Observational Experience Request Form

Availability

Indicate the available time(s) when you have at least 4 consecutive hours to spend with a provider. If you plan to take the train, please check the schedule to ensure there is time after class (or another responsibility).

Example:

You are free Wednesday’s after the 11:35-12:45 class. The next available train to Winfield (close to CDH hospital) leaves College Ave at 1:30pm, arriving at Winfield around 1:37, your observation would begin around 2pm. You can plan a three-hour observation experience (2-5pm). The train back is 5:49pm so you’d want to bring a book/homework for that time.

Please list the times you are available each day beginning as early as 7:00am. Include evenings, overnights, and weekends if you want to observe during those time slots. 

Example:
Mondays: 7am-12:30pm, 4:30pm-8:30pm
Tuesdays: 5pm-7am
Wednesdays: 7am-12:30pm, 4 pm-10pm
Thursdays: 7am-10:30am, 5pm to 8pm
Fridays: 7am- 11am, 5pm-7am
Saturdays: 7am-midnight
Sundays: 1p-10p

*During the week, the train runs from College Avenue station to the Winfield station from 6:43am until 10:45pm. On the weekends, 9:30am to 10:45pm.

The Health Professions office encourages students to care for their spiritual life. One way can be through the practice of sabbath and/or church attendance. We realize students may sabbath and/or attend service(s) on different days therefore we provide information about opportunities throughout the weekend.

Observation & Provider Interest

What type of provider would you like to observe:

• Pediatrics
• Internal Medicine/Family Practice
• Cardiology
• Neurology
• Orthopedics
• ENT (Ear/Nose/Throat)
• OB/GYN
• NICU
• Dermatology
• Surgery
• Endocrinology
• Gastroenterology
• Oncology
• Pathology
• Ophthalmology
• ANP - Advanced Practice Nurse (Nurse Practitioner, Nurse Midwife, Clinical Nurse Specialist, Nurse Anesthetist)
• Physician Assistant
• Dentist
• Oral Surgeon
• Orthodontist
• Physical Therapy
• Occupational Therapy
• Speech-Language Pathology

What nursing specialty would you like to observe:

• Pediatrics
• PICU
• Rapid Response Team
• Labor & Delivery
• ICU/Critical care
• Emergency
• Medical/Surgical
• General Nursing
• Nurse Educator
• Geriatrics

 

Immunizations

For one-day observation experiences, immunization verification is only required for the following:

• Edward/Elmhurst Hospitals require documentation of current influenza vaccine and will need to be submitted along with your application
• DULY PT/OT/SLP requires a COVID vaccine and verification will need to be presented to the provider at the start of the observation 

For multi-day observation experiences, immunization verification is required at all locations. We will contact you and share specific details.

Definitions:
One-day: a one day observation experience scheduled one at a time
Multi-day: an observation experience that spans multiple days with the same provider/specialty area

Professionalism Expectations

1. Arrive 10 minutes early so you are ready to go when your observation starts and gives a “cushion” if you are running late.
   
   
2. Act professionally and in accordance with Wheaton College student conduct and policies.
   - Professional behavior includes (but is not limited to): portray a positive attitude and avoid negative language, take responsibility and be reliable (including timely and respectful communication to the healthcare professional), avoid distracting behaviors while observing (making noise, tapping, pacing, etc.), respect patient and provider privacy, and demonstrate attentiveness and interest during the observation experience.
   - Dress in business professional attire unless otherwise instructed – no jeans, leggings, sweatpants, tshirts or sweatshirts. Please remember that this is a professional organization and that typically, the dress code is business attire. You may be asked to wear scrubs instead of business casual clothing. Scrubs are available through Amazon, Goodwill or Savers in addition to the Health Professions office having ones that may be borrowed.
   - Treat all staff, patients and caregivers with respect and dignity regardless of age, gender, race, ethnicity, national origin, religion, disability, or sexual orientation.
   
   
3. Adhere to HIPAA and organization confidentiality and privacy requirements.
   
   
4. Unless you have a break or are having lunch, phones are to be put away.
   
   
5. Respect the role of “observer” by not engaging in any direct patient care.
   
   
6. Report concerns about patient safety to attending physician or leadership.
   
   
7. Protect the well being of patients and staff by not shadowing if you are feeling ill or have had a fever and/or vomiting within 24 hours of your scheduled visit. Contact the Health Professions office AND shadowing site to report absence due to illness.

In the event the healthcare professional discontinues the observation experience due to professionalism concerns, students will not be able to request another observation through the Health Professions office for at least one semester.

Confidentiality Agreement

HIPAA is a federal privacy law that all healthcare professionals are required to adhere to in order to protect patient’s medical information and maintain confidentiality. As a student shadowing at a health care facility you have a legal and ethical duty to protect patient information and will not discuss with or disseminate patient information to anyone. Failure to maintain the confidentiality of a patient as required by HIPAA is considered a violation of the law and may have serious consequences. Your signature below indicates understanding and agreement with these expectations.

Randi Littrell will reach out to you about a potential placement for observation. This process could take 1-2 weeks or it could happen sooner depending upon your availability and healthcare professional choice. Please remember to respond promptly to the email.

Once the observation is completed and the reflection and thank you note submitted, you are welcome to complete this form again for your next observation.