Recent changes in requirements have brought further challenges, but also opportunities, for you, the teachers of our Family Medicine Clerkship.  The requirement that all medical students to spend at least four weeks of year 03, during Family Medicine Clerkship, or four weeks of year 04 at a rural facility has limited the continuity-of-care experience for about one third of the class.  Never-the-less, many of you have provided continuity experiences, whenever possible, during the four week window.  This change led to more emphasis on use of the "Learner Contract", by the students and by the Department of Family & Community Medicine (DF&CM).  If your student does not bring the Learner Contract to you early in the first week of the clerkship, remind them to do so and refer them to the department web page.  Discussion of the student-identified learning needs, as well as the learning/teaching opportunities in which you expect students to participate while they are with you will be of assistance as you complete the "Preceptor Assessment of Student Performance" at the end of the clerkship.  If possible, submit that evaluation electronically at https://survey.med.nodak.edu/ome/clerk/stuassessfm.asp.  Alternatively, we will accept the paper copy of the evaluation tool.

A second major change in recent years has been the mandate (as much as possible) the Family Medicine clerkship students gain substantial experience in evaluating musculoskeletal problems and dermatological problems.  Further, we are asking students to document that they have demonstrated their ability in both the musculoskeletal and dermatological examination to determing their competence in these important examinations.  This focus does not minimize the need for students to be observed completing other parts of the evaluation of the total patient, although various clinical departments have mandates for documenting observation of other parts of the exam. 

Preparation for their "Group Topic"  presentations also is more of a challenge for students with split clerkships.  For those students only the first presentation, addressing "Prevention" will be complete.  The second presentation, addressing an "At Risk Population/Access to Care" issue will be during the first week at their second FM site (or week 5 of the clerkship). Students in split rotations will be best served if they define their topic or at-risk population based on their first clinic assignment.  THe final presentation addressing a family issue for "The Family Connestion"  (week seven of the clerkship)  could focus on a patient problem or family issue identified during by either preceptor.  I will inform students of the need to both plan ahead and connect with their preceptor for the second month well in advance of beginning the second month.  For your information, as you are invited to sit in, observe, or participate in any and all facility or another identified site in your community.  If interactive video is not available in your community students will be able to connect via telephone (use a speakerphone) and streaming video with their laptop computers. These sessions generally run about two hours. You are invited to sit in, observe, or participate in any and all "Group Topic" sessions.

Feedback to students, formative, corrective, and summative part is an important part of their learning. You do that on a daily basis when students present patient evaluations and proposed plans, whether you agree with the student or teach them alternative or correct options or approaches. The aforementioned "Preceptor Assessment of Student Performance" is an additional tool for providing feedback, beginning with your initial meeting, when you discuss the "Learning Contract", and again as you complete the evaluation form. Students want and need formative feedback about their learning and progress, so provide that teaching with the on-the-spot patient-care discussions, but again with the evaluation tool.

The overall goals and objectives of the FM clerkship remain unchanged - we still ask that you provide a broad-based educational experience in an ambulatory primary care clinic. This clerkship should be an opportunity for the student to learn about the entire health care system in order to provide comprehensive care to the entire family. Continuity-of-care is a given, so if a patient requires a hospital admission or referral it would be appropriate for the student to be involved in that extended process, including home-health visits. By the end of the eight-week rotation, the student should be able to demonstrate enhanced abilities in the following:

• perception of the role of the family physician
• ability to establish effective physician/patient relationships
• skills in gathering and recording appropriate patient information
• skills in making appropriate clinical judgment and referrals
• working knowledge in application of primary and secondary prevention
• evaluation of the effect of the illness on the rest of the family, and the effect the family has on the illness
• sensitivity and knowledge of other cultures and their attitudes toward health care and morbidity
• skills in planning, implementing and evaluating health maintenance, disease prevention and continuous health care.
• awareness of costs incurred in evaluating health status and delivering care
• awareness and experience in patient education

You should have received a letter from the Office of Academic Affairs defining benefits available to you to both assist and recognize your teaching and mentoring efforts. If you would like to learn more about how to access some of the electronic benefits, like e-mail, electronic databases, and full text journal articles I encourage you to ask your medical student for assistance. Alternatively, below you will find the e-mail address and telephone number of resource people in the Harley E French Library of Health Sciences.

Finally, I will make arrangements to meet with you and your student to review student progress during the clerkship. If there are concerns or problems prior to that visit, please contact us.

Thank you for your time and energy commitment to teach Family Medicine to teach our students.

Faculty

Roger W. Schauer, M.D., FAAFP, Course Director: rschauer@medicine.nodak.edu

James R. Beal, Ph.D., Director, Research & Program Development, Department of Family and Community Medicine:
jrbeal@medicine.nodak.edu

Robert W. Beattie, MD, Chairman, Department of Family and Community Medicine:
beattie@medicine.nodak.edu

Staff

Mona Shilling, Administrative Secretary: shilling@medicine.nodak.edu (701-777-3214)

Don Larson, Coordinator, Computer Services: dlarson@medicine.nodak.edu

Library of Health Sciences

Barbara Knight, MA, MLS, bknight@medicine.nodak.edu (701-777-2166)