|
|
|
Preceptor Support
Page updated 10/24/08
MUSC and AHEC Support
for Preceptors
and Students
Community
Site Coordinators (AHEC
Health Professions Student Coordinators) serve as vital links between
preceptors, communities and medical students. They . . .
- Are the first point of contact for preceptors regarding
medical student scheduling and clerkship curriculum;
- Recruit new preceptors;
- Maintain a close working relationship with MUSC clerkship faculty;
- Arrange student housing (in areas where housing is
provided) and help settle students into housing upon arrival in rural
communities;
- Introduce students to practice, hospital, community,
community resources;
- Are a constant resource and point of contact for
community/practice projects;
- Provide guidance to students in arranging patient home
visits where needed;
- Are ALWAYS available to provide support and
assistance to students and preceptors.
Clerkship faculty and staff
(MUSC)
- Clerkship staff are dedicated to improving support to and communication
with preceptors.
- Please send your e-mail address to Ms. Shannon
Simpson at simpss@musc.edu.
We want to create a preceptor e-mail distribution list so that
clerkship changes and student information/schedules may be distributed
more quickly and efficiently.
- Please do
not hesitate
to contact clerkship faculty/staff with questions or concerns.
Preceptor feedback is important in our ongoing efforts to improve
student medical education.
P r
e c e p t o r
Preparing
for the new academic year . . .
- February & March
-
AHEC coordinators will contact preceptors in February and March
soliciting commitments for the upcoming academic year
- Late April - Rising
3rd-year students meet with clerkship
staff to choose their rural sites.
- May - MUSC/USC staff and AHEC
coordinators collaborate during May to address student requests
for rural sites (e.g. many students like to "go home" . . .
because they plan to practice there in the future, or perhaps
to enjoy Mom's home cookingduring the rotation!)
- June - preceptors
will be
sent the
schedule for the upcoming academic year that reflects the rotation
dates and names of students who will be rotating through their
practices.
The rotation
begins . . .
The
week
prior to the rotation,
- A student bio sketch will be faxed to the
practice (and/or e-mailed if we have the preceptor's e-mail
address).
- IF YOU DON'T RECEIVE A FAX OR ARE UNSURE IF YOU'RE GETTING
A STUDENT, please contact Mrs. Shannon Simpson right away at
(843) 792-9623 or simpss@musc.edu.
- Please share the bio sketch with office staff -
everyone will be
more comfortable when the student walks in the door that 1st day.
The student's school e-mail address
is included on the bio
sketch - if the preceptor / a practice staff member wishes to send a
"welcome" e-mail the student prior to the rotation.
MUSC
Orientation, Academic Days
, OSLE
- Day 1, all day - Students
will participate in clerkship Orientation and Academic Day activities
in Charleston with MUSC faculty.
- Day 2, all day - Students will participate in Academic
Day workshops in Charleston with MUSC faculty.
- Day 3, morning - Student will participate in OSLE in
Charleston.
- Day 3, afternoon - Students will travel to their rural
sites. Some students will have appointments with AHEC
coordinators to get settled into housing.
- Day 4, morning - Students will report to practice by 8:30
AM. Some students will have been directed otherwise by AHEC
coordinators (e.g. hospital orientation / meet preceptor at hospital
for morning rounds the first morning of rotation).
Student's 1st day
at the practice
- When the student arrives for afternoon clinic, it is
understood
that the preceptor may be busy with patients and be unable to introduce
the student to the staff. If this is the case, please have
someone in the office introduce the student to everyone and
show the student around the office.
- Sometime during the 1st day, we ask the preceptor to
schedule a
short meeting with the student to:
- Discuss preceptor expectations, and ask about the
student's
expectations.
- Advise the student of your schedule
(clinic/hospital/nursing
home, etc), including your day off during the week. The student
should try to schedule project and home visit activities on your days
off if possible. ASK THE STUDENT to give you a copy of the
clerkship calendar (on pink paper), so that you will be aware of all of
the
student's other clerkship requirements, and the 1-day optional Procedure Day at Anderson,
Greenwood, or Florence Family Medicine Residency.
- Discuss project ideas with the student if you are
interested
in a practice-based project, or you may prefer that the student discuss
the project with the AHEC coordinator when she makes her
1st visit to the student.
- Discuss good candidates for home visit patient.
- Tentatively schedule a short meeting in Week 3 to
discuss the student's mid-rotation evaluation (MUSC students).
|
Time in
the practice
Preceptor supervises student’s patient care activities:
- Student has initial encounter
with 4-6 patients per half-day
- Observe student’s history taking and
physical exam skills
- Student’s on-call schedule at preceptor’s
discretion (most rural preceptors do not find this beneficial to
students)
- Student's participation in the full spectrum
of patient care
Preceptors: Please Help Students
Obtain These Experiences
(MUSC students will
record
these experiences online via E*Value)
This list is meant to serve only as a guide - practice services,
procedures & populations differ among the rural
practices |
| PROCEDURES (# of Patient Encounters) |
DIAGNOSES (# of Patient Encounters) |
Provide anticipatory
guidance for health promotion/disease prevention: (1 each)
Infant, Child, Adolescent,
Adult, Elderly Adult
Demonstrate
self-care activiaties
to a patient: (1 each)
Breast self-exam, Foot care in in DM patient,
Inhaler use with asthma or COPD patient
Examine
& interpret studies or samples: (1 each)
Chest radiograph, EKG,
Skin KOH prep,
Urinalysis, Vaginal wet prep
Mid-Rotation feedback received
Negotiate
behavior change with a patient: (1 each)
Decrease or stop alcohol use,
Decrease or stop tobacco use;
Increase exercise, Improve diet
Obtain
study: (1 each)
Skin scraping for fungus, PAP
smear, Vaginal wet prep
Skills:
Perform physical exam: (1 each)
Ankle, Knee, Low Back, Shoulder
Work half-day
w/non-physician provider |
Abdominal
pain (1)
Alcohol abuse (1)
Chest pain (1)
Chronic Respiratory Disease-asthma, bronchitis, COPD
(3)
Congentive Heart Failure (1)
Depression and Anxiety (1)
Diabetes Mellitus (5)
Dizziness (1)
Fatigue & Chronic Benign Pain (1)
Headache (1)
Hypertension (5)
Musculoskeletal (1 each) Ankle Injury, Knee Injury, Low Back Pain, Neck
pain, Shoulder pain
Obesity (1)
Prenatal Care (1)
Skin rash (1)
Upper Respiratory Infections - OM, OE, Sinusitis,
Sore throat (5)
Vaginitis and Urinary Tract Infections - Dysuria (2)
Wounds (1) |
- Provide ongoing constructive feedback to help student
improve ALL
aspects of patient care
- Ensure supervision of student’s performance of lab tests
and
their interpretation
- Assist in providing the names of 2-3 patients whom
the
student could visit at home
|
- patient is willing/is
appropriate to have a visitor
- patient is interested in improving
his/her own health
- MUSC
request of preceptors: Please designate someone in the practice
to keep a list of patients visited by students. It will be the
student's responsibility to provide this person with the patient's
initials, full name, contact information and, if needed, brief
directions to home and/or unique patient information. (Student
written summaries of patient home visits include ONLY the patient's
initials for confidentiality purposes, so a list maintained by a
designated person in the practice will help both preceptor and student
identify patients and match existing written summaries.)
|
- Unique clerkship
component: Allow
student time to meet with practice business/office manager
to acquire information and insight into management aspects
of practice - student requirement (see Business and
Practice Management Exercise in Student section).
- Optional:
Some
students may have already chosen a career
path - and rural preceptors have helped them acquire experiences over
and above the rotation requirements. For example: A student
interested in radiology - the rural preceptor may introduce the student
to a local radiologist and give the student an afternoon away from the
Family Medicine clinic to visit/work with the radiologist. This
is strictly at the discretion of the rural preceptor.
