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Rural Medical Education
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  Grand Rounds
  Video Lecture Evalution
    (accessible after viewing videos)
  Checklist

Community Hospital Clerkship

Curriculum

Two consecutive one-month required clerkships take place in a community-based hospital and are designed to involve fourth-year students in all areas of community hospital medical care as provided by family physicians.

Experiences include:

  • Emergency room
  • General medicine
  • Surgical care

Students are encouraged to live in the community during the two month rotation to develop a better understanding of all aspects of rural medicine.

Syllabus
CH I - CE 9215
CH II - CE 9225

  1. General Description
    1. Course Title: Osteopathic Community Hospital Clerkship
      Course Length: (2) One-Month Rotations
      Course Format: Rural Hospital-Based Clerkship/Rotation
      Student Level: 4th Year Osteopathic Medical Students
      Course Coordinator: William Pettit, D.O.
    2. The Community Hospital clerkship gives fourth year medical students direct involvement and experience in a small hospital setting. This experience consists of two rotations (courses: I-CE 9215 and II-CE 9225) in an affiliated Community Hospital. Each clinical rotation is a one-month primary-care clinical experience designed to further develop the concepts of diagnosis and management and to develop decision-making and cognitive skills related to patient care.
    3. This course will also provide the student a chance to develop additional clinical psychomotor skills by performing routine basic procedures in a supervised setting. In addition, this course may include experiences such as hospital rounds, surgical assistance, labor and delivery management, hospital staff and committee meetings, hospital emergency room calls, community and public health functions. The student may observe, evaluate, and participate in discussions and medical care of patients, at the discretion and under the immediate supervision of an assigned physician through the combined coordination and direction of the OSU-COM site supervising physician and the course coordinator.
    4. The course coordinator will coordinate the course. The course coordinator will oversee student rotation assignments and course responsibilities in cooperation with the site site supervising physician. The site supervising physician will coordinate supervision of the student, assign patient responsibilities, determine a final evaluation of the student's clinical progress, and in coordination with the OSU-COM Clerkship Course Coordinator, will schedule academic presentations.
    5. It is further understood that an on-site physician must be in attendance at all times while the student is in the facility for training purposes. The site supervising physician may designate other physicians to meet this requirement.
    6. This practical clinical experience in primary care medicine is designed as an integral part of each OSU-COM clerkship program. The clerkship program is under the direction of the Oklahoma State University College of Osteopathic Medicine, and the courses (rotations) are conducted at affiliated primary care facilities. Successful completion of the course is an OSU-COM requirement for graduation.
  2. Student Responsibilities
    1. Pre-arrival Student Responsibilities and Information: 
      1. Students are required to contact the hospital contact at least one week prior to the beginning of the rotation to obtain hospital orientation and housing information. Housing is provided for students as a courtesy at Community Hospitals more than commuting distance from Tulsa or Oklahoma City. Students are required to contact the housing contact for their assigned training site as soon as possible if they will NOT be utilizing the housing for any reason. This decreases unnecessary costs to these hospitals providing the service and helps maintain these benefits for future students.
      2. Students are required to contact their assigned site supervising physician at least 1 week prior to the beginning of the rotation to coordinate the daily schedule and other pertinent aspects of the rotation.
      3. 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.
      4. Students are required to bring identification passwords for library resources (i.e. MD Consult), course syllabus, and current references for Family Medicine, Internal Medicine and Obstetrics/Gynecology with them.
    2. Student Responsibilities During the Clerkship:
      1. First Week of Rotation
        1. Attend required hospital and office orientations as appropriate.
        2. Meet with your site supervising physician for an orientation.
        3. Be prepared to discuss your clinical strengths and weakness relative to the rotation objectives.
        4. We suggest you use the student performance evaluation form as a guide.
      2. During the Rotation
        1. At all times dress appropriately (as defined in the Pre-Arrival information above), utilize College approved identification, and identify self as a non-graduate medical student not as a medical graduate or a licensed physician.
        2. View two Grand Rounds and complete the video evaluations.
        3. Complete the skills card, get it signed with level of performance.

