement also demonstrated the importance of trying a wide variety of different LPs before settling on an area of medicine. While you might have something particular in mind, trying it (and other fields) out will provide invaluable insight for future career and elective decisions!
Share your most memorable experience from the LP!
I was able to sit in on several family meetings (family members of an incapacitated patient and the medical staff gather to discuss care options). The differences in level of understanding and socioeconomic status between families were striking. It really emphasized the importance of being a good communicator, by being able to adjust your explanations according to the audience. Presenting a caring, yet informative, persona was imperative for every patient/family encounter. While communication skills might not be everyone’s favourite class, it really is one of the most important – what good is knowing all the pathophys or clinical guidelines if you can’t communicate it to those who need to know? Time in the ICU really highlighted the importance of this skill, as your ability to communicate will dictate the care your patients actually receive.
Any other comments?
If you do any sort of ICU, or other ward, placement, I would recommend staying for the whole day, or coming in at different times if you can only commit a half day at a time. Things operate very differently in the morning compared to the afternoon. And sometimes things come up (e.g. new consult) that requiring deviating from the original plan.
Also, come up with some learning objectives before you do any placement, and share these with your preceptor. These will help focus your learning in an overwhelming environment, where the learning opportunities are everywhere!
On November 28, I had the wonderful opportunity to attend an event at the Six Nations Reserve, hosted by the Aboriginal Student Health Sciences (ASHS) Office.
"Come Explore Health Careers Day" was an opportunity for various medical professional students at McMaster University to provide Grade 8 students at the J.C. Hill School in Ohsweken, ON, exposure to a variety of health careers. Our group consisted of 15 students from Medicine, Nursing and myself! I was super excited to work McMaster students from the other faculties, understand more about their roles, and share the role of Physician Assistants in medicine and health care teams.
We began our day by handing out awesome T-shirts to all the Gr. 8 students, which were designed by some lovely folks at ASHS. This was followed by an icebreaker with the Gr. 8 students that led us to discuss the roles of medical professionals such as physicians, physician assistants, nurses, midwives, OTs, PTs. I was pleasantly surprised that these students had a great understanding of the roles played by most of these professions!Ear
The icebreaker was followed by a presentation from an Elder of Six Nations, who spoke to the group about Traditional Medicine. I was so impressed with her presentation because she molded Aboriginal values with the use of medicine, while placing great emphasis on expressing emotions such as hurt, grief and anger. My favorite part of this session was when she described the importance of giving hugs to one another! She said, "It is important for our hearts to touch and that in itself is a form of medicine". I strongly believe that teaching affection and care to pre-teens is extremely vital to their development and success as teens and adults.
Engaging Clinical Activities
The rest of the afternoon was broken in to 4 sessions through which the students rotated: Infectious Disease, Sign/Symptoms of Myocardial Infarction (Heart Attack), Cardiothoracic Anatomy and Clinical Skills. These stations allowed us to teach students about the importance of hygiene and preventing the spread of disease; identifying the signs and symptoms of community members experiencing a heart attack; hands-on exploration of pig pluck (heart, lungs, trachea); and common medical skills.
I had the fortunate opportunity to be involved in this latter station where we showed students how to use a pen light to check pupillary reflexes. We also had some great laughs using tongue depressors in each other's mouths (the uvula totally freaked them out while making them giggle at the same time!). We also used the pen light to look into each other's noses (mainly mine!). One of the med students and I took turns showing the kids how to use blood pressure cuffs and measured blood pressure on all of us. The nursing students had set up an AMAZING Wound Care station by simulating lacerations on butternut squash! The students were absolutely fascinated by this station and learned to drape and cover large cuts.
Spreading Awareness about Physician Assistants
Not only did I get to show these students the cool clinical skills we've acquired so far, I was also able to engage discussions about the role of PAs with both the medical school students as well as the nurses. Both nursing and medical students were quite curious about our profession - they had some great questions and we had lengthy conversations about the education of PAs, our capabilities and our place in the health care system. Furthermore, gaining exposure to life on the reserve was such a valuable experience.
Get Involved in Spring 2015
The Six Nations Reserve is about a 40-minute drive from campus and there are multiple university groups that are connected with the reserve through research, medicine and education. I would absolutely recommend getting involved in any of these ventures because they help us gain a better understanding of Native culture, traditions, as well as health care and educational issues specific to reserve life. During the spring of 2015, the ASHS Office will be holding an educational seminar on campus to expose Grade 12 students from the reserve to the different medical programs available at McMaster University. This would be a great opportunity for the PA program and our class to get involved!
Fun Fact: Earlier that afternoon, the 403 EB (Toronto) experienced a mudslide, which caused a lot of chaos all around the university - there was massive blockage of all roads in and out of the university, Westdale, Ancaster, Dundas and Cootes. The mudslide was caused by a burst water pipe but thankfully no one was hurt!
Longitudinal Placements (LP) are clinical observerships organized by the student in domain of his/her choice to gain relevant clinical knowledge in that area of medicine
1. What LP did you do?
I did an LP in the Emergency Room at Sunnybrook Hospital in Toronto.
2. How did you go about contacting and arranging the LP?
Maureen Taylor is my preceptor for ProComp and she also works at Sunnybrook Hospital as a Physician Assistant in the ER. I emailed her and we were able to set up an LP.
3. What were the two main things you learned from the LP?
I really enjoyed the time I spent in the ER because I learned a lot about the structure of patient care in a busy, level-one trauma centre. It was really useful to learn how a PA functions within the ER team. I was able to observe several procedures.
4. What did you wish you knew beforehand to help you in your LP?
If I were to go again, I would like to read up on common medications used in the ER and their MOAs.
5. How has this experience helped you clinically, in class and/or in career decision making?
Being in the ER helped me bridge my understanding of history-taking and physical exams from the classroom to a clinical setting.
6. Any other comments?
I would recommend it to my classmates and I would love to try another LP in the ER!
Maureen Taylor, CCPA, McMaster PA Class of 2010
Prior to becoming a Physician Assistant, Maureen worked as a medical journalist and television reporter for the CBC for two decades. She is currently working as a PA at Sunnybrook Hospital in the Emergency Department. She is also a preceptor for the McMaster PA Program Professional Competencies class.
Follow her on Twitter @maureentaylor31.
Read more about Maureen here: