Clinical Log

Background

The Liaison Committee on Medical Education (LCME) is the agency that accredits medical schools in the United States. The LCME mandates that “an institution that offers a medical education program must have in place a system with central oversight to ensure that the faculty define the types of patients and clinical conditions that medical students must encounter, the appropriate clinical setting for the educational experiences, and the expected level of medical student responsibility. The faculty must monitor medical student experiences and modify them as necessary to ensure that the objectives of the medical education program are met.”

To ensure adherence to this mandate, UNC SOM created the UNC96, a list of conditions and symptoms reflective of the most important medical conditions in North Carolina (based on mortality, morbidity, prevalence, cost of care data, and faculty opinion). Before graduating, all students must observe or participate in the care of patients with each of these conditions and symptoms. Students progress towards this requirement is monitored through the use of the Patient Log (on one45).

UNC Pediatrics Clerkship Requirements

During the Pediatrics Clerkship, all students are required to have at least one clinical encounter, structured didactic, or interactive case completion (eg. CLIPP case) with patients with the following conditions (from the UNC96 list):

  • A newborn
  • A toddler or preschool well child check (age 1-5)
  • An adolescent patient
  • An infant well child check (age less than one year)
  • An older child visit (age 5-12)
  • Anemia
  • Asthma
  • Bronchiolitis
  • Cough, chronic
  • Dermatitis
  • Diarrhea, acute or chronic
  • Domestic Violence/Abuse
  • Evaluation of sick child in need of urgent medical evaluation.
  • Fever
  • Fracture
  • Headache (including migraine)
  • Heart Murmur (pediatric)
  • Inadequate growth
  • Influenza
  • Intellectual Disability (mental retardation, ADHD, etc)
  • Lymphadenopathy
  • Nausea and/or Vomiting
  • Neonatal Resuscitation
  • Obesity in children
  • Otitis Media
  • Pediatric patient with chronic disease
  • Pharyngitis
  • Red Eye
  • Respiratory Distress/Failure
  • Throat swab
  • Upper Respiratory Infection (acute)/Sinusitis
  • Write orders for an appropriately weight-based dosed medication for a child
  • Write orders for appropriate intravenous fluids on an inpatient

Monitoring

As noted above, patient encounters will be monitored by completion of the Patient Log (on one45).  At the midpoint feedback session, students will review the Patient Log with their Site Director.  This will allow students to focus subsequent clinical encounters to maximize the chance of a direct clinical experience with patients with the conditions listed above.  Also during that meeting, each student’s overall clinical experiences will be discussed, including a review of the Patient Log.   If needed, a student’s subsequent clinical rotation will be modified to the extent possible to maximize the chance of direct clinical experiences with patients with the conditions listed above.