        4. Provide appropriate patient care under the supervision of the attending physician(s). Demonstrate appropriate indications and techniques in using O.M.T.
        5. Complete all outlined rotation objectives.
      3. Midpoint
        1. Meet with your attending physician(s) and your site supervising physician for a verbal evaluation of your clinical performance, areas to improve, and a discussion of your progress on the assigned patient case.
        2. You are responsible for scheduling this meeting.
      4. Final Week
        1. Meet with your attending physician(s) and your site supervising physician at the end of each month of the rotation to review your clinical performance.
        2. Give the student performance evaluation form (or guide him/her to the online evaluation) to the site supervising physician for completion of the preceptor’s section.
        3. You are responsible for scheduling this meeting.
        4. Submit the checklist, student performance evaluation, site evaluation, skills cards and video-lecture evaluations to the Clinical Training Coordinator, Center for Rural Health.
        5. All forms and paper are due within 7 days (postmarked by the 5th day) of the end of the rotation.
        6. A grade will not be issued until all the paperwork has been received.
        7. If forms are not received within 7 days of the end of the rotation, the student’s grade may decrease one letter grade.
  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 two months in length and officially consists of two one-month rotations (courses: I-CE 9215 and II-CE 9225).
      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 required to contact the preceptor, site supervising physician, and the 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 of more than 50 miles outside the greater Tulsa area as specified in the student clerkship handbook.
      6. Attendance: One hundred percent (100%) attendance is required on all clinical rotations. The student is required to inform the site supervising physician and OSU Regional Coordinator of any absence in a timely manner. If a student needs time off the rotation, make up time may be required. A student is required to complete and submit an Exception to the Rotation application with the preceptor's signature, if absent for any reason.
      7. Rotation Changes: Under approved special circumstances only, students may trade rotation assignments by completing a Change of Rotation application. All forms must be forwarded to:
        Sherry Eastman
        OSU College of Osteopathic Medicine
        Center for Rural Health
        1111 West 17th Street
        Tulsa, OK 74107
        918-584-4375
        918-582-8938 fax
        sherry.eastman@okstate.edu
    2. All rotations begin on the first day of the month and will be sent instructions by the Center for Rural Health prior the the start of the rotation. Should a holiday fall on the first day of the month, students are encouraged to contact the site supervising physician and the regional coordinator to verify date of arrival.
  4. Student Performance Evaluation Procedures
    1. The student's overall performance (grade) is weighed using the following criteria*:
      1. 65% = Student Performance Evaluation
      2. 15% = Procedure/ Skills Card