Time
outside the practice (see "Student"
section of this page)
|
|
- The student is allowed to take 3
days (6 half-days) out of clinic any time
during the 6 weeks to work on the project and home visits.
- AHEC coordinators will assist students with their
community health improvement projects. However, preceptors are
welcomed to work with the student on the project - in the
community or on a project within the practice.
- One day during the rotation - student is allowed to
attend
activities at
the Anderson, Greenwood, or Florence AHEC Family Medicine Residency.
|
| |
| |
- Other: When feasible, invite student to
participate
in
community activities/meetings.
|
Evaluation
of Student
Provide daily/ongoing
feedback -
students want specific feedback on strengths and areas for improvement.
- Please don't be hesitant in pointing out weaknesses to
the
student. Preceptors are very nice people who, by nature, only
want to say, "You're doing great!" While this is encouraging to
the student, students will be better served if you help them address
their weakness now.
- If you have serious concerns
about a student (skills, professionalism) during the rotation,
PLEASE contact the appropriate school immediately (the earlier
in the rotation, the better) MUSC
Mid-rotation clinical evaluation
- discuss with student in Week 3 or 4. MUSC is flexible
concerning the mid-rotation evaluation method you prefer:
- MUSC instructs its students
to provide you with a blank copy of the evaluation instrument (a
time-saver for busy preceptors) or you may click here to view and print
a copy of the Student Mid-Rotation
Performance Evaluation instrument.
- Some preceptors prefer to ask the student to complete the
evaluation
himself/herself as a self-evaluation, then the preceptor and student
discuss strengths and weaknesses on which both will work to help the
student improve.
- Other preceptors verbally discuss the evaluation
criteria, with the student writing in comments made by the preceptor.
- And still other preceptors prefer to complete the
evaluation
instrument themselves, then discuss it with the student.
Final Clinical Evaluation:
- Please schedule a meeting to discuss the final clinical
evaluation
with the student before he/she leaves your practice in the final week
of the rotation. (MUSC -
Preceptor's
clinical evaluation of the student accounts for 40% of the student's
overall grade.)
- MUSC instructs its students to provide you with a blank copy of
the evaluation instrument or you may click here
to view and print a copy of the Student
Performance Evaluation (final evaluation instrument)
Preceptor completes the
final clinical evaluation instrument:
|
|
|
| Evaluation criteria
-
Anchor statements are included in each of 11 criteria to help you
evaluate the student. |
| |
- Please circle or check the appropriate
number between 1 and 7 (or N/A).
- If you feel the
student
falls between two of the numbers in a particular section, you
may circle the LINE between the 2 numbers. MUSC
will record the score with a ".5".
- MUSC has mandated that a score of "1" on any
criteria
of the final clinical evaluation could constitute failure of the
course. If you have a student who falls into this category,
please do not hesitate to contact course directors - as early in the
rotation as possible: Alec Chessman, MD - 843-792-2431, chessman@musc.edu; Donna Kern, MD
- 843-792-9890, kerndh@musc.edu
|
| Preceptor
written
comments - VERY IMPORTANT TO STUDENT. Excerpts
from your
comments are
included in the student's Dean's
Letter - a vitally important document
that accompanies the student's residency application. |
| |
- In addition to listing the student's strengths and
areas of
improvement, feel free to include comments about the student's
outstanding
qualities/achievements during the rotation.
- Don't hesitate to list areas of improvement -
comments you
make in this section are NOT necessarily included in the Dean's Letter.
|
| Please sign and date the
evaluation. Student does
not
sign the MUSC document. |
| |
|
| Preceptor
meets with the student to discuss the final evaluation the last
week of the rotation before the student leaves the practice. |
| |
- Please be as
specific as possible with the student during the meeting so that he/she
comes away from the meeting with an acceptable understanding of your
final evaluation.
- Preceptor may wish show the completed evaluation to
the
student and discuss the particulars.
