Curriculum for Rotations in Rural Medicine-Rural Focus Curriculum
Overview:
The rural medicine rotation is a preceptorial rotation lasting 1 block in each of the years of training. The rotation occurs in the rural physician's office and in other locations included in the rural physician's usual practice. The PGY1 rural rotation is completed with one of the programs established rural preceptors and the PGY2 and PGY3 rural rotations may be done away from the program and may include an international rural experience. These away rotations require prior approval of the resident's Team Leader in consultation with the Director . The teaching of rural medicine in the program includes this rotation as well as experiences in the Family Medicine Center, the noon conference series, and on other rotations (See other curricula).
Goals:
1) At the completion of this curriculum, the resident will have an understanding of the practice of rural medicine.
2) At the completion of this curriculum, the resident will have gained knowledge and skills in the areas of rural medicine pertinent to the practice of family medicine.
Objectives:
At the completion of this rotation, to the satisfaction of the rural medicine preceptor, the resident:
Rotation 1:
* is able to perform an appropriate history and physical examination on a rural medicine patient. (PC)
* presents clinical findings to the supervising rural physician with an appropriately broad differential diagnosis. (MK)
* demonstrates sensitivity and responsiveness to a diverse patient population, including patients with diversity of gender, age, culture, race, religion, disabilities and sexual orientation. (P)
* demonstrates communication and interpersonal skills which facilitate positive and therapeutic relationships (ICS).
Rotation 2:
* is able to interpret appropriate data related to the rural medicine patient and arrive at reasonable diagnostic and management decisions, weighing alternatives, benefits, and risks of diagnostic and therapeutic options, and co-managing patients appropriately with other specialists (PC).
* is able to work cooperatively with other health professionals as part of a health care team (PC).
* demonstrates sensitivity and responsiveness to a patient's culture, age, gender, and disabilities (P).
* demonstrates medical knowledge in rural medicine pertinent to the practice of family medicine, including the appropriate evaluation and treatment of (MK): medical illnesses common in rural practice and injuries common in rural practice. Residents will learn about illnesses and injuries commonly seen in the Family Medicine Center, but will learn to evaluate and manage these conditions in a rural setting, typically without the ready availability of subspecialty consultants. In addition, residents will learn aspects of practice management and community medicine characteristic of practice in a rural setting.
Rotation 3:
* is able to make appropriate decisions to assure high-quality care in a cost-effective manner (SBP).
* demonstrates compassion, respect, and integrity; responsiveness to the needs of patients and society that supercedes self-interest; accountability to patients, society, and the profession; a commitment to excellence and on-going professional development (P).
* demonstrates a commitment to ethical principles pertaining to the provision or withholding of clinical care, confidentiality of patient information, informed consent, and business practices (P).
* is able to recognize and manage less frequently encountered medical problems at the level of an independent practitioner with consultation as appropriate. (MK)
There are no specific procedural requirements for this rotation. However, there is a separate Procedures Curriculum and residents may gain experience meeting these requirements during this rotation. Procedures typically performed by residents on this rotation include (PC): anoscopy, cryotherapy, electrosurgery, excision and destruction of skin lesions, incision and drainage of soft tissues abscesses, interpretation of radiographs and EKG's, removal of foreign bodies, laceration repair, and endoscopy.
Implementation:
This is a preceptorial rotation, so the resident is assigned to a particular rural physician or rural medicine group. The resident will accompany the rural physician during his/her professional activities in the rural physician's office and in other locations involved in the preceptor's usual practice. In the course of seeing patients, the rural physician will provide experiential learning, role-modeling, and one-on-one teaching to the resident. At the discretion of the preceptor, the resident may be assigned to research specific topics in rural medicine.
The resident is responsible for contacting the rural physician prior to the start of the rotation to arrange a schedule for the rotation. Modifications may be made at the Director's discretion to the resident's usual residency obligations in order to facilitate attendance to the rural rotation. This may include usual obligations to his/her Family Medicine Center population, including attending scheduled clinics, caring for continuity patients admitted to Memorial Hospital, and rounding in the nursing home The resident is not expected to attend noon conferences, but must continue to abide by duty hour restrictions in keeping with usual program policies. Upon completion of the rotation, the resident must complete and return the evaluation form provided by the program.
Residents completing their rural rotation in an international location will present a noon conference about their experience.
Evaluation:
The rural medicine preceptor will complete an evaluation form at the end of the rotation assessing the resident's success in meeting the rotation objectives as outlined in this curriculum.
Rural Focus Curriculum Evaluation Rotation 1
1) Is the resident able to perform an appropriate history and physical examination on a rural medicine patient?
YES NO
2) Is the resident able to present clinical findings to the supervising rural physician with an appropriately broad differential diagnosis?
YES NO
3) Does the resident demonstrate sensitivity and responsiveness to a diverse patient population, including patients with diversity of gender, age, culture, race, religion, disabilities and sexual orientation?
YES NO
4)Does the resident demonstrate communication and interpersonal skills which facilitate positive and therapeutic relationships?
YES NO
Rural Focus Curriculum Evaluation Rotation 2
1) Is the resident able to interpret appropriate data related to the rural medicine patient and arrive at reasonable diagnostic and management decisions, weighing alternatives, benefits, and risks of diagnostic and therapeutic options, and co-managing patients appropriately with other specialists?
YES NO
2) Is the resident able to work cooperatively with other health professionals as part of a health care team?
YES NO
3) Does the resident demonstrate sensitivity and responsiveness to a patient's culture, age, gender, and disabilities?
YES NO
4)Does the resident demonstrate medical knowledge in rural medicine pertinent to the practice of family medicine, including the appropriate evaluation and treatment of medical illnesses common in rural practice and injuries common in rural practice?
YES NO
Rural Focus Curriculum Evaluation Rotation 3
1)Is the resident able to make appropriate decisions to assure high-quality care in a cost-effective manner?
YES NO
2)Does the resident demonstrate compassion, respect, and integrity; responsiveness to the needs of patients and society that supercedes self-interest; accountability to patients, society, and the profession; a commitment to excellence and on-going professional development?
YES NO
3) Does the resident demonstrate a commitment to ethical principles pertaining to the provision or withholding of clinical care, confidentiality of patient information, informed consent, and business practices?
YES NO
4)Is the resident able to recognize and manage less frequently encountered medical problems at the level of an independent practitioner with consultation as appropriate?
YES NO
Rev. 12/09/08