Course Title: FMED6260M: On Doctoring I / Academic Year 2015.16 Contact Information: Joshua Coren, DO, MBA, Chair, Family Medicine, Co-Course Director 856-566-6789 Corenjo@rowan.edu Lucia Weiss, M.S. Associate Professor, Family Medicine, Co-Course Director 856-566-6885 weisslb@rowan.edu, J. Niel Rosen, Ph.D., JD, Assistant Professor, Family Medicine, Co-Course Director 856-566-6246 rosenjn@rowan.edu Kathleen Maguire, maguirek0@rowan.edu Course Coordinator 856-566-6085 I. Course Overview/Description Rowan University School of Osteopathic Medicine (RowanSOM) offers a required Patient Care/Clinical Preceptorship course, On Doctoring I, for first year medical students under the direction of the Department of Family Medicine. The course consists of both in-class instruction and a clinical preceptorship. The in-class portion of the course includes topics pertinent to history taking, documentation, and physical examination skills focusing on vital signs and the normal cardiopulmonary examination. This course also includes lectures and discussion about what it means to be a professional. These sessions are an initial step in the student s development of a professional identity. The Clinical Preceptorship portion of the elective is intended to utilize an adult learning style. This method of learning allows students to identify their own learning issues and needs in a clinical setting while utilizing a practicing clinician as a resource in meeting their self identified objectives. The Department of Family Medicine provides students with some of its own learning objectives as a guide, but ultimately wants students to self identify their own learning issues while using the preceptorship as a mechanism of clinical integration. The clinical preceptorship will provide an opportunity for students to observe and experience the practice of clinical medicine in an ambulatory/non-hospital setting early in the medical school curriculum. Likewise, it provides a venue to observe and practice basic clinical skills presented during the in-classroom patient care curriculum. More importantly, the preceptorship exposes students to real patients with similar biopsychosocial issues presented in the medical school curriculum. The preceptorship also allows students the opportunity to identify a mentor, or shadow a clinician mentor, another key element of their learning they may want to consider during the time here at RowanSOM. Students gain a significant amount of knowledge and skills in the classroom, but ultimately, learn the art of medicine from the patients encountered and the stories that they tell. The first step in developing the true skills of being an excellent physician is to listen and observe. A
patient encounter, no matter how simple or complex, is priceless whether a practicing physician with 40 years of experience or a first year medical student. Also critical to the primary care physician is knowledge of the community, its residents, and the key community-based agencies that serve the population, It is the responsibility, as health care professionals, to partner, support, and empower patients to be good stewards of their own health and well-being. This can only be done if physicians are knowledgeable about the communities they serve and the people who live and work there. As such, this course serves to introduce medical students to the role of the primary care physician in the delivery of comprehensive, continuous, community-oriented care for family members of all ages through a process that looks at community needs, health risks and disparities. Historically, there has been a strong relationship between the School of Osteopathic Medicine and the New Jersey Area Health Education Center (AHEC) program, which creates a link between clinical practice and delivery of health care to underserved, minority and disadvantaged communities in southern New Jersey. In conjunction with the three AHEC programs, students will explore the services provided by the AHEC affiliated programs, determine how physicians and patients alike access the services and how those services may help patients overcome barriers in meeting their healthcare needs. A. Course Goals The On Doctoring I course provides a venue for students to identify and integrate clinical and professional learning issues by correlating the basic sciences and introductory clinical medicine learned in the classroom. B. Course Learning Objectives At the completion of this course, students will be able to: 1. Describe the ethical and practical components of the Doctor-Patient Relationship. 2. Conduct a patient interview using effective communication skills to obtain a basic medical history and present the information to an attending physician. 3. Demonstrate an ability to accurately assess vital signs. 4. Demonstrate understanding of chart notes and basic medical documentation. 5. Describe and demonstrate the components of a physical exam with focus on normal heart and lung sounds. 6. Describe strategies which increase the capacity of patients to think critically and make autonomous, informed decisions about their health care. 7. Identify the major issues in health care policy and reform that influence the provision of primary care in the US today. 8. Apply the biopsychosocial model of care to health challenges at the population level through awareness of community resources. 9. Identify target population (including demographics, health indicators, and socio economic status, etc.) served by their assigned AHEC or community-based agency.
