VCU Internal Medicine Training Program
Community Preceptorship Resident Curriculum
Revision Date: 7/1/2007
Revised by: Stephanie Call, MD
Purpose
Learning Objectives
How Learning Objectives are Met
Required Reading/Resources
Expectations
Evaluation
Contact
Resident Schedule
Printable version of the curriculum (pdf)
Purpose (PGY2/3 residents only):
The goal of the community-based ambulatory experience is to immerse the resident in a generalist practice experience. Working with community-based generalists as role models during these experiences, residents should develop a realistic understanding of generalist practice in a variety of community settings (e.g., urban, rural, managed care, etc.). Community-based settings are valuable in highlighting certain aspects of medical care that may be underemphasized in tertiary care institutions, including the value of the doctor-patient relationship, communication skills, clinical uncertainty, cost-effectiveness, clinical epidemiology, and practice management.
Learning Objectives
At the end of the rotation, residents will be able to:
- Patient Care:
- Identify and perform an accurate history and physical exam that is appropriate for the primary care setting and the presenting medical problems
- Evaluate, diagnose and manage common presentations in the ambulatory care setting, including plans for follow up and further management
- Order appropriate laboratory, radiographic and other diagnostic testing as indicated to provide appropriate management and diagnostic testing in the ambulatory setting
- Experience ambulatory care in a community-based setting, comparing and contrasting this experience to that which the resident has been exposed to date
- Medical Knowledge:
- To develop an appreciation of the scope and nature of generalist practice in community-based settings.
- To develop an understanding of the epidemiology, presenting manifestations, natural history, and treatment of common illnesses and problems in community-based settings
- Practice-Based Learning and Improvement:
- Become familiar with evidence-based resources and other information resources available to the community-based practitioner
- Discuss varying ways in which community-based practitioners access information when faced with uncertainty or clinical questions in patient care
- Observe and discuss the importance of performance improvement activities in the community based setting
- Interpersonal and Communication Skills:
- Demonstrate the ability to establish rapport and appropriately communicate information about their well being to patients and their families
- Demonstrate the ability to communicate effectively and efficiently in both written and verbal forms with consultants and other physicians
- Create ethically sound relationships with patients and their families, as well as with colleagues and support staff
- Professionalism:
- Demonstrate the principles of professionalism during all clinical encounters
- Show respect for all individuals involved in the health care team in the community-practice-based setting, including appreciating each members role in providing safe and effective patient care
- Systems-Based Practice:
- Identify the components of an efficiently run office setting and how this contributes to clinical effectiveness and physician satisfaction
- Discuss how community-based physicians function within a healthcare team
- Recognize resources in the community and how community-based physicians access these resources (e.g., home health, counseling, physical therapy, etc).
- Provide cost-effective patient care in the ambulatory setting
- Identify basic principles of practice management
- Develop familiarity with how community-based physicians interact with third party payors, including managed care organizations
How Learning Objectives are met:
- Direct patient care in the community-based practice
- Discussions with community-based physicians
- Observation of practice management and discussions with the practice management staff
- Interaction with consultants and support staff
- Interaction with the interdisciplinary health care team
Required Reading/Resources:
-
As suggested and assigned by community-based preceptors. Residents are expected to access literature and evidence-based resources to answer clinical questions on a real-time basis. These literature searches should be discussed with preceptors.
Expectations:
- Attendance / Punctuality. Call the CMR on call ASAP to report acute illness or personal / family emergency requiring absence
- Professional behavior at all times with staff, peers, consultants, patients and families
- Attendance at continuity clinics
Evaluation:
- Community-based preceptors will evaluate residents electronically via New Innovations. These evaluations should be discussed in person with the resident. There should be regular formative feedback from supervising attendings regarding performance.
- Residents will evaluate supervising physicians electronically via New Innovations
Contact:
-
Program Administrator – 828-9726, then assigned community preceptor setting. Residents should contact the program administrator to set up this rotation at least 90 days in advance, at which time they will need to complete and GME educational leave form. The program will, at this time, set up an educational agreement with the practice, establishing learning objectives, expectations, guidelines for supervision and evaluation and malpractice coverage. This paperwork must be completed 90 days in advance of the rotation.
Resident schedule:
- Residents should follow the schedule of the office practice, typically 8:00 or 9:00 am until 5:00 pm, except when assigned to their own continuity clinic.
