Misbah Keen MD MPH MBI CoDirector Jeanne Cawse

Misbah Keen, MD, MPH, MBI Co-Director Jeanne Cawse Lucas, MD Co-Director Jaime Fitch Education Specialist, Program Manager Updated 9/1/16 Fitch

GOALS Learn and apply key components of the Family Medicine approach to health care: ü Biopsychosocial Aspects of Care ü Comprehensive Care ü Continuity of Care ü Context of Care ü Coordination and Integration of Care Buffalo, WY

OBJECTIVES ü Learn and apply knowledge of common conditions, wellness and prevention ü Learn and apply effective patient centered care skills ü Act professionally in the care of patients and families, and within the health care team and communities Central WA FMRP in Yakima

FAMILY MEDICINE CLERKSHIP WWW. UWFMC. ORG

ASSIGNMENT TRACKER § Track all curricular activities and timelines online § Update Assignment Tracker each week § Bring print out of form to Mid and End of Clerkship Reviews.

COMMON CONDITIONS 1) 2) 3) 4) Acute Conditions Chronic Diseases Adult and Child Health Maintenance Pregnancy, Labor & Delivery Sitka, AK

EFFECTIVE PATIENT CENTERED CARE (EPCC) WEEKS 1&2 Learn EPCC concepts through articles, videos and direct observations WEEKS 2 6 Apply EPCC concepts into practice using the Patient Centered Observation Form, 4 -6 times. This is the clerkship’s mini CEX.

FORMAL CURRICULUM: FMCASES § 40 interactive virtual cases: - 33 fm. CASES (1 -33) - 5 CLIPP (1, 2, 3, 4, 13) - 2 SIMPLE Cases (2, 6) § Used nationally § Self-assessment questions included in fm. CASES Tacoma FMR

WHY FMCASES? 1) Curricular equivalence for all: Creates equal learning opportunities across rotation sites and time of year 2) Teaches you to be a doctor: • Muscle memory is important- flow is consistent with clinical encounters • Develops clinical reasoning, differential diagnosis building, and patient interaction skills • Studying a textbook may give similar knowledge but will not help build clinical competency

FMCASE UPDATES IN RESPONSE TO STUDENT FEEDBACK • PDFs and cases are inconsistent: All key content within cases is reflected in the PDFs. • Cases are redundant: Redundancy is planned for what is common and should be mastered. • Hard to search topics for further study: Look at this FMCases, SIMPLE and CLIPP content list to search cases by major diagnosis and content areas. Also on assignment tracker under corresponding diagnosis. • Old information, expired links: Tested annually. If they are not working, email Med. U and they will fix immediately.

USING FMCASES WELL • Look through the list of chief complaints. If you see a real patient with one of these chief complaints, do the corresponding case(s). • Pace yourself and work through at least 1 case/day • Plan to spend an average of 45 min/case. Core content is included within the body of the case. Links are a supplement and not required to do well.

PROFESSIONALISM § Review: 1) Professional expectations of the clerkship 2) Professionalism section of Feedback & Evaluation form § Discuss professional performance at Mid&End of Clerkship REQUIRED § Professionalism Awards o Student Award o Staff and Faculty Award 2014 -15 Faculty and Student Professionalism Award Winners

DUTY HOURS • Please check your UWSOM student handbook for work hours policy.

PROFESSIONAL LEARNING ENVIRONMENT • Teacher-learner relationships: Both have rights and responsibilities • Responsibilities of Teachers § Treat learners fairly, respectfully, and without bias related to their age, race, gender, sexual orientation, disability, religion, or national origin. § Give learners timely, constructive, and accurate feedback.

PROFESSIONAL LEARNING ENVIRONMENT • Responsibilities of Learners: § Be courteous and respectful of others. § Put patients' welfare ahead of educational needs. § Know limitations and ask for help when needed. § Maintain patient confidentiality. § View feedback as an opportunity to improve knowledge and performance skills.

