1. The Patient-Centered Medical Home: Lessons Learned From A New Family Medicine Clerkship Curriculum STFM 2009 Orientation / Curriculum Objectives

2. Health Policy / PC-MH / FM Careers Goal: To develop an understanding of the patient-centered medical home. Students will: –Recognize the characteristics of practices that are associated with improved health outcomes and lower costs: first contact care, patient-focused care over time, comprehensive care, coordinated/integrated care, family orientation, community orientation, and cultural competence. –Become familiar with the components of the “Joint Principles of the Patient- Centered Medical Home”: personal physician, physician-directed medical practice, whole-person orientation, coordinated/integrated care, quality and safety, enhanced access, and appropriate payment. –Become familiar with the health system and policy characteristics associated with improved health outcomes. –Recognize the relationship between the physician workforce and health outcomes. –Recognize the relationship of quality and cost of health care to the physician workforce.

3. Population Health and Prevention Goal: To review specific epidemiologic calculations and become familiar with components of population health. Students will: –1. Define and calculate sensitivity, specificity, positive and negative predictive values. 2. Describe three ways environmental or population factors can adversely affect health (specific examples). 3. Define COPC and list two pros and two cons. 4. Explain the purpose of medical surveillance and two specific examples. 5. Describe some contributing factors to disease outbreaks.

4. EBM at the Point of Care Goal: To review and consider the application of evidence–based medicine principles. Students will: –Review the basic principles of evidence-based medicine. –Develop an appreciation for the practical uses and limitations of EBM. –Understand the formulation of answerable and searchable clinical questions. –Develop skills in critically appraising and applying the medical literature.

5. COPC Goal: To introduce basic principles of community oriented primary care. Students will: –Be able to explain what is meant by “caring for the patient not in the room” –Compare individual clinical care to COPC population care –Identify the 5 steps in the COPC process

6. Intro to Patient Email Goal: To become familiar with the guidelines for patient email communication. Students will: –1. Recognize the emerging importance of patient-physician emailing. 2. Recognize appropriate and inappropriate topics and issues within patient emails. 3. Understand the definition of Patient-physician email –4. Become familiar with key structures/policies for implementation of safe, confidential, and efficient email communication. –5. Recognize the impact of implementing such a process on nursing and office staffs.

7. Intro to Practice Management Goal: To introduce basic concepts of practice management. Students will: –Become familiar with basic types of health insurance. –Become familiar with basic coding and billing terminology. –Recognize variations in physician reimbursement. –Recognize variations in physician liability insurance. –Recognize variations in basic types of physician employment. –Become familiar with basic concepts of healthcare finance.

8. Legal and Ethical Issues Goal: To review basic ethical principles and consider the requirements of informed consent Students will: –Understand the fundamental pillars of ethical medical practice: beneficence, non-maleficence, patient autonomy, and distributive justice. –Become familiar with the requirements for informed consent: procedure, risks, benefits, alternatives –Discuss basic legal principles that flow from these topics. –Recognize the limitations and clinical applications of the principles discussed.

9. ECG / Lab Basic Review Goal: To interpret common labs and EKGs: Students will: –Determine rate, rhythm, axis, and intervals. –Recognize ventricular hypertrophy, bundle branch block, and other common ECG morphologies. –Recognize ECGs suggestive of myocardial infarction, atrial fibrillation, and pre-excitation syndromes. –Acknowledge medical and financial justifications for ordering common lab tests. –Interpret common laboratory tests such as complete blood count, urinalysis, lipid panel, and comprehensive metabolic panel.

10. Intro to Leadership / Conflict Resolution Goal: To introduce the full-range leadership model and principles of conflict resolution. Students will: –Recognize that physicians are leaders within their team, office, group, specialty, profession, etc. –Become familiar with the full range leadership model including the traits of laissez faire, management by exception, contingent reward, and transformational leadership. –Become familiar with the characteristics of transformational leadership: individualized consideration, intellectual stimulation, inspirational motivation, and idealized influence. –Understand the principles of and steps toward conflict resolution.

11. Assessment of Knee and Ankle Injuries Goal: To become familiar with treatment of lower extremity injuries. Students will: –Become familiar with clinical approach to the lower extremity. –Become familiar with Ottawa Ankle Rule. –Become familiar with Ottawa Knee Rule. –Be able to evaluate patients with anterior knee pain. –Be able to evaluate patients with an acutely effused knee. –Be able to perform an anatomically-based physical exam of the knee.

12. Primer in Pain Management Goal: To introduce basic principles of pain management in primary care. Students will: –Become familiar with the definitions of common pain management terms. –Review basic pharmacologic approaches to pain management including the WHO pain pyramid, appropriate uses, and adverse effects. –Become familiar with the Federation of State medical Boards “Model Policy for the Use of Controlled Substances for the Treatment of Pain.” –Become familiar with the components of a Pain management Agreement –Understand the 4 A’s of Pain management: Analgesia, Activities of Daily Living, Adverse effects, Aberrant behavior

13. Core Concepts of Family Medicine Goal: To become familiar with the core concepts of Family Medicine Students will: –Recognize the core concepts of Family Medicine: Comprehensive Care, Communication, Continuity (cradle to grave), Community- Health/Community Agencies and Resources, Continuous Quality Improvement, Concordance and Collaboration, Compassion, Cost- Effectiveness, Culturally Competence, and Confidentiality –Participate in all group discussions, as well as display initiative, integrity, and professional/personal maturity. –Relate basic medical and scientific principles to the clinical vignette and case presentation while also thinking about the various community agencies available for this case scenario. –Incorporate concepts of Evidence-Based Medicine into the discussion and learning issues. –Become familiar with the differential diagnosis of vesicular rash; diagnosis, medication management and treatment goals for high cholesterol, high blood pressure, diabetes and metabolic syndrome.

14. Global Perspectives on Healthcare Goal: To introduce relevant determinants of health at the global, national and state levels Students will –Be familiar with the trends in health at the global, national and state levels –Be familiar with the at risk populations of Illinois –Compare the state healthcare trends to national and global trends –Be familiar with global, national, and state initiatives to address health disparities among vulnerable populations

15. Advanced PubMed Search Goal: To review and advance the student’s ability to use PubMed. Students will: – Understand the benefits and disadvantages of using index terms, such as the Medical Subject Headings (MeSH) vocabulary versus using keyword and free text searching methods –Review specific tools such as search limits, my NCBI, and previous searches. –Recognize the differences between PubMed, Cochrane Library, and Essential Evidence Plus –Develop efficient search skills and recognize the appropriate use for each resource and/or tool.

16. Intro to Dermatology Goal: To introduce basic principles of describing and identifying dermatologic lesions Students will: –Be able to define basic dermatologic terminology –Be able to describe dermatologic findings accurately –Identify some common dermatologic conditions