Course Objectives
Required Clinical Experiences

COURSE OBJECTIVES

The following are the learning objectives for the Family Medicine clerkship. Students are expected to demonstrate proficiency in these areas in order to satisfactorily complete the rotation/course. In addition, the extent of a student's mastery of these objectives will help guide the clinical /course evaluation and grade.

Course Objective

Mapped UCI School of Medicine Program Objective

Core Competency

FM-1. The student will appreciate the value of primary care as an integral part of any health care system and recognize the critical role family physicians have in fulfilling that role.

A-5. Knowledge of medical practice, including health care economics and health systems impacting delivery and quality of patient care.

Knowledgeable

FM-2. The student will recognize the key principles and methods used by family physicians including:

The biopsychosocial model of care
Comprehensive care
Care in the context of family, community, and/or culture
Coordination/complexity of care

A-4. Knowledge of population health, epidemiology principles and the scientific basis of research methods relevant to healthcare.

B-1. The ability to competently conduct a medical interview and counseling to take into account patient health beliefs, patient agenda and the need for comprehensive medical and psychosocial assessment.

B-6. The ability to function effectively within the context of complexity and uncertainty in medical care.

C-2. Professional behaviors reflecting compassion and respect for patient privacy, altruism and a commitment to comprehensive holistic medical care.

C-3. Sensitivity and awareness of diverse cultures, health beliefs, and social factors impacting patient health and illness.

Knowledgeable

Skillful

Altruism

FM-3. The student will be able to identify key characteristics of family physicians that define their style of practice including:

Prior knowledge of the patient
Care for a heterogeneous patient population
Providing several types of care within the same visit
A staged diagnostic approach
Opportunity for follow up care.

B-1. The ability to competently conduct a medical interview and counseling to take into account patient health beliefs, patient agenda and the need for comprehensive medical and psychosocial assessment.

Skillful

FM-4. The student will recognize social determinants of health which are conditions in which people are born, grow, work, and age. Students will be able to identify some of the personal, social, physical, economic, and environmental factors that influence health status. The student will be able to acknowledge the role of family physicians in improving the health of individuals and communities.

A-4. Knowledge of population health, epidemiological principles and the scientific basis of research methods relevant to healthcare.

A-5. Knowledge of medical practice, including health care economics and health systems impacting delivery and quality of patient care.

C-3. Sensitivity and awareness of diverse cultures, health beliefs, and social factors impacting patient health and illness.

Knowledgeable

Altruistic

FM-5. The student will enhance their basic skills in history taking, physical examination, communication, and clinical reasoning.

A-3. Knowledge of basic clinical skills required to meet the skills objectives, including interviewing, physical diagnosis, communication and clinical reasoning processes.

B-1. The ability of competently conduct a medical interview and counseling to take into account patient health beliefs, patient agenda and the need for comprehensive medical and psychosocial assessment.

B-2. The ability to competently perform a complete and organ-specific examination including a mental health status examination.

B-3. The ability to articulate a cogent, accurate assessment and plan, and problem list, using diagnostic clinical reasoning skills in all the major disciplines.

Knowledgeable

Skillful

FM-6. The student will evaluate, and manage acute conditions commonly seen in the office of a family physician.

A-2. Knowledge of the pathogenesis of diseases, interventions for effective treatment, and mechanisms of health maintenance to prevent disease.

B-1. The ability to competently conduct a medical interview and counseling to take into account patient health beliefs, patient agenda and the need for comprehensive medical and psychosocial assessment

B-2. The ability to competently perform a complete and organ-system-specific examination including a mental status examination

B-3. The ability to articulate a cogent, accurate assessment and plan, and problem list, using diagnostic clinical reasoning and skills in all the major disciplines.

Knowledgeable

Skillful

FM-7. The student will evaluate and manage chronic conditions commonly seen in the office of a family physician.

A-2. Knowledge of the pathogenesis of diseases, interventions for effective treatment, and mechanisms of health maintenance to prevent disease.

B-1. The ability to competently conduct a medical interview and counseling to take into account patient health beliefs, patient agenda and the need for comprehensive medical and psychosocial assessment

B-2. The ability to competently perform a complete and organ-system-specific examination including a mental health status examination

B-3. The ability to articulate a cogent, accurate assessment and plan, and problem list, using diagnostic clinical reasoning and skills in all the major disciplines.

