M3 Clerkship Description and Information

Third Year Clerkship In Family Medicine
Welcome to the Family Medicine M3 Clerkship page. Here you will find useful information pertaining to your M3 Clerkship month. This required clerkship gives all students a chance to experience family medicine practice in the office setting. There, under the guidance of superb family physician mentors, students will see the broadest possible range of patients, practice real-world medicine, and discover the satisfactions of family medicine. At the same time, they will be learning the core primary care skills that no other rotation can provide so comprehensively.

The emphasis is on practical problem solving using problem-based learning (PBL), and population-based concepts of medicine are addressed.

For more information, call Karren Yeek, 414-456-4333 (karren@mcw.edu) or Douglas Bower, MD, 414-456-4729 (dbower@mcw.edu).

Clerkship Information

Clerkship Curriculum Development
Clerkship Philosophy
Goals and Objectives of this Clerkship
Clerkship Description
Clerkship Components
Preceptor Ratings of Students
Grading
The Uniform Professional Conduct Policy
The Sick Leave/Time Off Policy
Student Evaluation of the Clerkship Experience
Reading/Informatics
Clerkship Question
Orientation - Powerpoint presentation
EBM - Powerpoint presentation

Clerkship Curriculum Development
The M3 Family Medicine clerkship was first offered at the Medical College of Wisconsin in July 2000. It continues to evolve, based on student feedback and faculty initiatives. The curriculum was developed by Dr. Alan David, Chairman of the Department of Family and Community Medicine along with the faculty of the Division of Predoctoral Education.

The two driving forces of the clerkship curriculum included:

1) The MCW Department of Family and Community Medicine, Division of Predoctoral Education Goal and Educational Priority Statement, and
2) The Association of American Medical Colleges (AAMC) Medical Schools' Objective Project (MSOP) recommendations. This group focused on recommending curricular innovation and change several years ago and defined the following objectives for medical student education:

• Increased ambulatory education
• Broaden the focus on disease and its affect on patient, family, and community
• Incorporation of evidence-based medicine, cost-effectiveness, and quality assurance
• Emphasis on health promotion and maintenance
  Your family medicine clerkship addresses these objectives well.

The ongoing implementation and development of the M3 family medicine clerkship is the responsibility of the Clerkship Director Dr. Douglas J. Bower and the faculty in the Division of Predoctoral Education for the Department of Family and Community Medicine. While the clerkship is a high priority for the entire Department of Family and Community Medicine, the Division of Predoctoral Education drives its day-to-day implementation. (top)

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Clerkship Philosophy
The M3 Family Medicine clerkship is designed to provide all students with an in-depth educational experience to appreciate the basic principles of Family and Community Medicine and apply them to the care of patients.

Regardless of specialty choice, students will develop an important appreciation of the challenges and the special doctor-patient relationship in family medicine practice.

Family medicine is a required discipline of study in all medical schools and provides opportunities for new kinds of learning. The family medicine educational experience is not merely a repeat of what is experienced on other major traditional clerkships (e.g. surgery, internal medicine, pediatrics, ob/gyn, psychiatry/neurology). Family physicians see patients unrestricted by age, sex, or disease process and they focus on the illness of a patient in the context of that patient as an individual, and in the context of that patient's family, that patient's community, and the population from which that patient arises.

Family Medicine is the content (body of knowledge and skills) that composes the discipline of family practice. Family practice is the application of the principles of Family Medicine to the care of individuals and families in day-to-day practice including first contact care, personal care, continuous care and comprehensive care.

In order to understand the practice of a family physician, one must understand the content/discipline on which that practice is based. Family Medicine is often criticized for having too broad a scope in which no one can be completely competent or, on the other hand, for not having enough depth in any one area to be of significant utility to many individual patients. What is often not understood is that Family Medicine is a process-oriented specialty in which the undifferentiated patient with multiple issues presents to the family physician that has to organize these issues, balancing the physician's prioritization of these issues with the patient's prioritization. This balance requires knowledge of the patient's origins in terms of family, ethnicity, culture, community, and health beliefs. Family Medicine goes beyond the scientific reductionistic method that is taught in most of medicine, particularly in the basic sciences. This means one looks for patterns and connections to make a big picture rather than focus on the smallest molecule. Thus, one of our major purposes is to teach the process of patient care in the family practice setting and to help students understand that Family Medicine is a process, problem solving, problem-prioritization specialty. Apropos, we will be using problem-based learning groups as a teaching modality because it fits the process of family medicine. PBL starts with a patient case and asks the learner to formulate the questions, prioritize the questions, and ascertain the answers individually and in collaborative small group effort. This method of learning and inquiry parallels exactly the discipline and practice of family medicine.

