Precepting PA students: How 
you can touch the future

According to Dr. Stephen Post, author of Why Good Things Happen to Good People, "Giving, far more than receiving, 
is a surprisingly potent force whose impact reverberates across an entire lifetime, nourishing health and happiness in astonishing ways." 


When I became director of PA Services for Cleveland Clinic, I soon discovered this was no ordinary job. The role has afforded me the opportunity to help advance the PA profession here and also to help cultivate PA students and future colleagues. I strive to accomplish two primary goals: enhancing professionalism and leadership among our institution's physician assistants. My simple strategy has been to engage PAs in leadership activities and create educational opportunities that support professional growth.


One of the most effective ways to advance profession­alism and leadership among practicing PAs is through precepting students. As we have employed this strategy with increased frequency over the years, I have seen a positive change in our institutional culture related to the PA profession. The benefits of building educational experiences for PA students here have been numerous. Our health system maintains affiliation agreements with more than 40 different PA programs from all across the country. Last year, I scheduled more than 250 student rotations at our institution. In the past 3 years, we have hired more than 60 recent graduates into full time careers. What began as an activity to foster leadership and build a sense of community among our institution's PAs has become a critically important pipeline for a growing workforce. Recent pilot research into the effectiveness of our student initiatives projects we will hire more than half of the students who train within our institution this year. 


Hospital and health system administrators, practice managers, physicians, and even many PAs believe precepting students reduces the number of patients a provider can manage in a day or leads to longer work weeks for the preceptor. These are myths, not substantiated in the literature, which I had to abolish among our institution's leaders. I am not saying that precepting does not require some planning and training, because it does. My approach has been to offer clear objectives to a training site, make the expectations of the preceptor and the student clear from the start, then plan the student's experience far in advance. I work hard to keep the staff members that support and schedule students happy. Having more students in my institution just made sense to me. So I set out to make attracting, recruiting, hiring, and on-boarding new graduates as painless and productive as possible.


Tangible and intangible benefits exist. The on-boarding of an employee who is new to your institution can cost a system more than $150,000 in the first year of service. This cost rises when an employee leaves within the first year. Cultivating and teaching PA students has allowed us to integrate them into our system while they are learning. The student gains competency and an understanding of our culture—the way our teams interact, use of our electronic medical record system, and how much PAs are valued in our institution. The students' interaction with a team offers a low-risk interview and offers us an opportunity to recruit the brightest and most successful into our organization. I complement this experience for the most desirable recruits and for our clinics' business managers with clear guidance and assistance for navigating certification, licensure, credentialing and rapport-building with potential supervising physicians. 


There are many intangible benefits. After many years as a PA, I enjoy the connection with the next generation of PAs that precepting affords me. The students make me feel younger, including continuous orientation to the latest technology du jour. They allow me opportunities to share my knowledge, and they enjoy my stories of the "good old" days. I like giving back to my profession. I like being there when a student needs advice or help developing a clinical skill. I enjoy giving encouragement, and I hope some of these future PAs will be brave enough to blaze new trails for others to follow. I feel like I have something to give, and it fills me with an enormous sense of gratitude. 


We can build a stronger profession by mentoring our future colleagues. During a surgical rotation, one of my former students interviewed a patient who became distraught and tearful. The student was overwhelmed by the emotional outburst, began to cry, and left the room defeated. I saw her in the hall, trying to stifle her sobs. I asked what was wrong and she described what had happened. She wanted to quit—the rotation and the profession. I told her that her empathy and compassion is indeed why she will become an incredible PA. She said it was that moment that made her understand the impact a PA can have on patient care and she decided that if I had that kind of confidence in her, then she would continue with the program and be the best PA she could be. This was a small moment in my day 15 years ago, but as a preceptor, my actions and words changed her life. 


This is how we can give back and shape the future of our profession. Volunteer to precept. Make a case for shaping new educational experiences for students within your institution. You can change lives and touch the future. JAAPA