Doctoring 101 BMS 6015 2003 – 2004 Course Syllabus

Course Directors
Doctoring 101
BMS 6015
2003 – 2004 Course
Syllabus
Elena Reyes, Ph.D.
[email protected]
(850) 644-5066
Curt Stine, M.D.
[email protected]
(850) 644-0523
Steven Grossman, M.D.
[email protected]
(850) 644-2373
Office Hours:
Office hours are by appointment but we encourage students to stop by our office
anytime for extra help or chatting about the course.
Course Coordinator
Candice Allbaugh
Office: Administration Bldg Rm 130
644-7473
Clinical Learning Center
Sarah Sherraden, RN, MSN
Office: Clinical Learning Center
644- 9812 / 644-9800 (CLC Front Office)
Informatics
Nancy Clark, MSEd
Office: Administration Bldg Rm 140
644-9706
Small Group and CLC Faculty:
Ellen Berkowitz, M.D.
Jacquelyn Lloyd, M.D.
Harold Bland, M.D.
Helen Livingston, EdD
Jerry Boland, M.D.
Karen Myers, MS, ARNP
Ken Brummel-Smith, M.D.
Ed Shahady, M.D.
Suzanne Johnson, Ph.D.
David Steele, Ph.D.
Tom Knobbe, Ph.D.
Gene Trowers, M.D.
Alma Littles, M.D.
Doctoring Curriculum Overview
Doctoring I and II is a two year curriculum covering Basic Clinical Skills and
Behavioral Science. The first year emphasizes normal human behavior and
development across the lifespan, patient doctor relationship and the patient within
the context of family, social and cultural context. Normal physiology and basic
physical exam are covered. The second year integrates with the rest of the Year 2
curriculum emphasizing pathology, advanced clinical examination skills, complex
relationships and presentations, review of systems and clinical reasoning skills.
Medical humanities, ethics, IT, biostatistics, evidenced based medicine and
professionalism are introduced throughout the two year curriculum.
Objectives for Doctoring 101
1. Demonstrate an understanding of the biopsychosocial model of illness and the
dynamic relationship between psychological, social and cultural factors and
human illness onset, course and outcome.
2. Define patient centered care and discuss its impact on health delivery.
3. Recognize that people of diverse backgrounds and belief systems perceive
health and illness differently.
4. Define professionalism and be able to discuss the issues involved for medical
students with transitioning into a professional physician role.
5. Identify and practice communication skills that serve to establish and
maintain a positive and productive patient - doctor relationship.
6. Describe the structure and function of the medical interview.
7. Compare and contrast three models of patient – doctor relationships.
8. Recognize that patients have different response styles to stress related to
illness.
9. Identify the components of the basic history section of the medical interview,
including chief complaint, history of present illness, past medical history,
social and family history,
10. Demonstrate ability to perform a medical interview by establishing rapport,
eliciting the chief complaint, HPI, PMH, Social and family history and the
patient’s perception of the problem.
11. Identify the main ethical and legal principles regarding confidentiality in
patient care.
12. Demonstrate understanding and use of universal precautions in healthcare
settings.
13. Demonstrate basic IT skills including knowledge of IT etiquette and policy at
FSUCOM, accessing email and internet, use of Blackboard, and library
resources for research.
Structure
Doctoring I has several different components which allow for a variety of teaching /
learning experiences to achieve the course objectives. Performance in all of these
areas is assessed and contribute to the final grade in the course.
·
·
Large group class presentations / discussions
o
Meets in COM 407
o
All students
Small group exercises
o
Six groups, each with 2 faculty and 6 –8 students. See group
assignment below
o
Meets in student community small group rooms – see
·
·
·
·
assignment below
Clinical Learning Center (CLC)
o
See schedule for dates and times for your group
o
See description below
Informatics
o
Computer Lab
o
See dates and times for your group
Assignments / Readings
o
To be completed outside of class times. Due dates are specified
with assignments
OSCE Objective Structured Clinical Exam
o
Scheduled at the end of the semester at the CLC
Clinical Learning Center
The Clinical Learning Center (CLC) is a simulated medical clinic that provides a
realistic and technologically-advanced clinical learning environment to support your
clinical education. During the summer you will be scheduled in the CLC one time
each week to practice the medical interviewing skills you are learning in small
group. In the CLC students will work in pairs and have the opportunity to practice
one-on-one interviews with standardized patients (SPs). SPs are individuals trained
to portray the chief concerns, medical histories, and illness experiences of “real”
patients. COM faculty will observe your interactions, answer questions and provide
feedback during your CLC sessions. You are expected to have read the assigned
readings before coming to your CLC session, to arrive on time, and to be properly
attired.
