Third Year Perspective – Clinical Education

I’ve fallen back into my coffee routine after a week-long hiatus. After midterms, we had some time off since our teachers were in Phoenix for the American Academy of Optometry convention, which is held at a different location each year. While it was nice to have a little time off from school, it is good to be getting back into the swing of things.

So far, the greatest challenge for me in third year is clinic. I find fine-tuning the flow of an exam to maximize speed, while maintaining and improving efficiency, to be enough to bring me just outside of my comfort level. A good preceptor will push students in such a manner, and maintain pressure to keep them from falling back into their comfort zone and falling idle. That has been the case for me this semester, and while I am very aware of my shortcomings in clinic, I am also actively working to improve on them each week.

I think this semester will prove to be one of great growth for me clinically, as it has been my most challenging in that setting. Exactly why that is, I am not sure – perhaps it is the fact that we are doing more than when we were second years or that we are now expected to complete an exam in an hour or less, which can be especially challenging when a routine eye exam becomes not-so-routine. This brings me to the next aspect of why third year clinic ups the ante – clinical decision making. We are beginning to break out of our shells in this respect, because we are now expected to call the shots for our patients, which can be a lot of pressure at first for a student. This is also what I mean by a good preceptor pushing us and getting us to work outside of our comfort level a bit. Instead of asking our preceptor what the clinical decision is, we are making the decisions, which are then double-checked at the end of the exam. So, not only are we making important clinical decisions for our patients, we are working to build trust between us and our preceptors and fellow students… it also enables us to build confidence and to trust in ourselves on our own conclusions.

One thing I am realizing as I do become more comfortable doing a full eye exam is that it is becoming less work, and more enjoyable, working with real patients. Things are starting to make more sense and I have really come a long way honing my interpersonal skills to relate to and address the patient’s concerns and goals.

Lastly, there is something to be learned from each patient encounter – whether it is honing our interactive skills or learning how to give directions for a specific test, or even seeing something we learned in class for the first time, there is value in each exam to the clinician. Every patient is unique, and no two exams are really the same, which is part of what makes the profession great.

Currently Listening to: “Norwegian Wood” by The Beatles

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