Monthly Archives: September 2016

Breaking Down PA School Interview Questions: Bonus Article

In addition to being asked to simulate an HPI with a standardized patient (If you don’t know what I am referencing see my last blog post here) a great number of programs are employing the MMI (multiple mini interviews) and also asking you to complete tasks. Sometimes odd tasks.  

So, why are they doing this and what are they looking for in their candidates?

1. Stress

PA school is stressful.  Interviews are stressful (no matter how you cut it). What better to do than to see how prospective students can react to a stressful situation.  Sound familiar? Sure does, admissions committees are taking the concept of behavioral interviewing and making it a reality.  The idea here is that if you can handle stress well during the interview, that behavior trait will transfer to PA school. 

2. Common Courtesy 

When you are stressed or someone corrects you, how do you react?  During my time as a student ambassador, I saw prospective students literally freak out when they didn’t understand a task or someone wasn’t following their directives. Be kind and polite.  DO NOT, I repeat DO NOT freak out.  This is a huge red flag to anyone (students, faculty, adjunct professors) evaluating you. 

3. Innovative Thinking and Effort

So, you don’t remember all the cranial nerves or parts of the kidney or understand how to tell someone to suture.  Don’t panic.  Stay calm and try and dig deep for anything you can remember about the task they are presenting.  If they give you 5 minutes to complete the task use that five minutes.  If you’ve never explained to someone to suture think about basic principles that might be important.  Its ok to say, “You know I’ve never done this before, but I’m going to do my best”.  This says that you can take on challenge in a positive way.  You might go on to say something like “I would think someone would need to wash their hands and create a clean environment to complete the procedure”.  So, maybe you don’t know what “sterile field” or “breaking sterile field” means.  Or the different types of sutures.  But, maybe you can say ” Well, the type of wound might matter as to how someone sutures”.  Keep it basic and simply TRY. I cannot stress enough, remain calm. 

4. Following Directions

A large part of PA school is being able to follow directions, complete tasks on time and multitask.  Programs want to know that you can complete a task they tell you to complete, in a specific manner. 

5. Action Speaks Louder Than Words

You are what you do. History repeats itself. However you want to say it, y’all get what I mean. You are what you do (just like you are what you eat haha 🙂 Show them you can handle stress, be kind and follow directions.  Don’t sweat it if you don’t know exactly what they are talking about, respond appropriately to the task and you will be just fine! 

 

Breaking Down PA School Interview Questions: Special Edition

I came across a post recently in a Facebook pre-pa group that some interviews are asking students basically to complete a HPI (History of Present Illness).  Now, if you did your patient care experience in mental health (because thats where you had a degree) you might find yourself fumbling.  So, if you run in to a situation that asks you to “talk to a patient about what is going on with them and give a diagnosis” I’ve got your basics covered!

What is an HPI?

  • History of Present Illness
    • Why is the patient coming in to see you and the story that goes along with it! 
  • Start with a “chief complaint”
    • This is usually something obvious such as abdominal pain, chest pain, fever, rash, red eye, sore throat, cough, etc
  • There are 7 vital aspects of the “HPI”
    • Onset
      • When did it start
    • Duration
      • How long has this been going on?
    • Location/Radiation
      • Where is the location of the symptom
      • For complaints like abdominal or chest pain ask the patient (especially if child) to point with one finger where it is the worst
      • Does the pain/symptom travel somewhere else besdies where it starts?
    • Quality
      • Describe what is going on
      • Is the pain sharp, dull, throbbing
      • When they have difficulty swallowing is it solids, liquids, etc
    • Quantity
      • The good old “on a scale of 1 to 10…10 being the worst and 1 being very little”
    • Aggravating/Alleviating
      • What makes symptoms worse
      • What makes symptoms better
    • Associated Manifestations
      • Depends on the chief complaint
      • Abdominal pain: diarrhea, constipation, fever, chills
      • Chest pain: diaphoresis, lightheadedness, palpitations, shortness of breath
      • Fever: Rash, cough, urinary symptoms (dysuria, frequency), recent travel, UTD on immunizaitons
      • Cough: is it productive or dry, short of breath, fever, chest pain

 

Breaking Down PA School Interview Questions IX

Q: On clinical rotation your preceptor is treating patients disrespectfully and making hurtful comments to you about them after they leave.  How do you react and what do you do (if anything)?

