Essentials of Clinical Medicine 3-4

PRCL 645 Essentials of Clinical Medicine 3: 6 Credit Hours
PRCL 646 Essentials of Clinical Medicine 4: 10 Credit Hours

Placement in the Curriculum:   Year Two
Duration:    August - May

Synopsis:    A continuation of the Essentials of Clinical Medicine (ECM) clinical skills sequence, the M-2 year builds on the interviewing skills acquired in the first year course and is designed to provide comprehensive preparation for clerkships and subsequent clinical activities.  Students learn fundamental skills used in taking a history, performing a physical examination, relating to the patient, clinical reasoning, and recording findings in the patient record.  The course also provides the first concentrated exposure to the clinical activities of physicians and to the structure and function of health care facilities (hospitals and clinics) as well as an expanded experience with an outpatient preceptor.

Competencies:    In the process of completing this course students acquire the following competencies:
●    Skill in conducting an effective interview (including gathering data and  maintaining a good doctor-patient relationship);
●    Skill in recording interview and physical examination data in written form;
●    Skill in problem list development and the development of a hypothesis of a patient's problem;
●    Skill in conducting a smooth and professional physical examination;
●    Skill in working with a team of colleagues;
●    Skill in the determination of the health practices and risks of a patient, and the ability to work with that patient to develop a plan to improve health risk behavior;
●    Skill in critical reading and clinical problem-solving using principles of evidence-based medicine.

Students will also:
●    Develop the professional behavior of a competent physician, including: active participation and preparation for the tasks at hand; responsibility; good working relationships with colleagues, patients, and their families; self-directed learning; professional behavior even under stressful conditions; professional grooming and attire;
●    Understand how the various members of the health care team work together in the care of patients;
●    Understand the health care environment, both locally and nationally, and  the effect it has on patients and their care;
●    Understand how personal beliefs may affect the care and treatment of  patients;
●    Be able to recognize and integrate the complexity of multiple levels of data as it affects patient care;
●    Be able to understand and appreciate the impact patients' illnesses have on their lives and the lives of their families.

Key Words:    Clinical skills, history taking, physical examination, communication, interpersonal skills, professional behavior, health risk appraisal, patient records, medical ethics, human values, professional standards, legal standards, epidemiology, biostatistics, prevention, screening, early intervention, predictive value, environmental medicine, health care system, evidence-based medicine

Assessment:    Clinical performance exams utilizing standardized clinical encounters and patients covering interviewing, history taking, physical examination, professional behavior, and clinical reasoning; attendance at and participation in working group sessions; completion of Longitudinal Primary Care experience requirements; papers; clinical case problems, Final essay Examination.

Students in ECM are evaluated using the grading system in effect for clinical clerkships.

Instructional Features:   

●    Six weeks of instruction in a hospital setting
●    Workshops and working group sessions in groups of 12-14 students
●    Simulated clinical encounters with standardized patients for teaching and /or assessing clinical and diagnostic skills and professional behavior.
●    Patient instructors for teaching physical examination skills.
●    Harvey Simulator for teaching the cardiac examination.   
●    Panels of Patients
●    Films
●    Teaching/Learning Experience