Goals of Observed Patient Encounter:
• Patient Care and Clinical Skills: Elicit focused histories and perform appropriate physical exams. Discuss the relevant diagnostic tests, differential and management plan, including health promotion and prevention.
• Interpersonal and Communication Skills: Deliver succinct oral presentations and comprehensive written notes. Improve communication skills with patients and family members
• Medical knowledge: Strengthen basic medical knowledge in real patient encounters including knowledge of psychosocial and family issues.
• Professionalism: Demonstrate behaviors of integrity and compassion with patients. Give and receive relevant feedback with colleagues.
Details of Assignment:
- Students do not need to prepare prior to their patient encounter
- Students will complete one observed patient encounter (OPE) with their preceptor during the first 3 weeks of the clerkship. This will be evaluated using the mini-CEX form, but will not be graded.- Students with then complete a second OPE with their campus director. Students will have the option of repeating the encounter only at the discretion of the campus director.- The OPE with the campus director will be graded.
- Clinic patients are scheduled with acute complaints, about one patient per hour per student. The format may vary slightly from campus to campus but in general, one student will see the patient with the faculty member while 2-3 students may watch on video. Student interviewers are prepped with the patient’s past medical history and chief complaint prior to entering the room. The faculty member will discuss with the student what to focus on for the visit. Students are expected to make a plan for acute problem while taking the patient’s comorbid conditions into consideration. Student interviewers may be asked to write a clinic note. Students will be observed completing the entire patient visit, including discussing the assessment and plan with the patient.
Example Encounter and Timeline:
8:00- 8:05 Patient is ready to be seen. Student and Faculty review the PMH and decide the appropriate focus for the visit
8:05- 8:25 Student interviews and examines patient (faculty also examines pt as necessary) Group uses the mini-CEX to evaluate their peer as they watch on video
8:25-8:40 Student interviewer presents history, PE, assessment and plan to the entire group Group discusses any adjustments to assessment and plan
8:40-8:50 Student delivers assessment and plan to patient
8:50-9:00 Group discusses the visit, gives feedback
Faculty will use the modified mini-CEX to assess student performance and provide feedback