Mandatory Class Attendance

[Acebecker]

Pete - I would caution you against disrespecting a senior PA.  While you may not agree, discussion as peers is still crucial. 

 

Might I inquire, Pete - What is your station within the medical system?  Are you a PA?

[PeteK777]

Pete - I would caution you against disrespecting a senior PA.  While you may not agree, discussion as peers is still crucial. 

 

Might I inquire, Pete - What is your station within the medical system?  Are you a PA?

 

It's disrespectful when I 1. Openly admit that I misquoted Reality Check in a previous post and 2. post a journal article in response to "all your stuff is just shiny...?" Are you sure I'm the one showing disrespect here? I would personally expect more from a senior PA but I wasn't planning on going there. Yes, I am a PA.

[rev ronin]

I think the assumption that the student is customer is shortsighted.  While not at odds with modern American expectations, it is at odds with the Hippocratic Oath, which places the practice of medicine, the interests of the patient, and the family of one's teacher ahead of the medical student's own interests:

 

https://www.nlm.nih.gov/hmd/greek/greek_oath.html

[Reality Check 2]

The most important educational experiences in becoming a PA are learning from those who came before you by having human contact and learning the art of medicine.

Nothing can replace learning how to really talk to a patient and touch them in a clinical exam and use your skills to provide care.

There is no technology that can replace that.

A patient can be diagnosed through history and the subtle nuances of their person should come through to the provider.

That cannot be mimicked by simulation or any video or even a lab test in a lot of cases.

 

I have done this for a long time and am passionate about the ART not the technology.

I firmly believe that if we forego the human part of the educational process, we will only serve to develop a breed of automoton drones who check little boxes, send meds electronically and dismiss the patient as simply a task completed rather than a life affected.

 

I don't care for your tone or responses but wish no fight - there is nothing to win.

My patients will receive from me what I was taught and my best efforts, skills and abilities and my desire to continue learning.

 

Good Day

[ohsnapPA]

I feel like physical diagnosis and clinical medicine should definitely be taught in the classroom, since they are more hands on learning subjects. But for some of the other didactic classes, I really do feel there is no more of a benefit in being in the classroom vs not being in the classroom listening to the same lecture online.

 

They're times when I would be studying all night for a test in the morning - and then have to sit through lecture until 7pm, physically and mentally exhausted, - sometimes dozing off or sleeping through a class (not proud of this)...I honestly think that's more disrespectful than not being in the classroom at all. I feel like your brain can take only so much in one setting...and mandatory class attendance sometimes can hurt the student more than it can benefit a student.

[fishbum]

I think the assumption that the student is customer is shortsighted.  While not at odds with modern American expectations, it is at odds with the Hippocratic Oath, which places the practice of medicine, the interests of the patient, and the family of one's teacher ahead of the medical student's own interests:

 

https://www.nlm.nih.gov/hmd/greek/greek_oath.html

 

Good point, Rev. I guess "customer" is a pretty poor characterization of what I'm trying to get across here, since it has some connotations that definitely don't apply (i.e., the customer is always right). What I mean is that the goal of the teaching should be to educate the student and that the student's outcome should be considered more important than the instructor's preferences, ego, comfort zone, or whatever else. I also believe that today's PA student is smart and motivated, and may not need the shepherding that some might think...and may have some pretty good ideas about how to best learn, having done a lot of it very successfully just to get in. 

 

This has been a good debate...even if no minds were changed, there's certainly value in confronting our own beliefs from time to time. I guess my only frustration is in the fact that medical providers and educators, two groups who should be keenly interested in the science that informs their practices, can sometimes be so quick to dismiss it or ignore it altogether. But that's certainly not unique to this discussion.

 

Thanks everyone...take care.  

 

Edit: added the word "not" in the last sentence.

[mcgp]

Just posting my experience here - 

 

My program tends to "spoil" us in ways that they record all lectures to refer back to when needed.

 

Due to my current housing situation, I have to commute 45 minutes everyday. If I do not have to go to class, I will stay at home and be productive. I will listen to my missed lectures and study at my own pace. However, I DO NOT skip clinical lectures, physical diagnosis labs and clinical application classes. The faculty discussed attendance issues in the past and they understand that everyone learns at a different pace and have various learning styles. I would say that about roughly 30% of my class regularly skip class.

 

At this point of my education (PA-S1), my goal is to learn the information in the best way possible in order to get a better hands on experience when I head off to clinical rotations in the fall. By staying at home and being more productive, I feel as though that it has helped me more than mindlessly paying attention in some lectures. 