10. Describe health care risks or disparities encountered by populations served in your assigned AHEC or community agency. 11. Describe programs or service provided by AHEC or affiliated community-based agencies. 12. Examine the thesis that medicine is a profession and interpret what being a professional means for medical students. 13. Define, analyze and contrast the basic moral obligations built into the practice of medicine: competence, beneficence, fidelity to trust, and accountability. 14. Identify virtues that excellent physicians possess. 15. Evaluate conflicts of interest, interpret their impact on patient and public trust, and assess whether physicians can be trusted to regulate themselves. 16. Summarize the scope of preventable harm to patients and identify several ways to improve patient safety. 17. Discuss the need for and challenges to the formation of interprofessional teams in the delivery of medical care. 18. Propose a professional oath for the class of 2018. Suggested Learning Issues for students: 1. Components of a physical exam with focus on normal heart and lung sounds 2. The role of OMM in daily practice 3. Health Promotion and Disease Prevention 4. Application of evidence based medicine and health promotion strategies 5. Healthcare disparities and their impact on health and wellness. 6. Ethical issues such as informed consent, truth telling, confidentiality and Autonomy 7. Roles of other healthcare providers, disciplines, and office personnel 8. Cultural competency in medical interviewing and the doctor-patient relationship 9. Professionalism and its meaning in medicine 10. Common chronic diseases such as hypertension, diabetes, and asthma 11. Common drug names and uses II. Expectations of Students A. Educational Sessions (See Blackboard for detailed weekly schedule) The On Doctoring I classes are held on Tuesday mornings. Students must attend all of the lectures and learning activities related to the course as attendance is mandatory. B. Preceptorship Sessions (Required forms are submitted through One45) As part of this course, students will complete two preceptorship sessions prior to the completion of the first year. Scheduling these preceptor sessions and sites will be through an on-line scheduling system. Preceptor sites include the 4 Family Medicine ambulatory clinical offices. Preceptorship hours may be on weekends, in the evening or during hours when students are not scheduled for classes.
Hammonton Family Medicine 373 South White Horse Pike Hammonton, NJ 08037 609-704-0185 Mt. Laurel Family Medicine 100 Century Parkway, Suite 140 Mt. Laurel, NJ 08036 856-380-2400 Stratford Family Medicine 42 East Laurel Road, Suite 2100 Stratford, NJ 08084 856-566-7021 Washington Twp. Family Medicine 570 Egg Harbor Road, Suite C-2 Sewell, NJ 08081 856-218-0300 An evaluation form is required for each session of the preceptorship. This form must be completed by the preceptor with whom you worked. You are responsible for identifying the preceptor in the One45 system. The link to the form will appear in your To do Box on One45 at the beginning of the Spring Semester for On Doctoring I. You should only select the link the evening/day after having completed the preceptorship session. Once you select the preceptor with whom you worked during the session, the system will send the evaluation form to the preceptor with whom you worked for completion. Once completed by the preceptor, the form will be processed by the online system. C. Community Learning Experience (See Blackboard for required form) As part of this course, students will participate in a 6-hour community service learning experience in the Spring semester, arranged through the AHEC coordinators. Students will complete a Community Fact Sheet about their community service learning experience and obtain a signature from their respective AHEC coordinator indicating they have successfully completed the assignment. Students are responsible for the completion of this form. D. Clinical Education and Assessment Center (CEAC) Standardized Patient Lab As part of this course, students must participate and successfully complete 4 Standardized patient encounters. For 3 of these encounters, students must submit part of a SOAP note, which will be graded by the course director, and feedback will be provided to the student. If the assignment is not satisfactorily completed, the student will be required to meet with the course director and work to remediate the assignment. Successful completion of this SOAP note charting is required to pass the course. E. Required Reading Specific readings have been identified by the lecturers for this course. Students are responsible for reading these article prior to attending classes, and should be familiar with the contents to ask questions relevant to the lecture.
F. Resources Medical Instruments For this class, students are required to have white coats and their medical instruments, including: stethoscope otoscope ophthalmoscope blood pressure cuff and reflex hammer G. Course Texts / Materials /Resources The library staff has compiled a set of resources which will augment the provided lectures and labs for the first year students enrolled in this course. Students should check these materials prior to any Lab sessions as these videos, articles and demonstrations will provide additional help in acquiring skills and knowledge. III. Attendance Policy A. Class attendance Attendance is required for all lectures and learning activities for the On Doctoring I course. Students unable to attend required classes due to illness or unforeseen circumstances must contact the Course Director and Office of Academic Affairs before scheduled class(es) or as soon as possible thereafter. A doctor s note will be required when you return to school. This needs to be submitted to the Course Director and the Director of Academic Affairs. Courses/sessions that expect attendance require students to sign in. Attendance will be taken either on a paper sign-in sheet or by an electronic attendance system at the beginning of class. It is a violation of the honor code to sign in for another student. All students are permitted one unexcused lecture-only absence per semester, but must review the ECHO recordings of the missed class. B. Conferences Students can request an excused absence for medical conferences from their course director. Permission for release from required activities, including exams is at the discretion of the course director. Most times this will be limited to one day for conference and one day for travel, as most student conferences are held on the weekends. Make-up exams, when required, it also at the discretion of the course director, but typically would be as soon as possible after your return. Documentation of your role in the conference must be submitted with your request. You must get permission from the course director before you make reservations and pay for the trip.
