The last time I wrote about placements, I was just 7 hours into the whopping 1600 placement hours that PA students are required to complete in order to qualify. I have now clocked up around 56 hours, all on GP placement so far.
During the first year of the postgraduate diploma in physician associate studies at Swansea University, we go out on placement to a GP surgery once a fortnight. We also complete placement blocks of 3-5 weeks in hospitals, with the first one starting this week!
So what do physician associate students do in GP land?
Initially we spend some time shadowing GPs and other members of staff in our designated practice. Different practices will have a different range of staff: GPs and practice nurses are standard in all practices but my practice has GPs, nurses, nurse practitioners, paramedics, pharmacists, a health visitor and health care support workers. I have been lucky enough to spend some time with all of these professionals.
Once we have settled in to our surgery, we begin practicing our history taking skills.
In my practice, the way we do this is that I will call a patient into my room and ask them about why they have come in, how their general health is, what medications they take, whether there is any family history of certain diseases and whether they have any allergies etc.
Once you get used to taking a history, it becomes easier to ask more targeted questions rather than following the set flow that we are taught in class. After taking a history from a patient, I will present my findings to my GP tutor and we will examine the patient together.
Once my confidence has grown, I’m sure that this exercise will extend to me taking a history and performing the relevant examination before presenting my findings to the GP tutor along with my proposed action plan.
Skills Sign Offs
As with all health care courses, physician associate students have a set of skills that they are expected to become competent at before qualifying. For physician associates, this includes taking blood samples, giving injections, performing an ECG, analysing urine samples, taking smear tests, setting up an IV infusion and inserting cannulas, among other things. GP placement days provide a great opportunity to get some of these skills signed off.
Note Taking and Navigating the Computer Systems
One very important thing that health professionals must master is taking notes. In GP practice, everything is computerised, so we learn how to use this system while on placement.
Patient notes are a legal document which must be accurate and thorough so that future professionals who see the patient know exactly what has been done in the past and what has been discussed with the patient and their family. I would personally argue that this is one of the most important skills that physician associate students must learn.
What actually happens on GP placement will vary between practices, especially those in rural areas vs those in city centres.
In general, the population seen in rural practices will be mostly elderly people with long-standing health problems such as heart failure and chronic airways diseases. City centre practices will see more of a variety of patients including students, drug users and individuals whose first language is not Welsh or English. The resources available in city centre vs rural practices will also vary considerably. In Swansea, we are lucky enough to spend time in both rural and city centre practices to ensure that we have a well-rounded understanding of general practice.
Overall, GP placement days are an opportunity for physician associate students to engage with patients, practice our skills and to further our knowledge of the services being provided by primary care in Wales.
It is also a great way for us to introduce people to the role of the physician associate, since it is such a new development in Wales – even the GPs we shadow ask us questions about our role!
So, future PA students in Wales, although many people look forward to the excitement and fast pace of hospital placements, make sure you embrace the opportunities to witness general practice in Wales and become pioneers for the PA profession!
Until next time,
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