1. General Description
   
   1. Course Title: Osteopathic Community Clinic
      Course Length: One Month
      Course Format: Small Community Clinical Experience/Weekly Didactic Seminars
      Student Level: 3^rd Year Osteopathic Medical Students
      Course Coordinator: William Pettit, D.O.
   2. The Community Clinic Clerkship is a one-month rotation designed to prepare the students for their rural and urban clerkships. The clerkship is comprised of clinical office experience in a small community and weekly didactic seminars. 
   3. The clinical experience occurs in a family physician's office within 40 miles of the Greater Tulsa area. As an integral portion of this program, these clinical experiences may also include such out-of-office experiences such as:
      1. hospital staff and committee meetings
      2. house calls
      3. hospital emergency room calls
      4. community and public health functions
      5. fraternal and social functions
      6. Mobile Telemedicine Clinic assignment
   4. The didactics include hands-on training and didactic seminars that relate directly to medical practice in rural and underserved areas. In addition, all students learn to utilize telemedicine equipment and participates in developing and researching a case presentation (with written Protocol of Care) that includes Evidence-Based Medicine (EBM).
2. Student Responsibilities
   1. Pre-Arrival
      1. Students are required to contact their assigned preceptor at least 1 week prior to the beginning of the rotation to coordinate the daily schedule and other pertinent aspects of the rotation.
      2. Appropriate Dress: All students must wear College approved identification and a clean, pressed white clinical jacket. Men are expected to wear a shirt, tie, and dress trousers. Women are expected to wear either slacks or a dress.
      3. Students are required to bring identification passwords for library resources (i.e. MD Consult), and current references for Family Medicine, Internal Medicine and Obstetrics/Gynecology with them.
   2. During the Clerkship
      1. First Week of Rotation:
         1. First weekday of the month meet with your preceptor for an office orientation.
         2. Be prepared to discuss your clinical strengths and weakness relative to the rotation objectives.
         3. Attended the rotation orientation and didactics the first Friday of the month at the Center for Rural Health.
      2. During the Rotation:
         1. At all times dress appropriately, utilize College approved identification, and identify yourself as a non-graduate medical student not as a medical graduate or a licensed physician.
         2. Attend all lectures/didactic seminars and complete all outlined rotation objectives and other assignments.
         3. Seminars: The didactic seminars are every Friday of the month beginning at 8:30 a.m.
         4. Case Presentation: Presented the end of the month, usually the last Friday.
         5. Mobile Telemedicine Clinic Experience: One day a month the student will be scheduled to accompany the OSU Mobile Telemedicine Clinic and complete a Mobile Telemedicine Clinic Experience essay.
         6. Clinical Experience: Monday-Thursday all day are scheduled for clinical experience in a physician's office or health care facility. These hours may also include such out-of-office experiences as hospital staff and committee meetings, house calls, hospital emergency room calls, community and public health functions, and fraternal and social functions, as an integral portion of this program.
         7. Provide appropriate patient care under the supervision of the preceptor. Demonstrate appropriate indications and techniques in using OMM.
      3. Midpoint
         1. Meet with your preceptor for a verbal evaluation of your clinical performance and areas to improve. You are responsible for scheduling this meeting.
      4. Final Week
         1. Meet with your preceptor at the end of the rotation to review your clinical performance. You are responsible for scheduling this meeting.
         2. Email the Case Presentation PowerPoint and the Mobile Telemedicine Clinic Experience essay to ruralhealth.clerkship@okstate.edu the day before the presentation.
         3. Complete the online site evaluation and submit it to the Clinical Training Coordinator, OSU-COM Center for Rural Health. Community Clinic checklist is provided for your convenience but is not required.
         4. All paperwork is due within 7 days (postmarked by the 5th day) of the end of the rotation.
         5. If forms are not received within 7 days of the end of the rotation, the student’s grade may decrease one letter grade (see Student Evaluation Procedures).
         6. A grade of “I” (incomplete) may be issued until all the paperwork has been received
3. Clerkship Calendar
   1. The student's actual working days and hours shall fall within the clerkship calendar. The specific scheduling of days and hours shall be made within the clinical facility by the preceptor, with approval by the OSU-COM Course Coordinator, and shall generally conform to the following.
      1. Rotation Period: This clerkship is one month in length.
      2. Date of Arrival: It is the student's responsibility to report to his or her official rotation site on the date specified. If there is a reasonable explanation for a delay in reporting (e.g., auto accident, illness, or similar reason), the student is to contact the preceptor and the OSU-COM clinical training coordinator immediately.
      3. Working Day: A typical working day is considered to be 12 hours in length (minimum 4 days/week); however, there may be instances when the working period may exceed 12 hours especially when accompanying the physician on "out of office" professional duties.
      4. Holidays: Students receive one day off for the Thanksgiving holiday and two consecutive days off for the Christmas holiday. Students are to request approval for specific days off for Thanksgiving and Christmas holidays from their preceptor.
