Requirements

During the outpatient clerkship, students are required to:

  1. Attend the required Orientation Session on the first day of the rotation
  2. Attend session at the assigned Continuing Care Facility.  Topics include "The Stealth Geriatrician" and Communication and Care at the End of Life.  Lunch is provided.  Session lasts from 10-3pm.
    1. Video 1 - Timed Up and Go
    2. Video 2 - Chair Rise
    3. Video 3 - Balance Assessments
    4. Handouts for afternoon session - "Communication Workshop", "Role play - Patient", and "Role play - Student".
  3. Participate actively in the clinical activities of the practice.  Useful tips for using EPIC in clinic can be found here.
  4. All students are required to participate in a 2 day Hospice Experience. It is important that you review the Palliative Medicine powerpoint prior to the dayback and review for your hospice experience.  See #6 below. All patients are consented prior to medical student involvement in their care.  They are told that you will be there and can decline.  They have agreed to your participation to help you learn.
  5. You have been assigned to a Hospice Nurse.  You should communicate with your assigned nurse the day prior to your scheduled experience to arrange a meeting time and place.  Students will participate in care delivery to patients enrolled in hospice and in the multidisciplinary meeting for your assigned hospice.  In some situations, this may not be local and the multidisciplinary meeting may require driving as well.  You may carpool with the nurse if she is near you or another student.  You can do call if you choose.  Discuss this with your hospice nurse.  The multidisciplinary meeting involves social workers, nurses, physician assistants, pharmacists and medical directors.  It is felt to be an integral part of your experience.  Please make every effort to attend this meeting.
  6. The nurse and you will meet and drive together visiting patients enrolled in hospice care.  The nurse will be completing a professionalism form on you, at the end of your 2 day experience.  After your hospice experience, you should write a 1-2 pg. essay reflecting on your experience.  This essay should be submitted to Carol Carden via email, the nurse that you worked with and one peer from the clerkship that you select personally.
  7. Read the Course Readings (link under "quick links"). Eleven readings/topics MUST be done prior to the dayback.  They are the first eleven topics in the course readings. You may read a different source but will be expected to know these topics in detail. The Internal Medicine, Essentials for Students, will be part of the book exchange if you wish to use it.  Chapters 1-3, 7, 9, 15-17, 20, 25-28, 30, 32-36, 40, 42, 49, 51-57, 60-62, 64-68, 71-74, 77, 80-81, 83-85, 87-88, 90-91, and 95 are the essential chapters for this rotation.  Each chapter is about 4 pages long.  I have omitted the cancer screening chapters because the USPSTF guidelines have been revised since the book was published. Please review these online with the link provided.  Hypertension and Hyperlipidemia guidelines have also been revised and the questions on the test will reflect the new guidelines.  The links are in the course readings.
  8. Read broadly about other symptoms and diseases encountered in the clinic. Use any source you like, but strongly recommend reading broadly and comprehensively for the shelf.
  9. Students should read on Hypertension, Diabetes, Drug Interactions, Dyslipidemia, the three USPSTF articles on breast cancer, colon cancer and prostate cancer screening, DVT, COPD, Osteoporosis and the powerpoint presentation on Palliative Medicine in the Course Readings before the dayback session.  You will have a scored quiz on the eleven readings at the Dayback session. It is part of your grade. You MUST bring A WORKING LAPTOP for the quiz and dayback activities. It needs to work on the UNC network.
  10. Complete the Patient/Procedure log (link to one45 account).
    Please review the LCME mandates for Clinical logs if you have any questions.
  11. Have a mid-clerkship assessment session with your preceptor(s).  See 14c below for further details.
  12. Preparation for Team Based Learning at the Dayback.  Read the following In The Clinic articles found in the course readings.  You may use another source, but are responsible for the interpretation in the ITC articles.
    a. COPD
    b. Osteoporosis
    c. DVT
  13. Attend the Dayback session - bring your laptop and power cord.

    a. There will be three OSCE's on Diabetes, Geriatric patient evaluation and Dying patient. I suggest reviewing the Diabetes presentation  Stealth Geriatrician, and Palliative Medicine ppt as well as the geriatric evaluation videos (links in #2 above) for dayback session.
  • Dying patient is about communication skills. There is no note but a few multiple choice questions.  You have 20min with the patient and 10min with the questions.
  • DM patient is 20minutes and you have to address the usual stuff with a DM patient, and do the pertinent exam. Then you have some multiple choice questions and short answer.
  • Falls patient is how do you evaluate an elderly person who has fallen.  All of the history and physical that you should do in 20min and a note for 10min.

b. TBL - Team Based Learning

  • You will have completed your readings on COPD, Osteoporosis and DVT.
  • You will complete an individual readiness assessment test at the start of each section of the dayback, i.e. before we discuss COPD, you will do a quiz on COPD to assess what you learned from the reading.
  • As a group be prepared to then answer the same questions and then work on a group exercise based on the topic
  • You will need your laptop for this exercise.  You must have your laptop and power cord.
  • Details for the exercise will be given at the Dayback.
  • Details for the grading of this can be found under grading.

c.  Midclerkship assessment

  • Print and bring your clinical logs
  • Use your one45 link to fill out your midclerkship feedback form.  Do this with your preceptor before the Dayback and your preceptor can write comments on it once you have it open.  You can fill out your portion and save it then open it again with your preceptor to look at and they can write comments.  Then you can submit the form.  It must be submitted before you return for your Dayback session.  We will pull it up at the Dayback.

d.  Complete Peer Evaluation form on one45.
e.  Review OSCE's.
f.   Expect to stay until 5pm.

15. Have the preceptor(s) review/complete the online evaluation of student through one45 during an end of clerkship feedback session.

16. Complete an evaluation of your preceptor(s) online through one45.

17. Complete an evaluation of the clerkship through one45.

18. Sit for the Adult Ambulatory Web-Based NBME examination on the last day of the rotation.