CapYear Cast - Debra Herrmann, DHSc, MPH, PA-C

Debra Herrmann, DHSc, MPH, PA-C, joins the CapYear Cast today to share five tips for surviving the didactic year at PA school. Not only is Debra a renowned PA educator, but she also has over twenty years of PA experience, so she can easily discuss both the academic and practical side of PA training. If you're interested in picking up some solid gold tips for how to crush the didactic curriculum, tune in! The links mentioned in the recording are below.

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Transcript below:

 

John: Hi, everybody, and welcome back to the CapYear Cast. I'm your host, John Walkup, and today we have a very special guest. We are joined by Debra Herrmann. She is a PA educator extraordinaire, and has, what, 15 or so years of education, 21 plus years in the field. And today she's going to walk us through the didactic curriculum, what it is, and how to survive.

It's going to be an interesting episode, and I suggest we buckle up - Debra, take it away. What is the didactic curriculum?

Debra: All right. Well, thanks John. Thanks so much for inviting me to share my thoughts about how to survive the didactic year of PA school, you know, as a PA educator and someone who's gone through this.

You know, I definitely have some tips that I want to share by the time we sort of wrap this up. But I'd love to start off by telling you a little bit more about it. The didactic year or the classroom phase of PA education. And so, you know, depending on the program that you decide to go to, that could be a year-long part of your curriculum, or it could be a year and a half or, or whatever it might be, but it's where you're going to, you know, learn the basic sciences that really.

Form the pathophysiology of the clinical medicine that you're going to be learning. In addition to learning all the physical diagnoses, things like how to take a history, how to do a physical exam, you'll learn how to interpret lab findings, you know, diagnostics, other diagnostics studies. You'll get a chance to try out procedures.

Like how to start an IV, how to do an ultrasound, guided IV. So all the things that you're going to need and draw upon when you go into your clinical phase of training, which is when you go out, and you do what we call clinical rotations in the various areas of medicine, pediatrics, emergency medicine, women's health, whatever your program calls it.

And most programs, you know, as you know, are accredited by a body called ARC-PA, and they sort of specify all the standards around a curriculum that must be taught in both the didactic and clinical phase of training so that there is some standardization you know, among all the different PA programs out there to choose from.

John: So this sounds like a jam-packed year, to say the least.

Debra: Absolutely. And you know what, this will probably won't be new to your listeners when they hear this, but most people describe PA school as like drinking out of a fire hose and particularly in your didactic year because lots of information is being thrown at you and it's really very challenging to absorb it all and to process it all and then be able to immediately, you know, sort of apply it in the context of patient care. And you know, despite this really, challenging experience, there are 175,000 certified PAs out there.

So my motto is if they can do it, so can you, you know, and so someone who's gone through it, like there were many times that I thought, wow, you know, my motivation decreased, and I just felt like, wow, I just can't learn One more thing today. I can't cram one more thing in there. But you remember the big picture and your “why” for even pursuing this and the “why” around being able to take care of patients as a physician assistant and to work with a team of other healthcare providers to provide really high-quality patient care. And all that comes back to you.

The other thing that I will, say (universally, PAs will say about PA school) is that it sort of sets the benchmark for the rest of your life and career. I find myself saying in multiple circumstances, whatever challenge I'm facing, whether it's when I went back or was thinking about going back to get my doctorate or even just challenges I face as a parent, I normally can say to myself, wow, if I can survive PA school, I can certainly survive this.

And that's what a lot of people will say, and, and I'm not alone in that. The other thing I would say is despite this challenge and how hard PA school actually is, if you ask PAs often, they'll say, “I wouldn't change a thing. I wouldn't have done anything differently.” I actually go a little bit further, I’m sort of that crazy person that, if given the chance to do it all over again to go back to PA school, I would do it. So, I'm sort of rare. Not a lot of people would volunteer to do that. But I happen to sort of love the educational process, which probably is why I am a PA educator.

John: Yeah, I think most people, if they were asked to go back and do, say, organic chemistry, again, most people would simply say no. And I think that's the general answer for most of, the harder yet very rewarding programs such as PA school.

So that's a great overview of what that year is. Now I understand you're going to share with us some tips on how to survive it. So without further ado, what are the tips? How do you survive the first, didactic year of PA school?

