Acupuncture and Chinese Medicine Clinical Student Handbook

Clinic Observation

Through observation of practitioner/patient interactions, students begin their preparation for clinic internship. Time spent in observing every component of clinic – from operations, documentation, intake, diagnosis, treatment, and prescriptions is a valuable experience and should not be taken lightly. It is a time that helps to frame introspection as much as opportunity and inspires academic and personal growth.

Observation Hours Required

As part of the requirements of the Accreditation Commission for Acupuncture and Chinese Medicine (ACACM), all students must complete a total of 150 hours of clinical observation.

Trimester Course ID Credits Hours Setting Cumulative Hours
T 1 ACL 3031 1.5 45 Classroom 45
T 2 ACL 3032 1.5 45 Classroom 90
T 3 ACL 3033 1 30 On your own 120
T 4 ACL 3034 1 30 On your own 150

Approximately 90 hours of clinic observation will be offered as part of the scheduled classroom curriculum in trimesters 1 and 2.

Thereafter, it is the responsibility of students to schedule the remaining 60 hours of clinical observation in NWHSU onsite or approved offsite clinics during trimesters 3 and 4.

BEFORE you can Intern in trimester 5:

  • You must complete 150 hours of observation, including
    • a minimum of 8 hours of observation in UHS
    • a minimum of 8 hours of observation in NHC-B Student interns

Students are required to complete 150 hours of observation, as well as coursework in HIPAA, OSHA, CPR/ BLS prior to beginning internship in T5. Documentation of completion must be given to the Registrar’s office prior to registering for T5 internships. All observation hours must be completed prior to entering the clinic as an intern in T-5.

Guidelines for Observers

An observer may be assigned by the supervisor to follow one intern through the duration of the shift. In all clinical observation situations, the student is expected to be a silent observer unless invited to participate with intake, pulse or tongue observation, or into discussions involving the intern/practitioner or supervisor, or unless other guidelines are given by the supervisor at the outset of the shift. An observer will therefore refrain from discussion with the patient in the treatment room, and will refrain from discussion with the intern/practitioner in the presence of the patient unless invited. An observer may take notes, observe the tongue and take pulse during the treatment, but should not ask any questions of either the intern/practitioner or the patient while in the treatment room.

Interaction with the Patient

Observe ordinary rules of social courtesy. Be friendly and responsive to each patient, but refer professional questions to the intern/practitioner or supervisor. If the intern/practitioner asks you to provide support to an anxious patient, do not assume the lead role by giving advice or technical explanations.

Excluding Observers from Treatment

At the discretion of the supervisor, a student observer may be excluded from some patient encounters. Sometimes the nature of the visit is such that the presence of a third party might interfere with the therapeutic relationship that has been established between the patient and the practitioner. Respect the patient's right to privacy.

To protect professional boundaries observers in onsite or offsite clinic venues may not observe the treatment of family members, or patients in the same class / cohort as themselves.

Assistance

Unless there are special circumstances, it is appropriate to offer assistance to the intern or practitioner, making sure to request in advance, the practitioner’s guidelines for assistance and/or instructions for performing unfamiliar procedures.

Assignments and Tasks for Observer

Opportunities for learning exist in many areas of the clinic. Supervisors will decide the most appropriate learning opportunity for the observer and will assign tasks accordingly. A supervisor may designate which intern can be followed by an observer. In all cases however, observers must follow their intern or LAc from intake through patient discharge, to allow for a full range of clinical experience.

In addition to observation, tasks may include, but are not limited to:

  • Assisting in the dispensary
  • Replenishing treatment room inventory
  • Researching clinical cases
  • Setting-up and/or breaking-down of treatment rooms
  • Assisting with treatment procedures (by invitation only)

Observer’s Professional Dress Code and Professional Demeanor:

Professional Appearance / Clinical Dress Code:

Student observers represent the University and their appearance and conduct need to reflect professional standards of a health care environment. In any NWHSU teaching clinic including onsite and offsite related clinical opportunities an observer is expected to maintain professional appearance and comply with the stated Professional Expectations and Guidelines stated above for Interns, while in campus or off campus clinic settings.

Structure of Clinic Observation:

There are three primary routes for students to gain clinic observation hours:

  1. Classroom Clinical Observation (T1–T2)
    1. T1: Students will register for ACL3031 Clinic Observation Course (45 Hours)
    2. T2: Students will register for ACL3032 Clinic Observation Course (45 Hours).
  2. Clinic Theater (T1–T4)
  3. Clinic Observation (T3-T4)
    1. T3: Students will register for three shifts under course ACL3033 Clinic Observation Course (30 Hours). ALL hours need to be completed in NWHSU on-site, or external community clinic settings. Students must complete 100% of hours.
    2. T4: Students will register for three shifts under course ACL3034 Clinic Observation Course (30 Hours). ALL hours need to be completed in NWHSU on-site, or external community clinic settings. Students must complete 100% of hours.

