Precepting is my Superpower

precepting-superpower

You’ll never forget them: the preceptors who helped you gain skills and confidence. The ones who intimidated or shamed you. The ones who made you love a specialty or abandon it altogether. The one who, as Tucker Brady, D.O.’19, describes Rachelle Gammon, D.O.’02, “exemplifies genuine, compassionate care.” The preceptor who, as McKenna Zimmerman, PA’19, says of Suzanne Ware, PA-C’01, “is so knowledgable about health care and her patients, super-compassionate and loves to teach.”

In this story, DMU salutes just some of the individuals who possess the best qualities as preceptors. The University is deeply grateful to these expert practitioners, mentors and models, and we know that someday in their careers, our students will be grateful, too.

"Students keep me on my toes"

Brianne Day, D.O.’08, shown here, right, with Harini Vijay, D.O.’20, practices at Mercy Waukee, IA, Family Medicine. The daughter of a family practitioner, she says she “wanted nothing to do with the medical field” until a medical service trip in Brazil that she experienced in high school let her see “firsthand how medicine can change people’s lives and how harmful lack of access to medical care can be.”
Brianne Day, D.O.’08, shown here, right, with Harini Vijay, D.O.’20, practices at Mercy Waukee, IA, Family Medicine. The daughter of a family practitioner, she says she “wanted nothing to do with the medical field” until a medical service trip in Brazil that she experienced in high school let her see “firsthand how medicine can change people’s lives and how harmful lack of access to medical care can be.”

“While in residency, we always had multiple medical students around. Teaching initially started as a way to reinforce my own knowledge, but then it became something enjoyable, to watch an untrained student develop into a capable diagnostician.

“Something that makes a great preceptor is actually caring that the students learn something. Nothing is more frustrating as a student than standing in the corner, and watching, watching, watching – never being involved or getting any hands-on experience…As students progress from third year to fourth year, they need to move from being a collector of information to an interpreter, and I try to start that process early. I want students that leave my rotation feeling comfortable in their skills and confident in voicing their opinions.

“Having students has forced me to stay up to date. Medicine is constantly changing, and it’s really easy to stay stuck in the ways you were trained and not flex with the times. Staying fresh on all the new updates and guidelines makes me a better doctor. I get a ‘proud mama’ moment when I see some students I’ve helped train go into family medicine, where they can make a difference in someone’s life.”

"A lot of mutual benefits"

Patrick Nelson, D.P.M.’09, and Robert Greenhagen, D.P.M.’08, born just two days apart and friends since childhood, co-own the Foot and Ankle Center of Nebraska and Iowa, which has several locations in both states. Greenhagen also is the president of the Nebraska Podiatric Medical Association and director of the Midwest Foot and Ankle Fellowship in limb salvage and advanced foot and ankle reconstruction. Above, they combine patient care with precepting Spencer Hammack, D.P.M.’20, at right.
Patrick Nelson, D.P.M.’09, and Robert Greenhagen, D.P.M.’08, born just two days apart and friends since childhood, co-own the Foot and Ankle Center of Nebraska and Iowa, which has several locations in both states. Greenhagen also is the president of the Nebraska Podiatric Medical Association and director of the Midwest Foot and Ankle Fellowship in limb salvage and advanced foot and ankle reconstruction. Above, they combine patient care with precepting Spencer Hammack, D.P.M.’20, at right.

“For those to whom much has been given, much is expected. Serving as a preceptor provides a lot of mutual benefits. It lets me show pride in my school and makes me stay up in the game. Young people always question, and I love the aspect of always getting better. I ask students questions all the time. I want them to be able to explain a case to me so that the patient can understand it. That way, the patient becomes educated, and the student can apply what they’ve learned in a textbook to the patient world.

“I tell students that the sacrifices they’re making and the opportunities they’ve been given will shape their next 30 to 40 years. We always require them to do a research project as a way of contributing to the well of knowledge that we all drink from.”
-Robert Greenhagen, D.P.M.’08

"A sense of duty"

“I personally had my own struggles through medical school. It was the direction and guidance of a few specific doctors and attendings that helped me get through. I never forgot what they did for me and felt it was my duty to do the same for someone else. A great preceptor is a teacher and student at the same time – one that is constantly learning while perfecting what they already do. They inspire not through vast deeds, but small moments.

