21.2. Principles of Clerkships

The central focus of the supervised clinical experience is the safe and compassionate care of the patient and a quality learning environment for the student.
The autonomy, personal dignity and values of the patient must be recognized and respected. This will improve the patient care and the student’s overall educational experience.
Joint decision-making and informational exchange should occur daily between the preceptor(s) and the PA student.
To allow PA students to prepare for future practice, an opportunity to obtain hands- on experience and involvement in the delivery of medical care to diverse patient populations and exposure to a variety of medical conditions must be provided.
Appropriate supervision must be provided based upon patient acceptance, preceptor comfort, and student performance and ability.
The PA student’s ability to ask questions, obtain information, examine, diagnose, manage, and treat patients during this experience will increase preparedness for future clinical practice.
At the beginning of the clinical year, PA students are prepared to take detailed histories, perform physical examinations, provide an oral presentation of findings and develop a differential diagnosis.
As the year progresses, students should be able to more effectively structure an assessment and treatment plan and present this in discussion with the preceptor.
By the end of the clinical year, students should be prepared to practice with the supervision of a physician in a fairly autonomous fashion in the diagnosis and management of common primary care conditions.
At the start of each clerkship, students may observe patient encounters initially. However, students should be provided the opportunity for hands-on patient care by the end of the first week/start of the second week at the latest in most clinical settings. As the preceptor feels more comfortable with the student’s skills and abilities, the student will be allowed progressively increased autonomy. However, all patients will be seen by and the overall care of the patient continues to be the responsibility of the preceptor.
As the year progresses, the student’s goals will change. Students are always encouraged to develop goals for each clerkship and share these with the preceptor.Personal goal setting is an important self-directed learning tool, which will help you work on knowledge base and skill sets.

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21. Introduction to Clerkship