Debra: I have five, and I hope that's easy for folks to remember.

And I want to give you a little detail about each one. But I'll just summarize them quickly by saying, the first tip is to really know your learning preference and then to use this knowledge to develop your study strategy in PA school. The second tip is to be aware of the forgetting curve. The third is to take a team approach. The fourth tip is to manage your time wisely, and the fifth tip is to remain resilient.

We'll just take them one by one. Okay, so to know your learning preferences. It's really important to give some thought to the ways in which you take in information, the ways in which you know that you store information, retrieve it, and then also express information.

And so most folks consider this your learning preference or learning style. And so the way to sort of figure that out for yourself is to think back to other structured educational programs that you've been in and how you've learned what you already know.

Were you one of those folks who was a read-write person where you had to write out something in order to process it and to observe it and to learn it and to retain it and then be able to retrieve it? Or were you somebody who had to talk it out, you know, say it out loud, you're more auditory. Or are you someone who has to act it out, physically move it out because maybe you're more of a kinetic learner?

What we find is that most students in PA programs have a mixture of learning preferences or styles. And so you have to draw upon that when you're deciding how you're going to study and how you're going to organize your materials to help maximize the retention and retrieval of that information.

One other tool that I would say - so let's say some by some chance, you just have no idea what your learning style is. Maybe you're just really, really smart and you made it through undergrad without having a particular approach or even knowing what your learning preferences are. There's a tool out there called the VARK, and at the program where I teach at, we had this. Students take the VARK at orientation and the way you get to that, it's www.vark-learn.com. It's great. It'll give you a sense of what your learning preferences are, but it also will give you some guidance on what does this mean for the way that you should organize your materials and how to study. I think that's a really, really first important tip for surviving the didactic year.

John: That's great. I mean, that was one of my questions, actually. There are many types of learning, and speaking for myself, I was very much a kinetic learner. In that classroom setting, sometimes it's very difficult to act it out and, and learn by doing, especially when it’s coming from a lecture, and you're, you're learning stuff that's completely new and foreign.

Debra: Yeah, absolutely. I actually have a kinetic component to my learning preference, and so what I found myself like, especially when I was taking an anatomy exam, I found myself sort of moving my joints and sort of trying to visualize inside what was going on. So there are many ways to exercise that kinetic learning preference in PA school. You just have to be careful and make sure you have the appropriate amount of space.

John: Okay, now on to number two, please.

Debra: The second tip is to beware of the forgetting curve. There is some literature out there, and this is another thing that we share in our orientation for our PA students who are coming in, about this concept that you've learned a lot of material, let's say you learned 100% of that material, if you don't touch, try to recall, or review that material by the second day you've lost 50% of that.

What the forgetting curve tells us is that you’ve got to spend about 10 minutes per class hour to recall and review material from that day in order for it to stick in there. So let's say that you're in class. Most PA program students are in class sometimes eight hours a day, which means that you're going to need to spend about 80 minutes a day just recalling and reviewing what you learned that day. If you do this over time, when you sit down to prepare for the event, where you're going to have to apply this knowledge, whether it's an exam or whether it's a patient encounter, you're not starting from scratch. You've got a nice foundation to draw upon and that you've been building over time. And so we really do emphasize that with our students, that that's a really necessary component of the learning and retention process.

John: Interesting. I suppose a lot of that comes down to effective notetaking while in class.

Debra: Absolutely. It definitely does.

John: Okay, tip number three. Let's have it.

Debra: Take a team approach. In your prior educational studies, you've seen when they report exam scores, and you see the exam scores as sort of like a bell curve. You know, the average amount of students have hit the average, but then you've got some people who have exceeded the average, and you've got some people that are not close to the average, right? They're on the negative end of the spectrum of the bell curve. What studies have shown is in PA school in particular, where the competition for grades and where you rank in the class really ends because you're going to benefit from working together to raise that average and to really allow everyone to achieve on that more positive end of the bell curve. The other piece to that is in thinking about, “well, if I'm taking a team approach, who should be on my team?”