[Acebecker]

Pete - Nope, being humble enough to admit that you took things out of context is not what I was talking about.  Good on ya' for that one. 

 

"Feel free to dive in past the intro if you need more convincing." - this is what I was referring to.  My apologies for not being more specific previously.  The reason I say this sounds disrespectful is because this is precisely the tone I use when I talk to insurance companies who are denying needed treatments for my patients.  :)  

[PA2B2017]

Have been following this thread avidly.

 

I am a PA-S1; I can’t speak to what I will have the opportunity to learn from preceptors and clinical rotation experiences; I hope it’s better than even the best of my didactic eduction to date. :)

In my former life, I have been at the lectern (I taught at the university level – upper (4000) and graduate (6000) levels (in a traditional masters, not professional program)).

I attend a program with a mandatory attendance policy … WITH provision for a certain number of absent hours each semester for personal reasons … on written request (plus a phone call if the absence was not scheduled in advance) … as long as it’s not missing a guest lecturer, physical diagnosis lab / exercise, exam, simulation, or other session deemed mandatory by the faculty.

 

Good points have been made even when they are opposing views.

 

Random thoughts, from my own perspective, to many of the points made:

 

When attendance is (or could be) a waste of my time:

Yes, while I can ‘learn from everyone I meet’, what I’ve learned from one particular faculty member has a lot more to do with what NEVER to do if I am EVER in front of a classroom again … from them I’ve learned NOTHING about the subject matter they were supposed to teach or in some way impart. I STRONGLY suspect that the mandatory attendance policy that was instituted here was in some large part related to the lack of attendance by prior cohorts for this particular faculty member’s courses (this is based on comments from prior students as well as comments from the faculty person in question about their retaliation when students miss their class!). The slides, and lectures, are out of date (INACCURATE) and don’t even correctly reflect the information in the text for the class – IF I bothered to listen in class, I’d be SCREWED for my clinical rotations and the PANCE. Not only is the material out of date, the lecturer reads the slides and then restates it incorrrectly, or ties the information together incorrectly, or contradicts previously presented info.

I would never find myself interviewing with the above lecturer because I would NEVER work WITH, FOR, or HIRE this person. I don’t even have a dog, but I wouldn’t take a flea-bitten stray to them for care based on the incompetence of their educational ability - if they can't explain it to me here, how can they get it right and explain it to a patient!?

FYI, I do attend all sessions unless I have an actual personal appt or family crisis (I think I have missed 2 hours of class time since January 1, and that was due to a sick person at home). However, I do not pay attention if the lecturer is not doing more than reading from the slides or otherwise engaging me in actively learning at least something. I do use the time to do school related work, usually for the subject in question. Fortunately I can tune other stuff out and work on notes or material.

Feedback on lecturers is futile when there’s no one listening – the lecturer referenced above has been this bad for YEARS. (when meeting former students, more often than not, THEY will ask if so-and-so is STILL here – they are ... I hope someday I learn why it continues … could speculate but it would be completely random – incriminating pictures? accusations of discrimination? pity?)

 

When attendance is mixed (good/not good) use of my time:

Fortunately some of the faculty here are great educators and/or use multiple modalities to impart knowledge. e.g., recording lectures that can be played, replayed, at preferred rate of speed, and uses class time for case studies, discussion, the "stories" pull things together and make the information useful.

SOME guest lecturers, who are practicing clinicians, have taught me a lot of what I can expect to see in rotations and in practice, but I have to make a note and file it away, OUT of my mind for now, because it’s not what I’m going to see on my exam(s) on that subject.

Some guest lecturers read from the slides with little to no additional value imparted. The information presented is good, and hearing it along with seeing it is more valuable [for me] as far as retaining it. How good/bad the use of my time is depends on whether or not they take 2 hours to present content they could have covered in 1 hour! Then it’s hit or miss how much attention I’m paying – I may be researching more information on the topic and tuning them out part of the time.

Technology IS changing the way human brains are developing! It’s too early to draw conclusion about everything that means for learning in children today and future generations. It’s going to be fascinating to see the results … In the meantime, since the better lecturers in my program make reference to resources like UpToDate, I wish they’d at least give us a cursory education on resources we can use in clinical practice and not just 'death by PowerPoint’.