To understand the content of Family Medicine, two research articles are required reading. They are both authored by Kurt Stange and found in The Journal of Family Practice in the May, 1998 issue. The first article is entitled, "Illuminating the 'Black Box'," which is a description of 4454 patient visits to 138 family physicians. The second article is entitled, "The Value of a Family Physician," and concludes with this statement, "Family physicians prioritize and deliver care according to a broad agenda based on patient needs." This statement is consistent with the believe/value of family physicians that they are the providers of broad based, family oriented care. (top)

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Goals and Objective of this Clerkship
There are nine goals for this learning experience with pertinent objectives that specify what is to be learned in this clerkship. In many ways, the goals reflect the distinctive system of values and approach to problem solving of family physicians

Goal 1
Provide personal care for individuals and families as the physician of first contact and continuing care in health as well as in illness.

1. Compare and contrast the epidemiology of diseases seen in patients in primary and tertiary care settings and discuss the implications of this epidemiology for the care of patients in these settings.
2. Describe and discuss the forces that can affect the process, timing, and reasons for the patient to seek medical care.
3. Demonstrate a basic level of competency in the history, physical examination, procedural, and problem-solving skills needed to assess and manage the wide spectrum of problems seen in family medicine.
   Identify how normal and abnormal family relationships affect health and illness.
4. Describe the importance of maintaining continuing personal responsibility for the patient's and family's health care.
5. Use the initial patient encounter to begin to establish an effective relationship with the patient and family.
6. Demonstrate a basic understanding of the professional and ethical issues facing family physicians, including the role of the physician as part of managed care systems.

Goal 2
Assess and manage acute and chronic medical problems frequently encountered in the community.

1. Discuss the diagnosis of common, acute, and undifferentiated medical problems using probability estimates of disease prevalence specific to the geographic and socioeconomic community of the practice location.
2. Assess and initially manage common acute illnesses using a focused problem-oriented approach.
   
3. Demonstrate an understanding of the need to make basic diagnostic and treatment decisions that consider the limitations of clinical data.
   
4. Develop a treatment plan that responds to the ongoing changes in patients and their illnesses.
   
5. Recognize the importance and complexity of providing longitudinal, comprehensive, and integrated care for the patient with common chronic medical problems.
   
6. Describe the skills and information required to develop, in conjunction with the patient and patient's family, a chronic disease management plan that enhances functional outcome and quality of life.
   

Goal 3
Provide anticipatory health care using education, risk reduction, and health enhancement strategies.

1. Identify health risks in given patients, families, and communities.
   
2. Demonstrate basic knowledge used for selecting protocols and strategies for reducing identified health risks in patients, families, and communities.
   
3. Use appropriate screening tools and protocols for health maintenance in specific populations.
   
4. Identify appropriate indications and schedules for immunizations in all age groups.
   
5. Counsel patients and families about signs and serious effects of harmful personal behaviors and habits.
   
6. Demonstrate basic knowledge of the complex factors involved in behavioral change.
   
7. Identify the roles of the family physician and other members of the health care team in patient education and health promotion.
   

Goal 4
Provide continuous as well as episodic health care, not limited by a specific disease, patient characteristics, or setting of the patient encounter.

1. Encourage patients seen for episodic or acute illness to seek continuing medical care.
   
2. Describe the prevalence, essential pathophysiology and natural history of common problems and illnesses over the course of the individual and family life cycles.
   
3. Document in the problem-oriented patient record appropriate information for acute and continuing care.
   
4. Recognize and explain the various settings in which family physicians provide care.
   
5. Recognize the need for the family physician's continuing role and responsibility in the care of patients during the process of consultation and referral.
   

Goal 5
Provide and coordinate comprehensive care of complex and severe problems using biomedical, social, personal, economic, and community resources, including consultation and referral.

1. Describe the role of the family physician as a coordinator of care, including understanding the value of serving as a member of a health care team and understanding the roles of other family practice health care team members.
   