At the end of the semester you will take an Objective Structured Clinical Examination
(OSCE). OSCEs are skills-based examinations conducted in the CLC and are the
primary evaluation method for assessing your clinical skills. OSCEs typically consist
of several “stations” (patient exam rooms). At each station, you are asked to
perform a particular task (e. g. take a history of a patient’s present illness). You
are observed performing these tasks by a faculty member and assessed against a
standard set of observable, behavioral criteria.
Code of Conduct
Professional Dress:
Medical students, faculty and staff are all ambassadors and representatives of the
College of Medicine. Your appearance and behavior reflect on all of us. Professional
attire should be worn in all settings where patients are seen, including the
Clinical Learning Center (CLC), a preceptor's office or clinic, a hospital or nursing
facility or even when interacting with a standardized patient during a small group
activity.
Note: Professional attire consists of clothes consistent with community norms, no
jeans, seductive or revealing clothes, or shorts
o
For men, professional attire consists of slacks and a collared shirt. In the CLC
o
and other clinical settings, a tie and lab coat are also required.
For women, professional attire consists of skirt or slacks and blouse. In the
CLC and other clinical settings, a lab coat is required.
The established "norms" of certain clinical settings may modify these standards, but
any variations in professional attire must be approved by the student's supervisor.
Confidentiality:
You are expected to behave in a professional manner at ALL times , whether you are
with patients, with faculty or among classmates. All clinical material presented is
confidential. You are free to discuss this material with your classmates but not with
anyone else (including roommates, spouses, etc). When discussing clinical material
among classmates, please be aware that others around you may hear (e.g. cafeteria
line, elevators, halls, etc.).
Sometimes even when a specific name is not mentioned, the material may be
specific enough to reveal patient identity. Furthermore, others around you may not
realize you are discussing a simulated case from class. Therefore, it is best to not
discuss cases / patients in public.
Information learned about your classmates and their families in class is considered
confidential. You are not free to disclose this material without the specific consent of
the person.
Be careful to keep all patient notes in a manner that is not accessible to others.
Patient records, even if it’s for a simulated patient in class, should be returned to
faculty, destroyed or kept in a secure place if needed for future reference.
Students found in violation of the confidentiality agreement, may be referred to the
Student Evaluation & Promotion Committee for breach of professionalism.
Attendance
You are expected to attend all scheduled activities. You are expected to be on time.
Being on time is defined as being ready to start at the assigned time. If you have an
emergency that prevents you from attending a scheduled activity, you are to call and
notify the Office of Student Affairs and request that they inform your supervisors /
professors for that activity. If at all possible, also call and at a minimum, leave a
message with one of the course directors or the front office at the CLC. It is
important that you realize that your absence or tardiness negatively impacts a
number of other people. Attendance, including tardiness, is part of your evaluation
for professionalism. Negative evaluations will result in decreased grades and in
severe cases, referral to the Student Evaluation & Promotion Committee.
Required Texts:
Seidel, HM, Ball, JW, Dains, JE, Benedict, GW. Mosby’s Guide to Physical
Examination. (5th Ed). St. Louis: Mosby, 2003.
Seidel, HM, Ball, JW, Dains, JE, Benedict, GW. Mosby’s Physical Examination
Handbook (3rdEd). St. Louis; Mosby, 2003
Stoudemire, A. Human behavior: An Introduction for Medical students. (3rdEd).
Philadelphia: Lippincott-raven, 1998.
Choose one of the following:
Fadiman, A. The Spirit Catches You and You Fall Down. New York: Farrar, Straus,
Giroux, 1997.
Verghese, A. My Own Country: A Doctor’s Story.New York; Vintage, 1994.
Doctoring Grading Components:
•
Final examination
o Multiple choice format 8/30/03
25%
•
OSCE (History)
o Scheduled during Final Exam week
10%
•
Small group
o Attendance , preparation and
participation
18%
•
Clinical Learning Center (CLC)
o Attendance, participation and
preparation
18%
•
Medical Informatics
o Requirements outlined in MI syllabus
15%
•
Book review
o See assignment below
14%
Book Review
Choose either Fadiman’s or Verghese’s book and write a five page (12 point font,
double spaced, 1 inch margins) essay on the book. This is not a “book report” merely
summarizing the book’s content. Your review should reflect a close and careful
reading of the text. In it you should reflect on what this book teaches about the
physician-patient relationship, the biopsychosocial model, and the “culture” of
western biomedicine. Do not procrastinate. We encourage you to start reading as
soon as possible and keep a journal of your reactions to what you have read,
especially in light of class discussions throughout the semester. The specific grading
criteria will be distributed at a later date.