- OR, you may wish to complete the evaluation after
the
student leaves. IF SO, we ask that you still conduct a short
meeting with the student to discuss his/her evaluation.
|
| Send completed evaluation
to MUSC in a timely manner. |
| |
- You may give the completed evaluation to the student before
he/she leaves - for the student to deliver to clerkship
staff.
- Or, you may fax or mail the completed evaluation;
the address and
fax number are on the last page of the evaluation
instrument.
|
|
|
|
|
| Top of
Page
| Top of Preceptor Section |
Evaluation
of Preceptor
At the end of the rotation, the
student will be asked to complete the
"Student Evaluation of Preceptor Clinical Teaching Skills".
The criteria on which the
student will
be evaluating his/her
experience with the preceptor(s) - on a scale of 1 - 4:
1=Poor
2=Fair 3=Very Good 4=Excellent
(Note:
Pursuant
to preceptor requests, clerkship staff will provide feedback to
preceptors based
on these student evaluations.)
Leadership
- Provided an orientation to clarify expectations.
- Treated each team member in a respectful manner.
Role-Modeling
- Demonstrated good "bedside manner" and positive
interpersonal
communication skills.
- Exhibited enthusiasm and interest in teaching students.
Instruction and
Feedback
- Asked 'probing' questions to help me apply medical
knowledge to
solve problems.
- Shared his/her thought processes about patient care
decisions,
and reflected how he/she thinks and learns.
- Observed the performance of my history-taking and physical
exam
skills and suggested specific ways to improve them.
- Guided and directed me in making case presentations clear,
well-organized, and concise.
- Stimulated me to be a more self-directed learner.
Evaluation
- Provided ongoing instructive feedback, including areas
for improvement.
- Evaluated me in a "fair" manner.
OVERALL, I WOULD RATE THIS
PERSON'S
CLINICAL TEACHING SKILLS AS:
POOR
FAIR
VERY
GOOD EXCELLENT
Give an example of one of the
most
important things you learned from the preceptor:
OTHER COMMENTS (by students):
Student
clinical experiences are described in the Preceptor section above, or
go to our syllabus to see "Core Objectives" that begin on
page 3.
This "Student" section is
designed to
help the
preceptor understand the student's other clerkship responsibilities and
requirements.
Clerkship
Calendar
Students will be given 2 copies
of the
clerkship calendar in their orientation
packets that includes all clerkship activities, deadlines and
requirements. Students will be directed to give one of the copies
to the preceptor. Click here to see
typical clerkship student calendar.
The required textbook is Essentials of Family
Medicine, 5th Edition. by Sloan et al., Williams & Wilkins:
Baltimore, 2002.
The
CD
ROM available with the textbook includes sample test questions
that will prove helpful in preparing for the online exam to be given at
MUSC on
Thursday of Week 4 of the rotation. A
practice exam based on the CD ROM sample test questions is also located
in WebCT for student use.
Online
Access
through MUSC Library-- http://www.library.musc.edu/:
click on
"Full Text Books and Journals
- Hypertensive
Vascular Disease (from
"Essential Hypertension" up to but not including
"Treatment"), Harrison's Online.
Chapter 246, pp. 1-21.
- Zoorob
RJ, Arif AM, Morelli V. Hypertension. Primary
Care: Clinics in Office Practice. September 2000,
27(3)
- Hall,
W. Dallas.
A Rational Approach to the Treatment of Hypertension in Special
Populations. American Family
Physician. July 1999, 60(1).
Diabetes Initiative of South
Carolina< -http://www.musc.edu/diabetes/:
click
on "Professional Education" then "Manual for Primary Care
Providers"
Cultural Competency
-
Blue, Amy V. The Provision of Culturally Competent Health Care ("Cultural Competency" link in this web site)
Reducing
Medical
Errors - An
overview and link to a brief article on health care
system medical errors (" Reducing Medical Errors"
link in this web site)
Included in
student orientation packet
Continuous
Quality Improvement (CQI) - Langley GJ, Nolan KM. Nolan
TW. The
Foundation of Improvement. Quality Progress. June 1994:
81-86.
