Maximizing Students’ Learning Experiences
Preceptors have a critical role to ensure PA students are maximizing clinical learning activities with reference to program attendance policy. The intent of this policy to support achievement of these programmatic goals while allowing students sufficient time for self-care including physical rest, management of obligations outside of school, and recreation in order for them to be optimally effective as learners and healthy as people. In addition to ensuring students do not exceed with upper limit of works hours, preceptors should also make sure students have every opportunity to participate in patient throughout the entire course of the rotation. Strategies to ensure optimal learning include having colleagues supervise students when you are out of the office, connecting students with other members of the health care throughout the rotation, and not giving students “study days” near the end of the rotation.
I. Attendance Policy
1) Attendance is mandatory for dates students are assigned to a clinical rotation site as stipulated in the Work Hours Policy. In general, the student should be participating in supervised clinical experiences if the clinic is open and the preceptor and/or team is providing care to patients. Students are expected to be on time for clinic, conferences, rounds and other learning events throughout the course of the rotation. Preceptors are asked to notify the PA Program with concerns regarding tardiness or absences and document attendance issues on the student evaluation form under professionalism.
2) If the preceptor is on vacation, sick, or away from the clinical site, every effort should be made to have the student work with another provider in order to meet required work hours and maximize clinical learning opportunities. If this is not possible, the student or preceptor should notify the assigned clinical coordinator at the PA Program.
3) Students must notify the preceptor and the assigned clinical coordinator at the PA Program regarding time missed for any reason. Absences of greater than a half day or half shift require completion of the Student Time Away Form, which will be signed by (1) the preceptor and (2) the student’s assigned clinical coordinator. Clinical preceptors cannot approve time away without the permission of PA Program faculty. Any absences for reasons other than illness, family emergency, or a PA Program approved holiday require prior approval by the PA Program. Students are responsible for submitting Student Time Away Forms by email, fax, or in-person to the assigned clinical coordinator.
4) Students are allowed to miss up to one day/shift from a rotation for an excused absence (illness or family emergency, including funerals) without the need to make up the clinical hours. Any absence(s) greater than one day/shift due to these circumstances will require arrangements to make up the clinical hours, which will be coordinated with the preceptor and assigned clinical coordinator.
5) Official approved PA Program holidays are noted in the Clinical Year Manual. On some clinical services, students may be asked to work on the specified holiday. If this is the case, the student should be given a day off during the week of the holiday to compensate for time worked on that day.
6) All time away from rotations (illness, discretionary day, holiday, inclement weather, clinic closure) should be accurately reflected in the E*Value Time Log completed by students for faculty review. Any questions about adequacy of logged time should be directed to the clinical coordinator during the rotation, particularly if related to unexpected clinic closure or preceptor absence. An inadequate time or patient log may result in changes to a student’s clinical year schedule or require additional clinical time during weekends, EBP II, time during an elective course, over a school break, or may result in delayed program completion.
Violations of the Attendance Policy
A violation of the attendance policy is a violation of professionalism, academic policy, and the honor code. We expect each of you to adhere to these policies, as they will facilitate your success in the clinical year and help you establish “best practice” for professional conduct throughout your career. Time logs are reviewed by faculty at the conclusion of each rotation to ensure attendance and work hour requirements have been met. Failure to meet those requirements may result in make-up time during another rotation, weekend or break and/or delay of program completion.
II. Work Hours Policy
The Physician Assistant Program in the Duke University School of Medicine has adopted a work hours policy for students to provide guidance and protection for students in the clinical phase of the curriculum. It is recognized by faculty and students that the goals of educating students in this setting include the development of medical knowledge, clinical skills, and professional attributes through participation in in supervised clinical experiences. It is the intent of this policy to support achievement of these programmatic goals while allowing students sufficient time for self-care including physical rest, management of obligations outside of school, and recreation in order for them to be optimally effective as learners and healthy as people.
1. Students will be expected to be on-site on any clinical service no more than 80 hours per week, averaged over a rolling two-week period during the clinical rotations. This maximum should include actual time spent in the hospital or clinic on “on-call” nights, but need not include time a student may spend at home reading or studying.
2. Students will have one full day completely free of patient-care responsibilities in the hospital or clinic per 7-day week, averaged over any rolling two-week period for the clinical rotation.
3. Students will not be expected to be in the hospital or clinic setting for more than 30 consecutive hours, followed by a minimum of 8 hours off or away from clinical duties.
4. In conjunction with the restrictions on total time spent in the hospital or clinic, preceptors should design learning activities to make most efficient use of time from the standpoint of learning. Learning activities appropriately include:
a. The care of patients assigned to the student, the student’s team, or services being cross-covered, and other activities that are the work of the student’s team, and
b. Classes, conferences, rounds, projects and individual learning assignments that are part of a course.
5. Students should not be expected to use the hours allocated on tasks that are not directly related to learning activities (e.g. performing personal favors or services for other medical personnel), nor should they be expected to do work unrelated to their learning activities solely because residents must leave due to work hours restrictions.