2. Describe the important factors related to communication during the patient care process, including communication with others within the practice, consultants, patient, and family.
   
3. Demonstrate an awareness of cost-effective health care, quality assurance, and available resources.
   
4. Recognize appropriate consultation resources, both medical and non-medical, and discuss effective use of these resources.
   
5. Recognize the social, community, and economic factors that affect patient care.
   

Goal 6
Establish effective physician/patient relationships by using appropriate interpersonal communication skills to provide quality health care.

1. Respect the individuality, values, goals, concerns, and rights of the patient and the patient's family.
   
2. Demonstrate a basic knowledge of ethical principles, such as autonomy and beneficence, and the issues of informed consent and confidentiality, which contribute to the formation of a strong and effective physician/patient relationship.
   
3. Collect and incorporate appropriate psychosocial, cultural, and family data into a patient management plan.
   
4. Develop diagnostic and treatment plans in partnership with the patient and the patient's family.
   
5. Demonstrate interpersonal skills which will enhance communication with the patient and the patient's family.
   
6. Discuss physician, patient, and family factors that contribute to difficult physician/patient/family relationships.
   

Goal 7
Develop medical problem-solving skills to define and prioritize a patient's problems, and develop and implement a management plan - evaluating and adjusting it continually.

1. Gather data efficiently and accurately.
   
2. Recognize patterns of illness and wellness and use them in the assessment and management of patient problems.
   
3. Prioritize problems appropriately and use problem-solving skills to manage patient problems.
   

Goal 8
Develop proficiency in assessing and using computer-based resources for improving their knowledge and performance in-patient care, including:

1. Appropriate use of Computer-based databases, using principles of Evidence-Based medical practice
   
2. InfoRetrieverTM and other medical literature databases
   
3. Other appropriate resources available on the Internet World Wide Web
   
4. Computer-based clerkship resources (Syllabus, reference materials, patient encounter database)
   

Goal 9
Integrate principle of community medicine, and the population factors of heritage, environment, and disease prevalence into a patient's care, including:

1. Safety issues, pollution, and public health
   
2. Genetics
   
3. Culture and religion
   
4. Family relationships and dynamics
   
5. Socioeconomic status and occupation
   
6. Educational level/opportunities
   
7. Age and lifestyle
   

Goal Summary:
These goals and objectives describe an all-encompassing and very daunting task. However, each of these goals can be accomplished at a level of learning specific for that of a third year medical student. Mastery of these goals is the life-long task of learning that an individual assumes when he or she enters the specialty of family practice. These goals and objectives will be accomplished by means of different learning opportunities. The majority of time will be spent in a clinical practice seeing patients and working with a family physician. Problem based learning groups will help students learn the clinical problem solving process and medical management of selected common conditions. There will be required readings, and other current reference articles accessed through the M-3 Family Medicine Clerkship web site (http://www.family.mcw.edu/M3Clerkship.htm). In addition, students will have "point-of-care" reference material available on medical software loaded on your PDA. Finally, students will be introduced to the knowledge skills and attitudes for systematically addressing community identified health concerns building on a Community Oriented Primary Care (COPC) model. (top)

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Clerkship Description

Overview/Schedule
This clerkship is organized by calendar month with the first day of the clerkship consisting of an orientation morning at the Department of Family and Community Medicine department offices located on the first floor of the Curative building on the medical school campus. The first day of each clerkship will be the first regular working day of that calendar month at 8:30am. A typical week will have the student spending eight half days in the clinical practice to which they have been assigned. Monday mornings and Thursday afternoons will be devoted to problem-based learning small groups and to community health discussion groups which (for most students) will meet in the departmental offices; however, some studentsmay meet at alternative sites for these sessions (you will be notified where to go at the time of orientation). The last day of the clerkship will be devoted to the final exam and student evaluations of the clerkship. The final exam will be an objective multiple choice question test. Students will evaluate the clerkship after the final exam. The specific schedule time/location for all activities will be provided at orientation. (top)

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Clerkship Components

1. Clinical Experience

A. Practice Assignment
Each student will be assigned to a clinical practice with family physician faculty from the Department of Family and Community Medicine or to the practice of a voluntary community family physician or family physician group. Students will be notified of the assignments in advance. Please contact Karren Yeek (414 456-4333) about your assignment. There will be one physician at each site who will coordinate the schedule at that practice site and the schedule with other physicians at different times during the clerkship at that site. The physician clerkship coordinator at that practice site will provide an orientation to the practice, to the office staff, to other physicians, and to that practice's schedule. While the emphasis of the clerkship is office-based family practice patient care, the faculty have been instructed to allow for opportunities for supervised learning outside of the office when feasible and appropriate. These additional activities might include: work with hospitalized patients, involving the student in selected call experiences (such as deliveries), attending sporting events as team physicians, spending select time with other health care providers or organizations, visits to patients outside the office or hospital such as at home or in nursing homes, and in other opportunities to learn what the life and practice of a family physician is all about.