Paper Due Date: Friday, July 18, 2003 Noon to Candice’s office.
Course Grading Scale
A = >90%
B+ = 87 – 89.9%
B = 80 – 86.9%
C+ = 77 – 79.9%
C = 70 – 76.9%
D = 65 – 69.9%
F = < 64.9%
ADA STATEMENT:
Students with disabilities needing academic accommodations should:
1. Register with and provide documentation to the Student Disability
Resource Center (SDRC);
2. Bring a letter to the instructor from the SDRC indicating you need
academic accommodations. This should be done within the first week
of class.
Academic Honor Code:
Students are expected to uphold the Academic Honor Code published in the Florida
State University Bulletin and the Student Handbook: The Academic Honor System of
the Florida State University is based on the premise that each student has the
responsibility (1) to uphold the highest standards of academic integrity in the
student’s own work, (2) to refuse to tolerate violations of academic integrity in the
University community, and (3) to foster a high sense of integrity and social
responsibility on the part of the University community.
Doctoring I Summer 2003
Topic in Large Group
(Topic in Small Group)
Date
Session Goal/Focus
Readings
Course Overview and
Reflections on Anatomy
May 20
None
Biopsychosocial Model FSUCOM perspective
(Introductions/Giving and
receiving feedback)
May 27
Overview of course /
requirements.
Introduction to
professionalism and role
of the physician.
Introduction to the
biopsychosocial model
and the concept of
patient centered care
Stoudemire
pps3-4,3655,7078,495-497
Mosby (text)
Introduction to the
Medical Interview:
(Establishing
rapport/Gathering patient
June 3
Introduction to structure
& function of the medical
interview; Relationship
building and establishing
pps 38-48
Steele
pps.2-23
information)
The Patient Centered
Clinical Method
(Interviewing skills/CC,
HPI, patient’s
perspective)
rapport
June 10
Stoudemire
Eliciting and
understanding the
patient’s experience
pps. 3-9
Steele
pps. 4-18,
29-33
Stoudemire
pps 6-9. 911, 495-508
IT (Life-long learning)
June16, 17
18, or 19*
See Med Informatics
syllabus
Social and Family History
(Interviewing skills/
CC,HPI, SH, FH)
June 24
Understanding the
patient’s context and
health risks
Past Medical History
(Interviewing skills/CC,
HPI, SH, FH, PMH)
July 1
Stress, Illness & the DrPt Relationship
(Interviewing skills/CC,
HPI, SH, FH, PMH)
July 8
IT (Accessing Medical
Information)
July 14, 15,
16, or 17*
See Med Informatics
syllabus
Confidentiality and
Privacy. “Forum theatre”
format / panel discussion
EXAM
July 22
Role of confidentiality in
medical practice and
patients’ rights to privacy
Eliciting past medical
history to understand CC
and assess health risks
Biopsychosocial
formulation of the
patient’s illness
experience
Mosby (text)
pps. 18-23,
26-27, 146,
151;
Appendix G
Mosby(text)
pps. 23-26
Steele
pps. 24-28
Steele –
handout
material
July 30
CLC AActivity
(Topic)
Session
Goal/Focus
Dates
CLC Reading
Assignments
Orientation to
CLC/Universal
Precautions
Orientation to
facility and to
universal
precautions for
health care
June 11,
12, 16*
Mosby (text)
pps. 49-51
workers.
Interview with SP
(Interviewing
skills/CC, HPI)
Practice
interviewing
skills.
Demonstrate
ability to identify
the CC and
perform HPI.
Practice
interviewing
skills.
Demonstrate
ability to perform
a social history
and family
history.
Demonstrate
ability to identify
the CC and
perform HPI.
Practice
interviewing
skills.
Demonstrate
ability to perform
a past medical
history.
Demonstrate
ability to perform
a social history
and family
history.
Demonstrate
ability to identify
the CC and
perform HPI.
Same as previous
week
June 18,
19, 23*
Interview with SP
(Interviewing
skills/CC, HPI, SH,
FH, PMH)
OSCE Prep
OSCE
(Interviewing
skills: CC, HPI, SH,
Interview with SP
(Interviewing
skills/CC, HPI, SH,
FH)
Interview with SP
(Interviewing
skills/CC, HPI, SH,
FH, PMH)
Interview with SP
(Interviewing
skills/CC, HPI, SH,
FH, PMH)
Mosby (text)
pps. 1-18, 2326; (handbook)
1-2.