“I want students to think outside of the box but be logical. I want them to understand that being a good surgeon is not always doing surgery. I want them to see that sometimes the best way to treat a patient is just by listening.”
-Patrick Nelson, D.P.M.’09

Flex YOUR preceptor superpower

Serving as an educator for DMU’s clinical students in the real world is a stimulating and rewarding experience and one that will keep you current on health care practices and theories. Depending on your profession, you may earn continuing medical education credit. Preceptors are eligible for faculty development programs presented by the University; some receive adjunct faculty appointments. Most important, you will play a critical role in shaping your future colleagues and ensuring the high quality of health care.

"Icing on the cake to get to train students"

Cassie Mitchell, D.P.T.’11, NCS, is a physical therapist at Younker Rehabilitation, Iowa Methodist Medical Center, in Des Moines, where her patients include those who are post-stroke, have spinal or brain injuries, and medically complex hospitalizations. She decided to work as a physical therapist in high school after volunteering as a peer partner in an adapted physical education class.

“Students who had spent their entire lives in wheelchairs had the opportunity to walk for the first time in gait trainers,” she recalls. “It was the most incredible process to be a part of.”

“I have always been a bit of a nerd who loves to learn and be challenged with new information. I also love teaching and collaborating. I knew that mentoring students would fill both of these buckets for me.

“Students on rehab are generally in their last rotations, so my primary goal is to ensure that, professionally, they are ready to step into a full-time position without a clinical instructor attached to their hip. It means they can safely put their hands on patients, answer patient questions and make decisions in real time without constant reassurance from a mentor. It also means that after a session they can verbalize questions or concerns to someone who hasn’t ever laid eyes on the patient. Finally, it means that they can ‘manage the work’ – patient care, documentation, interdisciplinary communication, etc. in a relatively efficient and professional manner. It is icing on the cake to get to train students in these skills while sharing my love for evaluating, treating and handling the complex neuro population.

“I believe that mentoring interns truly allows me to keep growing as a PT. Students bring with them hard questions that keep me on my toes, as well as current research and best-practice information. They allow us to collaborate on complex patients and brainstorm through the options for best treatment. Finally, it is really fun to treat complex patients with two sets of skilled hands to facilitate a great intervention.”

"Elevated as a clinician"

Steve Olsen, M.S.P.T.’03, CSCS, is a physical therapist and clinic director of 21st Century Rehab in Altoona, IA.

“Being a preceptor always just seemed to me to be the logical progression within the profession. I really can’t remember many specifics of the first experience as a preceptor, but I remember overall that it was a positive one and felt that it elevated me as a clinician. I feel it is a professional responsibility to ensure that all new graduates are prepared as much as possible. It also helps keep us as experienced practitioners at the top of our game and ensures that we are continually learning.

“I try to make students feel comfortable by advising them that when they are treating patients that I will not be observing just to ‘grade’ their performance or look for mistakes, but also to serve as a lifeline if they have questions or need assistance…I want our students to feel confident when treating patients and our patients to feel confident that students can get them better. For students, I do this by ensuring them that I won’t call out or overtly correct their mistakes in front of patients. To build patient confidence in students, I point out the strengths of each student to patients, and I refer to students as ‘interns’ rather than ‘students,’ as it sounds more professional.

“Some of the most memorable experiences for me have been the former students who have gone on to work for our company. It is enjoyable to see the progress they make as they become autonomous practitioners.”

"It reminds me of the reason I joined this career"

Rachelle Gammon, D.O.’02, shown here with Tucker Brady, D.O.’19, wanted to become a doctor after dissecting a frog in the sixth grade. Now a pediatrician with UnityPoint Clinic Ankeny, IA, she admits that she “really disliked pediatrics” because, she later realized, of the “rather negative” preceptor she had on that rotation. One of the most important lessons she drew from her attendings was how to interact with families facing extremely difficult health situations.
   “I was able to see another side of my teachers as they helped us deal with loss and guided us through those hard times,” she says. “Being a kind human being in the face of loss is a gift that they provided me.”
Rachelle Gammon, D.O.’02, shown here with Tucker Brady, D.O.’19, wanted to become a doctor after dissecting a frog in the sixth grade. Now a pediatrician with UnityPoint Clinic Ankeny, IA, she admits that she “really disliked pediatrics” because, she later realized, of the “rather negative” preceptor she had on that rotation. One of the most important lessons she drew from her attendings was how to interact with families facing extremely difficult health situations. “I was able to see another side of my teachers as they helped us deal with loss and guided us through those hard times,” she says. “Being a kind human being in the face of loss is a gift that they provided me.”