B. Student Responsibilities
Students will be expected to dress professionally -- neatly and cleanly wearing a clean white coat and bringing appropriate pocket instruments to their rotation on a daily basis. Any absences from the clinical practice must be due to either clerkship learning opportunities, such as problem-based learning small group meetings, or must be cleared with the preceptor in advance or afterwards in instances such as personal illness. The students will be expected to keep a log using their PDA software for the majority of patients that they have seen, with whom they have been professionally involved. The patient encounter log, will be described in more detail later in this section in this syllabus (#4).

2. PBL
Problem based learning (PBL) groups will be assigned at your clerkship orientation. The PBL cases are intended to emphasize clinical problem solving and patient management. You will need to formulate and prioritize clinical questions and then find appropriate resources and quality evidence to answer your questions. With the facilitator's guidance, you will be learning from all the groups' members and teaching all of your group members.

3. Community Health Curriculum

A. Purpose of Curriculum
To introduce third-year medical students to the knowledge, skills and attitudes for systematically addressing community-identified health concerns building on a Community-Oriented Primary Care (COPC) model.

B. Learning Objectives
Students will begin to:

1. understand that health encompasses physical, spiritual, emotional, and economic factors;
   
2. understand the stages of the COPC model and how to implement each stage;
   
3. understand the benefits and challenges of working with communities;
   
4. develop the skills, knowledge and attitudes necessary to effectively work with communities; and
   
5. identify and understand community -based resources.
   

C. Overview of Community Health Curriculum
During the Community Health sessions students will be introduced to the Community- Oriented Primary Care (COPC) model of working with communities. COPC involves a team of health professionals and community members working in partnership to respond to a community's health concerns. The approach combines principles of primary care, public health and epidemiology. Students will work through each of the four components of the COPC model: Community Data Collection and Analysis, Selecting a Health Concern and Designing an Intervention, Planning and Implementing an Intervention, and Evaluating an Intervention

D. Due Date/ Deadlines
At the end of every Community Health session students will be given a learning issue that will be due at the beginning of the next Community Health session. Late assignments will not be accepted.

E. Grading System
A grade for the Community Health Sessions will be determined based on students' class participation and learning issues.

4. Patient Encounter Log

A. Why
It is important to know what you are seeing and it is important for us to know the content of this clerkship month-by-month, site-by-site and over the entire year as the clerkship evolves, develops, and completes its first cycle. Therefore, you will be required to record any significant encounter with a patient in which you have played a role, either observing a significant part of the clinical encounter or by conducting part of that encounter and presenting it to your faculty physician.
B. How
Your palm pilot will be used to efficiently log your patient care experience. The log will be done in an anonymous fashion to protect the patient's individual identity. Thus, you will not record social security numbers, chart numbers, or name - simply age, sex, diagnoses, procedures, and other important information that would describe this patient's role in that particular practice. Record your palm data on the day you see the patient. It should take no more than two minutes per patient, or for five patients about ten minutes per half day.
C. Outcome
Accumulated patient data, recorded by students over time, will enable us to build a profile of each practice to better understand and guide the learning of future students in that particular clinical site and to better organize and direct the overall clinical learning for students who will come after you in this clerkship.You may obtain a printout at the end of your clerkship (or any time during the clerkship) of your individual data by contacting Karren Yeek karren@mcw.edu 414 456-4333.
D. Patient Experience Objectives
Objective 1: Each student's documented clinical experience will include at least one encounter with 80% of the top 20 diagnoses/diagnosis groups seen in family practice.