 

Why mandatory attendance CAN have value in a PA program (and it's not necessarily the Medical Knowledge competency):

Professionalism (and Interpersonal & Communication Skills)

This is a professional program for a professional degree. Treat it with respect. We are being trained for our future profession. Conduct yourself NOW the way you will when you are that professional PA. You wouldn’t just not show up for your scheduled work hours, would you? You wouldn’t trade shifts with someone without informing your supervisor (as appropriate), would you?

Promptness / Tardiness is a measure of professionalism as well. Would you show up late for your shift as the hospitalist at the ICU (or whatever), or just leave early on a whim?

You are learning your history-taking and physical examination skills through repeated practice, aren’t you? Consider treating ALL aspects of your didactic education as “practice” for your future.

More and more PAs are young, recent college graduates. This is not a pejorative comment, but a lot of individuals in these programs may have never worked in a professional capacity, and/or some likely haven’t held a full-time job; consider your didactic training a full-time job!

[fishbum]

Why mandatory attendance CAN have value in a PA program (and it's not necessarily the Medical Knowledge competency):

Professionalism (and Interpersonal & Communication Skills)

This is a professional program for a professional degree. Treat it with respect. We are being trained for our future profession. Conduct yourself NOW the way you will when you are that professional PA. You wouldn’t just not show up for your scheduled work hours, would you? You wouldn’t trade shifts with someone without informing your supervisor (as appropriate), would you?

Promptness / Tardiness is a measure of professionalism as well. Would you show up late for your shift as the hospitalist at the ICU (or whatever), or just leave early on a whim?

You are learning your history-taking and physical examination skills through repeated practice, aren’t you? Consider treating ALL aspects of your didactic education as “practice” for your future.

More and more PAs are young, recent college graduates. This is not a pejorative comment, but a lot of individuals in these programs may have never worked in a professional capacity, and/or some likely haven’t held a full-time job; consider your didactic training a full-time job!

 

If I recall correctly, no one has advocated skipping out on classes in a program that requires attendance. Pete's program didn't require it. The one I'm going to does require attendance and I'll be there for every class. I don't think anyone has a problem fulfilling the professional's responsibility to show up when required. The question (at least in the beginning) was whether its useful for programs to require students to attend. 

[PA2B2017]

If I recall correctly, no one has advocated skipping out on classes in a program that requires attendance. Pete's program didn't require it. The one I'm going to does require attendance and I'll be there for every class. I don't think anyone has a problem fulfilling the professional's responsibility to show up when required. The question (at least in the beginning) was whether its useful for programs to require students to attend.

 

Yes.

[LazyLion]

I think there's quite a bit of grey area here... it really just depends. A few of our instructors are absolutely fantastic and I feel like I absorb and learn so much from their lectures in person. However.... we have a few who are just "okay" as teachers - for these classes, I feel like my time would be better spent by just learning it at home - and these aren't classes where we have "class interaction". It's just inefficient. I could use that wasted time to read & watch a few YT vids and learn the same material faster, then use my saved time to focus on my hardest classes. 

[fishbum]

Yes.

 

So that I, an adult in my thirties, having been successful in a couple of careers, having run my own business, having raised a family, having friends, hobbies, a home, and retirement savings, having held leadership positions in civic organizations, and having completed a not-easy undergraduate degree and pre-med coursework can get some practice with things like punctuality and being accountable to a supervisor...the things I'll need to know when I get out into the "real world" that I'm so unfamiliar with now? Give me a break. I've got a whole lot to learn in PA school...and there's a lot I can learn from Rev, Ace, RC2, and many more experienced folks. But how to be an adult is nothing I need graduate school to teach me.

 

To be fair, you did mention the younger crowd of PA students needing this kind of help. I guess the argument is more applicable there, but I'm still struggling with this idea. 23 year-old kid graduates college, works hard to get into PA school, works hard in PA school, graduates, passes PANCE, then goes to work where he doesn't show up on time, disregards his supervisor, leaves the unit whenever he feels like it, etc. If only his PA school had given him an opportunity to practice professionalism by making him show up to every lecture....even the ones he professionally ignores by sitting there working on something else the whole time. I'm not buying it. But maybe I'm giving the younger students a little too much credit. 