“The decision to become a preceptor was easy. I felt like it was my responsibility and payback for all of my preceptors, and I had many who contributed to my education. My goals as a preceptor are pretty straightforward: to introduce students to pediatrics and give them the tools to approach children from age one day to 18. Children and their families can be intimidating…I feel that the biggest tool we have as a physician is to connect with families and hear their story. If we can use that information and perform the physical exam with the child trusting us, then we are winning.

“I really try to get to know my students. It is a joy to see that fire they have in their eyes. Sometimes as we are out and practicing, we can lose that initial fire that we had as we approached medicine. Having students gives me that joy again and makes me feel young.

"Sometimes I get worried about the future of medicine, and then I meet DMU students and so many have given me that reassurance that we have amazing new doctors to come, and they care deeply.”

"Real value in patient care"

Dallas Sanders, PA-C, is a physician assistant and diabetes educator with Mercy Clinics Internal Medicine in Des Moines.

“I want students to feel like this is a good rotation. I knew when I was a student when a provider was phoning it in. I tell students that everybody who comes on this rotation is very smart. No one gets here if they’re not an excellent test taker. But that doesn’t always translate to good patient care. A test taker chooses from A, B, C or D. As a provider, you have to make a differential diagnosis involving a possible combination of factors. We practice internal medicine, so we rarely see patients who take less than several medications or who have just one condition.

“I love to read my journals and pride myself on knowing the clinical trials. I talk to the students about that. There’s no rule that says as a PA, you can’t be as smart as the doctors. Plus you may have a supervising physician who asks you, ‘Why did you do that?’ You want to be able to answer.

“I’ve had students the past 12 years; I wouldn’t do it if it wasn’t mutually beneficial. They help me make sure each patient is up to date on immunizations and is getting regular checks so that I can take care of the patient’s diabetes or hepatitis. I feel I get real value in patient care.”

"We have to have fun at work"

Jim Dickbernd, M.S.P.T.’95, is a certified orthopedic manual therapist and therapy director at the Concentra Dixon Clinic in Des Moines. He serves as a preceptor for students from Creighton University, the University of Iowa, St. Louis University and Northern Illinois University as well as DMU.
Jim Dickbernd, M.S.P.T.’95, is a certified orthopedic manual therapist and therapy director at the Concentra Dixon Clinic in Des Moines. He serves as a preceptor for students from Creighton University, the University of Iowa, St. Louis University and Northern Illinois University as well as DMU.

“I took my first PT student back in 2006, from DMU. I naturally like to teach, and I realized that year how much I enjoy teaching students and watching them grow and enhancing their skills.

“Mentors for me have all generally possessed the same type of personality: showing confidence in respect to all patients, possessing a strong work ethic and approaching their care with a sense of humor. I feel strongly that we have to have fun at work…I believe a great preceptor would be a role model for this type of personality to his/her students.

“Being a student is an apprehensive time. Building confidence is our job as a preceptor. Positive reinforcement works well by building confidence and skills in students. I also have students come in early some days to learn new skills that are relevant to patient care….I do not believe at all in [using] negative reinforcement or intimidation.

“I have had many great experiences with students from many schools over time, but I have to say a real memorable experience for me was just in the recent month. I gave a lecture for the IPTA [Iowa Physical Therapy Association] conference, and my two students attended the lecture. They bought me flowers and brought me treats to congratulate me after the lecture. Special times like that make my job as a clinical instructor even more special.

“I would highly encourage my colleagues to become preceptors to students because they are our future! Our profession grows because of them, and this can be strongly enhanced because of our abilities to teach and mentor...To me, being a mentor is the absolute best part of my job.”

"A great way to stay connected to DMU"

Andrew Mueting, D.O.’12, is a physician with Avera Lakes Family Practice in Spirit Lake, IA. The first in his family to become a doctor, he enjoys the variety of his “full-spectrum” practice, treating patients in the clinic, hospital, emergency room and delivery room.

“Prior to medical school, I spent time with a number of different providers who took the time to teach me and act as a mentor.