PROFESSIONAL RESILIENCY Recipe for FM Clerkship Success handout

PROFESSIONALISM CONCERNING COMMENTS AND LOW SCORES § We aim to protect student confidentiality. § Unless there is imminent danger we do notify the site until anonymity can reasonably be assured. § We would like permission to contact you, but we respect your choice. Omak, WA

REQUIRED ACTIVITIES Week One: üSite Orientation üAttendance review including possible travel day üOrientation Webinar (Mon noon-1 pm PT) Week Two: üRequired clinical reasoning asynchronous material, accessed through Catalyst. Outside of Havre, Montana

REQUIRED ACTIVITIES Week Three üMid-Clerkship Review Week Six üFinal Exam (Thu 9: 30 am-12: 30 PT) üEnd of Clerkship Review End of Week Six üSite and Faculty Evaluations Pocatello, ID 4 6 times during the rotation üUse of the PCOF form as the mini-CEX

CLINICAL REASONING PRACTICE TEST § Required Material on Catalyst at this URL: § Here is the link: https: //catalyst. uw. edu/webq /survey/fmclerk/287255 § 14 questions based on fm. CASES 2, 4, 6, 20, 21 Wyoming FMR § Review answers § Offer exam strategies § Voluntary conference call with the clerkship Co Director: Monday of Week THREE from 12 N – 1 pm PACIFIC TIME

CLINICAL KNOWLEDGE ASSESSMENT § More residency programs are using USMLE scores to screen applicants. § Recent increase in STEP 2 passing score (now 209). Whitefish, MT

CLINICAL KNOWLEDGE ASSESSMENT Final Exam Thursday of week 6 from 9: 30 am 12: 30 pm PACFIC TIME § Online, closed book § 100 Questions § Based exclusively on fm. Cases, CLIPP and SIMPLE cases Anacortes, WA

EVALUATION PROCESS Site Director collects feedback from preceptors about student’s performance. Site Director incorporates feedback into preliminary grade form considering depth, length of time, and when each faculty worked with the student. Final grades are assigned by Clerkship Directors at the Seattle office based on the site’s scores and final exam performance.

GRADING Student Evaluations are based on 11 scoring categories and the final exam Knowledge of Subject Area Data-Gathering Skills Clinical Skills Patient-Centered Care Skills Management Skills Integration Skills Communication Skills Relationships with Patients Professional Relationships Dependability and Responsibility Educational Attitudes

FEEDBACK & EVALUATION FORM

GRADING CRITERIA 2016 -17 The Family Medicine Clerkship Student Clinical Evaluation is composed of eleven scoring categories: Knowledge of Subject Data Gathering Skills Patient ‐Centered Care Skills Management Skills Integration Skills Professional Relationships Communication Skills Clinical Skills Dependability and Responsibility Educational Attitudes Relationships with Patients Each category will have a score of 1 to 5 and a GPA will be calculated based on aggregate of the scores. Clinical Honors: GPA of 4. 9 to 5. 0 Clinical High Pass: GPA of 4. 2 to 4. 8 Clinical Pass: GPA of 2. 8 to 4. 1 Clinical Fail: GPA of less than 2. 8 OR a score of 1 in any category For the 2016 17 school year the final exam scores will be interpreted as follows: The national mean score for fm. Cases final exam is 74. 5 with a standard deviation of 7. 5 Honors (82 percent and above) – grade adjustment: + 0. 1 High Pass (75 to 81. 9 percent) – grade adjustment: No adjustment Pass (60 to 74. 9 percent) – grade adjustment: – 0. 2 Fail (less than 60 percent) – Remediation needed – Per UWSOM policy, after successful remediation, the highest Final Grade a student can receive is a Pass. Final Grade Honors: GPA 4. 9 to 5. 0 High Pass: GPA 4. 2 to 4. 8 Pass: GPA 3. 0 to 4. 1 Fail: GPA of less than 3 OR a score of 1 in any category.

FINAL EXAM SCORES Honors (82 percent and above) – grade adjustment: +0. 1 High Pass (75 to 81. 9 percent) – grade adjustment: No adjustment Pass (60 to 74. 9 percent) – grade adjustment: 0. 2 Fail (less than 60 percent) – Remediation needed – the highest Final Grade a student can receive is a Pass NOTE: If you get a Pass on the Exam it is not possible to get Honors as a Final Grade.

REMEDIATION In the event that you fail the exam, you are required register for online remediation course FAMED 598. You will need to study for the test again and will be required to re-take and pass the exam.

EHR ORIENTATION CHECK LIST See: Family Medicine Clerkship website > Info for Students

QUESTIONS? YOU CAN ALWAYS CONTACT US AT FMCLERK@UW. EDU