Kaitlyn GreinerIntern Final Evaluation-Internship Experience

This internship allowed me to accomplish all of the goals and objectives that I set for myself. For my health assessment goal, I wanted to be able to effectively use the patient chart database, Epic, to read and interpret patient records with ease. I definitely accomplished this goal by working on my two research projects and by navigating through patient records during the clinic. Between each patient in clinic, I would review their chart to learn about their history and chief complaints for the appointment. I was able to gain a thorough understanding by knowing this information and then hearing the diagnosis and treatment that Stefanie recommended when actually seeing the patient. This also helped me to understand why she asked the questions that she did when seeing the patient. This first goal also helped with my second goal. For my health planning goal, I wanted to be able to articulate a plan for surgery for a patient with gastroparesis or a disease related to the pancreas. By studying the patient chart before seeing the patient and then observing Stefanie set a plan of action for the patient, I was able to observe certain patterns and learn from these patterns what the best treatment would be for a patient with certain issues. The first research project that I helped Stefanie with familiarized me with the database. I had to navigate to find information about the patients on certain year anniversaries after their total pancreatectomy surgery date. The second project required me to navigate through new territories of the database than I had previously. This project involved seeking patient information after other various surgeries. I entered in the demographics and pre-op information. I was looking closely at information before the surgery. This project helped me to connect the pre-op symptoms and test results to the surgery that resulted from these problems. This project really helped me achieve my health planning goal of articulating a plan for surgery for a patient with problems. The projects also helped me to accomplish my health assessment goal. I am now able to navigate through and interpret lab results, various test results, progress notes from our clinic or from other physicians, and much more patient information with ease as a result of this internship.

My implementation goal was to be able to describe the collaboration from several fields used in the implementation of healthcare in the GI surgery clinic. This goal was accomplished by attending clinics on an average of two days per week. Just by sitting in the office of the clinic, I was able to see the interaction of the doctors, PA’s, dieticians, radiologists, residents, nurses, administrative staff, and a number of other professionals from different fields. MUSC works as a team to provide care for the patients. For example, the radiologists are just a call away from the different departments of the hospital to interpret various tests that were conducted there at the university. Also, the dietician works very closely with the other healthcare professionals within the GI surgery clinic. Overall, professionals from many healthcare fields work together as a team in the GI surgery clinic and I was able to observe this interaction through my internship.

For my intervention evaluation goal, I wanted to be able to describe how the GI surgery center evaluates their treatment and surgery success. I was able to see a large volume of successful or unsuccessful stories as I went through each patient for my projects. While some of the patients were deceased at the time that I was compiling their information, others had lived many years since their surgeries. The purpose of my first

project was to evaluate patient success after surgery using a database, so I am very familiar with these evaluations of success. The other main way that evaluations were made was through the conferences with residents, professors, and doctors. The residents present a recent complication for the audience. Not only do the residents learn from these mistakes, but everyone in the audience benefits from the presentations as well. These conferences were such enriching learning opportunities.

For my affective goal, I wanted to be able to articulate how I felt about pursuing further graduate studies in the physician assistant field by the time that I completed my internship. I now feel that I can articulate my feelings with more clarity. I spoke with other newer PA’s about the benefits of the career and obtained some great advice from them. I can see that I would be capable of being a physician assistant and that their responsibilities really make a huge difference in the world. I could truly see myself being a physician assistant in the future. I was also able to sit in for a PA class lecture where Stefanie was the guest speaker, so this gave me a glimpse into the life of a PA student. My plan to apply to PA school is still intact after having obtained an in-depth experience of the life of a PA, so my educational goals have not been changed. The uncertainty about my career goals has not changed either. I am still applying to optometry school as well, so I remain unsure about whether I will end up being a PA or optometrist in my professional career. This will depend on which schools I get into and my feelings when I tour each school.

