Clinical Journal

1. Describe your clinical experiences this week.
2. What were your personal goals for clinical experience this week? How did you meet these goals?
3. Describe a specific experience with one of your “special” patients that facilitated your learning this week.
4. What do you see as the role and responsibilities of the nurses, doctors, lab assistants, etc in the clinical area?
5. Briefly describe your most significant event this week. How will this event influence your clinical practice?
6. Is there anything you would have done differently this week? Why? What would you do?
7. Identify a personal goal that you would like to meet next week.
8. Discuss the most challenging communication incident you encountered. How would you handle this situation in the future?
9. What do you think people in this community need? What information have you based this on?
10. Describe your “most interesting” patient’s situation: patient’s age, past medical/surgical history, current condition, correlate with past disease processes, risk factors with this condition, correlate all medications, with labs (name, classification, dosage, frequency, route, and if IV infusion, the ml/hr, side effects).
11. Find an evidence based journal article that relates to one of the areas you have addressed in your reflective narrative. Include a discussion of how the information in the article relates to your patient care experience and how the article facilitated your learning.
12. Identify doctor (s) diagnoses in order of priority. Identify a measurable outcome and three interventions for the priority diagnosis that was utilized in the care of this patient. Include an evaluation of the success of the interventions. Be Specific.
13. What medical advice was offered the patient and/or family? What communication principles was utilize?
14. What prevents the patient from being transferred or discharged? Discuss how and with whom was collaborated with in relation to this patient.
15. Discuss cultural, ethical, or value issues you encountered today. Relate how you felt and what you learned from these issues.
16. How is the clinical office organized, managed, supervised, operated?

Observable & Describable Clinical Experience

Filing. Answering Phones. Triage patients on phone/office. Call in prescriptions. Order special studies. Relay results to patients. Run lab tests (UA’s, pregnancy & glucose tests). Develop & read Xrays. Read clinical charts. Read & Learn patient medical histories. Log patient history, diagnosis, & ailments in computer system. Review blood work and apply knowledge (diabetic, anemic, etc). Shadow/ears-drop-medical assistants/nurses. Communicate with patients. Read and interpret patient charts. Learn about drugs and ailments (viral, anti-bacterial, fungal). Learn uses of medical equipment and instruments. Comfort patient (snacks, treats, blankets, water, humor, etc). Gain insight into patient and doctor relationship. Learn safety and health guidelines and rules. Learn about medical supplies, ordering, stocking. Observe procedures (first aid, pap smears). Learn patient intake (vitals, history). Understand the duties, roles, and hierarchy of each staff member. Learn how a medical office is managed and operated. Develop communication, leadership, mentoring, teaching, maturity, and management skills.

Kinds of Clinical Experience

As a prospective applicant, you should seek out experiences that will provide an in-depth look at the intended health profession and the work life of those who currently practice it. Hopefully, you will have an opportunity to closely observe the professionals and talk with them in order to get your questions and concerns answered. The goal is to understand the scope, limitations, satisfactions, dissatisfactions, and future directions of the intended field.

Health care settings provide varying forms of experience. These experiences will range from peripheral to central and direct and may be paid, voluntary, or for academic credit. The setting can vary from large hospital to small clinic and may be rural, urban, or suburban. The key issue is determining if the experience will give you a clear and comprehensive view of your field of interest. Generally, it is good to seek experience that will provide a broad rather than a narrow introduction to the career field. For example, those interested in physical therapy should not limit experience to sports injuries but should seek hospital exposure to the broad range of problems seen in such a setting. Similarly, the pre-veterinary student should become familiar with the work of small and large-animal veterinarians.

For pre medical students no particular setting or experience is preferred. For example, you do not need to work in an emergency room to "prove" your motivation or that you can "stand the sight of blood." A rural clinic may be an ideal place to really understand the physician's role and to clarify your reasons for going into medicine. It also should be understood that there are many settings where you can demonstrate that you are a helping, caring person, such as a nursing home, a hospice, a teen center, or a battered women's shelter. The key question to ask yourself is whether the setting and experience will allow you to explore carefully the intended field and to demonstrate motivation to pursue a career in it.

For allied health professions it is recommended to gain experience in your chosen field. For example if you are interested in optometry school gaining experience at an optometrists office is recommended.

How to Obtain Clinical Experience

There are many ways to find experience in a health field. Many hospitals have a volunteer office from which information or opportunities and placement may be obtained. Be clear on what will be expected of you and what you can expect from the experience. For example, if new volunteers start folding towels, how long will it be before more substantial experiences can be expected? In other instances, a community agency may act as a clearinghouse or referral to volunteer opportunities. Check with the appropriate staff member to determine what is available. ALso listed in the phone book under County Government Offices is Health Services. This listing provides a wealth of information. Examples of agencies listed: Aids Services, Alcohol Services, Children's Medical Clinics, EMS, Homeless Projects etc. The Career Center may offer listings of volunteer positions, internships, or even paid jobs in health care organizations or facilities. Paid positions probably will be hard to find in a time of budget constraints. You may be able to arrange for academic credit for your volunteer work through a form of "Field Study" or other title. There may be a class that offers an experience component in a health facility. At UCSC Health Slugs and AMSA may assist its members in locating experiences with local health professionals. Summer enrichment programs often offer direct health care experience as a part of their curricula.

While it is often wise to seek experience in more than one setting in order to obtain a comprehensive view of the intended field, in-depth exposure should be sought. Brief, fleeting volunteer experiences normally will not be effective in helping you decide if the intended career is the "right" one, nor will they be persuasive in demonstrating to the admissions committee that you are truly interested in the field. In other words, those who get accepted have a "track record" that shows they are truly interested in the field and that they know "what they are getting into." In many fields, lack of direct experience will raise serious questions about the applicant and often will prevent the applicant from being accepted.

But even more importantly, those considering a career in a health profession (or another area) should explore their intended field to make certain that it is the appropriate one. In short, it is necessary to determine if the field excites them and if they will be able to carry out its responsibilities and obligations willingly and well.