Clinical Observation ("Shadowing")

 

Note: This page is intended mainly for pre-occupational therapy, pre-physical therapy, and pre-physician assistant students.

 

General Information

Many health professions programs require that those considering the given profession undertake clinical observation (or job shadowing - here, we use the terms interchangeably) prior to applying. Without exception, those programs which do not have a specific shadowing requirement nonetheless strongly recommend it. Refer to the Clinical Observation / Shadowing section of the HPPLC pre-OT, PT, or PA page for additional information, and check websites of individual programs to determine their specific requirements.

 

Specific Benefits of Clinical Observation; Shadowing Requirements

Clinical observation is clearly the best way for you to determine whether the daily responsibilities and the setting typical of the profession are a good fit for you, and whether you feel you have the aptitude and level of dedication necessary to develop the skills and attributes required of those who thrive and find fulfillment within the profession.

In addition, most health professions programs require some job shadowing, and these experiences can help you build your credibility with program admission committees by showing them that you have thoroughly researched the profession. Along those lines, extensive shadowing can greatly strengthen personal statements, letters of recommendation, and admission interviews.

Furthermore, most OT, PT, and PA programs require or recommend that at least one of your letters of recommendation come from a professional within the field with whom you have undertaken substantial clinical observation. While you should emphasize quality over quantity (being sure to meet minimum shadowing requirement for each program you are considering), more shadowing, especially in a variety of settings, can garner more experience from which to draw throughout the admission process.

Therefore, we strongly encourage you to arrange clinical observation fairly often, and in a variety of settings. "Variety of settings" means, for example, in-patient, out-patient, ICU, ER, family practice, clinics, and so on - whatever pertains to your preprofessional area. That is not to say you must shadow in all settings, but simply that undertaking observation in a variety of settings is beneficial if you can reasonably arrange it. (Note that some programs will have specific requirements; for instance, a certain number of in- and out-patient observation hours. Check their websites.)

Note that while shadowing earlier in your academic career can be beneficial, your freshman year of college should be almost exclusively focused on academics (learning how to study for college / IUB courses, acclimating yourself to college life and to the university in general, learning how to manage your study time, meeting with instructors and your advisor, and so on). Academics should never take a back seat to other activities, preprofessional or social. After freshman year, and once you are more certain you wish to pursue the profession you are considering, you can begin to work more shadowing into your schedule - maybe some hours during subsequent fall and spring terms, and additional hours over the summer or other breaks.

 

How to Arrange Clinical Observation

Network

Take advantage of any connections you might have, such as family members, family friends, neighbors, or acquaintances who are members of the profession or who know someone who is in the profession. If you are pre-PA, you might also ask your family physician if he or she employs a PA with whom you could undertake clinical observation, or can refer you to any such resources. If you are pre-OT or PT, you too can ask your family physician for referrals. Physicians typically know people who work in other healthcare professions.

Each time you shadow a healthcare professional, ask if he or she can refer you to anyone else for shadowing. Networking in this manner can sometimes open the door to shadowing, service, or internship opportunities.

Use the internet

The internet is also an excellent tool for locating opportunities. For example, an internet search for "bloomington indiana physician assistants" yields useful results. One such result, www.healthline.com/doctors/physician-assistants has limited, but useful, state/city listings of PAs. If you are pre-PT or OT you can, of course, perform the same kind of search and come up with similarly useful results. If you want to locate professionals in other locations, then simply include the other location among your search terms.

How to request clinical observation

We suggest you mail, email, or hand deliver a professionally written résumé to each potential shadowing resource you have identified. Include a very brief, well-written cover letter (one or two paragraphs) in which you explain a little about yourself and your goals, including why you are interested in the profession and in undertaking clinical observation. Doing so can help you establish credibility. A couple of days later, make a follow-up phone call to see if they have received your résumé and have had time to review it for consideration. In light of HIPAA, students are finding it more challenging to find providers who are willing to allow shadowing. Polite professional persistence is your best strategy. If you have the option of utilizing summers and other breaks for shadowing in other locations, you should pursue those opportunities as well.

Additional suggestions for pre-PA students

If you are a pre-physician assistant student, you might also consider shadowing some physicians to gain a better understanding of the differences between the two professions, how their responsibilities and duties overlap, and the different ways in which physicians supervise their PAs. PA program admission committees will sometimes ask interviewees to compare the two professions, and because, as a practicing physician assistant, you will be working alongside physicians, it simply makes sense for you to gain an understanding of that profession as well. And again, each time you shadow a PA or a physician, ask if he or she can refer you to anyone else for shadowing. (You might also read HPPLC's description of the two different kinds of physicians, allopathic (MD) and osteopathic (DO).

