Tuesday, January 29, 2013
Monday, January 21, 2013
SPs Part II
Quick update on the SP from last week. Nailed the diagnosis. Lucked out. I always feel like I luck out. Maybe I need to learn to give myself more credit. OK I am just that good. Hehehe.
I'm sure they're just starting us off easy but overall, it was actually, dare I say it, fun :) All those repetitive, draining SP encounters during H&P are paying off. Felt like I had a mystery to solve, and it was really cool to be able to say to a patient for the first time, "I think you have _____, and I'll prescribe you ____ which should take care of it." Then, after feeling on top of the world, this happens:
I debated whether or not I should post this but the message I'm trying to drive home is that PA school is great and making you feel average. Can't let it get to you. Above is how my standardized patient rated me. Our PARS scores don't really affect our grade - they're for our reference, and if anything alarming shows up, your advisor will sit down with you and address it. They explain to the SPs to rate us VERY critically, which is why the scale is from 1-9 rather than, say, 1-5. You rarely get 8s and 9s. Also, every patient rates slightly differently. In general, they say to focus more on the comments on the bottom. Sometimes you walk out of the exam room like you own the place and then you get your PARS score and it's all 4s. Other times you think "Crap I blew it...," turn to look at your classmate who also just exited their exam room next to yours, the look on their face says "Yup I blew it too,"...and then you get back your scores and it's 6s and 7s. The one that really frustrates me is "Demonstrated empathy." I mean, how many times can I say "That must be really frustrating to work through," "Oh I know it hurts, I'll try to be gentle," "I'm so sorry your posterior nasal drip is waking you up at night!" to my fake patient with a fake illness before I start sounding over-the-top fake myself?!?
Anyway, last time my focus was on getting a gauge for our new 25 minute time limit and being thorough, which I feel I accomplished. Next time...I guess I'll work on my empathy.
Leaving you with a photo of how Jeremiah organizes his tools for the comprehensive neuro exam because you really do need tubes of cinnamon water and cotton swabs snapped in half. People who sew, better start making your tool belts now:
I'm sure they're just starting us off easy but overall, it was actually, dare I say it, fun :) All those repetitive, draining SP encounters during H&P are paying off. Felt like I had a mystery to solve, and it was really cool to be able to say to a patient for the first time, "I think you have _____, and I'll prescribe you ____ which should take care of it." Then, after feeling on top of the world, this happens:
Anyway, last time my focus was on getting a gauge for our new 25 minute time limit and being thorough, which I feel I accomplished. Next time...I guess I'll work on my empathy.
Leaving you with a photo of how Jeremiah organizes his tools for the comprehensive neuro exam because you really do need tubes of cinnamon water and cotton swabs snapped in half. People who sew, better start making your tool belts now:
Thursday, January 10, 2013
I'm half PA book smart
The heme exam I was studying for on new years was fine. I feel like some clin med exam topics are harder than others but in the end I always score about the same anyway. Not sure what that means.
Last week my advisor sent out an e-mail mentioning that we had already completed 31 weeks of school, and had 31 remaining until rotations. Which means that as of today, we are more than halfway done with didactic...and I have only blogged 4 times...I'll work on that. Anyway. Crazy. 30 weeks left. Felt like only yesterday when this photo was taken:
You mean that at this point I should be half book-smart to being a real PA?? Hah yeah right. Yesterday was our first Clinical Seminar small group meeting. This is where one student pretends to be the patient, another is chosen to be the PA, and as a group we chug through the differential, H&P, diagnostic studies, diagnosis, and treatment. The faculty seem to get really excited about students who go all out and dress the part of the patient (for example, old people, street walkers, using puppets...). I'm sure for them, they've done this so many times that it's like "meh...*yawn*." Don't worry teachers, I'll do something good when it's my turn!!
I was nervous because I didn't want to get called on to be the first PA. Thankfully I wasn't...but then I was called to be the scribe. This gives me anxiety because I write like a dude and I'm really embarrassed about it, but hey here is a photo and don't judge my handwriting!