[rev ronin]

So that I, an adult in my thirties, having been successful in a couple of careers, having run my own business, having raised a family, having friends, hobbies, a home, and retirement savings, having held leadership positions in civic organizations, and having completed a not-easy undergraduate degree and pre-med coursework can get some practice with things like punctuality and being accountable to a supervisor...the things I'll need to know when I get out into the "real world" that I'm so unfamiliar with now? Give me a break. I've got a whole lot to learn in PA school...and there's a lot I can learn from Rev, Ace, RC2, and many more experienced folks. But how to be an adult is nothing I need graduate school to teach me.

 

To be fair, you did mention the younger crowd of PA students needing this kind of help. I guess the argument is more applicable there, but I'm still struggling with this idea. 23 year-old kid graduates college, works hard to get into PA school, works hard in PA school, graduates, passes PANCE, then goes to work where he doesn't show up on time, disregards his supervisor, leaves the unit whenever he feels like it, etc. If only his PA school had given him an opportunity to practice professionalism by making him show up to every lecture....even the ones he professionally ignores by sitting there working on something else the whole time. I'm not buying it. But maybe I'm giving the younger students a little too much credit. 

One of the reasons PA school has to teach professionalism is that colleges cannot be relied upon to do so anymore.  It's another reason I prefer PAs who have been working out in the real world before coming to PA school.  They have a better understanding of what's important in life, and how important the "unimportant" things can be.

[ohsnapPA]

One of the reasons PA school has to teach professionalism is that colleges cannot be relied upon to do so anymore.  It's another reason I prefer PAs who have been working out in the real world before coming to PA school.  They have a better understanding of what's important in life, and how important the "unimportant" things can be.

 

Are you implying Pa school teaches "professionalism" through mandatory attendance?

 

I think it's also a really generalized assumption to say that young people coming out of college are not professional or as professional as an older candidate. Possibly more experience fine tunes interpersonal skills...but I strongly believe that age does not dictate maturity / professionalism. 

[Acebecker]

Age certainly does not dictate maturity or professionalism.  However, a greater portion of experienced individuals are professional/mature vs. fresh-out-of-college graduates.  I have no data to back that up but it is my experience and the experience of...  I would bet...  Pretty much everybody who knows a lot of college graduates and a bunch of 30-somethings who have been in the professional work force for 5+ years. 

 

I want to add that in the "fresh-out-of-college" crowd I'm not talking about graduates of professional programs (nursing, MA, business, etc).  I'm talking about general college graduates.  Shoot, I graduated from a state university in kinesiology/athletic training and most of the people I graduated with were no more professional than an 18 year old college freshman who valued parties over studying. 

 

I'll also add that as I have sat on the admissions committee for our local PA school I have also seen that the younger a person is, the more likely they are to be less professional than those who are experienced. 

 

EDIT:

Doug - I think you might be giving them too much credit.  I've had good experiences with new-grad experienced PAs working in our clinic, I've had not-so-good experiences with new grad young PAs working in our clinic (leaving early, refusing to see certain things/take care of certain people, etc.).  It's interesting. 

[fishbum]

 

EDIT:

Doug - I think you might be giving them too much credit.  I've had good experiences with new-grad experienced PAs working in our clinic, I've had not-so-good experiences with new grad young PAs working in our clinic (leaving early, refusing to see certain things/take care of certain people, etc.).  It's interesting. 

 

I'll have to defer to your experience on this one...I haven't had near the exposure to "next gen" PAs that you have. Most of what informs my opinion has been interactions with young applicants and students, many of whom have impressed me more than I ever thought such a young, inexperienced person would. 

[PA2B2017]

The mature, responsible student (regardless of their age in years) isn't the one that is going to learn anything about professionalism from mandatory attendance. The ones who aren't ... or who think that 'work-life balance' means they set their own hours, pick and choose their patients, or otherwise self-define how they are going to practice medicine ... are the ones that DO need more structure of some sort ... especially before they go on to clinicals and to a rotation with a 'RealityCheck2' as their preceptor!

 

That's what I see in the students in my cohort and in the class ahead of and behind mine ... AND you could start this thread over with the subject of dress codes and have similarly dynamic responses ...

[Reality Check 2]

We are kind of tilting at windmills.

 

If a program requires attendance - go - or pick another program.

 

Debating its validity isn't going to change anything.

 

PA2B2017 - trying to be flattered by your preceptor comment. I don't ride a broom and am not as bad as some think. I have high expectations of everyone. I try to make it fun too sometimes......

[fishbum]

We are kind of tilting at windmills.

 

If a program requires attendance - go - or pick another program.

 

Debating its validity isn't going to change anything.

 

 

 

Well said.