Butler University in Indianapolis maintains a list of some PAs with whom you might arrange shadowing. The list mainly includes PAs in central Indiana, but a few from other states and other parts of Indiana as well. The list is partial, and you should not exclusively rely on it for locating PAs! For more PA shadowing ideas, refer to the section above on using the internet.

Additional suggestions for pre-OT and PT students

Consider shadowing both OTs and PTs. In some settings, OTs and PTs function very differently from each other, but in other settings they function in similar ways. Having an understandings of these differences and similarities, and how they vary across settings, can help you better understand whichever one of the two you choose to pursue. This knowledge has the added benefit of potentially helping you during admissions interviews. There is also a good chance you will have professional interaction with both OTs and PTs at some point in your career.

 

Etiquette (IMPORTANT)

It is critically important that you conduct yourself in a thoroughly professional manner during all such interactions. Review the HPPLC page on professional etiquette, and the section on your areas's HPPLC site related to professional conduct. Adopt any of the suggestions you have not already incorporated into your own conduct.

 

Log Your Hours, and Keep an Informal Journal of Your Observations

As you undertake clinical observation, remember that within the health professions the focus is always supposed to be on service to patients; on the caregiver-patient relationship, and effective rapport-building communication therein; and on patient advocacy. It's always about the patient, period.

Within this context, be an engaged, active participant in your shadowing experiences by asking questions and taking notes. Do not pressure yourself to recall from memory months or years from now the details of your current clinical observations. Doing so simply creates more stress for you. You will almost certainly incorporate details and experiences from your shadowing into your personal statement. You will also draw upon the same experiences during admission interviews, and even during clinical rotations during the professional program itself. If you invest a bit of time and effort now, you will thank yourself later.

Log your clinical observation hours

• In a notebook, spreadsheet, or by some other means, keep a log of who you shadowed and for how long, their contact information, and ask for their signature or initials (this latter item is in case a given program requires more formal reporting of hours - see below).
• Applications through central application services like OTCAS, PTCAS, and CASPA have a section where you formally record your observation hours. In this case, you can simply plug in the information you kept in your log.
• Not every program uses a central application service, and even some who do may still require you to report hours directly to the program itself using their own forms (for instance, as part of a secondary or supplemental application in addition to the central application service process). In these instances, if you keep a careful log of your clinical observation experiences as described above, you will be able to use it to fill out subsequent forms.
  • Note: you might then need the given professional with whom you shadowed to sign the program's form (usually printed from their website). If you have gotten the professional's signature in your log next to the listings of the hours you spent with them, it will save you time and effort if you need to ask them later to sign a formal observation or volunteering form for a given program.

Keep a shadowing journal (take notes regarding your observation experiences)

• Ask the person you are shadowing if it's okay for you to have a pad and pen with you to jot down observations (while of course following patient privacy protocols).
• During your clinical observation experiences, ask lots of questions about the profession, the work routine, and so on. The notes you keep can serve as a launch pad or brainstorming tool for your personal statement.
• After each observation, spend fifteen or twenty minutes reflecting on the experience and writing down your thoughts. Assess and name the variety of skills and attributes the person you shadowed exhibited - ones that you believe are important to successful practice in the profession. What did you learn about the profession that you did not previously know, and/or how did the experience change your impressions about some aspect of the profession? Did the experience help confirm that this is the profession you wish to pursue? (If it had the opposite effect, pay attention to that as well - it does happen sometimes, and this is useful information! Come talk with a HPPLC advisor. We can help you weigh options and alternatives.)

• In your journal, occasionally record in specific detail interactions you yourself had with a given OT, PT, or PA which impacted your decision to pursue the profession or taught you something you did not previously know about the given profession.
• Similarly, we suggest that on occasion you record details relating a specific interaction the OT, PT, or PA had with a patient which impacted your decision to pursue the profession, or which expanded your understanding of the profession. (Always keep the patient anonymous, of course - you can give them fictional names in your journal if that helps - and adhere to patient privacy protocols.) The pay off for this small investment of time and effort is that when you are writing your personal statement or being interviewed, you will be able to be very specific: "One time I was shadowing a OT / PT / PA at such and such a place, and here is exactly what I saw, and here is exactly how that particular experience reinforced my understanding of the profession and my decision to be an OT, PT, or PA." This level of specificity can greatly enhance a personal statement or interview. Vagueness and over-generalization are the enemies of a strong application. Keeping a journal is one way to avoid these pitfalls.

 

Final Thoughts

Feel free to schedule an appointment with a HPPLC advisor if you wish to discuss your clinical observation experiences. If you want to explore other health professions, we can discuss that too, and we also encourage you to use related resources on our Other Health Professions page.

 

Important

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.