      5. Travel Time: Travel time may be taken for rotations requiring travel as specified in the student clerkship handbook.
      6. Attendance: One hundred percent (100%) attendance is required on all clinical rotations. Please contact the supervising preceptor and Sherry Eastman at 918-584-4375 (leave voice mail if no answer).
         1. If a student needs time off from the rotation, make up time may be required. A student is required to complete an Exception to the Rotation Application with the preceptor and course coordinator signatures if he/she is absent for any reason (or multiple reasons) for more than 3 days or will be missing a seminar or lecture.
      7. Rotation Changes: Students may trade rotation assignments, under approved special circumstances only, by completing a Change of Rotation form at least 60 days prior to the rotation. All forms must be forwarded to:
         Sherry Eastman
         OSU Center for Health Sciences
         Center for Rural Health
         1111 West 17th Street
         Tulsa, OK 74107
         918-584-4375
         918-582-8938 fax
         sherry.eastman.okstate.edu
   2. NOTICE: All rotations begin on the first weekday of the month. Should a holiday fall on the first weekday of the month, students are encouraged to contact the supervising physician at the new facility to verify date of arrival.
4. Student Performance Evaluation Procedures
   1. The student's overall performance (grade) is weighed using the following criteria:
      1. 15% = Lecture Attendance
      2. 60% = Student Performance Evaluation of Clerkship in Physician’s office
      3. 10% = Mobile Telemedicine Clinic Experience Essay
      4. 15% = Case Presentation
   2. Each course requirement must be passed with a 70 percent or higher to pass this course. Letter grades of A, B, C, or U will be assigned according to procedures outlined in the student handbook.
   3. Lecture Attendance: Attendance will be taken during all lectures. For each missed lecture (unexcused), 5% will be deducted from the final grade up to 15%. Arriving late or leaving early from a lecture must be preapproved and points may be deducted.
   4. Student Performance Evaluation: At the completion of the Community Clinic clerkship, the preceptor will evaluate the student's performance on clinical activities and other activities of the rotation on the student performance evaluation form. The final (overall) clerkship grade will be determined and issued by the Course Coordinator following the completion of the rotation.
   5. Mobile Telemedicine Clinic Experience: One day a month the student will be scheduled to accompany the OSU Mobile Telemedicine Clinic where they will be taught telemedicine principles by OSU-CHS Telemedicine staff and have the opportunity to practices a variety of skills. An essay describing the experience will be graded based on the learning objectives.
   6. Case Presentation: An evaluation of the case presentation is conducted by the attending physician evaluator based on the learning objectives listed below which include factors such as, the appropriateness of the student’s assessment and medical plan recommendations, summary of EBM references used, appropriate community resource recommendations, presentation and design techniques, and video conferencing skills used.
   7. Final Grade: The final (overall) grade will be determined and issued by the Course Coordinator following the completion of the rotation. The grade is based on the student performance evaluation, case presentation, attendance, telemedicine essay, other required activities and timely receipt (within 7 days) of all the paperwork. If paperwork is not received within 7 days of the end of the rotation, the student’s grade may be decreased one letter grade.
   8. Students are responsible for ensuring that all paperwork for Community Clinic is completed and received by the OSU-COM Center for Rural Health by the 7th day following the end of the rotation (postmarked by the 5th day).
   9. In addition to an academic grade, all students are held accountable for the non-cognitive academic standards as the standard of professionalism for their conduct. A grade of S (satisfactory) or N (needs improvement) is determined by the Course Coordinator based upon evaluation of the student by the preceptor and other course participation factors.
   10. A grade of "I" (Incomplete) may be assigned if: A student is unable to complete the course requirement of approved 100% attendance.The Course Coordinator recommends an extension of the student's Clerkship and sets forth reasoning for the recommended extension. The student fails to submit the required paperwork.
   11. Grievance Authority: Grievance of a rotation, performance evaluation, or course grade should start with the Course Coordinator. The final grading authority will be with the Course Coordinator.
5. Program Evaluation
   1. Students are required to complete a site evaluation form at the end of each rotation. This tool is used to evaluate the course curriculum, faculty (preceptors), AHEC support, if appropriate, and student experiences at that site.
   2. Students are required to complete and return the form with other paperwork to the Center for Rural Health within 7 days of completing the rotation (postmarked by the 5th day).
   3. The Course Coordinator reviews all site evaluations and will address any problems or issues, which are identified in the evaluations.
   4. Data will be collated for the preceptor & the seminar presenter's feedback. Preceptors and seminar presenters will receive aggregate reports only.
   5. The individual site evaluations and responses will remain confidential.
6. Rotation Objectives
   1. The Community Clinic clerkship prepares third year students for rural and community clerkship experiences.
   2. Goals
      1. Observe and demonstrate knowledge in telemedicine technology use and operation.
      2. Acquire an understanding of differentiating factors in rural and urban medical settings.
      3. Demonstrate appropriate clinical and interpersonal skills.

* Lecture Topics may vary from month to month.