Cultural
Competency - Dobbie AE, Medrano M, Tysinger J, Olney C. The BELIEF Instrument: A Preclinical Teaching
Tool To Elicit Patients' Health Beliefs. Family
Medicine 2003: 316-319.
Community/Practice
Project
Students will participate in a
community or practice health project that encompasses the
population-based health approach
and uses Continuous Quality Improvement ( CQI)
concepts and tools to measure its effectiveness. Details are
included in the syllabus.
- AHEC site coordinator
assistance
- Coordinators will visit students at the practice to provide project
assistance / connect students with community resources.
- Practice project -
Preceptors wanting to conduct a practice project (e.g. diabetes /
hypertension education information for patients, standards of care) may
work directly with the student. AHEC coordinators are also
available to provide project format guidance.
- Student communication with
MUSC
- Students will correspond with MUSC online to inform faculty members
of project ideas and project progress during the rotation according to
the clerkship calendar. Faculty
members respond with timely feedback to students. AHEC
coordinators will be a constant resource and point of contact for
students. Students will submit completed documents to MUSC staff
according to calendar and syllabus guidelines.
- Project presentation -
On the last day of the rotation, students will present their projects
(in PowerPoint format) to MUSC faculty members.
- Student's grade -
The
community/practice project accounts for 10% of the student's overall
grade.
Patient
Home Visits
Students will visit 1 patient in the patients' homes - a minimum
of
2 visits to the 1 patient. Students will utilize CQI
tools and principles in working with the patient and preparing the
written summary of the home visits. See syllabus
for details and sample of written summary.
What
kind of patient is a good candidate for home visits?
One who has room for improvement, and is both willing and able to make
changes.
- Initial visit to patient's home - Students are
expected to gather the information necessary to develop with the patient an intervention
plan to improve the patient's health.
- Consult with preceptor
-
Students should discuss the home visit with preceptors.
Preceptors report that students sometimes bring to light environmental
/ financial / family situations in the home that were previously
unidentified.
- Follow-up visit to
patient's home - Students will return to the patient's home for
a follow-up visit at least one week after the initial visit to discuss
the patient's
progress with the intervention plan and revise the plan if necessary.
- Consult with preceptor
-
Students will update the preceptor on the patient's success (or
failure) with the health improvement intervention.
- MUSC
request of preceptors: Please
designate someone in the practice to keep a list of patients visited by
students. It will be the student's responsibility to provide this
person with the patient's initials, full name, contact information and,
if needed, brief directions to home and/or unique patient
information.
(Student written summaries of patient home visits include ONLY the
patient's initials for confidentiality purposes, so a list maintained
by a designated person in the practice will help both preceptor and
student identify patients and match existing written summaries.)
- Student communication with
MUSC
- Students will complete written summaries of the patient home visits
and submit them online according to the clerkship calendar. Faculty members respond with
timely feedback. Students will submit home visit summary
documents to MUSC staff according to calendar and syllabus guidelines.
- Student's grade -
The
patient home visits account for 10% of the student's overall grade.
Business
and Practice Management Exercise
This is the only opportunity in
the
students' 4 years of medical school to acquire information and insight
into the management aspects of delivering medical care.
- One half-day -
Students
will spend one-half day with the office manager and office staff.
- Gather information and
prepare
summary - Students will gather information to answer the
following 4 questions and prepare a concise but thorough summary:
- List
the different patient care pay sources for this practice setting. Group them into different type:
Managed Care, Fee for Service, Government
Funding, Self-Pay. Is there a sliding
fee scale?
- Explain
under what circumstances must the provider obtain pre-approval from the
payor
source prior to referring a patient for further testing, treatment or
consults.
- What
are all the steps in the process of registration for a new patient?
- From
the business office perspective, what are all the steps through which
the
paperwork is processed after a patient visit?
- Student communication with
MUSC
- Students will e-mail completed exercise to MUSC staff according to
calendar and syllabus guidelines.
- Student's grade -
Pass/Fail - Satisfactory completion of the exercise is a course
requirement.
