Curriculum

Family Medicine Clerkship

Director: Katharine Conway, M.D., MPH,  Clerkship Director and Assistant Professor, Family Medicine

Clerkship Description: Family Medicine is the medical specialty that is concerned with the total health care of the individual and the family. It is the specialty in breadth that integrates the biological, clinical, and behavioral sciences. The scope of Family Medicine is not limited by age, gender, organ system, or disease entity. The unique aspects of Family Medicine include: Biopsychosocial Model (Patient-Centered); Comprehensive Care (Whole Person Care); Continuity of Care (Continuous Healing Relationships); Context of Care (Evidence-Based); and, Coordination/Complexity of Care (Integration).

Students will:

  1. Participate in the practice of clinical medicine within the Family Medicine model emphasizing patient-centered, continuing, coordinated, contextual and comprehensive care to all patients.
  2. Demonstrate knowledge of ambulatory Family Medicine topics utilizing clinical decision-making skills.
  3. Develop clinical skills through hands-on patient care experience emphasizing communication with patients, families, staff and colleagues.

Boonshoft SOM Educational Objectives/Competencies

Code

What competencies / milestones will this unit address?  

Foundational Knowledge – Medical Knowledge: Master fundamental biomedical concepts, terms, processes, and system interactions

1.1A

Apply knowledge of the expected changes in organ function as well as normal physiologic changes across the lifespan into the care of patients with core medical problems

1.1B

Describe how the altered structure and function of the body and its major organ systems are manifest through major diseases and conditions

1.1C

Describe the scientific basis for the diagnostic tests used in medicine

Foundational Knowledge – Medical Knowledge: Describe the determinants of health

1.2A

Using available data, compare and describe the health status of the U.S. to the health status of other countries for key health indicators

1.2B

Identify determinants of health, risk factors and protective factors that influence the diagnosis of a specific patient with a health condition

Foundational Knowledge – Medical Knowledge: Utilize evidence in making clinical decisions

1.3A 

Develop a clinical question, identify relevant research findings, critically evaluate the validity and reliability of that research, and apply the findings to the care of patients

1.3B

Incorporate pertinent biomedical information and research findings into clinical decision making and identify barriers to implementation

1.3C

Apply basic statistical approaches to clinical situations

Application – Patient Care (Clinical Skills): Conduct patient interviews and physical examinations

2.1A

Independently conduct an organized, comprehensive history and physical and recognize common abnormal findings

2.1B

Independently conduct a focused, prioritized history and physical

Application – Patient Care (Clinical Skills): Diagnose patient health problems

2.2A

Prioritize a differential diagnosis by applying knowledge of the basic sciences and pathophysiology

2.2B

Propose appropriate ancillary diagnostics and summarize diagnostic results

Application – Patient Care (Clinical Skills): Propose evidence-based health maintenance and therapeutic treatments

2.3A

Develop a cost-effective plan of care under supervision

2.3B

Identify and select relevant, evidence-based health promotion and education tools, as well as materials for common acute and chronic conditions encountered in the clinical setting

2.3C

Demonstrate the ability, under supervision, to perform basic medical procedures 

Integration – System-Based Practice: Connect knowledge of patient populations and health delivery processes in making diagnoses and therapeutic recommendations

3.1A

Describe the reporting process for disease surveillance

3.1B

Describe the epidemiologic investigation process

3.1C

Identify available community resources to improve the health of individuals and populations

Integration – System-Based Practice: Advocate for the humane, just, safe and prudent care of persons

3.2A

Demonstrate behavior that conveys caring, honesty, genuine interest and tolerance when interacting with a diverse population of patients and families

3.2B

Recognize the impact of contextual factors on patient care

3.2C

Recognize the importance of effective communication in the prevention of medical errors

Integration – System-Based Practice: Adapt to the complex economic and social structure of health care delivery

3.3A

Recognize how the health care delivery system in which one works affects patient care

3.3B

Recognize the improvements in systems can enhance quality of care and identify strategies to improve systems of care

Human Dimension – Personal and Interpersonal Professional Development Goals: Reflect upon one’s personal strengths and weaknesses to make changes in one’s behavior

