Family Medicine Clerkship

Director: Sara Tisherman, M.D., 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:

Participate in the practice of clinical medicine within the Family Medicine model emphasizing patient-centered, continuing, coordinated, contextual and comprehensive care to all patients.
Demonstrate knowledge of ambulatory Family Medicine topics utilizing clinical decision-making skills.
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 will this unit address?
*Foundational Knowledge – Medical Knowledge*
1.1	Master fundamental biomedical concepts, terms, processes, and system interactions
*Foundational Knowledge – Medical Knowledge*
1.2	Describe the determinants of health
*Foundational Knowledge – Medical Knowledge*
1.3	Utilize evidence in making clinical decisions
*Application – Patient Care (Clinical Skills)*
2.1	Conduct patient interviews and physical examinations
*Application – Patient Care (Clinical Skills)*
2.2	Diagnose patient health problems
*Application – Patient Care (Clinical Skills)*
2.3	Propose evidence-based health maintenance and therapeutic treatments
*Integration – System-Based Practice*
3.1	Connect knowledge of patient populations and health delivery processes in making diagnoses and therapeutic recommendations
*Integration – System-Based Practice*
3.2	Advocate for the humane, just, safe and prudent care of persons
*Integration – System-Based Practice*
3.3	Adapt to the complex economic and social structure of health care delivery
*Human Dimension – Personal and Interpersonal Professional Development Goals*
4.1	Reflect upon one’s personal strengths and weaknesses to make changes in one’s behavior
*Human Dimension – Personal and Interpersonal Professional Development Goals*
4.2	Find one’s own meaning in medicine
*Human Dimension – Personal and Interpersonal Professional Development Goals*
4.3	Take care of oneself
*Human Dimension – Personal and Interpersonal Professional Development Goals*
4.4	Deliver effective patient presentations and document accurately in the medical record
*Human Dimension – Personal and Interpersonal Professional Development Goals*
4.5	Communicate and work effectively with others
*Human Dimension – Personal and Interpersonal Professional Development Goals*
4.6	Demonstrate leadership skills in a variety of settings
*Caring/Valuing – Professionalism Goals*
5.3	Value and behave in a manner consistent with the highest ethical standards of the profession
*Learning How to Learn – Practice-Based Learning*
6.1	Develop a personal plan to become a better medical professional
*Learning How to Learn – Practice-Based Learning*
6.3	Appropriately utilize evidence-based 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.	1.1, 2.1
LO2	Explain disease specific treatment strategies and associated prognosis and complications.	1.1, 2.1
LO3	Evaluate patients’ presenting clinical problems, including: (history, physical, DDx, Tx, completing focused visit, progress note, participating in office-based procedures).	1.1, 2.1
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).	1.1, 2.1, 2.2, 2.3
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.	1.1
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.	2.1, 4.4
LO7	Observe and Perform under supervision basic office-based procedural skills.	2.2
LO8	Demonstrate appropriate interpretation of labs and testing.	2.2
LO9	Begin to formulate diagnostic reasoning, and justify therapeutic decision-making.	1.3, 2.2, 2.3
LO10	Demonstrate clear and concise oral presentations and written documentation reflecting a systematic approach to pediatric, adult, and geriatric patients.	2.1, 4.4
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.	1.2, 3.1, 3.2
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.	1.2, 3.1, 3.2
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.	3.3, 4.5, 4.6
LO14	Establish professional relationships and effectively communicate with patients, their families, instructors, colleagues and staff.	4.1, 4.3, 4.5, 4.6
LO15	Recognize limits of personal knowledge.	4.2
LO16	Assess individual strengths, weaknesses and health (physical and emotional) and be willing to seek and accept supervision and feedback.	4.2, 4.3
LO17	Work effectively with the broad, interdisciplinary team in patient care and appropriately incorporate their unique care skills.	4.1, 4.3, 4.5, 4.6
LO18	Demonstrate the ability to act with honesty/integrity while maintaining ethical duties to patients and others.	5.3
LO19	Demonstrate the ability to act in a manner that is dependable, dedicated and punctual.	5.3
LO20	Demonstrate the ability to act with patience, altruism and equanimity.	5.1, 4.1, 4.6
LO21	Recognize when additional information is needed to care for the patient and demonstrate ongoing commitment to self-directed learning.	6.3
LO22	Demonstrate effective skills in navigating the medical literature to answer clinical care questions.	6.3
LO23	Demonstrate the ability to acquire and soundly manage knowledge, identify knowledge deficiencies and create a plan for knowledge gains	4.2, 6.3
LO24	Demonstrate the ability to seek out and listen to feedback on performance, accept it positively, and respond to it constructively by improving performance.	4.5, 4.3, 4.1
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.	6.1, 6.3

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