So it's got to be people who learn a little differently than you, who think a little differently than you, that probably have a very different clinical background coming into PA school. A different cultural background even. So when you think about coming together with a study group or your tribe that you're going to eventually identify with in PA school, you want it to be a very diverse group so that you can maximize the learning within your group and really achieve extraordinary results on any anything that you can measure from a learning outcome standpoint,

John: You want to match other folks' strengths to your weaknesses essentially, and sort of bridge any gaps you might have. Is that, is that as simple as asking somebody, “Hey, how do you learn? I learn like this…”

Debra: That's a great question. I think for our cohort of students because they've all taken the VARK in advance, and we talk about this, and we bring this to their attention, you know, really early on in the PA process, I think they do a better job of really reaching across and finding people who are very different from them from a learning style or cultural background or prior clinical experience. So that's something that PA programs could think about really providing for their students. We make some group groups for our student and we try to diversify those groups and students often will say, “Well, all right, they put us together for this small group session. This must mean that we're a good group because we've got a variety of different perspectives here.”

That's something that students can do on their own or they could advocate for within their PA program.

John: Great. I love it. We're seeing some synergy now between these tips. It's fantastic. All right, onto tip number four, please.

Debra: This is all about managing your time wisely. One of the things that I know that personally helped me was to think a little differently about the time that I have. I think about it this way: there's 168 hours within a week, right? And each one of these hours is a tile that can be moved around, right? So the first thing that you have to do with managing your time wisely is to automatically put in the really important stuff. So that's how many hours you need to sleep, time to make nutritious meals for yourself, or to find nutritious meals for yourself. Time for exercise and relaxation. Time to recharge your batteries with people who really are positive influences in your life, your support system, all of that. Time to interact and be social and have some balance in your life with family and friends.

Then, once you've put in those really important items, you see what you have left. You also have to look at, “Okay, well what does my class schedule look like?” You got to plug that in, and then you start to really get a sense of, “Alright, well, what time do I really have leftover?”

You'll be amazed at actually how much time is leftover, especially if you don't get going down a social media rabbit hole or a Netflix streaming event or something like that. You have to think very intentionally about the time that you do have. I'm not saying you can't build in a social media rabbit hole or a Netflix streaming time, but you've got to use your time wisely. Another way to do that is to look ahead at what's coming. PA programs are really great at giving like a calendar that shows when you're going to have exams, what days you're going to be in class for eight hours versus what days you're going to be in class for four. You just can play around with those tiles and your time and make it work for you in your particular situation.

The other thing I would say that's a good use of your time is to make sure that you prepare for the sessions ahead of time. For instance, taking a look at the posted slides or notes or skimming the readings that are assigned the day before  going into a class session is really helpful because it gives you some familiarity with the terms that are going to be used or the concepts that're going to be taught. So you're getting this sort of 30,000 foot view of the topic, this big picture. In the class it helps you get more of the details that you can hang on that sort of bigger picture and you can process the information a little bit better because you're not constantly trying to catch up or questioning, “Now what? I don't even know what that means.” You've given yourself a leg up in the processing by just becoming familiar with whatever is going to be covered in that class session by doing a little prep work.

John: This is fantastic because part of the CapYear Academy is about stress and overwhelm and how that can really wear you down. A lot of it comes down to a lot of things in the clinical setting happening at the exact same time and that just sends our brains haywire. It freaks people out and it sounds like that happens a lot in PA school too. However, if you've structured your time appropriately and you do have that downtime, you'll be kind of able to mitigate that. My question for you is how well do PA schools sort of understand the pressures that the students are under, and what kind of resources do they offer to help you cope?

Debra: Very well. I would say very well because, remember, you can't be a PA educator without being a PA or a physician or a clinician of some sort.

So everybody's been there, done that. They definitely understand it from a very personal experience with it. And that's great. I'm so glad that you asked about resources at PA programs. You know, oftentimes, you're assigned to a faculty advisor who can help think about what's working well for you, and what's not working well for you. Almost like a personal coach of some sort who can help you ask the important questions of yourself, “what is working well, what's not, what does that mean? What's going to be my action plan? What could I maybe try that might work a little bit better?” So most PA programs have some mechanisms in place around advisement for students.

In addition to that, you have each other. And you can talk to your fellow students, your peers, about what you know, what they're doing, how they're approaching things. That's always a really great resource and an eye-opening experience because, again, we're all going to approach this from different perspectives based on our prior experience and then our own learning styles and preferences.