June 25,
26, 30*
Mosby (text)
pps. 18-23, 2627; (handbook)
1-4.
July 2, 3,
7*
Mosby (text)
pps. 1-27;
(handbook) 1-4.
July 9, 10,
14*
Mosby (text)
pps. 1-27;
(handbook) 1-4.
Same as previous
week.
July 16,
17, 21*
Mosby (text)
pps. 1-27;
(handbook) 1-4.
Same as previous
week.
July 23,
24, 25*
Assessment of
interviewing and
data collection
July 30,
31*
FH, PMH)
skills.
Doctoring 1 Small Groups
Group A
Curt Stine, M.D.
Helen
Livingston,EdD
Group B
Gene Trowers, M.D.
Group C
Steve Grossman, M.D.
Elena Reyes, Ph.D.
Suzanne Johnson, Ph.D.
Pandya, Kartikey
Davis, Margaret(Maggie) Chambers, Shani-Kay
Altbuch, Tristan
Duarte, Robert
Barrero, Jorge
Connelly, Erin
Kubal, Timothy
Denker, Adam
Crescentini, Robert
Nall, Courtney
Finger, Tamara
Hotte, Charles-Eric
Pai, Savita
Langley, Adam
Asif, Shazia
Allbritton, Robin
Shepherd, Kristen
Shamis, Mason
Torberntsson, Peter
Parikh, Pragnesh
Stich, Erica
Wallace, Karen
Toskich, Beau
Group D
Ken BrummelSmith, M.D.
Dave Steele, Ph.D.
Group E
Group F
Ed Shahady, M.D.
Tom Knobbe, Ph.D.
Harold Bland, M.D.
Ellen Berkowitz, M.D.
Mitchell, Hope
Bingham, Christopher
Boulibekov, Batyrjan
Beach, John
Armada, Sady
Childers, Brandy
Gaines, T. Griffin
Gamenthaler, Andrew
Gonzalez, Roberto
Garcia, Rosemarie
Jeoboam, Marie
Lu, Kit
Mahoney, Joseph
Mills, Anthony
Moyles, Kyle
Patel, Lina
Patel, Nishita
Nickerson, Rebecca
Plum, F. Josef
Rousso, Joseph
Visser, Gary
Worley, Michael
Doctoring 1 CLC Groups
Wednesday 8:00 am
Pandya, Kartikey
Altbuch, Tristan
Wednesday 10:00 am
Davis, Margaret
Duarte, Robert
Thursday 8:00 am
Chambers, Shani-Kay
Barrero, Jorge
Connelly, Erin
Crescentini, Robert
Wednesday 9:00 am
Hotte, Charles-Eric
Asif, Shazia
Shamis, Mason
Stich, Erica
Thursday 10:00 am
Mitchell, Hope
Beach, Johm
Gaines, T. Griffin
Garcia, Rosemarie
Thursday 11:00 am
Mahoney, John
Patel, Lina
Plum, F. Josef
Visser, Gary
Kubal, Timothy
Nall, Courtney
Wednesday 11:00 am
Pai, Savita
Allbritton, Robin
Torberntsson, Peter
Wallace, Karen
Monday 8:00 am
Bingham, Christopher
Armada, Sady
Gamenthaler, Andrew
Jeoboam, Marie
Monday 9:00 am
Mills, Anthony
Patel, Nishita
Rousso, Joseph
Worley, Michael
Denker, Adam
Finger Tamara
Thursday 9:00 am
Langley, Adam
Shepherd, Kristen
Parikh, Pragnesh
Toskich, Beau
Monday 10:00 am
Boulibekov, Batyrjan
Childers, Brandy
Gonzalez, Roberto
Lu, Kit
Monday 11:00 am
Moyles, Kyle
Nickerson, Rebecca
Informatics Sessions Groups
June 16-19 and July 14-17
Monday
Pandya, Kartikey
Wednesday
Mills, Anthony
Altbuch, Tristan
Connelly, Erin
Tuesday
Boulibekov,
Batyrjan
Childers, Brandy
Gonzalez, Roberto
Crescentini, Robert
Pai, Savita
Lu, Kit
Davis, Margaret
Allbritton, Robin
Torberntsson,
Peter
Wallace, Karen
Langley, Adam
Shepherd, Kristen
Duarte, Robert
Kubal, Timothy
Worley, Michael
Chambers, ShaniKay
Barrero, Jorge
Denker, Adam
Nall, Courtney
Mahoney, John
Patel, Lina
Finger Tamara
Mitchell, Hope
Beach, Johm
Parikh, Pragnesh
Toskich, Beau
Plum, F. Josef
Visser, Gary
Gaines, Griffin
Garcia, Rosemarie
Patel, Nishita
Rousso, Joseph
SYLLABUS
Medical Informatics Component
M1 Applied Clinical Practice of Medicine
FSU College of Medicine
Nancy Clark, Instructor
Summer Semester 2003
Thursday
Bingham,
Christopher
Armada, Sady
Gamenthaler,
Andrew
Jeoboam, Marie
Hotte, Charles-Eric
Asif, Shazia
Shamis, Mason
Stich, Erica
Moyles, Kyle
Nickerson,
Rebecca
Location and Times:
The class will be divided into 4 groups of 12-13 students (TBN). All classes will be
held in the computer lab in the COM Library. Each group will meet twice: once
during the week of June 17 and once during the week of July 15.