1. Hypertension/elevated blood pressure	11. Sinusitis
2. Diabetes	12. Otitis media/ear pain
3. General medical exam/Adult physical	13. Hyperlipidemia
4. URI (Upper respiratory infection)	14. GERD (reflux)
5. Prenatal Exam/Pregnancy	15. Acute Phargngitis
6. Low back pain	16. Headache
7. Routine infant exam/Well child	17. Bronchitis
8. Sprain/strain/tendonitis	18. Osteoarthritis/DJD
9. Asthma	19. Obesity
10. Depressive disorder	20. Allergic Rhinitis/Vasomotor Rhinitis

Other important top diagnoses:

21. UTI (Urinary tract infection)	26. Vaginitis
22. Contact dermatitis/atopic dermatitis	27. STD/HIV
23. Abdominal pain	28. Domestic violence/Partner violence
24. Anxiety state	29. Menstrual disorder
25. Coronary artery disease/chest pain	30. Thyroid disorder

Objective 2: Each student's documented clinical experience will include a minimum number of patients in all age/sex demographic groups (see table below):

Age	Rationale	Minimum numbers
		Male	Female	Total
0 - 5	Well child	2	2	4
6 - 10	Elementary school age	1	1	2
11 - 19	Adolescents	2	2	4
20 - 49	Childbearing/Early adulthood	3	3	6
> 50	Postmenopausal/Late adulthood - Geriatric	4	4	8
	Totals	12	12	24

(top)

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Preceptor Ratings of Students
This section describes the methods for preceptors to rate students' performance at their clinical sites.

Preceptor Evaluation of Student Performance

A. Mid-clerkship evaluation
You and your preceptor will complete a mid-clerkship evaluation form. This evaluation should provide early feedback to the student to allow the student to improve their clinical learning and/or performance for the remainder of the clerkship. Students should use the form to do their own self-assessment first, then give it to your preceptor for their feedback. Fax the form to 414 456-6523 or turn in to Karren Yeek, the clerkship coordinator, as soon as it is completed.
B. End of clerkship evaluation
The responsible preceptor designated at your site will complete an M-3 clerkship evaluation form. This is the college wide form used for all M-3 clerkships. If you have had contact with multiple teachers at your clinical site, the site coordinator will solicit and synthesize feedback from as many of your clinical teachers as is possible. The evaluation form is "behaviorally based" and allows your preceptor(s) to rate your performance. Your preceptor will not give you a grade (e.g. honors, high pass, pass, etc.). Preceptors are making an effort to rate students in a consistent manner from site to site. The ratings are sent to the clerkship director who ultimately will assign you a standardized score based on the ratings (see "grading", next section). Preceptor comments are included in your final evaluation, which is sent to the Registar's office. (top)

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Grading
The grade for the Family Medicine Clerkship will be based on four components.

• 50% - preceptor's ratings on the M3 Clerkship Evaluation form
  
• 20% - final examination
  
• 20% - PBL facilitator's rating on the PBL Evaluation Form
  
• 10% - Community health case study
  

A standardized score will be calculated for each of the four clerkship components. (A standardized score is calculated by subtracting the average score from the student score and then dividing by the standard deviation.) The clerkship grade will be calculated by combining the standardized scores for each of the four clerkship components using the percentages listed above, i.e., 50% clinical preceptor rating, 20% exam, 20% PBL ratings, and 10% community health case. The distribution of clerkship grades will be approximately 20% to 30% Pass, 40% to 60% High Pass, and 20% to 30% Honors.

Remediation - Exam Retake
A student who fails the written exam may be allowed to retake the final exam (once within two weeks of original exam) if extenuating circumstances can be documented which contributed significantly to the failing score.

Patient Case Log
Students who do not completely record and download their patient encounters will drop one grade level from the earned clerkship final grade. We recommend you download your data weekly; however, the log data must be downloaded by the end of the month. No later. (top)

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Uniform Professional Conduct Policy for Clinical Rotations

This policy was approved by the Clerkship Directors, June 2001

During Clinical Rotations medical students will adhere to the following standards of professional conduct:

1. Professional Appearance

a. Identification: While on clinical rotations, students at all time must wear MCW Name Tag/ID Badge and appropriate identification at all times as outlined by the facility at which they are rotating.
b. Clothing and Accessories: Clothing, including white coats, must be clean and professional looking. Any clothing or personal accessories (e.g., jewelry, tattoos, or piercings) that interfere with the provision of patient care, is not acceptable. This includes clothing or personal accessories that limit a student's ability to effectively communicate with patients, families, staff and/or their ability to perform a physical examination or procedure.

