Keeping a Clinical Journal
We strongly recommend that you keep a dedicated journal throughout your clinical rotations. Journaling is more than just documenting your daily activities — it is a powerful tool for reflection, self-awareness, and professional growth. Writing down your patient encounters, challenges, successes, and personal reactions helps you process what you’re learning, track your progress, and identify areas for improvement. Journals can also serve as a safe space to explore your emotional responses to difficult cases and to celebrate small wins that might otherwise go unnoticed. Over time, this record becomes a valuable resource that not only prepares you for evaluations and certification boards but also strengthens your development as a thoughtful, reflective, and compassionate PMHNP.

Here is a list of activities to help you prepare for clinical!

1. Reflection

Write a short journal entry: “What are my top 3 goals for my clinical experience?”

2. Consider Expectations

• Your preceptor asks you to see a patient independently and present back. You realize you’re not confident about the interview structure. What should you do?

  • Note: Students should prioritize patient safety, communicate their readiness level, and request to observe before practicing independently.

• What do you want to get out of your first week of clinical? Your first month or semester?

  • Your goals should go from observing to being more and more involved fairly quickly. Your previous experience, knowledge experience, and preceptor will help determine what privileges you may have.

3. Practice Interviews with Peers or Family

• Role-play psychiatric interviews using DSM-5 criteria.

• Practice taking a brief history and doing a mock Mental Status Exam.

• Use standardized forms/checklists (you can provide templates).

4. Psychopharm Flashcards & Cheat Sheets

• Make flashcards for first-line medications: indications, side effects, labs.

• Daily drill on “must-know” black box warnings (SSRIs + suicidality, Clozapine + agranulocytosis, Lithium + toxicity, etc.).

• This course should help with this!

5. Documentation Drills

• Practice writing SOAP notes and MSEs from case vignettes.

• Time yourself (goal: <15 min per SOAP note).

• Compare to model examples.

6. Case-Based Self-Study

• Choose one diagnosis per week (e.g., Major Depressive Disorder).

• Write out: diagnostic criteria, differentials, first-line meds, and therapy approaches.

7. Risk Assessment Role-Plays

• Practice suicide risk assessment (C-SSRS or SAD PERSONS) with a peer.

• Role-play safety planning conversations.

8. Clinical Prep Binder or Digital Folder

• Organize:

  • Quick-reference handouts (MSE, SOAP template, labs, meds).

  • Journal prompts.

  • Clinical day checklist.

• This binder/digital folder becomes a go-to toolkit for rotations.

9. Communication Skills Practice

• Record yourself explaining diagnoses in plain language.

• Practice empathetic responses to difficult scenarios (e.g., “I don’t want meds,” “I don’t believe in therapy”).

10. Review Common Labs & Monitoring

• Memorize which psych meds require which labs (e.g., lithium = BMP/TSH; valproate = LFTs/platelets).

11. Self-Care Plan

• Clinical hours can be stressful. Create a personal wellness plan:

  • Stress-relief strategies (journaling, exercise, mindfulness).

  • Boundaries around school/clinical/personal life.

  • Identify supports (friends, mentors, study groups).