Contact Information:
Nancy Clark Office 644-9706, Cell 443-6568, Office: Room 140, COM Admin
Building. Office hours: - by appointment.
Course Objectives
Goal: Students will acquire demonstrate skills in information management
and technology to prepare them for their role as life-long learners,
clinicians, educators/communicators, researchers and managers.
Schedule and Assignments
Orientation Session May 12-16, 2003 (Orientation) (2 hrs)
FSU COM Technology Survival Skills:
• network drives, finding a printer, using Blackboard, basic e-mail, and
computer etiquette in classes. advanced E-mail, attaching files, E-mail
etiquette, proper use of Distribution Lists, using Public Folders, FSU
calendars, web-based e-mail versus POP3 on laptop, remote access issues,
virus issues, IT policies on downloading music and other personal files,
what to do when something isn’t working.
• Assess keyboarding skills and make arrangements for remediation (Mavis
Beacon),
Orientation Session 2 (2 hours) FSU COM Technology Survival Skills
Continued May 19-22
• Distribution and Basic Operation of Laptops, configuring Outlook, use of
Personal data software (Outlook), contacts, tasks, notes, using the
wireless network, CD burning, file maintenance, organizing My Documents,
Session 1 (2+ hours) June 16-20 – Lifelong Learning
LLL: Adult Learning Theory, Learning Styles, Identifying learning needs,
Strategies
for remaining current, Utilizing IT for LLL, Medical News Resources,
Students will take a Learning Styles Inventory, Medical Specialty Aptitude test and
the Hemispheric Dominance Test online and do hands on activities accessing medical
news websites. We will review basic Word Processing skills for paper writing.
Assignment
Create a written plan in the form of a thought paper outlining the individual plan
for remaining current. Limit 3 pages plus a title page. (30 points)
Format:
Describe the results of your learner characteristics and styles
inventory, hemispheric dominance test and Medical Specialty Aptitude
inventory, giving examples of your behavior in a class situation and for
hobby or interest that support these findings.
Describe your preferred teaching/learning strategies. Tell me about
your favorite teacher, and how they taught. What similarities do they
have with your preferred learning styles?
Identify areas where you need to improve or ways you might need to
adapt to new situations
Describe how you will recognize your own learning needs when there is
no teacher directing the learning agenda
Describe strategies you will use to address these needs
Describe ways you may have to change your normal study habits to
prepare for a lifelong career versus passing the next test
Session 2 (2+ hours) July 14-19 - Accessing Medical Information
Accessing Medical Information: Remote versus local access, FSU COM website,
assessing validity of information on the web, Medical Library Website, Medical Search
Engines vs Google, e-Books, e-Journals, medical resource portals, Web browser
bookmarks, MyHQ. (2 hrs)
Assignment
Develop a basic set of organized medical reference and medical school subject
bookmarks/favorites. Create your own set of online bookmarks on MyHQ.
Bookmarks files are 15 points.
Resources:
Most resources can be found at http://www.med.fsu.edu/library/default.asp and at
http://www.med.fsu.edu/informatics. All other instructional materials will be handed
out in class or posted on the web. Software and teaching files will be stored on the
server for easy access.
Grading:
Informatics will comprise 15% of the overall grade for the Doctoring 1 course.
Grading in this component will be based on student attendance of class sessions,
student generated portfolio burned on a CD of projects from class products.
Attendance and
Component Points
20 point per session attended
Total Possible
40
Participation
Learning Plan thought
paper
Bookmarks File and
MyHQ web page
Burn and turn in a CD
containing all
assignments: the
paper and the
bookmarks file.
including orientation
Attendance is mandatory.
Points will deducted for being
late, non-participation, or
having to do a makeup
session
30 points
30
20 points
20
10 points
10
Total 100 points