Knowledgeable

Skillful

FM-8. The student will be able to conduct a wellness visit for a patient of any age and gender using evidence-based health promotion and disease prevention plans.

A-2. Knowledge of the pathogenesis of diseases, interventions for effective treatment, and mechanisms of health maintenance to prevent disease

A-3. Knowledge of basic clinical skills required to meet the skills objectives, including interviewing, physical diagnosis, communication and clinical reasoning processes

B-4. The ability to search the medical literature, including electronic databases, and to locate and interpret up-to-date evidence to optimize patient care.

B-5. The ability to practice effective preventive medicine by identifying, addressing and advocating for strategies to maintain health and well-being, to identify and treat disease early where appropriate and to advise on lifestyle practices.

Knowledgeable

Skillful

FM-9. The student will be able to manage a follow up visit with a patient having one or more acute or chronic conditions.

A-1. Knowledge of the structure and function of the major organ systems, including the molecular, biochemical and cellular mechanisms for maintaining homeostasis.

A-2. Knowledge of the pathogenesis of diseases, interventions for effective treatment, and mechanisms of health maintenance to prevent disease.

A-3. Knowledge of basic clinical skills required to meet the skills objectives, including interviewing, physical diagnosis, communication and clinical reasoning processes.

B-1. The ability to competently conduct a medical interview and counseling to take into account the patient health beliefs, patient agenda and the need for comprehensive medical and psychosocial assessment.

B-2. The ability to competently perform a complete and organ-system-specific examination including a mental status examination.

B-3. The ability to articulate a cogent, accurate assessment and plan, and problem list, using diagnostic clinical reasoning and skills in all the major disciplines.

Knowledgeable

Skillful

FM-10. The student will enhance their skill in the evaluation and management of common musculoskeletal conditions.

B-1. The ability to competently conduct a medical interview and counseling to take into account patient health beliefs, patient agenda and the need for comprehensive medical and psychosocial assessment.

B-2. The ability to competently perform a complete and organ-system-specific examination including a mental health status examination.

B-3. The ability to articulate a cogent, accurate assessment and plan, and problem list, using diagnostic clinical reasoning and skills in all the major disciplines.

Skillful

FM-11. The student will improve patient-centered communication skills. This may involve active listening, showing empathy, collaboration, recognizing the patients/family’s specific concerns, and reflecting on one’s own personal frustrations when patients do not adhere to offered recommendations or plans.

A-2. Knowledge of the pathogenesis of diseases, interventions for effective treatment, and mechanisms of health maintenance to prevent disease.

A-3. Knowledge of basic clinical skills required to meet the skills objectives, including interviewing, physical diagnosis, communication and clinical reasoning processes.

B-1. The ability to competently conduct a medical interview and counseling to take into account patient health beliefs, patient agenda and the need for comprehensive medical and psychosocial assessment.

B-2. The ability to competently perform a complete and organ-system-specific examination including a mental health status examination.

B-3. The ability to articulate a cogent, accurate assessment and plan, and problem list, using diagnostic clinical reasoning and skills in all the major disciplines.

B-6. The ability to function effectively within the context of complexity and uncertainty in medical care.

C-1. Honesty and integrity reflecting the standards of the profession, in interacting with colleagues, patients, families and professional organizations

Knowledgeable

Skillful

Altruistic

FM-12. The student will improve information gathering skills to answer clinical questions using an evidence-based medicine approach that allows them to critically evaluate the validity of information sources. They will learn an approach to using quality internet sites as resources and critically evaluate the information to be used in the management of patient problems.

B-4. The ability to search the medical literature, including electronic databases, and to locate and interpret up-to-date evidence to optimize patient care.

D-1. A commitment to lifelong learning and independently seeking new knowledge and skills in their own recognized areas of learning deficit.

Skillful

Dutiful

FM-13. The student will recognize the value of a team approach to patient care. The student will participate as an effective member of a health care team and be able to discuss the roles of different team members. They should be able to communicate effectively with professionals from other disciplines and specialties.

C-1. Honesty and integrity reflecting the standards of the profession, in interacting with colleagues, patients, families and professional organizations

Altruistic

FM-14. The student will be motivated to serve our community. The student will continue their personal growth and be committed to the development of professional, ethical, and altruistic behaviors and attitudes reflecting the highest standards of the profession.

