Clerkship

Resources Performance Evaluation Site Evaluation

Syllabus
Class of 2007

 

1. General Description
   1. Rotation Title: Osteopathic Manipulative Medicine (OMM) Clinical Outpatient and Hospital Rotation
      Rotation Length: One Calendar Month
      Rotation Format: Clinical based OMM, OSU Health Center and OSU Medical Center (formerly TRMC)
      Rotation Level: 3rd Year Osteopathic Medical Students
      Prerequisites: Satisfactory completion of years one and two at OSU-COM
      Course Coordinator: Kenneth E. Graham, D.O.
   2. This course is a continuation of OMM I, II, III and IV. The course is designed to follow up the student’s first two years of OMM instruction and to provide OMM clinical instruction in the outpatient and hospital setting. The unique feature of this program is an OMM guidelines approach which was developed to enable the student's understanding of how to approach the patient in both the outpatient and hospital setting. This approach establishes clinical guidelines for the evaluation and treatment of patients utilizing OMM. This format is designed to use the problem-oriented approach to quickly and simply help the student understand how to incorporate OMM into the management and treatment of the ten most common musculoskeletal presentations and other common visceral presentations (asthma, emphysema, ileus, nausea and vomiting, etc.) in the outpatient and hospital settings. It is hoped that the student will see these guidelines as a starting place from which further diagnosis will lead to further treatment and will also deepen their understanding of the pathophysiological processes involved with disease.
   3. Five to Six students at a time will rotate for three weeks in the Outpatient OMM Clinic at OSU-HC and two students at a time will rotate for one week at OSU Medical Center. The two students rotating at OSUMC are required to spend either a Saturday or a Sunday at OSUMC.
   4. At the end of this rotation the students will have a practical and didactic examination over the guidelines and didactic material presented. The course coordinator or his designated representative will also meet with the students on a weekly basis at the clinic or the hospital to check on the performance of the students, answer questions, examine patients, and ensure that the instructional program is running smoothly.

   