Academic
Days / OSLE / Procedure Day
Mandatory
- Charleston
- Variety of activities:
first 2 and 1/2 days of rotation
-
problem-based learning, evidence-based medicine, hands-on workshops
(diabetes, suturing, musculoskeletal exams, EKG's, geriatrics), PharmD
interactive lectures (HTN Jeopardy, asthma, CHF, medical myths),
motivational interviewing, Family Medicine Journal
Club, teaching OSLE
- Student's grade -
Pass/Fail - Satisfactory completion is a course requirement.
Optional
–Anderson, Greenwood,
or Florence
Family
Medicine Residencies "Procedure Day"
- 1 day -
Students
may
take 1 day out of clinic during the 8 weeks to attend Procedure Day at
the Anderson, Greenwood, or Florence Family Medicine Residencies.
- Students will get
rotation-specific
information in their orientation packets.
- Student notifies
preceptor
&
AHEC coordinator – Students must notify community preceptor and
AHEC coordinator(s) prior to attending the optional day.
OSLE
/ OSCE
Objective
Structured Learning Experience (OSLE) - a teaching tool, no grade
Objective Structured Clinical
Exam
(OSCE) - 15% of student's overall grade
- OSLE - Day 3 of rotation
(at
MUSC) - Students will rotate through 8 stations and be evaluated by
faculty and Standardized Patients on their ability to gather
information, perform a physical exam, respond to emotion, and negotiate
a mutually agreeable assessment and plan with the patients. This
experience is designed to help the student prepare for the OSCE. Click here for more information about
OSLE and synopsis of OSLE stations.
- OSCE - Last day of
raotation
(at
MUSC) - Students will rotate through stations with similar format to
teaching OSLE. Standardized Patients will assess students'
clinical and relationship skills.
Exam
The exam is based on questions
prepared by editors of the Essentials
of Family Medicine, 5th edition.
- Practice exam - A
CD ROM
accompanies the textbook with practice test questions. Or,
students are able to access the practice exam online via a clerkship
password-protected web site.
- Exam - Next to last day of
rotation
-
Students will report to the MUSC Library or AHEC regional offices
(Mid-Carolina, Pee Dee or Upstate) to take the online exam.
- Student's Grade -
The
exam accounts for 15% of the student's overall grade.
Top of
Page | Top of Student Section
Society
of
Teachers of Family Medicine
Preceptors are welcome to go to
the
STFM web site ( http://www.stfm.org)
to inquire about joining the organization and receiving access to the
Society's resources.
The Teaching Physician is a publication
of the Society of Teachers of Family Medicine.
Preceptors:
If you would like to receive The Teaching Physician
on a regular basis, please send your e-mail address to Ms.
Shannon Simpson (843-792-9623, simpss@musc.edu) so that
you can be added to the distribution list.
Top of Page
MUSC
Library
MedMentor
For
Clinical Faculty,
Preceptors, and
Facilitators who work with
MUSC students:
MedMentor
-
http://www.library.musc.edu/about_lib/Services/medmentor.php - click
here to go to the MUSC Library and learn more about quick and
easy access to Library and Informatics resources.
MUSC
Family Medicine Clinical Faculty Appointment
Clerkship faculty and staff are happy
to
provide information and
guidance to preceptors who wish to apply.
Community
Preceptor Application Packet (pdf format)
Nine-page packet that includes
guidelines and forms to apply for an appointment as MUSC Family
Medicine
Clinical Faculty.
If you wish to have
the
packet e-mailed as a Word document or mailed as a printed document,
please contact Ms.
Shannon Simpson - 843-792-9623, simpss@musc.edu |
Also, please feel free to contact
Donna
Kern, MD, Clerkship Co-Director - 843-792-9890, kerndh@musc.edu - with questions
about a faculty appointment.
CME
for Precepting
Students
Preceptors can receive 20 hours
of CME
credit through the AAFP for
precepting health professions students (medical students, nurse
practitioner
students, etc.) http://www.aafp.org/PreBuilt/Rep101.pdf
|