4.1A

Seek and integrate feedback from patients, peers and faculty to better understand one’s development as a physician and as a member of the health care team

Human Dimension – Personal and Interpersonal Professional Development Goals: Find one’s own meaning in medicine

4.2A

Develop the skill of self-reflection and apply the insights to one’s professional 

Human Dimension – Personal and Interpersonal Professional Development Goals: Take care of oneself

4.3B

Engage in formal and informal self-awareness practices

4.3C

Demonstrate flexibility within the dynamic medical environment

Human Dimension – Personal and Interpersonal Professional Development Goals: Deliver effective patient presentations and document accurately in the medical record

4.4A

Present patient encounters accurately and succinctly

4.4B

Document patient encounters accurately in a timely, focused, and prioritized way

4.4C

Document supervised procedures accurately and succinctly in the medical record

Human Dimension – Personal and Interpersonal Professional Development Goals:Communicate and work effectively with others

4.5A

Seek feedback on one’s communication skills

4.5B

Effectively assimilate into the appropriate role and contribute to the health care team

4.5C

Communicate with patients and families in a timely, clear, empathetic, and humble manner

Human Dimension – Personal and Interpersonal Professional Development Goals: Demonstrate leadership skills in a variety of settings

4.6A

Meaningfully contribute to the clinical team

Caring/Valuing – Professionalism Goals: Value and behave in a manner consistent with the highest ethical standards of the profession

5.3A

Demonstrate the highest standards of individual and team-based ethical behavior that is patient centered, culturally sensitive, and socially just

5.3B

Apply knowledge of medical ethics to clinical situations

Learning How to Learn – Practice-Based Learning: Develop a personal plan to become a better medical professional

6.1A

Broaden action plan to integrate the clinical practice of medicine

Learning How to Learn – Practice-Based Learning: Appropriately utilize evidence-based resources to address uncertainty in medicine and gaps in knowledge/skills

6.3A

Identify appropriate resources to address uncertainty in medicine and gaps in knowledge/skills

Clerkship-Level Objectives

Code

What are the clerkship-level objectives for this course?  

Boonshoft SOM Objectives

LO1

Frame a patient encounter in an organized fashion, reinforcing etiology, pathophysiology, clinical manifestations, diagnostic strategies and therapeutic interventions.

1.1abc, 2.1a

LO2

Explain disease specific treatment strategies and associated prognosis and complications.

1.1abc, 2.1b

LO3

Evaluate patients’ presenting clinical problems, including: (history, physical, DDx, Tx, completing focused visit, progress note, participating in office-based procedures).

1.1ab, 2.1a

LO4

Diagnose and manage patients with acute and chronic conditions including: (back pain, childhood illness, obesity, diabetes, gastrointestinal, gynecologic condition, headache, heart disease, hyperlipidemia, hypertension, mental health, musculoskeletal injury, osteoarthritis, psychiatric illness, respitory disease, substance abuse, skin lesions, rash, uti, upper respiratory infection).

1.1ab, 2.1ab, 2.2ab, 2.3c

LO5

Apply the fundamentals of family centered and community based care involving full spectrum care of pediatric, adult, and geriatric patients in settings of acute complaints, chronic disease management, and preventative care.

1.1ab

LO6

Demonstrate systematic approach to adult patients of all ages and stages of lifeutilizing sound skills in gathering components of the history and physical exam.

2.1ab, 4.4a

LO7

Observe and Perform under supervision basic office-based procedural skills.

2.2ab

LO8

Demonstrate appropriate interpretation of labs and testing.

2.2b

LO9

Begin to formulate diagnostic reasoning, and justify therapeutic decision-making.

1.3abc, 2.2ab, 2.3ab

LO10

Demonstrate clear and concise oral presentations and written documentation reflecting a systematic approach to pediatric, adult, and geriatric patients.

2.1ab, 4.4abc

LO11

Identify the social determinants of health for a specific patient, and develop a plan to coordinate care to include community resources to try to improve the health of the individual.