I had one preceptor who told me that the best way to thank him for helping me was to ‘pay it forward’…It has been a great way to stay connected to DMU. It also has been a great way to get students to our facility. Hopefully, it is a win-win for us both.”

"Learn one new thing every day"

Suzanne Ware, PA-C’01, shown here with McKenna Zimmerman, PA’19, decided to go into health care when she was a preschooler after an accident sent her to the hospital for treatment and x-rays. She worked as an x-ray technician for 12 years before pursuing her physician assistant degree. The 2015 Alumna of the Year of the College of Health Sciences, Ware practices at Mercy Clinics Internal Medicine in Urbandale, IA.
Suzanne Ware, PA-C’01, shown here with McKenna Zimmerman, PA’19, decided to go into health care when she was a preschooler after an accident sent her to the hospital for treatment and x-rays. She worked as an x-ray technician for 12 years before pursuing her physician assistant degree. The 2015 Alumna of the Year of the College of Health Sciences, Ware practices at Mercy Clinics Internal Medicine in Urbandale, IA.

“The first time I became a preceptor was around 2007. Pam and Dan Chambers [now DMU physician assistant emeriti faculty] contacted me and asked if I would consider taking a few students. I was really nervous about it! Was I experienced enough, smart enough to teach students? That year, I had three or four students. Since that time, I take a student nearly every month.

“My philosophy and goal as a preceptor are to have every student learn one new thing every day. We are always learning. What works best with students is letting them have autonomy to an extent that they learn. Giving assignments over things we have discussed during the day helps reiterate information as well.

“I would definitely encourage colleagues to precept students. I feel it keeps me up to date with a lot of the newest medical advancements as well as helps mold students to be better practitioners.”

Enjoying the "breakthrough moment"

Michelle Brown, M.S.P.T.’99, D.P.T., is a physical therapist at the University and the site clinical coordinator for the DMU Physical Therapy Clinic.

“I want to pay forward how others have impacted my life and career. My mentors are compassionate, they challenge one to look at the whole picture, they treat students with respect and as part of the team. They are passionate about PT, teaching and are service-oriented.

“My teaching and feedback methods align with the social learning theory as I utilize guided practice during labs and in the clinic. Feedback is given freely but with the understanding that it has a potential for building up or breaking down an individual. I model and facilitate self-reflection during treatments with students to formulate an approach to both instruct and provide constructive feedback. I try not to micromanage students…I encourage students to step out of their comfort zone.

“I enjoy watching for what I call the ‘breakthrough moment.’ This is when a student realizes it is not about a grade or doing everything perfect, but it is about the patient. When the student steps out of the introspective, cognitive mode and switches to patient-focused and relationship-building, then the fun and learning can really begin.”

Students "keep you honest"

R.D.L. “Lee” Evans, D.P.M.’95, was an assistant professor in DMU’s College of Podiatric Medicine and Surgery from 1998 to 2001, when he joined Des Moines Orthopaedic Surgeons in West Des Moines, IA.

“I very much enjoy having students in my office for two reasons. Number one, students ask lots of questions and keep you honest and, number two, they stimulate your mind to continue to be a lifelong learner….I have had great experiences with the students and found that the product the College of Podiatric Medicine and Surgery puts out is of the highest quality in the country.

“There certainly is no secret formula to being a mentor for these young students. I think you simply have to like them. I think you have to like what you do for a living. And I think you have to like watching them learn.”

Shaping the Future

Garrett Feddersen, D.O.’13, is the emergency medical director at Buena Vista Regional Medical Center in Storm Lake, IA. He pursued the specialty after two friends had a car accident in high school. “I was the first one on the scene and got angry I didn’t know what to do,” he says. “I signed up for EMT-B classes, and it snowballed from there.”

“I push my students to see the patients first, report to me and then complete most of a note. Not only does this help with my workflow, but it also gives the students actual practice knowledge and gets them more familiar with the electronic health record and how to see patients efficiently. Engage the students, and they’ll learn and help you at the same time.

“The medical students of today are your colleagues tomorrow. Part of being a preceptor is purely selfish – in the future I want to work with competent colleagues who are respectful to each other and who are well-trained. It is also a great recruiting tool down the road, if they have seen your system and enjoy working in it, especially for rural health care systems.”

 

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