What are they looking for?

  • Maturity and leadership.  That you can make a decision to talk to your clinical coordinator about this preceptor.
  • That you can keep your cool under a stressful situation
  • Despite your preceptor being “in charge” of you, you can stand up for what is right in an appropriate respectful manner

What to avoid?

  • Stating you would do nothing.  This is a red flag that you don’t have respect for patients or the maturity to do the right thing even if it is someone in a higher position than you doing wrong. 
  • Say that you would create any kind of immediate confrontation directly with your preceptor

What to say?

  • That you would remain calm while on site at rotation
  • Contact your clinical coordinator immediately at the end of the day
    • State that you were in a very uncomfortable position
    • Make it clear that you don’t support his/her actions
  • How should your clinical coordinator react?
    • They may or may not take a question like this in this direction.  They should definitely leave you with some sense that the situation is at least being looked in to. 
  • What if they ask you if you are comfortable going back to the site?
    • Be honest. If a preceptor is being disrespectful to patients you probably shouldn’t be at that site.  

 

 

Don’t Call me Doctor, A spin off…

I must first reference and give credit where credit is due to http://www.mypatraining.com (Inside PA training) Find their podcast HERE.

As PA’s we get called pretty much anything but “Physician Assistant”.  Nurse, Doctor, Medical Assistant and my LEAST favorite “Physician’s Assistant”.  I have several points to make which I feel strongly about regarding this topic, much like Paul from Inside PA training.

#1 Introduction and Correction
The absolute first thing I do when I walk into a room with a patient is introduce myself as a Physician Assistant.  Not doing so I believe is a violation to your patients.  They deserve to know who is seeing them and treating them.  Plus, I’m really proud of being a PA.Secondly, if they refer to me as “doc or doctor” I immediately correct them.  I also agree with Paul, that correcting patients more than once gets redundant and IMO you can appear a bit rude continually correcting.

#2 Gender Dependence (unfortunately gender bias does exist my friends)
I definitely get referred to as a nurse more than a doctor.  Although I get both the ratio is ill proportioned.  I notice when seeing patients they refer to my male colleague PA’s as “doctor” more frequently.  I’ve worked with many female residents who were continually called nurse, after they introduce themselves as a resident physician (COME ON PEOPLE!)
Now, to be clear I’m not hating on nursing at all.  However, medical schools are becoming to be predominated by women.  PA’s and NP’s are predominantly female. Female providers of the medical field are not sparse, yet this continues to occur.

#3 NP’s with Doctoral level degrees
This might be my top pet peeve.  Not all, in fact very few NP’s do this.  However, I have come across several who introduce themselves as ” Hi, I’m doctor so-and-so the nurse practitioner”  OK, I know what some of you are thinking “But they said they’re an NP!!!”  Lets think about our general patient population and telling them you’re a doctor and an NP in the same sentence. It’s confusing.  Most people aren’t aware NP’s can obtain  a doctoral level degree, but this doesn’t make them an MD or DO.  I understand you earned that education, by all means but those initials after your name on your white coat–but in my opinion–keep it simple for patients.

#4 “But I want to see the DOCTOR”
This honestly has happened to me only once or twice.  It was so insignificant that I can’t even remember the instances.  You absolutely have to oblige with patient request.  I mean, they say the number one factor in being sued is likability of the provider.  Imagine if you gave someone flack and forced them to see you and god-for-bid something went wrong.

#5 “Are you going to finish your education”
I usually take this opportunity to quickly educate patients on the PA profession.  A short sentence will do. “Actually as a PA I am already licensed to provide medical care under the supervision of a physician”.  Sometimes they ask a few more questions, if they ask why most of the time I tell them well I get to do most of what a doctor does with a 1/4 of the debt (which in my case isn’t necessarily true but it gets the point across) 🙂