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The Psychology of Chemistry

Carrie Williams '08

It’s been said that there’s no substitute for experience. And there’s no adage more apt when college graduates apply to medical schools, since the schools want to know that the students have a pretty good idea of what they’re getting themselves into.

“It’s vital that students have clinical experience when they apply to medical school,” says Karen Campbell, Ph.D., the P. Kenneth Nase, M.D. ’55 chair of biology. “If they don’t have that experience and they can’t speak intelligently about what it means to be a physician, they will not get in.”

That’s why a program developed by Albright College and the Reading Hospital and Medical Center is particularly advantageous – for student and hospital alike.

Called Personal Productivity Assistant (PPA), the program puts students bedside, where they document the physician’s entire encounter with the patient. These student scribes update the patient’s medical records, ensure that the patient is ready for tests, complete prescription orders, contact family members and private physicians regarding the patient’s condition, and provide relevant information before the patient is discharged.

It all begins with three weeks of intensive training at the hospital during Albright’s January Interim.

“We teach the students medical terminology, a significant amount of anatomy, some pathology, the overall flow of an emergency department, and a lot of abbreviations that allow for faster note taking and charting,” says Scott McCurley, M.D., associate director of emergency medicine. “They’re taught what’s significant and what’s insignificant when it comes to charting.”

That knowledge alone can give students a leg up in medical school, as Carrie Williams ’08 can attest. Williams entered the PPA program as a junior premedical student in January 2007, and stayed on after graduation as head scribe. She took her Medical College Admission Test (MCAT) in May, has applied to several medical schools, and is now waiting to hear from them. In the meantime, she’s been comparing notes with aspiring physicians who’ve already entered medical school.

“Medical students have told me that charting isn’t touched on that much in medical school,” Williams says. “You’re sort of left to your own devices to figure out how to make a chart and what information goes into a good chart. So scribes get a jump start on that.”

As the Health Sciences advisor at Albright, Campbell has coordinated the program since its inception. “It’s really an interesting job,” she says, “because the students see a cross-section of types of patients as well as physicians.”

McCurley says that’s one of the most important aspects of the program. “When I meet with the scribes in December, I tell them that one of the most important things they’re going to learn is what it’s like to be a physician. They’re going to be partnering with physicians eight to 10 hours a day for four months. That interaction is the unique piece of this whole thing, because they get to see what the day-today life of a physician is really like.”

The PPA program is distinct from the hospital’s shadowing program, where students merely observe what the doctors are doing. “Shadowing doesn’t have the excitement and intrigue of being part of the patient’s care,” McCurley says. “The scribe position does, because they’re wrapped up in the process.”

Or, as Campbell says, “They’ve got real responsibilities.”

A Perfect Match

The program got its start about five years ago, when Campbell was discussing the long-running shadowing program with a few physicians. The physicians had learned that some hospitals were paying people to do charting. They were excited about the concept, but the Reading Hospital didn’t have the money to pay for it.

Campbell had the perfect response. “I told them that Albright has students who want that experience, and we could offer them course credit,” she says.

The first group of six premedical students chosen to participate (not all are) started in January 2005. Since then, about two dozen have completed the program.

During the school year the students earn four credit hours by working one 10 to 12 hour unpaid shift a week in the Reading Hospital Emergency Department or at one of its urgent care centers. And the doctors can tell when the scribes are on duty. “We’ve noticed a 10 to 25 percent increase in productivity for physicians who use scribes,” McCurley says. “They spend less time doing paperwork, which is a big burden in modern medicine, and more time at the bedside caring for the patient. So a good student scribe allows the doctors to see more patients more efficiently. That’s the ultimate goal.”

The program has been so successful that the hospital now budgets for it over the summer months, so several students, like Williams and Chris Sheerer ’11, are asked to continue working – for pay rather than credit – after the school year ends.

Students Grow Quickly

While the students are helping the physicians and their charges, they’re also growing as medical professionals in their own right. “They develop very quickly,” McCurley says. “Some of them start off scared to death to be in the room with a patient who’s in a crisis of some sort, whether it’s a medical crisis or a psychiatric crisis.

“The first week there’s inevitably someone who almost passes out or does so because they see something that makes them uncomfortable. A month later they’ve become immune to it and are able to work without any trouble at all. And that’s real valuable.”

“The part of it that I find unique is that we get to interact with patients on a day-to-day basis,” Williams notes. “Not only that, we get to see medicine from the physician’s side.

It’s really tough as a premed student to get patient-care experience. Usually you’re not involved with the medical community per se while you’re working toward a degree. This is the only program I know of where you report directly to an attending physician to learn what their role is.”

“Scribing has taught me so much about practicing medicine,” says Sheerer, who entered the program in his freshman year. “I have learned countless amounts of medical information and terminology, as well as the ‘hands on’ aspects of medicine that would be impossible to learn just by reading a book. I know that this job will help me in medical school.”

“We’ve noticed a 10 to 25 percent
increase in productivity for physicians
who use scribes.” - Scott McCurley, M.D.

While the students’ goal may be to gain experience that will help qualify them for medical school, the PPA program can also help them decide if that’s what they want to do in the first place.

“Going through the premed track can be very daunting,” Williams says. “You can get bogged down in classes like biochemistry and organic chemistry, but when you come here you remember why you’re taking those classes. It’s so you can do this as a job, and it reminds you what you’re working toward. It helps you decide if it’s really what you want to do.”

Practical experience aside, that may be how the program helps the students the most.

“Some people have a fantasy view of what working in the medical field would be like,” McCurley says. “They may do a year or two of medical school and incur huge debt, and then decide it isn’t for them after all. But they’ll have to deal with that debt for the rest of their lives, and that can be overwhelming. So if they can get experience that helps them decide if they really want to go into medicine, then that’s very valuable.”

So far, McCurley says, “We have not had any who have had less of an interest in pursuing medicine because they went through this program.”

To the contrary, most of them, Williams and Sheerer included, have reaffirmed their interest in medicine.

“Working in the ER has only amplified my aspirations to go to medical school and become a physician,” Sheerer says. “Although the hours may be long and most of the time are tedious, figuring out diagnoses and feeling like you made a difference in the patients’ lives is very rewarding.”

What PPAs Do

The personal productivity assistant (PPA) is responsible for enhancing the efficiency of the physician by improving documentation of
the medical record and keeping the patients informed of their status. The PPA reports directly to the attending physician. The PPA: accompanies attending physician during the history and physical exam; records information on the medical record; orders the dictated testing and medication; and continuously monitors the completion of labs, radiographic studies and test results. All actions of the PPA are reviewed concurrently with the physician.

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