2. Rotation Calendar

1. The student's actual days and hours are set forth within the rotation calendar. The specific scheduling of days and hours shall be made by the course coordinator, and shall generally conform to the following:
   1. Rotation Period: The rotation is one calendar month in length, between September 1^st of one year to August 31^st of the next year.
   2. Date of Arrival: All rotations begin and end on the first and last day of each calendar month. It is the student's responsibility to report to the course coordinator or his designate on the first week-day of each month. If there is a reasonable explanation for a delay in reporting (e.g., auto accident, illness, or similar reason), the student must contact the course coordinator immediately.
   3. Work Day: A typical day is considered to be 9 hours in length (8:00am-5:00pm); however, there may be an occasional instance when the working period may exceed 9 hours.
   4. Weekends: This applies to the two students assigned to OSUMC only. Weekends are assigned on a rotating basis throughout the month, with one student working on Saturday and the other working on Sunday.
   5. Holidays: Students will receive time off in accordance with OSU-COM policy.
   6. Travel Time: See Clerkship Handbook.
1. Course Objectives
   1. Apply appropriate Osteopathic Principles and Practice for the diagnosis and treatment in the outpatient and hospital setting.
   2. Demonstrate competency in the following OMM guidelines for the outpatient and hospital patient presentation:
      1. Ankle and/or Foot Pain
      2. Knee and Leg Pain
      3. Hip, Groin and ITB Pain
      4. Low Back Pain
      5. Shoulder and Arm Pain
      6. Elbow, Wrist and Hand Pain
      7. Neck, Upper Back and Thoracic Outlet Pain
      8. Midthoracic, Rib and Intercostal Pain
      9. Headache
      10. ICU, Critically Ill or Bedfast
      11. Ventilator Extubation Assistance
      12. Ileus, nausea and vomiting
      13. Non-Cardiac Chest Pain
      14. COPD and Lower Respiratory Patient
   3. Demonstrate competency in performing a complete osteopathic structural examination in both the outpatient and hospital setting.
   4. Exhibit interpersonal skills with patients and their families that facilitates the communication process between physicians and patients:
      1. Active listening
      2. Empathy and sensitivity
      3. Appropriate eye contact
      4. Proper closure of interaction
      5. Attentiveness and concern
      6. Proper greetings and introductions
      7. Confidence in her/himself
      8. Respect and support
   5. Utilize appropriate medical records documentation strategies using the SOAP format.
   6. Demonstrate an awareness of medical, legal and ethical issues and the ability to respond appropriately to these issues.
   7. Gain general knowledge and skills in communicating effectively with patients and in presenting patients, both verbally and in writing.
   8. It is very important that the student develop and practice respectful attitudes toward fellow students, attendings and especially patients. Toward this end, the student should demonstrate:
      1. Self-assurance and security, tempered with openness and honesty regarding areas where the student is lacking knowledge and skills.
      2. Willingness to share knowledge and to learn from all other health care professionals.
      3. Willingness to educate patients to assume responsibility for their own health care.
      4. Willingness to seek out and hear constructive criticism and to become skilled at self-evaluation.
      5. Willingness to maintain and demonstrate ethical and professional behavior.
      6. Willingness to maintain high ethical standards.
      7. Willingness to accept responsibility for patient care appropriate to his or her level of knowledge and skills.
      8. Willingness to provide feedback to teachers and trainers in order to improve the educational process.
      9. Pride in the Osteopathic profession.
   9. Follow the patient, at appropriate intervals (e.g., daily/weekly), recommending modification of the original plan when necessary and recording the patient's progress utilizing SOAP format.
   10. Because of the unique nature of this rotation, one hundred percent (100%) attendance is required. Students will not be permitted to take vacation or time off during the rotation except as required by college policy (eg. board examination, etc.)
   11. Students are required to attend all scheduled meetings.
2. Student Responsibilities
   1. The student will be responsible for completing the following activities during the rotation.
      1. Meet with supervising physician at all assigned times.
      2. Be prepared to discuss their clinical strengths and weaknesses relative to the rotation objectives.
      3. Complete all outlined rotation objectives as previously listed.
      4. Meet with the supervising physician for an evaluation/feedback conference at the end of the rotation.
   2. Dress Code
      1. Students are expected to dress appropriately.
      2. Men are expected to wear a shirt, tie, and dress trousers.
      3. Women may wear either slacks or a dress.
      4. Unless specified differently by the supervising physician, the student will wear a cleaned and pressed white clinical jacket at all times.
      5. Students are expected to wear their identification badge at all times.
3. Student Evaluation
   1. Each student’s performance in OMM will be evaluated in accordance with the following criteria:
      1. Students are expected to perform a minimum of ten OMM treatment sessions weekly and document the treatments in the patient’s chart, as well as record them in a student OMM logbook, including:
         1. the date
         2. treatment performed
         3. the patient’s medical record number (MR #)
      2. All this information must be completed if the student is to receive credit for the treatment session.
      3. The logbook must be signed by the student and the assigned attending at the end of each week.
      4. Student logbooks are turned in as a part of their rotation grade.
   2. 100% attendance is required at all weekly study sessions. Missed meetings will be reflected in the students overall grade.
   3. Practical and Written Examination. At the end of the rotation the student will be given a written examination over the didactic material presented followed by a practical examination of the guidelines taught during the course.
      1. 40% = Student OMM Log
      2. 10% = Weekly 1 hour sessions (2.5% deduction for each missed session)
      3. 20% = Practical Examination
      4. 20% = Didactic Examination
      5. 10% = Clerkship Performance Evaluation
      6. Mandatory = Site Evaluation
   4. A grade of less than 70% will result in failure of the rotation.
4. Suggested Texts
   1. Osteopathic Manipulative Medicine Guidelines for the Hospitalized Patient, by Kenneth E. Graham, DO, 3rd edition
   2. Osteopathic Clinical Evaluation and Treatment of the Ten Most Common Musculoskeletal Presentations, Kenneth E. Graham, DO, 1 st Edition 2001
   3. Supporting Texts
      1. Foundations for Osteopathic Medicine, Robert C. Ward D.O., editor, 2nd Edition, 2002
      2. Osteopathic Principles in Practice, Michael L. Kuchera D.O. and William A. Kuchera, D.O. 2nd Edition, 1991
      3. Osteopathic Considerations in Systemic Dysfunction, Michael L. Kuchera D.O. and William A. Kuchera, D.O., 2nd Edition, 1994