[PA2B2017]

 

PA2B2017 - trying to be flattered by your preceptor comment. I don't ride a broom and am not as bad as some think. I have high expectations of everyone. I try to make it fun too sometimes......

It was intended as a complement - I think I would enjoy your lectures and learn a lot with you as a preceptor! I think you have a low tolerance for a PA student on rotation with you that was in any way less than professional, and you are right to do so.

[rev ronin]

Are you implying Pa school teaches "professionalism" through mandatory attendance?

 

I think it's also a really generalized assumption to say that young people coming out of college are not professional or as professional as an older candidate. Possibly more experience fine tunes interpersonal skills...but I strongly believe that age does not dictate maturity / professionalism. 

It's an attempt to educate in professionalism, yes.

 

Saying young people are less professional is a generalized observation, not assumption.  It's observable fact that a fewer percentage of 20's year olds know than 30's year olds than 40's year olds know how to conduct themselves professionally. Even if they had all been raised in the same era, the older someone is, the more time they have had to play "catch up".  It's as true for conduct, effort, and punctuality as it is for grades--I'm a far more competent person in all those spheres with a couple extra decades of life experience and professional business experience.

[ndpa09]

We are kind of tilting at windmills.

 

If a program requires attendance - go - or pick another program.

 

Debating its validity isn't going to change anything.

 

PA2B2017 - trying to be flattered by your preceptor comment. I don't ride a broom and am not as bad as some think. I have high expectations of everyone. I try to make it fun too sometimes......

 

I don't think anyone in this thread has advocated skipping mandatory classes. Where is that comment even coming from?

 

I'm pretty sure the purpose of this thread was to essentially discuss the necessity of mandatory attendance - which I think is fair. After all this is a message board....

 

If someone learns better by independently going through a recorded lecture with the ability to immediately rewind to a section they didn't understand why not allow that? Or, you can have that person sit through 4 hours of lecture and get absolutely nothing out of it. Wouldn't you want your students the learn the material in the most efficient and effective way possible? I feel like that should be the main goal of any educator....

 

The great thing about not having a mandatory class is that people who do learn best by going to class.... can still go to class! But since they learn best that way, everyone should have to do it?

 

Personally, I can re-listen to a 50 minute lecture in about 20 minutes, then make a second pass over the material in the time it would have taken me to sit through the entire 50 minute lecture. That's what works best for me and it's frustrating I can't just do that from the get go. It saves me time and I stay focused that way. 

 

If the only way a program can teach professionalism is by requiring attendance then that program is doing their students a disservice. 

 

Quick example of how silly mandatory attendance can be- in my program we takes classes right along side our medical student counterparts.  We had our first respiratory exam on a Friday but that Thursday morning we were scheduled for 3 hours of lecture material, which would be on the second respiratory exam...2 weeks later. When I got to class there were about 10 medical students there, and guess where the rest were? In the library studying for our test the next day. Then of course we had more mandatory classes we had to attend until 5 PM. Guess who had the higher average when we took that first respiratory exam? 

[ohsnapPA]

We are kind of tilting at windmills.

 

If a program requires attendance - go - or pick another program.

 

Debating its validity isn't going to change anything.

 

PA2B2017 - trying to be flattered by your preceptor comment. I don't ride a broom and am not as bad as some think. I have high expectations of everyone. I try to make it fun too sometimes......

 

My original intent was to discuss if mandatory attendance is really necessary for PA school. I don't advocate skipping every single lecture. I'm just bringing up the subject whether a student can use their discretion more on going to lectures, since PA school is a graduate level program, and we're all adults (soon to be colleagues) here...

 

I think it's also a bit ridiculous to equate 100% attendance to professionalism....We had to deal with this mandatory attendance thing from preK to high school, and I don't think it taught us to be more professional at all...

 

Missing some didactic classes in PA school for most students is to maximize time efficiency and learning ability, because there is so little time to learn a great deal of information in one year... If anything, I do agree though that the 100% attendance policy for clinical year is more of an indication of professionalism / respect, since that correlates to what is expected in the real world / on the job 

[dmdpac]

I think it's also a bit ridiculous to equate 100% attendance to professionalism....We had to deal with this mandatory attendance thing from preK to high school, and I don't think it taught us to be more professional at all...

 

... If anything, I do agree though that the 100% attendance policy for clinical year is more of an indication of professionalism / respect, since that correlates to what is expected in the real world / on the job 

 

There is a substantial disconnect between these two thoughts.