PSD Community Preceptor Program

PSD Community Preceptor Program

Preceptor& Student’sHandout

An Overview

AcademicYear 2016-2017

Dr.Carol Geller, DirectorCommunityPreceptorProgram

Dr.BarbaraPower,PSD Co-Chair

(Revised: 05 July2016)

PSD Community Preceptor Program

Introduction

Thank you foragreeingtoparticipateinthe CommunityPreceptorprogramasa preceptor. Despite rapid advancesin technology, the HistoryandPhysicalexaminationremainsthecornerstonesofmakinga clinicaldiagnosisfora physician.

ThePhysicalSkills Development(PSD)course teaches ourmedicalstudents these examinationskills thattheycan usefora lifetime.

Whatisthe PSDPreceptorProgram?

ThePSDPreceptorProgram(for theAnglophonestreamclasses)consists ofseven sessions tobe heldbetween September 2016 andMarch2017.Theeightsessions willbedistributedas4sessions foryear1 inthe Winterof2017and 4 sessionsfor year2 inthe Fallof2016.Thestudents willcontactyou to arrange an agreeabletime for the sessions.

You have a lotofflexibilityin howyou organizethesessions buthere aresome guidelinesto follow:

Ingeneral, weaskthestudentsto beflexible-Asession should startby1:30 and go tothe end ofthe clinic (aminimumof3 hrs). Students areexpectedto stayuntiltheend ofclinic. Studentsshould checkwiththeirpreceptorto seeif theywould like themto informtheirofficestaffon the agreeddates. Ifpossible, studentsshould be exposedto a varietyofpatients with differentmedicalproblems requiringdifferenthistoryand physicalexamination skills. Notallthesessions need to be office basedforexampletheycanaccompany you on homevisits,tothe nursinghome, emergencyroometc.

They are there toPRACTICEaswellasto observe.

Feedback– pleaseshareyour knowledge and your passionforFamily Medicine. Please give feedbackto the studenton theirperformance.

ObjectivesGoals

Theoverallgeneral objective of thecommunitypreceptorsessions is to exposestudents torealclinicalsituationsandto provide opportunitiestofurtherdeveloptheirhistoryand physicalexamination skills.

Specific Goals

  • Toenhanceexposure ofmedicalstudentsintheirearlytrainingto familyphysicians in acommunitybasedclinicalsetting.
  • To providean opportunity formedicalstudentstoPRACTICEa focused history and/orphysicalexaminationdependingon the setting.
  • To providean opportunity for the medicalstudentto appreciatetherole ofthefamilyphysicianinthecommunity.
  • To providean opportunity foralongitudinalrelationship between the medicalstudentand the familyphysician aswould be experiencedthrough thesessions.

Prior to yoursessions,the studentshouldprepare specificobjectivestheyhope toachieve duringthe sessions.Pleasereview themwith the student.

PSD Community Preceptor Program

Non Specific/Possible Objectives

  • Howto writeaSOAP (subjective objective assessmentand plan) -
  • Howto presenta history -
  • HistoryofPresentIllness/Facilitative Skills- s_facilitative_skills.doc
  • Earlyconcepts ofa differential diagnosis-
  • Earlyconcepts ofFIFE(feelings/fears,expectations,function impairmentandexpectations)–
  • Brown Interview Checklist -

Whata1stYearmedicalstudentknows and has completedby January ofYear1:(firstyearstudentwillbewith you inthe winter2017)

1. Howto take acomplete medicalhistory(InterviewingSkills)

2. MSKphysicalexam(lowerlimb, shoulder, upperlimb, back, neck)

Thefollowingphysicalexamination skills are taughtin theWinterof Year 1startinginJanuary

  • Taking vitals includingBlood pressure/Pulserate…
  • Cardiovascular exam
  • PeripheralVascularExam
  • RespiratoryExam
  • Basicapproachtothe AbdominalExam

Whata2ndYearmedicalstudentknows andhascompleted by September ofYear 2:(second yearstudentwillbe with you in thefall2016)

See above sectionfor Year1

Thefollowingskills are taught in theFallofYear2startingin September

  • Sensitive issues
  • Interviewingskills
  • Pelvic examination
  • Breastexamination
  • Rectalexamination

Evaluation

In order to pass,itismandatoryfor the student(s)to attend alltheirsessions. Please reportabsences toDonnaWilliams

(). In addition,an evaluation mustbecompleted byboth the student(on one45) andthe preceptoronpaper.