C-1. Honesty and integrity reflecting the standards of the profession, in interacting with colleagues, patients, families and professional organizations

C-2. Professional behaviors reflecting compassion and respect for patient privacy, altruism and a commitment to comprehensive, holistic medical care

D-2. A commitment to patient care and to the well-being of patients and colleagues

D-3. A commitment to serve our community

D-4. A commitment to personal well-being and the well-being of family and friends

Altruistic

Dutiful

REQUIRED CLINICAL EXPERIENCES

There are two levels of student responsibility that may be expected for a required clinical experience (case log):

Comprehensive Encounter
The student is the primary evaluator for this encounter. They will obtain the patient history, perform the physical examination, and discuss/develop differentials and management plans with the team. In the appropriate settings, the student will follow-up on the diagnostic workup, re-evaluate the patient, and contribute to disposition planning.

Focused Encounter
The student contributes to the care of the patient as part of the clinical team. This can include conducting a focused history or physical examination, reviewing and interpreting the diagnostic workup, performing or assisting with a procedure, or actively participating in an operative case.

Patient Type/Clinical Condition	Course Mapping	Program Mapping	Procedure/Skills	Clinical Setting(s)	Minimum Level of Student Responsibility	Alternative Clinical Experiences/ Teaching Modules
Health Maintenance/ Preventative Care	FM2 FM3 FM4 FM5	A3 A4 A5 B1 B2 B3 B6 C2 C3	Develop a health promotion plan for a patient of any age or gender. Counsel the patient on this plan. The plan should be based on health promotion and disease prevention recommendations supported by evidence- based medicine guidelines. Students will recognize how personal beliefs, culture, and other factors might impact on a patient's compliance. Use appropriate communication skills in getting the patient to adhere to treatment plan. Conversely, students should recognize problems for which no recommendations exist or certain tests or procedures that are not recommended.	Ambulatory	Comprehensive Encounter	Teaching Session/ Lecture
Continuity of Care/Barriers to Care	FM 2 FM 3		The student will participate in a case where there was a barrier to access of care or barrier to utilization of a care resource. The student will recognize the specific issue(s) that prevented access to care and how the situation was resolved.	Ambulatory	Comprehensive Encounter	Teaching Session/ Lecture
Contextual Care (Care in the context of family, culture and/or community)			Student will participate in an encounter with a patient and family OR participate in an encounter with a patient from a different culture OR participate in an encounter where community factors affect the patient's health. In a family encounter student may have to display communication skills that effectively transfer information to both the patient and family or deal with a family disagreement. With a patient from a different culture the student may have to recognize cultural factors that may impact the patient's care or affect communication and understanding of a treatment plan. In the context of community, the student will need to recognize community factors such as lack of certain services, poverty, lack of health care providers, geographic barriers, etc., and how they affect health of patients and how to overcome these obstacles.	Ambulatory	Comprehensive Encounter	Teaching Session/ Lecture
Coordination of Care			Student will participate in an encounter with another member of the health care team (such as: nurses, social workers, specialty physicians, pharmacists, etc.). The student will be involved in coordinating the patient's care and relaying information effectively to other members of the health care team. Students should be able to identify the role of each member of the care team.	Ambulatory	Comprehensive Encounter	Teaching Session/ Lecture
Musculoskeletal Care	FM10	A2	Student will participate in a case involving a musculoskeletal problem Obtain history and perform appropriate musculoskeletal exam. Communicate with preceptor, create differential diagnoses, and develop treatment plan.	Ambulatory	Comprehensive Encounter	Teaching Session/ Lecture
Integrative or Complementary Medicine			Student will participate in a case where patient is taking an alternative medication or supplement or is utilizing an alternative medical treatment. Student will take a medication history identifying the supplement(s) used and their purpose. For an alternative treatment, the student will identify the treatment and the reason for it. The student will investigate the medical literature for evidence-based information on the efficacy of the supplement, potential interactions with other medications and side effects, as well as identify evidence-based recommendations that exist, if any.	Ambulatory	Comprehensive Encounter	Teaching Session/ Lecture
Skin or Nail Disorder			Student will participate in case involving a skin or nail disorder. The student will use proper terminology in describing the skin and nail disorder. Develop a differential diagnosis and identify other diseases or conditions that may potentially cause the skin or nail problem. Discuss treatment options and instruct the patient in the proper care of the problem.	Ambulatory	Comprehensive Encounter	Teaching Session/ Lecture