Classroom Clinic Observation:

One hundred percent (100%) of T1 & T2 clinic observation is structured as classroom clinic observation with ACM instructors treating patients, as other students observe in a classroom setting. These classroom clinic observation sessions are integrated into the curriculum as regularly scheduled classes, and enrollment is completed at the Registrar’s office.

  • With the exception of holidays and required university events, attending each classroom observation for the entire trimester should provide 45 hours of clinical observation. Each class is scheduled for 15 weeks as a three-hour class. Only ONE 4-hour shift with an excused absence per T1 rotation may be made up in one of the Northwestern on-site teaching clinics. Only ONE 4-hour class with an excused absence per T-2 rotation may be made up in one of the Northwestern on-site teaching clinics OR in an external community clinic.

Attendance, Forms and Passing the classroom observation class:

Attendance is mandatory, and the instructor will record attendance. The attendance records are reviewed at the end of each trimester by the ACM Clinic Coordinator to ensure compliance with ACM attendance policy.

ACM attendance policy for Observation courses requires that a student attend 100% of the total number of scheduled hours to receive full credit for that course. If a student does not attend the mandatory 100% of scheduled hours, the student will not pass the class and will receive an “Incomplete.” Credit for the class will not be allowed until the “Incomplete” is satisfied. “Incompletes” must be satisfied within the term.

Clinic Observation:

Beginning in T3 and through T4 clinic observation takes place in either NWHSU on-site clinics, or offsite ACM community clinics. See “Scheduling Observation” for instructions on registering for specific sites. If a student wants to intern at Aliveness, Courage Kenny, Cerenity Senior Care Center, Salvation Army, or Pillsbury Hours, they must complete a minimum of 4 hours of observation at that site. Up to three clinic observations can be completed at each site. A list of current off-site community clinics can be found in the Appendix B.

Where can you do your Observation Hours?

  1. On-site Northwestern University Clinics
    • Northwestern University Health Services (UHS) / DeRusha Clinic (DRC) -- these are the same clinic, sometimes called different names.
    • Northwestern Bloomington Natural Health Clinic (NHC-B)
      1. Student intern shifts
      2. Shadowing / observing professional ACM providers
    • Human Performance Center (HPC)
  2. Off-site community clinics (not hospitals) listed in Appendix B.
  3. Clinical Theatres- Be sure to sign in and out

Two shifts (8 hours total) of observation in UHS / DRC and two shifts (8 hours total) in NHC-B must be completed before beginning T5.

IMPORTANT: If you are observing at an off-site clinic or NHCB make sure you send an e-mail or call the supervisor/Practitioner that you are going to be observing at least 24 hours in advance. This gives them time to notify you if the patient has already declined to be observed by a student, or if there is any other information you should know about the case.

Clinic Theater:

Clinical Theater is offered occasionally throughout each trimester for the opportunity to observe a variety of ACM faculty in the diagnosis and treatment of patients. Offered in the evenings, it presents another route to obtain observation credits outside of the scheduled classroom or clinic Observation. This schedule is coordinated by the front desk staff at NHC-B, and posted at the beginning of the trimester so students can determine whether clinical theater is a viable option for completing observation hours for the term. Sign up with NHC-B staff to attend clinical theater.

IMPORTANT: If you are cancelling attendance at a Clinical Theater shift, contact the NHC-B front desk staff. If the Theater shift has low attendance, it may be cancelled and both the patient and the supervisor will need to be notified.

Remember: Registering for T5 clinic internship requires completion of 150 observation hours.

Scheduling Observation T1-T4 on the “R” Drive

The following steps are required to schedule clinical observation opportunities:

  1. You will need to use computers in the NWHSU library or in the computer lab. You cannot access the ACM Observation Sign Up on your personal computer.
  2. Open “My Computer” and double click on the “R Drive” which should say “Apps on Library.”
  3. On the “R Drive”, double click on the “ACM Observation Signup folder.”
  4. Double click on the file to open it in Excel.
  5. Use the tabs to navigate to the clinical site where you want to observe.
  6. Enter your name in the open line that indicates the time slot you choose to observe.
  7. Close and Save the document.

Please be considerate and cautious in remembering the following:

Cautions:

File Traffic

Excel will not allow multiple users to modify at the same time. Therefore, if one person has the spreadsheet open and is reading it or modifying it, a second person opening the spreadsheet will get a message that another user has it open for editing and the second person will be asked if they want to open a read-only version. Do NOT use the read-only version as you will not be able to save your entries.

Clerical Caution

Make sure to type in your name and carefully save the document so as not to erase another student’s entry. If you do not remember to save the document, your entry is lost. If entries are “accidentally” erased, we will only have minimal back up capacity. Type and save carefully.

If you need to cancel or change your observation, please make sure to remove yourself from the ACM Observation Calendar so another student has the same opportunity.