Nadia Pasha, MD
Inpatient Medicine Physician, Duke Raleigh Hospital
Why did/do you decide to precept Duke PA students?
I have been involved in PA teaching at Duke Raleigh Hospital for over 6 years and I truly enjoy it! I took on a leadership teaching role 4 years ago because I have a passion for teaching and find it extremely rewarding. It’s an amazing feeling to see how you can positively impact young brains and mentor them to become great clinicians. You have the ability to mold them and teach them what you feel could have been done better when you were a learner. It’s a great way to pay forward and educate those who will probably be taking care of us and our loved ones.
How do you orient students to your practice setting?
Typically 2 weeks prior to their rotation, students receive an email with FAQs and details on student & preceptor expectations. These have also been shared with the preceptors so there is role clarity. I also orient students in person whenever possible. I always give them my cell phone number and they know they can reach out to me anytime. Recently I am working on a short orientation video so I can further improve this process and students can have something to refer back to, whenever needed.
How do you integrate students into your clinical workflow of seeing patients?
Hospital Medicine can be a very busy & fast paced service with acutely sick patient. Each student meets with their provider and continues to work at their own pace depending on where they are in their rotation. They may see anywhere between 2-4 patients and help in managing the patients including placing orders in a supervised environment. They are encouraged to take ownership of their patients as they will be providers within the next year. They sometimes present their patients at Multi D rounds. We have also successfully advocated for a slightly lesser work load for the teaching service. This provides students with extra one on one time with their preceptor and they are able to discuss cases they saw in details. I teach students small tips and learning points as we go along and round.We provide students with IPE experience as they spend one day with each service- DPT/ ICU rounding RN and IR. Students also observe procedures on their patients including EGD, Cath and Bronch. We are working on innovative ways to add more to this experience.
How do you make time to assess students’ knowledge and observe clinical skills?
Students meet with their preceptor in the morning and are assigned patient. They go and see their patients and meet with their preceptor later in the day to discuss the case with special emphasis to their assessment and plan. I have found that this is the part students struggle with the most. Preceptors ask questions which helps them identify and assess the learner so they can build on the student’s knowledge base. They give them feedback in real time and students are expected to read up on what they learned. They are encouraged to ask questions. To help our preceptors become better educators, we constantly work on tips ,techniques , lectures and workshops to help them improve. As mentioned previously, our precepting provider has a decreased work load which gives them extra time to teach.
What is your approach to providing constructive feedback to students?
In my experience the best way to give feedback is to first ask the students on what they feel is going well and what is work in progress. Students are usually very critical of themselves. I always encourage them and compliment them on what they are doing good. This boosts their moral and motivates them to work harder. Ask them how they think they can do better and then add recommendation to their ideas. Set some clear goals for the upcoming week and then circle back. I always ask them how we can support them and make this rotation better for them and for others. This creates an environment of collegiality and helps us improve as well. They walk away with a positive experience.
In very rare cases, if you feel a student is not engaging or lacking in their basic knowledge, I recommend reaching out to the PA program and letting them know ASAP so everyone can work towards the same common goal- helping the students become better clinicians.
What advice would you give a clinician new to precepting?
Just like different learners have different learning styles, different educators might have a different teaching style and that’s ok. Identify what works for you and how you can use this to teach your students. Ask your students for feedback and it is empirical that this is done in a safe environment and the students don’t feel intimidated. Make sure you let them know that your goal is to help them and support them. They can help you by telling you what works and what doesn’t. Self-reflect and stay open minded. Over time you will become more confident and understand what are good teaching techniques for you and your learners.
Is there anything else you would like to share about your experience as a preceptor?
Teaching can be great experience if we continue to evolve and change according to the needs of our students and patients. Students feel that they fit in if they are given tasks during their rotation. Do not hesitate to tell them to call and co-ordinate care with other health professionals for their patients or have them update and teach their patients. This gives them a sense of fulfillment. Be sure to support them I they have any questions during this process.
It gives me great pleasure to write LORs for my students and see how they grew in their professions. It will feel very rewarding to you too.