Perspective

Perspective. It is what PA students desire during their education as they prepare to enter the clinical workforce.

Teaching about medical conditions, with their associated testing, diagnoses, and treatments is often straightforward. But perspective can be one of the most difficult knowledge pieces to convey – especially during a pandemic when there are no face-to-face activities, leaving students feeling socially isolated while learning from remote locations.

I was driving to an urgent care shift during the first month of the pandemic. I am faculty at an upper midwestern PA program, a job that I have been lucky enough to have for the past decade that allows me the opportunity to also practice clinically. As I was thinking about the upcoming shift and numerous respiratory conditions that were certain to fill the schedule, I began to wonder about some of our prior graduates, now practicing clinicians, and how they were faring in this new medical environment.

While many of our graduates stay in-state or join practices in adjacent states, a large number end up further away. I was wondering how those distant graduates are managing during this pandemic. As I thought about them, I wondered if our current didactic- and clinical-year students would be interested in a different perspective on COVID-19 — one from outside of our region. The students were keenly aware of local, regional, and national COVID-19 news reports, but those reports seemed to have a different message each day and were dependent on many unrelated factors.

Our program stopped all face-to-face lectures for didactic students, moving to an online format. Second-year students were pulled from clinical rotations, as was the case across much of the U.S. This all happened over their spring break, making the transition to virtual learning sudden and more difficult. I asked the practicing clinicians to answer a few standard pandemic questions and add anything else that they thought would have been pertinent when they were students.

I texted a few graduates for whom I had current numbers and messaged a few others through social media. I initially contacted an ED PA in upstate New York, an orthopedics PA in North Carolina, an oncology PA in Minnesota, a transplant PA in Texas, a rural family medicine PA in western Montana, and a dermatology PA in southern California.

The perspectives, though geographically varied, were also quite similar. They reported organizational confusion and announcements that had different directives from day to day. There were shortages of PPE in all locations, with most clinicians being instructed to clean and reuse their PPE. There were personal anxieties about coronavirus and the unknowns of this new contagion. There were concerns about families and whether practicing clinicians should self-quarantine to keep their loved ones safe. There was worry about those fragile patients who were now being told to stay home and only call the clinics for a telemedicine visit. They wondered: How would cancer patients fare after their staging surgery for treatment had been delayed? How would those patients with behavioral health diagnoses deal with the pandemic?

From the reports that came in from all across the country, I put the information into a blog that the students could follow a few times a week – and the response was refreshing. They were tired of seeing all of the misinformation online and just wanted some perspective that wasn’t influenced by outside factors. They also wanted to hear from clinicians, those individuals that hold their future careers, and understand what those clinicians were experiencing.

I had more than 30 previous graduates write COVID-19 stories for the blog. They were from rural and urban areas and from a variety of different disciplines. They were from warm and cold climates. And they were from both new and seasoned PAs.

For the students, it helped provide some perspective to the numerous unknowns they were currently experiencing. With talk of furloughs and layoffs, what did the job market look like for a clinical-year student preparing to graduate? Would the students beginning their clinical year even be allowed to see patients in an actual clinical rotation?

Students at our program are surveyed to death, but I did ask for some responses on the blog to see if it was at all beneficial to our didactic and clinical year students.

Here are some of the student responses:

“Not feeling so alone in all of this.”

“A nice change of pace from other outlets of information…felt much more personal.”

“Helps to feel connected to the program and is great to hear stories from multiple practice locations and disciplines.”

“Helps solidify that everyone is going through the same thing.”

We also asked students to tell us what they were struggling with most at that time:

“The thought of getting sick and getting my family sick.”

“Social isolation.”

“Uncertainty of graduating and maybe being in the workforce and what it might look like.”

“Finding a job after graduation. I feel very discouraged.”

“Personally, I am struggling with the possibility of having a delayed graduation.”

“I worked hard to get into school, and it took me longer to get accepted than I had hoped. So, to get here and have it not be the experience I imagined is difficult.”

One wonderful thing that came from this blog is the amazing feeling of knowing that all of these competent and caring practitioners graduated from a program that we, as faculty, put our heart and soul into each and every day, despite the budget cutbacks, COVID-19 furloughs, or whatever else is thrown our way.