C. Religious Holidays We value the diversity of our student body and recognize that many students celebrate holidays that are important religious observations and are not included in our Academic Calendar. In order to provide flexibility for this, students must make the request to Jackie Giacobbe, the Director of Academic Affairs, at least one month prior. If the holiday or religion is not common, then it is the student s responsibility to provide verification and explanation of the importance of the holiday to Academic Affairs. Academic Affairs will then inform the Course Director of the student s need for the absence. IV. Grading Policy A. Grading Scale The Patient Care/Clinical Preceptorship course is a pass/fail course. A Passing grade will be given to students who fulfill the responsibilities listed below. 1. Attend all classes and complete readings/assignments. 2. Complete all Standardized Patient labs and submit the required assignment 3. Complete a take-home essay and email it as a.doc or.docx file to Dr. Rosen (rosenjn@rowan.edu) by March 31, 2015. 4. Complete the Institute for Healthcare Improvement s Introduction to Patient Safety and email a certificate of completion to Dr. Rosen by November 30, 2014. 5. In small groups of 6 students, develop a professional oath and email it as a.doc or.docx file to Dr. Rosen by January 31, 2015. 6. Complete the 2 preceptor session at an assigned family medicine clinical office; Ensure that 2 preceptor evaluation forms are submitted through the One45 system. 7. Complete a community service learning experience in collaboration with their assigned AHEC. A completed Community Fact sheet must be submitted to the student s assigned AHEC coordinator. 8. Complete all required course evaluations. B. Remediation For assignments graded as non-pass, students must meet with the course director for remediation, and complete all required work in order to pass the course.
V. Grade Appeals A student who chooses to appeal a grade must contact the Course Director within 2 weeks of the grade being posted on One45. The appeal should be in writing via email or hard copy and sent to the Course Director, with a copy to the Course Administrator / Coordinator. The Course Director has 2 weeks to make a determination about the grade appeal. If the student chooses to make a second appeal, it is made to the Department Chair, who will also make a determination within 2 weeks. A final appeal can be made to the Senior Associate Dean for Academic Affairs, and that decision is final. VI. Dress Code Professional appearance and attitude are essential to good doctor-patient relationships. Students are expected to maintain high professional standards of dress and behavior. If there are guest speakers and/or patient panels, you are expected to wear your white coat. For your preceptorship sessions, male students attire should include shirt with tie, trousers (no blue jeans), and a white lab coat with name tag. Female students should wear discreet dresses, skirts or slacks (no blue jeans), with high neckline blouses or tops, and a white lab coat with name tag. All students should wear appropriate shoe attire for a business environment, closed shoes, no high heels, and no sneakers. VII. Professional Conduct Students are expected to follow the RowanSOM Honor Code of Professional Conduct presented in the Education Handbook http://www.rowan.edu/som/education/undergraduate_medical/documents/studenthandbo ok.pdf Clinical Experiences: Please be aware that you are being evaluated at all times. Clinical faculty, nurses and other office staff provide valuable 360 feedback to your course director. Therefore, you should always consider yourself on when working in an office. Even though the preceptorship sessions are designated as 3 or 4 hour sessions, it is your responsibility to stay in the office until all patients have been seen or your preceptor dismissed you. All members of the clinical office staff are officially part of the patient s care team, regardless of their role. When interacting with other professionals, students should be respectful of all team members, and work to recognize and value the contributions of each. Verbal and written communication should be professional, formal and appropriate. Emails should be addressed in formal letter style, (e.g. Dear Dr. Doe ) and should be addressed to both the clerkship director and the clerkship coordinator, who is often more accessible.
VIII. Course Evaluations At the end of the course, students will be asked to complete online evaluations for both the overall course and the individual faculty members in One45. Student grades will not be released until all of these evaluations have been submitted. We ask that students be honest and constructive in their comments. We take evaluations seriously and would like suggestions for improvement, as well as hearing about things that were appreciated. Your constructive evaluations help us to make our course better for the next students. IX. Americans with Disabilities Act Students with disabilities needing accommodations should register with Center for Teaching and Learning and provide documentation delineating the accommodations. This should be done no later than two weeks before the accommodations are needed. X. Remediation Policy Students who fail the course will have to remediate by doing required reading and writing assignments during the summer.