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Journal Guidelines for
Hands-On and Direct Patient Care Experience

(Direct experience guidelines for pre-PA, OT, and PT students and alumni)




Your Direct Experience Journal Is Important To Your Application

This is your journal. No one else will read it unless you want them to. Write whatever thoughts, ideas, feelings, and impressions you would like. (Read the important information on this page about client / patient privacy.)

  1. Pulling examples from your direct experience journal and offering them to those writing your letters of recommendation can provide them with insight into your goals, and why you have chosen those goals.
  2. When writing your personal essay and responses to application questions, you will need extremely detailed examples from your direct experience. The same holds true for admission interviews. This is another purpose of your journal: don't expect yourself to recall your experiences with enough detail and clarity months or years afterwards.
  3. Drawing on your direct experience journal during the admission process will help you build credibility with programs as someone who is committed to lifelong learning and a career in healthcare, and someone who will be comfortable working in a healthcare setting. Personal essays and admission interviews are largely about self-assessment, and conveying your self-insight to admission committees. Your journal is a primary self-assessment tool, and will greatly help you with this aspect of the application.
  4. Your journal will help you articulate your reasons for wanting to work in healthcare, and your chosen field in particular. As you write, you will also see how you are developing some of the foundational practical skills, professionalism, personal qualities, experience, and competencies that are so important to succeeding in and after professional school.
  5. If you are currently not positive you want to pursue the field you have in mind, the process of keeping a direct experience journal, in addition to your clinical observation journal, can help you think things through and make the decision that is best for you.



Hands-On and Direct Care Are NOT Shadowing

Hands-on and direct patient care are not the same thing as shadowing! Shadowing is watching, hands-on / direct care is doing.

  • Pre-OT / pre-PT students and alumni do not need literal, direct patient care experience, per se, but should at least garner service that involves being of direct service to people. For examples of opportunities, review Volunteer and Job Opportunities for Pre-OT and Pre-PT Students, also linked from the HPPLC OT and PT pages.
  • Pre-PA students and alumni must garner literal, direct patient care experience. Different programs have different requirements, and how they define "direct patient care" varies. For guidance and opportunities, fully utilize the Direct Patient Care Guidelines for Pre-PA Students.




It is a privilege to witness the struggles and progress of other people, so you'll want to fully respect their experiences in your descriptions of your interactions as you provided them care or service. To this end, as you write your personal essay, gather letters of recommendation, or undergo interviews, you must protect the privacy of those you are writing about.

  • Follow any and all privacy rules explained to you in the given setting.
  • Don't take notes during hands-on experience, as this could be off-putting to the patient / client.
  • In your journal and throughout the application and interview processes, don't use the last names of the patients, clients, or others you serve.
  • In the application you will probably need to name the locations or facilities where your experiences took place. But when you are writing or discussing the specifics of your experiences there (e.g., in essays or interviews) you might avoid using the name of the facility in combination with even the first name of a patient or client. This information combined with further details could in theory render the person identifiable.



Journal Guidelines

Remember: this is your journal. No one else will read it unless you want them to. Write whatever thoughts, ideas, feelings, and impressions you would like. (Review the client / patient privacy guidelines above.)


Immediately or as soon as possible after a given day's hands-on or direct care experience, invest 20 minutes writing about it in your journal.

  • Important: record in very specific detail the most meaningful, eye-opening, and instructive interactions you have with the people you care for or otherwise serve. This high level of detail, combined with your own insights and impressions, is part of what puts the "personal" in "personal essay." Details bring your essay to life as you explain why you were summoned to this profession, describe ways in which you formed connections with people, demonstrate your ability to assess your experiences, and provide examples of how you have worked to develop related transferable skills such as building rapport and trust.
    • Try to recall and include even the smallest details from important conversations or other interactions you have with the people you serve. If possible, even write down the most pertinent and important dialogue word for word - what they said, what you said.
    • If non-verbal cues such as posture and facial expressions provided you with insight into what the person was feeling or experiencing, write these down as well.
    • Reflect on your experiences. Above all, remember this is your journal. Write it for yourself and no one else. You might ask yourself:
      • How did the interaction impact me personally? How did it make me feel? What thoughts came to me?
      • How did the patient respond, and how did the moment we shared seem to affect him or her?
      • What did I learn about others and myself?
      • What practical skills, elements of professionalism, personal qualities, and competencies came into play during my interactions?
      • Did I learn something new about my chosen profession, or about healthcare in general? Or did the experience underscore something important that I already knew?
  • In your journal, assess and name the specific skills and attributes you tried to improve upon in your work that day - skills and attributes you believe will be important to successful practice in the profession. Describe in detail your developing practical skills, professionalism, personal qualities, and competencies.
    • For a good example of what is meant by "competencies," review the IU PA program's version. This example can be instructive no matter what health field you are pursuing, but most programs will have comparable information on their own sites (often in the form of a program philosophy, mission statement, or description of the rationale behind its coursework).
  • If anything troubled or confused you about your day's experience, write that down too. At your next opportunity, discuss with your patient care, volunteering, work, or other supervisor if appropriate. You are also very welcome to discuss with a HPPLC advisor.
  • Did you learn something about the healthcare system or healthcare practice that you did not previously know? Describe in detail.
  • Did you gain some insight into yourself, either as a person or as a budding healthcare professional? Describe in detail.
  • Did the experience help confirm that this profession is a good fit for you? Explain.
  • If it had the opposite effect, and you are questioning your choice of profession, pay attention: this is useful information! Come talk with a HPPLC advisor. We can help you think things through and, if necessary, help you come up with possible alternatives.

Vagueness and over-generalization are the enemies of a strong application. Keeping a detailed journal is one way to avoid these pitfalls. This small investment of time and effort pays off when you write your personal essay or undergo admission interviews, and are able to be very specific, providing admission committees with compelling narratives that speak to your personal and professional development, and your reasons for wanting to work in direct care within your particular field.


Log Your Hours

For tips and guidelines on how to log both your hands-on experience hours, as well as clinical observation hours, click HERE.






This information was prepared for Indiana University Bloomington students by the Health Professions and Prelaw Center. Please note that specific requirements and policies can change at any time without notice. Students are responsible for obtaining the most current information directly from application and testing services, and the schools and programs in which they have an interest. Refer to each program's web pages, bulletins, and other publications for the most current information. Students are responsible for understanding degree course requirements, as well as other requirements, policies, and procedures related to the degree(s) they are pursuing; for enrolling in appropriate courses; for understanding IU policies/procedures; and for following through properly with regard to all of the preceding.