Rural Medical Education | Community Clinic Clerkship

Oklahoma State University
Center for Health Sciences

Rural Medical Education

Friday Lecture Schedules

November '09
October' 09
June '09
August '09
September '09

Community Clinic Clerkship
Community Clinic Orientation Checklist

Syllabus
CE 9245

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. A one-month required clerkship that gives third-year students continued preparation for clerkship training in rural and community-based rotations.
  - Monday through Thursday student's clinical experience is in a physicians' office and may include hospital meetings, house calls, emergency room calls, and attending health or social events.
  - Every Friday students attend didactics which covers a variety of topics.
  - One day a month students are assigned to accompany the Mobile Telemedicine Clinic.
  - Students prepare a Curriculum Vitae
  - Students complete a Procedure Card
  - Students prepare and present a Case Presentation using PowerPoint and distance learning technology.
  - There is a quiz over the lectures at the end of the rotation.
3. Students in the Rural Health Option program should contact the Rural Medical Eduation office for their site options.
Student Responsibilities (See Clerkship Handbook for more details)
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.
  4. Students should verify their access to the online Careers in Medicine site prior to the seminar on that topic.
  5. Students should read the Non-Physician Clinician handout prior to the seminar on that topic.
2. During the Clerkship
Clerkship Calendar
1. For guidelines on Reporting Time, Holidays, Travel Time, and Attendance: All rotations begin on the first weekday of the month. The student's actual working days and hours shall fall within the clerkship calendar. The specific scheduling of days and hours shall be made by the preceptor, with approval by the OSU-COM Course Coordinator, and shall generally conform with the student clerkship handbook.
2. Delays and Absences: 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. If a student is absent for any reason (or multiple reasons) for more than 3 days or will be missing a required event he/she is required to complete an Exception to the Rotation Application with the preceptor and course coordinator signatures. If approved, make up may be required.
3. 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 ( 918-584-4375) or fax 918-582-8938 or email sherry.eastman.okstate.edu
Course Evaluation Procedures
1. The student's overall performance (grade) is weighed using the following criteria:
  
  50% = Student Performance Evaluation by preceptor
  
  10% = Mobile Telemedicine Clinic Experience and Evaluation
  
  5% = Curriculum Vitae
  
  15% = Case Presentation
  
  15% = Procedure/Skills Card (minimum of 5 signed procedures or skills)
  
  5% = Quiz (points will be deducted for missed lectures or non-participation)
2. 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. Seminar Attendance and Quiz: Attendance will be taken during all lectures. For each missed lecture (unexcused), points will be deducted from the final grade up to 5%. Arriving late or leaving early from a lecture must be preapproved and points may be deducted. A short quiz about the lectures will be given at the end of the rotation and count 10%.
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. An evaluation describing the experience will count 10% and 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, presentation and design techniques, and video conferencing skills used for 15% of the final grade.
7. Curriculum Vitae(CV): The CV will be 10% of the final grade and returned with feedback.
8. Procedure/Skills Card: Completed cards will go in the students file and student will be provided a report prior to graduation. Although a minimum of 5 are required for the rotation, students can use as many cards as needed to add value to the report. These cards count 5% and are required for all Rural Health rotations.
9. 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/participation, telemedicine experience evaluation, Curriculum Vitae, seminar quiz and other required activities. 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). If paperwork is not received within 7 days of the end of the rotation, the student’s grade may be decreased up to one letter grade for each month it is late.
10. 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.
11. 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. The individual site evaluations and responses will remain confidential.
12. 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.
13. 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.
Rotation Objectives
1. The Community Clinic clerkship provides third year students with clinical experiences in a small community clinic setting.
2. Goals
  1. Observe and demonstrate knowledge in telemedicine technology use and operation.
  2. Demonstrate understanding of Electronic Health Records (EMR/EHR)
  3. Prepare an effective Curriculum Vitae (CV)
  4. Acquire an understanding of differentiating factors in rural and urban medical settings.
  5. Demonstrate appropriate clinical and interpersonal skills.