I completed the first research project that I was assigned for Stefanie very successfully. I was working on the Islet Longitudinal Outcome Database. It took about a whole workday to get past the learning curve of the project, but after that day I was really confident in my abilities. By the end of the project, I was reading through patient charts very quickly and was able to interpret them with ease. After I finished the anniversary patients, I went back to the patients that I started with at the beginning and checked over my work because I was then fully capable of completing their data input easily. For example, I checked over my calculations of pain medication conversions because I was a little shaky with this part at the start of the project. I was able to hone this skill through the course of the project.

This project required many skills, such as conducting these pain calculations. One major skill that it required was organization. Stefanie had already listed the patients out in a very organized fashion and it was imperative to remain consistent with this method in order to input the data for the correct year for each patient. I also researched any words or topics that I did not understand to successfully input the correct data. I researched before asking questions because it was important that I try to figure something out as best I could first so that I could learn to do all of my work independently. This is an important skill for a PA to have because the doctor cannot be bothered with many questions when working. Diligence was an important skill for this project. It was a project that required attentiveness and commitment. I worked on the project without stopping for one entire day each week of my internship plus any extra time that I had in clinic. This input of time and attention to detail were essential to successfully completing this project. This organization, independent research ability, and diligence were my strengths in the project. My weakness was that it took until the end of the project for me to become an expert in the work. This caused me to need to check over my work in the end. Though, there was really no way to avoid this delay. The project required practice in order to complete it

successfully. In spite of this weakness, I feel that I was able to positively contribute to the internship site with my two research projects. All in all, I helped two PA’s out with their research. I completed the anniversary work that needed to be done for Stefanie’s project and I accomplished a lot on Megan’s project. They were both behind with their projects and I helped to get them back up to date. The projects not only helped the two PA’s, but also provided me with some hands-on experience with patient charts and taught me more than I could have imagined.

Although this internship was a much different learning experience than a typical classroom setting, I used much of the knowledge that I’ve learned from my courses at Clemson throughout my time at MUSC. I have listed some of the specific courses as follows:

1) Anatomy and Physiology (and labs)2) Anatomy and Physiology Lab TA course for Dr. Cummings3) CPR/First Aid for the Professional elective4) General Microbiology5) General Chemistry/Organic Chemistry

By far, the most helpful course was anatomy and physiology. This course helped with understanding various surgeries in my research projects as well as understanding patient problems. It was very important to be able to visualize the anatomy of a human when such complex surgeries are being discussed and explained to patients. Being able to serve as an undergraduate TA for this lab helped immensely. Both my general chemistry and organic chemistry classes helped with reading and comprehending patient lab work on Epic and inputting this data for my projects. Being able to make connections between lab results and patient outcomes would have been very difficult without a chemistry background. Microbiology was in the back of my mind when noting how clean the clinic must remain at all times. When entering and exiting every patient room, Stefanie uses hand sanitizer on her hands for safety. My CPR and First Aid course helped with having background knowledge for the removal of surgery staples and when observing surgical wounds.

The pre-internship course also prepared me well for this internship. The course helped me to figure problems out on my own and this was essential to know for the internship. The course also trained me on the subject of health literacy. This health literacy training was utilized daily. Stefanie asked each of her patients about their current medications and I was able to see the range of full health literacy to very little literacy among her patients. I observed Stefanie using more simplified terms with the patients who she sensed were not very health literate. I hope to be able to help my future patients in this same manner so that they understand as much as possible regarding their health. I also saw that it was mentioned on patient records if the patient was not very health literate. This shows that health literacy is a very important skill to have because it was mentioned on patient charts. My own health literacy was tested and utilized with both projects. I was required to read and interpret patient records as well as database information. My health literacy was improved from this internship immensely. I did need to research many health terms with which I was not previously familiar. My research and the daily exposure to health terms truly ingrained a great deal medical terminology in my mind. Overall, this internship provided me with educational experiences in many aspects of the healthcare field.