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Originally Posted by pedirn57

Thanks to everyone who responded now one more question, how many patient's a day should I be expected to see on my own at first. If any one remembers I had started clinicals earlier, and it was not a good fit and she had me going in to see 20 patients a day, honestly by the time my day was done my brain was mush,

When we precept PA students we usually do it in four week blocks. Usually the first week is mostly observational. Seeing how things run, maybe scrubbing some surgery. The second week we have them do some inpatient notes. Usually I give them 1-2 patients that will be there most of their rotation so that they can see continuity in action. We add more each week both in what we expect out of the plan and what we have them document. At the end of four weeks I would expect 3-4 very good notes on each inpatient they are seeing. I would never give them more than 1/2 the patient population. I also try to involve them in as many procedures as possible.

In the clinic we tend to grab the next patient up. Again I stress a good complete note. When I worked private practice, I would have the patient see every other patient. 2 patients an hour so that worked out to eight patients a day at the most (this was mostly outpatient consults). If we were early in the clinical year, I might have them do one patient per hour or one patient per two hours. However, I would expect them to use that time to look up unfamiliar conditions and present a good consult.

I did my FP rotations in a busy practice. The patients were scheduled every 15 minutes. In the beginning I saw one patient out of four. This allowed the PA to keep up while allowing me to look up any unfamiliar conditions. Eventually as the rotation to progressed I saw every other patient or 16 per day. This in my mind should be around the maximum that a student should see during a day, and only a student with some experience in clinical who already has a good grasp of a focused visit and how to document it.

Realistically a student should not be seeing every patient unless they are in their final rotations and want the experience of a high throughput clinic. The purpose of clinicals is not to let the student do your work. It is to provide them with a good learning experience. This means that the preceptor has to properly assess where the student is in their clinical experience and help them move to the next level. It also means being on the look out for good cases and unusual presentations. Providing learning materials is also helpful.

Unfortunately there are any number of preceptors that regard a student as an excuse to sit back and take it easy. Ideally the program uses student ratings to eliminate these preceptors. I precept because I enjoy teaching and because it makes me think.

Good luck

David Carpenter, PA-C