2. Communication

a. Introduction to Patient: Students will introduce and identify themselves to the patient and their families as "medical students". The student will advise the patient that he/she has been directed to evaluate the patient and share the findings with the staff physician who is responsible for the patient's care.
b. Cultural Differences: Students must acknowledge and respect the cultural differences of patients, families, and staff.
c. Respect: Students will demonstrate respect in all interactions with patients, families, supervisors, peers and members of the healthcare team.

3. Patient Care Responsibility

a. Responsibility: Patient care is the responsibility of the supervising physicians.
b. Supervision: Students must be supervised in their interactions with patients. Student/patient interactions must be within the confines of resident/faculty teaching.
c. Patient Access: Student interaction with patients is limited to only those patients of the supervising physician or service to which they have been assigned. Student should limit and qualify discussions of any findings (e.g., H and P, laboratory findings, prognosis, treatment) with the patient.
d. On Call: When the student is on call, he/she may interact with patients seen in consultation by the service to which they are assigned or with those patients in need of emergent/urgent problems that require evaluation/treatment.
e. Confidentiality: All aspects of patient care (e.g. conversations re: H & P, diagnosis, test results, treatment, prognosis, and written medical record) will remain confidential. Discussions should occur in appropriate venues with treating physicians for the purposes of patient care or education.
f. Medical Records: Students may make notations in the actual or electronic chart consistent with the protocol of the facility to which they are assigned and at the direction of the supervising physician.

4. Professional Responsibility

a. Responsibility to the Profession: The student will report any witnessed violations of this policy or other forms of unprofessional behavior to his/her immediate supervisor and/or clerkship director.
b. Attendance: The student will participate in clinical care activities as assigned by the supervising physician. In case of a personal emergency, the student must contact the supervising physician and the clerkship coordinator to discuss absence from the assigned service.
c. Sick Leave/Time Off: A written request to the Clerkship Director must be submitted at least one month before the start of the rotation. The Clerkship Director, per the attached policy, will evaluate requests individually. (top)

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Request for Time Away from M3 Clerkship Rotations
Approved by M3 Clerkship Directors September 18, 2002.

The knowledge and experience acquired on clinical clerkships must be the top priority for the rotating medical student on a clinical service; attendance on a rotation is required for all assigned activities. There are, however, occasions when time away may be necessary. A serious illness or death in the family, or other circumstances judged by the Clerkship Director as compelling are examples of reasons to allow time away. In cases requiring substantial time away from the school, the student must contact the Associte Dean for Student Affairs to arrange for a formal leave of absence.

Each clerkship director will evaluate the time-away request associated with his/her clerkship and has the final approval.

PROCESS FOR TIME AWAY REQUEST
The process, as outlined below, must be followed and gives no assurance that a student's request will be granted:

1. Submit a written request to the Clerkship Director at least one month before the start of the rotation. Exceptions to this time requirement can be made for extenuating circumstances or dire emergencies, as judged by the Clerkship Director.

2. Written requests should include the following:

a. Student information
Name:
Address:
Phone number:
Pager number:
E-mail address:

b. Clerkship information
Name of clerkship:
Dates of clerkship:
Dates of requested time off:

c. Explanation of reason of requesting scheduled time off

d. With the request for time away, the student must submit a plan that specifies how the time missed will be addressed.

3. After approval of the clerkship director, the student is required to notify the attending physician and chief resident on the service is required. Any student granted time off a clinical clerkship must arrange coverage for night call, care of his/her patients, and all clinical responsibilities during the time off. The plan for addressing missed time, once approved by the clerkship director, must be implemented with oversight by the clerkship director and/or his/her designee.

Clerkship Director: Douglas J. Bower, MD
Clerkship: Family Medicine
Address: Department of Family Medicine, MCW
Phone: (414)456-4333 (Clerkship Coordinator, Karren Yeek)
(top)

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Student Evaluation of the Clerkship Experience

Three methods will be used to assess students' perceptions of the clerkship experience. Students will use the MCW Clinical Clerkship Evaluation Form to evaluate the overall clerkship experience including the PBL sessions. Students will use the MCW Clinical Teaching Evaluation Inventory to evaluate the clinical teaching effectiveness of preceptors. Students will use the PBL Facilitator Evaluation Form to evaluate the effectiveness of PBL facilitators. (top)

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Reading/Informatics

Required Readings:

A. Textbook
The Department of Family and Community Medicine will loan each student the required textbook for this clerkship: Sloane's Essentials of Family Medicine, Fourth Edition, copyright 2002. All students are required to read chapter 3 (p 37-40) and chapters 5 thru 15.

