Doctoring and Clinical Skills – Phase 1: Year One of College of Medicine
Placement in the Curriculum: Phase 1
Synopsis: Doctoring and Clinical Skills (Longitudinal; 19 credits) is the primary vehicle for the Clinical Practice theme and students’ introduction to the care of patients. The course will combine classroom exercises and discussion in small groups, skills practice with patient-instructors and with each other, clinical simulation-based exercises for instruction and assessment, in-hospital practice of the complete history and physical examination, and office-based primary care experience in working with patients.
Competencies: In the process of completing this course, students acquire the following competencies:
● Gather data and establish rapport with patients.
● Recognize and describe common reactions of patients to doctors and doctors to patients.
● Identify common sociocultural, gender, and aging issues which commonly arise in interviews.
● Interpret trends within the changing health care environment that influence clinical practice and future developments.
● While acquiring skills to interview and talk to patients, students become acquainted with the impact of chronic disease, the meaning of illness in the context of patient, family and community; the role of culture, community resources and agencies in the work of primary care providers.
Key Words: Patient-doctor relationship, psychology of illness, socialization of doctors, undergraduate primary care education, ambulatory care education, continuity of care.
Assessment: Small group participation grade; written assignments; research papers; standardized patient examination of interviewing skills; attendance at 6 sessions with primary care preceptor; professional behavior checklist from primary care preceptor. Students in ECM are evaluated using the grading system in effect for clinical clerkships.
Instructional Features: Lectures, small group discussions, special topics. The Introduction to Primary Care (IPC) program that is part of this course places students with preceptors throughout the Chicago area and focuses on continuity of care in family practice, medicine, and pediatrics. Other features include early exposure to clinical medicine through on-site observation, training and practice.
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.
● 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
● Teaching/Learning Experience