Alec the PA (bottom left) was killing it up there. After narrowing down the differential, we figured out Mrs. D gave away that Jillian (bottom right) had mycoplasma pneumonia, an atypical pneumonia that tends to affect younger patients living in crowded areas and is characterized by having a slow-onset of generally mild symptoms, including cough with absence of sputum, headache, fever, sore throat, and fatigue. Unilateral lung consolidation in the lower lobe is usually found upon physical exam, and it is treated with macrolides (erythro, clarithro, or z-pack). Applicants, now you have one less condition to know when you get into PA school.
Tomorrow is our first standardized patient encounter of the term. This one is different from our previous encounters because we will do a directed history and physical rather than a comprehensive. This will also be the first time that we'll be on our own with the emphasis on attempting to hash out a diagnosis on the spot. After a whole term of seeing weekly SPs, I've realized the following things help get me through it:
1. Don't freak out.
2. Get yourself pumped! Don't be so worried about doing poorly that you start dreading it. Just remind yourself that this is a simulation of what you have always wanted to do and sometimes the SPs are fun and down to joke around and you're going to make mistakes and miss things and not nearly know everything but as long as you don't do anything malpractice-worthy it's cool.
3. Dress cute. Ok maybe that's just me but whatever.
4. Don't freak out. This really applies to PA school in general.
I will let you know how the SPs go. Really though, I'm stoked. School is getting real. Also, for those of you lucky enough to be interviewing 1/18 next Friday afternoon, Camilla and I will be leading the tour. Can't wait to meet some of you! Interviewees always look like nervous uptight penguins walking around campus and it cracks me up (don't be ashamed, we've all been there). They put you in this waiting room with glass walls that faces the lobby and every time I walk by, I'm tempted to make funny faces against the glass and do the dougie or something, but then I think, "hmmm...better not."
Last week my advisor sent out an e-mail mentioning that we had already completed 31 weeks of school, and had 31 remaining until rotations. Which means that as of today, we are more than halfway done with didactic...and I have only blogged 4 times...I'll work on that. Anyway. Crazy. 30 weeks left. Felt like only yesterday when this photo was taken:
 |
| white coat swag |
You mean that at this point I should be half book-smart to being a real PA?? Hah yeah right. Yesterday was our first Clinical Seminar small group meeting. This is where one student pretends to be the patient, another is chosen to be the PA, and as a group we chug through the differential, H&P, diagnostic studies, diagnosis, and treatment. The faculty seem to get really excited about students who go all out and dress the part of the patient (for example, old people, street walkers, using puppets...). I'm sure for them, they've done this so many times that it's like "meh...*yawn*." Don't worry teachers, I'll do something good when it's my turn!!
I was nervous because I didn't want to get called on to be the first PA. Thankfully I wasn't...but then I was called to be the scribe. This gives me anxiety because I write like a dude and I'm really embarrassed about it, but hey here is a photo and don't judge my handwriting!
 |
| Mrs. D did not seem pleased I was busting out my iPhone photography in the middle of seminar but I tried to explain to her that I'm the official class blogger and the authenticity of my posts would be severely jeopardized if there was a lack of photos!!!!! |
Tomorrow is our first standardized patient encounter of the term. This one is different from our previous encounters because we will do a directed history and physical rather than a comprehensive. This will also be the first time that we'll be on our own with the emphasis on attempting to hash out a diagnosis on the spot. After a whole term of seeing weekly SPs, I've realized the following things help get me through it:
1. Don't freak out.
2. Get yourself pumped! Don't be so worried about doing poorly that you start dreading it. Just remind yourself that this is a simulation of what you have always wanted to do and sometimes the SPs are fun and down to joke around and you're going to make mistakes and miss things and not nearly know everything but as long as you don't do anything malpractice-worthy it's cool.
3. Dress cute. Ok maybe that's just me but whatever.
4. Don't freak out. This really applies to PA school in general.
 |
| Waiting in the hallway just before our final SP encounter of fall term. Don't know why we were so excited about it because it wasn't like we weren't going to have SPs for the rest of the year... |
I will let you know how the SPs go. Really though, I'm stoked. School is getting real. Also, for those of you lucky enough to be interviewing 1/18 next Friday afternoon, Camilla and I will be leading the tour. Can't wait to meet some of you! Interviewees always look like nervous uptight penguins walking around campus and it cracks me up (don't be ashamed, we've all been there). They put you in this waiting room with glass walls that faces the lobby and every time I walk by, I'm tempted to make funny faces against the glass and do the dougie or something, but then I think, "hmmm...better not."
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