B. Journal Articles for Community Health
The following articles are required reading for the Community Health sessions:

Candib LM, Gelberg L. How will Family Physicians Care for the Patient in the Context of Family and Community? Family Medicine 2001;33(4):298-310.

Cohen S, Doyle WJ, Skoner DP, Rabin BS, Gwaltney JM. Social Ties and Susceptibility to the Common Cold. JAMA 1997;277(24):1940-1944.

Green AR, Retancourt JR, Carrillo JE. Integrating Social Factors into Cross-cultural Medical Education. Academic Medicine 2002;77(3):193-197.

Jones RB, Hampshire AJ, Tweddle S, Mounlt B, Hill A. The clinician's role in meeting patient information needs; suggested learning outcomes. Medical Education 2001;35:565-571.

Lantz PM, Lynch JW, House JS, Lepkowski JM, Mero RP, Musick MA, Williams DR. Socioeconomic disparities in health change in longitudinal study of US adults: the role of health risk behaviors. Social Science and Medicine 2001;53:29-40.

Main DS, Tressler C, Staudenmaier A, Nearing KA, Westfall JM, Silverstein M. Patient Perspectives on the Doctor of the Future. Family Medicine 2002:34(4):251-259.

Williams MV, Davis T, Parker RM, Weiss DB. The Role of Health Literacy in Patient-Physician Communication. Family Medicine 2002;34(5):383-389.

C. Journal Articles for Clerkship
The following articles are required reading for the Clerkship.

Strange K, et. al. Illuminating the 'Black Box'. Journal of Family Practice, 1998, 46(5):377-389.

Strange K, et. al. The Value of a Family Physician. Journal of Family Practice, 1998, 46(5):363-368.

D. Recommended Electronic Resources

1) For bookmarks of web sites, go to http://www.mcw.edu/clinicalresources
2) For PDA informatics go to http://www.lib.mcw.edu/html/pda_information.html

READING ADVICE

1. In the first few days, read chapters on "principles."

a. Chapter 15 - Approach to Common Problems in Family Medicine
b. Chapter 6 - Information Mastery: Basing Care on the Best Available Evidence
c. Chapter 8 - Helping Your Patients Stay Healthy
d. Chapter 5 - The Challenging Patient Encounter

2. Within the first week or so, read on Preventive Medicine concepts, community medicine and content of Family Medicine:

a. Chapter 11 - Well Child and Adolescent Care
b. Chapter 12 - Well Adult Care
c. All required journal articles

3. By mid-clerkship read on women's health issues and selected special topics:

a. Chapter 10 - Prenatal Care
b. Chapter 9 - Pregnancy Prevention and Contraception
c. Chapter 13 - Promoting Health for Women at Menopause
Then,
d. Chapter 3 (p 37-40) - Outside the Office Walls
e. Chapter 7 - Complementary and Alternative Therapies in Family Medicine
f. Chapter 14 - End-of-Life Care

4. Optional Reading (if interested in Family Medicine)

a. Chapter 1 - From Cradle to Rocker: Providing Care Across the Human Life Cycle
b. Chapter 2 - Keeping the Focus on "Family" in Family Medicine
c. Chapter 3 - (p 41-59) Outside the Office Walls
d. Chapter 4 - Family Practice in an Era of Rapid Change

5. Recommended Supplementary Reading (as you see patients)

a. Chapter 16 to 48 mostly problem orientated
b. Reference links on the M3 Family Medicine Clerkship web page http://www.family.mcw.edu/M3Clerkship4.htm

6. The CD included with Sloane's book, with practice multiple choice questions can be used, but is not required

7. Use Medical InfoRetriever™ password provided by the Clerkship (CD version included in Sloane's book is incomplete)

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Questions
If you have any questions regarding the mechanics of this course, please feel free to contact: Ms. Karren Yeek (414) 456-4333 or karren@mcw.edu. If you have questions about grading, course organizations, and content, please contact clerkship director, Dr. Douglas J. Bower (414) 456-4729 or dbower@mcw.edu.
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