Longitudinal Clinical Experiences (LCEs)

Course Description: 

“In the Longitudinal Clinical Experience (LCE) courses (PAP 110, 120, 130), students participate in practicums, which, by definition, expose them to the practical aspects of clinical medicine. From the first semester in the program, students consistently describe how these LCE opportunities help to solidify their knowledge and enhance their level of confidence. These experiences only strengthen their confidence and competence in Year 2 during clinical rotations”

LCE is longitudinal clinical experience (called Longitudinal Placements or LPs at McMaster’s PA Program). We are expected to do 30 to 40 hours Max, in any clinical setting.

In certain semesters, we have certain requirements for areas of medicine. For example, 10 hours of LCE has to be primary care, which includes family medicine as well as emergency medicine. And you can do the remaining hours in other specialties.

The thing about LCEs is you are expected to reach out and network and, this goes back to the importance of networking skills.

We are given an LCE database of clinical preceptors and locations, to reach out to people who’ve taken students on before. These LCEs are done based on your interests, and you do these clinical placements and again, throughout the week.

Tuesdays are officially allocated for those placements. Your day could range from just four hours of clinic, or 10 hours like when a General Surgery LCE which was from 7:30 a to 5:30 PM. So it can be short or long days.

Every semester has a different requirement and as you progress through 1st year PA school, you’ll find that second and third semesters LCE requirements are more focused on specialties. While first semester you have primary care as well as allied health professionals, which is when I was able to do those super cool, EMS places and with the paramedics.

Expectations as on an Observer on LCE Placements

Expectations of PA students during LCE placements varies with the setting. For example, with my paramedics placement, I wasn’t able to do anything. There was a lot of observership and I did have a lot of discussions with the paramedics – like what their thought process was in that emergent situation and why they did certain things. For those kinds of experiences, you’re writing a reflection piece, reflecting on what your goals were going in and what you learned throughout what things we found challenging .

If the LCE was in a more clinical setting, like when I did general surgery or when I did family medicine and ER, you do write S.O.A.P. notes. In first semester PA school you are expected to write a certain number of SOAP notes and reflections.

In addition to the paramedic placement, I did the coroner’s office, which was another interesting experience where I could reflect on how I felt during the experience.

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🚨PARAMAZING🚨 Yesterday I had the opportunity to do a 12-hour LCE placement with the Paramedic Services in the core of Downtown, Toronto (##thesix )!! . . A common question I got asked was, “did you see anything cool?!” and the honest answer: no (even the paramedics asked me to come again to see the “cool” stuff). However, we got calls for chest pain, post-op intestinal hemorrhage, hyperemesis, fentanyl overdose, SOB, and diabetic ketoacidosis, which I agree was not "action-packed", BUT it was a good review of everything I've learned thus far! . . The setting was also relatively calm so I was able to bounce ideas and discuss the thought process behind each call with the medics. Essentially, it all boils down to getting pertinent information relevant to the CC and ensuring the vitals (HR, BP, RR, and Glasgow Coma Scale/LOC) are stable, before transferring care to the hospital. In emergency situations, this involves a lot of quick-thinking, but it is important to focus on the “acute” care and what you can do to help the patient NOW! . . It was also exciting to be on the other side of the sirens for once and own the road – not going to lie, kinda felt cool 😏 . . All in all, a super memorable experience – 11/10 would recommend!🚑 . . S/O to @kyle.gibson.winn for sponsoring me with paramedic attire for the day!! . . #paramedic #clinicalplacement #clinicals #canadianpa #uoftpa2020 #paramedicine #ambulance #siren #calls #paschool #pastudent #physicianassistant #physicianassistantstudent #medicine #womeninmedicine #canadaneedspas #prepa #uoft #uoftmed

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📸 Photograph ▶️ ✂️ Dissect ▶️ Narrate 📝 . . This year, 15 students from the UofT PA program got the opportunity to do a placement at the Coroner's Court in Toronto, observing autopsies. If you are considering the PA program at UofT, this is a great experience for your LCE placements! . . This placement was heavily emotional for some. To keep it generic, there were autopsies on homicides, decomp, drug overdose, liver pathologies, and much more! . . As healthcare providers, we focus on caring for patients when they are alive and well. However, we often forget about what happens after the patient is declared "dead". This experience highlighted all the hard work that pathologists and pathology assistants do, to narrate the biological story of the 'cause of death'. Yes, there are some cases where you can't identify the exact cause, but there are a lot of steps before that to ensure there is a thorough work-up. Fair warning for those reading on, it may get a bit graphic…😶 . . The general process is as follows: photographs are taken for patient identity/pathology, an external assessment is conducted, and the dissection starts with a Y-shape incision on the chest, followed by extraction of the internal organs (usually by the pathology assistant). The pathologist then starts to investigate the organs, starting from the posterior side (aorta) and eventually dissecting into the following organs at varying orders: heart, lungs, kidneys, stomach, pancreas, liver & gallbladder, spleen. The following organs were assessed if there was a need for further analysis (brain, colon, reproductive organs (i.e. uterus)). The pathologist would also weigh some organs (which was recorded on the board) and take samples of fluids and tissue for further analysis under the microscope.🔬 . . Overall, this was a very rewarding experience and helped to enhance my knowledge in anatomy and pathology. And of course, thank you to the staff and cases who provided this learning opportunity! 🙏🏽

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