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Acting Internship | 6 credit hours

The Acting Internship (AI) is a four-week inpatient experience that allows students to prepare for the rigors of internship and can be taken at a UNC School of Medicine branch campus or clinical site. Students can select the clinical experience and site for the rotation. Letters of recommendation for residency application may be requested at the end of this rotation.

Selective Course Contact

Selective Course Director: Dr. Lindsay Wilson and Selective Course Coordinator: Mindy McKinney

Grading and Assessments

Acting Internship is graded on a scale of Honors, High Pass, Pass, and Fail.  Assessments include:

  • Mid-course Feedback (formative)
  • Written Assignment on Discharge Summary or Hand-off Exercise (formative)
  • Common Assessment Form (summative)

Acting Internship Selective Course Enabling Competencies and Learning Objectives

Patient Care and Clinical Skills Enabling Competencies

PC1. Obtain an accurate, age-appropriate medical history.

  • Reliably obtain accurate information from patients, including patients with special situations or low literacy levels, in area or specialty of interest.
  • Adjust interview to overcome potential barriers including socioeconomic circumstance, literacy levels, ethnicity, and cultural practices.

PC2. Demonstrate proper technique in performing both a complete and a symptom-focused examination, addressing issues of patient modesty and comfort.

  • Demonstrate accurate exam technique in the specific clinical setting in which one is practicing.
  • Demonstrate sensitivity to patient comfort and modesty.

PC4. Justify each diagnostic test ordered and proposed with regard to cost, effectiveness, risks and complications, and the patient’s overall goals and values.

  • Discuss with the care team and patient the rationale for ordering specific tests, the risks and benefits of tests that are proposed, and how these tests with contribute to the care of the patient.

PC5. Apply clinical reasoning and critical thinking skills in developing a differential diagnosis

  • Integrate information obtained from history and physical examinations and diagnostic testing, and review of the clinical literature to formulate an appropriate differential diagnosis and plan of care for patients in area or specialty of interest.
  • Recognize the importance of aligning the diagnostic and treatment approach for each patient with the goals of the patient and family.

PC6. Apply the principles of pharmacology, therapeutics, and therapeutic decision-making to develop a management plan.

  • Differentiate between alternative medications for common conditions based on therapeutic effectiveness, individual patient characteristics, and cost considerations.
  • Identify cost considerations and barriers to medication use.

PC7. Identify and incorporate into the care of patient’s appropriate prevention strategies for common conditions.

  • Select appropriate prevention strategies for diseases, recognizing intended and unintended consequences.
  • Appropriately select and integrate prevention strategies into management of patients in area or specialty of interest.

PC8. Identify when patients have life-threatening conditions and institute appropriate initial therapy.

  • Participate in diagnosis and management of patients with common life-threatening conditions in area or specialty of interest.

PC9. Demonstrate sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation.

  • Participate in diagnosis and management of diverse patient populations with sensitivity to gender, age, race, religion, disabilities, gender identify, and sexual orientation.

Medical Knowledge Enabling Competencies

MK1. Describe the normal structure and function of the human body and of each of its major organ systems across the life span.

  • Integrate knowledge of the expected changes in organ function as well as normal physiological changes across the lifespan into the care of patients with core medical problems in area or specialty of interest

MK2. Explain various causes (genetic, developmental, metabolic, toxic, microbiologic, autoimmune, neoplastic, degenerative, behavioral, and traumatic) of major diseases and conditions and the ways in which they operate on the body (pathogenesis).

  • Discuss the pathogenesis of major conditions related to area or specialty of interest.

MK3. Describe how the altered structure and function (pathology and pathophysiology) of the body and its major organ systems are manifest through major diseases and conditions.

  • Identify pathology and pathophysiology of the body and its major organ systems in common diseases and conditions in area or specialty of interest.

MK5. Demonstrate knowledge of the common medical conditions within each clinical discipline, including its pathophysiology and fundamentals of treatment.

  • Use knowledge of pathology and pathophysiology to develop diagnostic and therapeutic plans for patients with common conditions in area or specialty of interest.

MK6. Demonstrate knowledge of the basic principles of human behavior throughout the life cycle, including human sexuality and development during infancy, childhood, adolescence, adulthood, and end of life.

  • Use knowledge of human behavior to develop diagnostic and therapeutic plans in area or specialty of interest

MK7. Recognize the medical consequences of common societal problems.

  • Create discharge/management plans that address the impact of social conditions and problems on patients in area or specialty of interest.

Interpersonal and Communication Skills Enabling Competencies

IC1. Communicate effectively in oral format with patients and patients’ families.

  • Demonstrate effective oral communication, using literacy-level appropriate language, with patients and families in area or specialty of interest.

IC2. Communicate effectively in oral format with colleagues, and other health care professionals.

  • Demonstrate effective oral communication in SOAP format when presenting new patients to other team members (i.e. resident and faculty physicians) and use accepted method or standardized tool when presenting patients to other team members during hand-offs.

IC3. Communicate effectively in written format with colleagues, and other health care professionals.

  • Demonstrate effective and appropriate written communication (discharge summaries, advance care planning notes, medication reconciliation) in the electronic medical record.

Professionalism Enabling Competencies

PR1. Identify and consistently demonstrate ethical principles and behaviors in the care of patients

  • Treat everyone including patients, families, team members, faculty, peers, and staff with unconditional positive regard during every interaction and recognize the importance of patient centered delivery of healthcare.
  • Identify resources within the hospital to assist practitioners in resolving complex ethical dilemmas.

PR2. Demonstrate professional behavior consistent with expectations for the medical profession including punctuality and attire.

  • Arrive on time each day and actively prepare for and participate in patient care and teaching activities.
  • Ask for and incorporate feedback regularly to improve performance.

PR3. Demonstrate respect for and ability to adapt to different patient and medical cultures and expectations,

  • Identify and adjust to the cultural nuances and expectations of different medical specialties.
  • Identify and adapt to patient cultures to maintain patient-centered care.

Life Long Learning Enabling Competencies

LL1. Demonstrate skills in retrieving, critically assessing, and integrating social and biomedical information into clinical decision-making.

  • Critically assess and apply biomedical information to address diagnostic, prognostic, and or treatment questions in area or specialty of interest.

LL2. Reflect upon clinical, service and educational experiences, evaluate positive and negative aspects, and make changes to improve future experiences.

  • Reflect on clinical experience (For AI, performing patient hand-offs), evaluate positive and negative aspects of this experience, and describe changes to improve future experiences.

LL3. Demonstrate personal accountability by actively seeking feedback, admitting errors openly, and honestly modifying behavior.

  • Request, respond and apply feedback from faculty and peers to improve professional behavior and clinical performance.

Social And Health Systems Enabling Competencies

SHS7. Demonstrate collaborative teamwork skills and the ability to work effectively with other members of the health care team.

  • Demonstrate teamwork skills and initiative, working collaboratively with all members of the team.

SHS9. Identify necessary elements for coordinated care of patients with complex and chronic diseases.

  • Work effectively with various members of the care team including care managers, social workers, pharmacist, medical assistants, nurses, and others to coordinate care for all patients and specifically those with complex needs.