      3. 20% = Video Lecture Evaluations
    2. Each course requirement, including each individual video-lecture evaluation, must be passed with a 70% or higher to pass this overall clerkship course. Letter grades of A, B, C, or U will be assigned according to procedures outlined in the course catalog.
    3. Student Performance Evaluation: At the completion of each month of the Community Hospital rotation, the site supervising physician will evaluate the student's performance on clinical activities, assigned patient case and seminar activities of the rotation on the student performance evaluation form. 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, video-lecture evaluations, other required activities, and timely receipt (within 7 days) of all the paperwork. If forms and paper are not received within 7 days of the end of the rotation, the student’s grade may be decreased one letter grade. All requirements must be passed with 70% or above to pass this clerkship.
    4. Students are responsible for scheduling "verbal reviews" and a written evaluation review with their preceptor. It is recommended that verbal reviews be conducted at various points throughout each rotation, allowing the preceptor and student to discuss the student's areas of weakness and plan of action for improvement. A "verbal review" conference should be scheduled at least once mid-way through each month rotation and a written evaluation review on the final day of each month rotation. Students are responsible for scheduling the meeting times for these performance reviews.
    5. Students are responsible for ensuring that all paperwork (including the student performance evaluation, site evaluation, and video-lecture evalutions) 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).
    6. In addition to an academic grade, all students are held accountable to 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 site supervising physician.
    7. A grade of "I" (Incomplete) may be assigned if:
      1. A student is unable to complete the course requirement of approved 100% attendance.
      2. The Course Coordinator recommends an extension of the student's Clerkship and sets forth reasoning for the recommended extension.
      3. The student fails to submit the required paperwork.
    8. 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 (attending and site supervising physicians), and student experiences.
    2. Students are required to complete and return the form to the Center for Rural Health within 7 days of completing the rotation.
    3. The Course Coordinator reviews all site evaluations and is responsible for addressing any problems or issues, which are identified in the evaluations.
    4. Data will be collated annually. site supervising physicians will receive an aggregate report only.
    5. The individual site evaluations and responses will remain confidential.
  6. Rotation Objectives
    1. Goals: Provide the student practical clinical exposure, knowledge, and additional didactics in a Community Hospital setting focussing on primary care medicine. Accomplished through a basic structure developed to achieve proficiency in the following areas:
      1. Supervised patient evaluation, diagnosis and management of general medical maladies.
      2. Application of didactic general medicine principles.
      3. Development & expansion of clinical psychomotor skills.
Subject/Method Learning Objectives Resources/Assignments
Clinical Psychomotor Skills Development & expansion of clinical psychomotor skills:
  1. Participate in daily patient rounds and conferences
  2. Perform clinical workups of patients admitted to hospital (supervised/critiqued)
  3. Review reading/case presentations
  4. Review evaluations on required Grand Round lectures (4 total)
  5. Attend/participate in formal clinical presentations by hospital staff and guest presenters
  6. Receive performance feedback from site supervising physician and attending

Required Internet video lectures:
  1. Must review 2 Grand Rounds and submit evaluations during each month of rotation = 4 total.
  2. Keep copies of evaluations submitted online.
  3. Technical Assistance contact Jon Barnaby (607-4081).
Required readings and case presentations:
  1. Assigned by site supervising physician
Hospital Procedures
Supervised patient evaluation, diagnosis, & management of general medical maladies
  1. Perform specific, assigned medical/surgical case responsibilities
  2. Perform general medicine assignments
  3. Obtain a complete and accurate history and physical examination
  4. Keep adequate and up-to-date medical records
  5. Identify patient problems utilizing the SOAP format
  6. Provide patient case presentation to attending physician with appropriate management strategy
  7. Propose a plan for management of patient, for review by the attending
    1. Properly indicate the need to perform laboratory or radiographic tests
    2. Determine appropriate physical activity to be permitted by patient
    3. Determine type & caloric content of patient's diet
    4. Determine and recommend appropriate therapeutic measures
    5. Determine requirement for special precautions or consultation
  8. Follow the patient, at appropriate intervals, recommending modification of original plan when necessary & recording in SOAP format
  9. Determine appropriate time of patient discharge or release from hospital
  10. Propose a method for patient follow-up
  11. Maintain a humane approach, recognizing fears and anxieties of patient and family - understand the impact of patient's background and environmental relationships to his/her illness or trauma
  12. Apply appropriate Osteopathic Principles and Practice for diagnosis and treatment of hospitalized patient
Required Procedure/Skills Cards:
  1. Complete a procedure/skills card and submit at the end of each month of rotation (2 total).
  2. Must have dates and levels of skills observed, assisted, or performed initialed by physician.

  3. All physicians initialing cards, must include name, MD/DO and contact informtion on back of card.

Application of Didactic General Medicine Principles
Practical application of general medicine principles

  1. Develop familiarity with a variety of clinical procedures through observation and assistance.
  2. Develop manual proficiency in clinical procedures through actual supervised performance
  3. Define and be aware of the availability of various clinical procedures and consider available procedures as aids in diagnosis
 
OMM
Hands-on Application
  1. Demonstrate appropriate techniques and indications in the use of OMM