Subject/Method	Learning Objectives	Resources/Assignments
Distance Learning Lectures/Hands-on Training Distance learning/ literature searches Telemedicine overview/ equipment Telemedicine skills demonstration and hands-on practice	Recognize various uses for interactive videoconferencing Name components of videoconference equipment Connect and participate in a videoconference Perform troubleshooting to prevent or correct videoconferencing issues Demonstrate skill in videoconferencing by presenting using PowerPoint	OSU Medical Library - Online Resources Telemedicine skills demonstration and hands-on practice Telemedicine website Accompany the Mobile Telemedicine Clinic (MTC) to a site and complete a MTC experience essay.
Case Presentation student presents to a physician at at distant site PowerPoint Basics and Proper Design Methods Presentation Skills Online Medical Literature Search	Demonstrate presentation skills through a PowerPoint presentation requiring the use of medical literature searches and EBM references Construct a differential diagnosis and develop treatment/management strategies for common diseases and conditions seen in family practice. Protocol of Care - Demonstrated by student in the following format: Problem or diagnosis Description of disease or problem Criteria for diagnosis Lab or diagnostic procedures Management Special diet (if any) Lifestyle changes Activity Medication Class of drugs used & dosage Pharmokinetics Drug interactions Indications/ Contraindications Side effects OMT – Rationale Patient education Follow-up Physician/Nurse Visits Procedures, if any Lab Preventing & treating complications	OSU Medical Library - Online Resources Prepare PowerPoint lecture and present at the end of rotation using videoconferencing skills. The student selects a patient case and a written Protocol of Care is submitted using PowerPoint & presented to an attending physician and classmates during a Friday seminar Include a summary of Evidence-Based Medicine (EBM) references used (resources include): MEDLINE - Ovid Search Engine Ovid UpToDate InfoPOEMS/ InfoRetriever FIRST Consult PIER (From ACP)
Medical Conferences attend when available	Attend 4 sessions of choice Network with physicians Attend lectures on current, timely topics Discover the CME and Conference methods Meet with Key leaders in the medical community	Attend one of the following and complete an evaluation Emergency Medicine CME OOA Summer CME OOA Winter CME Family Medicine CME Small Rural Hospital Conference Rural Health Association of Oklahoma Conference DO Day on the HIll (OK)
Non-Physician Clinicians (NPC) and Their Role in Rural Health Care lecture with Turning Point Participation	Evaluate the non-physician clinicians' role in osteopathic medicine and the rural community Compare and contrast the physicians role in healthcare and the NPC with reference to education, scope of practice, and licensure Describe what physicians can expect from NPC's professionally Discuss how the physician can advise patients on how the NPC fits into the scope of practice and their role in the case management scheme Know what academic knowledge and practice skills/procedures separate rural practicing primary care physicians from rural practicing NPC's? Describe basics of the Patient Centered Medical Home and the concept of case management Discuss the concept of “collaboration” between physicians and NPCs.	Pre-lecture reading assignment monograph series 2005 Participate by answering TP questions and discussions
Curriculum Vitae Seminar	Locate and sign on to the Careers in Medicine Website Learn how to use Careers in Medicine to evaluate personal characteristics, skills, and interest to aid in career decisions. Identify strengths and training important in the medical field and for various specialties. Identify the steps needed to prepare a professional curriculum vitae specifically designed for health professionals	Prepare a CV
Rural Health Topics: Overview of Rural Health and the CRH lecture with Turning Point participation Economics of Rural Health Care lecture with Turning Point participation Communication and the Cancer Patient lecture	Identify the diferent service areas the Center for Rural Health supports Idenitify two sponsored programs that office under the Center for Rural Health Describe Critical Access Hospitals Discuss rural primary care physician lifestyle Evaluate factors used in determining the need for a rural physician in a rural community Identify Cancer Survivorship Issues Identify the essential components of cancer survivorship care Identify the role of the primary care physician in cancer treatment Locate and discuss the Institute of Medicine's report concerning end of life treatment summaries Recognize communication barriers when treating cancer survivors Understand how to communicate effectively with cancer survivors	There will be a quiz on the topics at the end of the rotation
Rural Physician Series	Discuss a variety of topics relating to rural practice as presented by rural preceptors. May include but not limited to: Billing and Coding in the Rural Office Emergency Medicine in Small Community Hospitals Rural Community Leadership and the Rural Physician Geriatric Care in a Rural Setting Diabetes and the Rural Physician	There will be a quiz on the topics at the end of the rotation
Clerkship Local physician's office or local health care facility	Apply clinical skills in physician's offices in small community	Complete a Procedure/Skills card
* Lecture Topics may vary from month to month.