1.2ab, 31.abc, 3.2abc

LO12

Consider patient, physician, and system barriers to successfully negotiate treatment plans and patient adherence; and identify strategies that may be used to overcome these barriers.

1.2b, 3.1bc, 3.2abc

LO13

Identify the role of each team member to the care of the patient, and call on interdisciplinary resources to provide optimal and comprehensive care.

3.3ab, 4.5bc, 4.6a

LO14

Establish professional relationships and effectively communicate with patients, their families, instructors, colleagues and staff.

4.1a, 4.3c, 4.5abc, 4.6a

LO15

Recognize limits of personal knowledge.

4.2a

LO16

Assess individual strengths, weaknesses and health (physical and emotional) and be willing to seek and accept supervision and feedback. 

4.2a, 4.3ab

LO17

Work effectively with the broad, interdisciplinary team in patient care and appropriately incorporate their unique care skills.

4.1a, 4.3c, 4.5b, 4.6a

LO18

Demonstrate the ability to act with honesty/integrity while maintaining ethical duties to patients and others.

5.3ab

LO19

Demonstrate the ability to act in a manner that is dependable, dedicated and punctual.

5.3a

LO20

Demonstrate the ability to act with patience, altruism and equanimity.

5.1a, 4.1a, 4.6c

LO21

Recognize when additional information is needed to care for the patient and demonstrate ongoing commitment to self-directed learning.

6.3a

LO22

Demonstrate effective skills in navigating the medical literature to answer clinical care questions.

6.3a

LO23

Demonstrate the ability to acquire and soundly manage knowledge, identify knowledge deficiencies and create a plan for knowledge gains

4.2a, 6.3a

LO24

Demonstrate the ability to seek out and listen to feedback on performance, accept it positively, and respond to it constructively by improving performance.

4.5a, 4.3bc, 4.1a

LO25

Demonstrate scholarship in the form of contributing to a positive learning environment, collaborating with colleagues, health care teams, and patients through the use of a Quality Improvement project.

6.1a, 6.3a

To review all Boonshoft SOM Educational Milestones please visit the Educational Milestones page. 

Required Clinical Experiences

Clerkship/Clinical discipline

Patient type/Clinical condition

Clinical setting

Level of student responsibility

Family Medicine 

Neurocognitive Disorders

Ambulatory

Moderate

Family Medicine 

Cancer

Ambulatory

Moderate

Family Medicine 

Chronic respiratory condition

Ambulatory

Full

Family Medicine 

Psychiatric Condition

Ambulatory

Moderate

Family Medicine 

Diabetes

Ambulatory

Full

Family Medicine 

Cardiovascular disease

Ambulatory

Full

Family Medicine 

Hypertension

Ambulatory

Full

Family Medicine 

Infection

Ambulatory

Moderate

Family Medicine 

Obesity

Ambulatory

Moderate

Family Medicine 

Substance abuse

Ambulatory

Moderate

Family Medicine 

Acute & Chronic Musculoskeletal Condition

Ambulatory

Full

Family Medicine 

Genitourinary complaint

Ambulatory

Moderate

Family Medicine 

Skin lesion/Rash

Ambulatory

Full

Family Medicine 

GI/Hepatobiliary condition

Ambulatory

Moderate

Family Medicine 

Headache

Ambulatory

Full

Family Medicine 

Preventative Care

Ambulatory

Moderate

Family Medicine 

Acute Pediatric illness

Ambulatory

Full

Family Medicine 

Behavior Change

Ambulatory

Moderate

Family Medicine 

Continuity care

Ambulatory

Moderate

Family Medicine 

Family stress

Ambulatory

Moderate

Observation: Student is observing encounter

Moderate Participation: Student completes the History and Physical (either complete or focused) and participates in the differential diagnosis. (*Student directly interacts with the patient)

Full Participation: Student completes History and Physical (either complete or focused), participates in the differential diagnosis, and then completes a therapeutic treatment plan, which can include documentation.

For Procedures:

            Observation

            Assisted in the procedure

            Fully performed the procedure

 

Last edited on 07/12/2018.