LEARNING OBJECTIVES AND COMPETENCIES
Although the Family Medicine Clerkship will be conducted at a variety of clinical sites in different settings, all students are expected to accomplish a core group of competencies. These competencies are based in three major domains: Patient Care, Health Promotion and Disease Prevention, and Professionalism.
A. MEDICAL KNOWLEDGE
- Students completing the Family Medicine Clerkship should demonstrate an understanding of how to assess and manage acute and chronic medical issues frequently encountered in the Family Medicine setting. These include:
- Sinusitis and Pharyngitis
- Viral Infections
- Otitis Media and Otitis Externa
- Heart Disease
- Obstructive Airway Disease
- Gastritis, Esophagitis, and Peptic Ulcer Disease
- Urinary Tract Infections
- Vulvovaginitis and Cervicitis
- Musculoskeletal Disorders
- Common Dermatoses
- Diabetes Mellitus
- Anxiety Disorders
- Care of Acute Lacerations
- Athletic Injuries
- Domestic Violence
- Common Problems of the Newborn and Infant
- Normal Pregnancy, Labor, and Delivery
- Common Problems of the Elderly
- Care of the Dying Patient
- Biological and Chemical Terrorism
- Evidence-Based Family Medicine
- Provide risk reduction strategies screen and counsel for:
- High Blood Cholesterol and other Lipid Abnormalities
- Breast, Cervical, Testicular, and Skin Cancer
- Diabetes Mellitus
- Alcohol Abuse
- Tobacco Use
- Motor Vehicle Injuries
- HIV Infection and other Sexually Transmitted Diseases
- Childhood and Adult Immunizations
- Post menopausal Issues
B. COMMUNICATION SKILLS
- Write a coherent history and physical, or SOAP note.
- Clearly present a patient’s history and physical exam.
- Effectively talk to patients and their families, especially in difficult situations, i.e. end of life issues.
- Motivate and instruct patients in health promotion and disease prevention.
- Demonstrate an understanding of how family, culture, and religious beliefs can influence healthcare decisions and outcomes.
- Respectfully and effectively communicate issues of patient care with non-physician healthcare workers, including clergy.
- Explain to patients and families, findings from clinical investigations, including plans for follow up, possible courses of therapy with indications, risks, and benefits, and alternatives.
- Collaborate with fellow students, healthcare professionals, patients and families. Including strategies for teaching in small groups, especially giving feedback.
- Demonstrate an effective physician-patient relationship to provide quality health care and understand the therapeutic role these relationships confer.
- Understand the major obligations of physicians to their patients and show skill and service to people who come for care for a variety of reasons.
- Demonstrate advocacy for patients over personal interests.
- Display behaviors that foster patient trust in the physician, by appropriate dress, grooming, punctuality, honesty, respect for patient confidentiality, and other norms of behavior in professional relationships with patients
- Converse appropriately and behave with personal integrity in all course and clerkship activities and in interactions with peers, faculty, residents, and non-physician staff and identify these interactions as analogs of future professional relationships thereby maintaining the same high standards expected in patient care.
- Work collaboratively as members of a healthcare team in a variety of settings.
- Demonstrate commitment to and examples of service to patients in need.
- Recognize and accept their own limitations in knowledge and clinical skills and commit to continuously improve their knowledge and ability.
D. PATIENT CARE
- Perform, record, present and interpret a complete screening physical exam.
- Effectively observe, communicate, and interact with patients, families, and other healthcare workers to obtain histories, deal with difficult situations, and insure proper record keeping.
- Integrate data from the history, physical, and laboratory to construct a problem list, develop a prioritized differential diagnosis along with therapeutic, diagnostic, and patient education plans for each problem identified.
- Make clinical decisions and solve problems using deductive reasoning based on data obtained about the patient, principles of clinical epidemiology, and evidence-based medicine.
- Construct appropriate management strategies (diagnostic, therapeutic and behavioral) for common conditions, both acute and chronic.
- Develop care plans for patients with chronic conditions not amenable to immediate cure, including: rehabilitative services, care of chronically disable persons and patient facing the end of life.
- Interpret the results of the most frequent commonly used clinical laboratory tests.
- Perform relevant routine clinical exams and procedures including:
- Breast Examination
- Testicular Examination
- Pelvic examination and PAP smear
- Skin exam
- Exhibit an understanding of how to perform database retrievals, retrieve patient-specific information, select and use information technology, and employ electronic communications for the direct care of patients.
E. PRACTICE BASED AND LIFELONG LEARNING
- Demonstrate knowledge of specific topics related to students’ patients and use the medical literature to gather relevant information for patient care.
- Use information technology to access and manage clinical information and perform on-line searches to support ongoing self-directed learning.
- Search, evaluate, and critically review scientific evidence appropriate to the care of individual patients or as an approach to a clinical problem
- Demonstrate an understanding of the variations in physician behavior for common conditions, the importance of developing evidence-based practice methodology to lessen variations, the role of practice pathways to manage common problems, and the need to individualize recommendations for the patient.
- Formulate questions regarding outcomes seen in patient care and consider simple methods of quality improvement including improved patient satisfaction, decreased complication rates, improved clinical outcomes, and improved access to healthcare for patients from underserved groups.
- Demonstrate a commitment to identifying errors in medicine, reasons for errors, and develop basic strategies to reduce medical errors.
- Demonstrate a plan for professional growth.
F. SOCIAL AND COMMUNITY CONTEXT OF HEALTHCARE
- Demonstrate an understanding that some individuals in our society are at risk for inadequate healthcare, including the poor, uninsured, underinsured, children, unborn, single parents, elderly, racial minorities, immigrants, refugees, physically disabled, mentally disabled, chemically dependent, and those with incurable diseases.
- Demonstrate an understanding of the impact of economic and health insurance issues on patient care.
- Under supervision, develop diagnostic and treatment strategies that are cost-effective, sensitive to limited resources, and do not compromise quality of care.
- Appropriately recommend use of consultants and referrals.
- Demonstrate knowledge of non-biological determinants of poor health including child abuse, domestic violence, and the economic, psychological, social, and cultural factors that contribute to their development and continuation.
- Demonstrate an understanding of economic, psychological, social, and cultural factors that impact patient health.