Someone may give you an idea, tell you something that they're doing and you're like, “Wow, I would've never thought about that. I'm so glad I asked that question.” But then there are resources usually within the educational setting for which the PA program is situated. So whether that's a university, most of them have disability support services so it's not unusual.

It's been my experience as a PA educator that sometimes people find out during PA school that they have some type of learning deficit. Whether they have a lot of test taking anxiety or they have some issues processing material in certain formats. And so our support the support services at our university has been really great about meeting with students who are struggling, you know, academically or personally to achieve their goals and have helped them figure out, “Well, what does this mean” and what accommodations could help to to really equalize that student's experience and to maximize their success.

Some universities actually have learning strategies, specialists, or student support services that have resources on study skills, time management, test taking, and all of that. So there are many different resources available to PA students because everybody knows how hard it is.

There’s been a lot of development and thought into how to make sure that each and every student gets the best chance to be successful. And trust me, all PA programs want their students to be successful, so they have some type of resources built in to ensure that.

John: That’s fantastic. The moral of the story is don't be afraid to ask because, undoubtedly there are resources for help.

All right, you talked about resiliency. It’s the fifth tip for surviving the didactic year, right?

Debra: It's to remain resilient. So like I said, you're coming into this, and you're excited, and you know your “why”. Whatever that “why” is for you. And you've got to keep a hold of that “why.” You have to keep it in your mind at all times because I will tell you honestly, and I'm an optimist, but there were definitely deep, dark days in PA school that I experienced where I just didn't have the motivation and I didn't think I was going to be able to cram one more thing in my brain and that I just wasn't going to be able to do it. I wasn't going to be able to be successful. You’re going to definitely have days like that, and your motivation is going to ebb and flow.

So you have to build in things that's going to keep your motivation up. You have to take time to recharge your batteries. You have to take some time to relax. You have to surround yourself with people and opportunities that really motivate you and help you feel positive. You know, for a lot of students who come into PA school, they've spent a lot of time being leaders or providing or engaging in service and volunteering and things like that. And a lot of times, they come to PA school, and they stop doing those things, and they're like, “I'm just going to concentrate on my studies.” And that's really the wrong approach because most of the time, volunteering or putting yourself out to be a leader around something is something that really does recharge your batteries and brings meaning to your life and helps to just distract you from other things that are going on.

So I really think it's important for you to make sure that you are doing things that bring value to you. You keep doing those things, maintaining your relationships with the important people in your life and not seeing them again in the process and feeling like you have to study all the time.

And then the other thing that I think is really important about remaining resilient is really doing some reflection on the stress that you're experiencing. And oftentimes, it's not the stress that really is the problem, it's your response to the stress. It's how you're handling the stress.

It's how you're perceiving, and it's what it's causing you to do, how it's causing you to feel. And you can make a decision to change your response and how you deal with it, and how you could win. It’s your mindset around it, right? And so, you know, things that help are making sure you maintain your sleep, a healthy diet, exercise, if that's meaningful to you and helps you. I know for in our program, we give students tools around mindfulness-based stress reduction. And for many of our students, that's been a real guiding light for them and helps them remain grounded and present and not as worried and anxious about the process of going through PA school and having to drink out of that firehose.

So those are just some of my tips around how you might remain resilient while you're in a very challenging program.

John: Right. And some of those are so foundational. Eat well, sleep well, try to focus yourself, try to almost lean back on why you're in this position in the first place: to help people. These are just wonderful tips. All five, frankly, are awesome tips, and I'm so glad you had a chance to come on today and share them with our audience. I'm sure everyone finds them helpful. We will put the links in the description below.

On behalf of CapYear Cast, Debra Herrmann, this was awesome. Thank you very much for coming.

Debra: Thank you so much. I really appreciate the opportunity. And to all of you out there who are applying to PA schools or have just been admitted to PA schools or NPA schools or graduated, hats off to you. Congratulations, and what a wonderful career and adventure this is going to be for you. Enjoy it day by day and encourage other people to get involved in the PA profession.

John: All right, thank you very much, and thanks, everybody, for listening, and we'll catch you next time on the CapYear cast.