Professionalism

Confidentiality-As amedicalstudent,he/shehassigned the Declaration ofProfessionalism. You may view theDeclaration of Professionalismat:

Professionalismhasbeenidentified as aCoreValue oftheMD Program; ifyou have anyconcernswithregards to professionalismideallythisshould be discussed with each other. If itis necessarypleaseseeand completethe attached ProfessionalismConcern formorcontactDonnaWilliams ()orDr. CarolGeller () forfurtherguidance.This formis also availableelectronicallyatProfessionalismConcern Form

For furtherinformation regardingthe supervisionofamedicalstudent, pleaseconsult the documententitledProfessional Responsibilitiesin Undergraduate MedicalEducationavailable onthe CPSO websiteat

Thestudentis enrolledasamedicalstudentatthe FacultyofMedicine, UniversityofOttawa. He/she is covered for Comprehensive GeneralLiabilitywith thelimitperoccurrence of$5million (Canadian)inclusive forbodilyinjury, personal injuryand propertydamageduringhis/herplacement

ANote AboutVariationsIn PhysicalExam

Werecognize thatsincethephysicalexamis bothan artaswellasa science, variationsin examinationtechniquesexist, especiallyamongexperts. Studentsaretold thatpreceptors willprobablyhave developed theirown “version” ofthe physical examination overyears ofexperience. Youarefreetoteach the examasyou see fit, butifthere should bea disagreementas to the properexamination techniques, allstudents willbe instructedto refertoBates’Guideto PhysicalExaminationand HistoryTaking

Libraryand Web Resources

Acopyofa videoseries producedbyLippincottbasedon theBatestextbookisavailable onthe PSD website.Studentsand preceptors have oftenfound this to be helpful in visualizingsome of the manoeuvrestaughtin PSD.

ThePSDWebsiteis located at toinvite you to consult the curriculumschedulesinorderto appreciatethestudent’s leveloftraining.

Year1:

Year2:

ThereisalinktotheBatesVideoonthemenubarinthetoppage.(YoucanalsogettotheBatesvideo directlywithout going throughthePSD website at:

You mustuseyourfacultyaccount(username and password)toaccessthePSDWebsiteandBatesVideo.Should you not have one, please use eCurriculumCPPasyourusername and PSD-contentasyourpassword.

Contact Information

Ifyou have anyquestions regardingthePSD CommunityPreceptorProgram, do nothesitate to contactDr. CarolGeller, DepartmentofFamilyMedicine, Leader forthe CommunityPreceptorProgram(;(613)233-4697) orDonnaWilliams UndergraduateMedicalEducationCoordinatorforthe DepartmentofFamilyMedicine (;

613-562-6335 x 1441).

DressCode For Students

Properdressnotonlyprojects professionalismand confidence,butisalso a markof respecttothe patient– whateverthe settingmaybe. A professionaldemeanourcontributesto patienttrustandenhances theirconfidence in you. It is an important factorinfosteringpatientcompliance with medicalrecommendations.Wehave adoptedthe UniversityofOttawa’s guidelines fordress codein clinicalencounters(adapted belowforyour reference)oryou may go to

_2015.pdfto view thecomplete guidelines.

NOTETOMEDICAL STUDENTS:Theseguidelines weredeveloped byfacultyand studentsin orderto provide recommendationsto students, both male and female, so thattheyareappropriatelydressedand areawareofotherissues related toappearance whenencounteringpatients.Theprecisedetails willvarywith eachsituation andoften depend on the clinicalsetting.

SUGGESTIONS: Be wellgroomed and clean. Bodyodourshould be wellcontrolled. Do notexposeyourshoulders, cleavage, midriff, orupperthighs. Specifically, skirtsshould notbe above the knees whensitting. Avoid T-shirts,shorts, jeans andclothingwith obviouslogos. Avoid provocative attire.Keepjewelleryto a minimum, especiallywhen itcomes to visible piercings. Longhairshould be tied backduringpatientexaminations. In addition, although paediatric patients may appreciate green orpurplehair, theirgrandparents mayhave lived in atime whenhairdye did notexist.

  • You should beprepared towearyourwhitecoat.
  • It is suggested thatmaleswearashirtwith a collarandbe preparedto weara necktie. You should always wearyouridentification badge.
  • Whenin doubt, useyourpreceptorasa guide.
  • Acceptpositive and constructive feedbackand modify yourbehaviouraccordingly.

Health andsafetyregulations inthehospital/communitysettingcurrentlydictate that:

Perfumesandstrongscents(fromshampoo, hand creams, deodorants, etc.)are notpermitteddueto the possible sensitivityof patients and coworkers.

Shoes-notsandals-mustbe wornin clinicalsettings where exposureto bodyfluidsislikely

Shoesthatare open inthe backare acceptable,in mostsituations.

It’s importanttotrimfingernails, as longorartificialnailscancause harmto patients and have been demonstratedto transmit infection.

Scrubsuits(i.e., “greens”)are notto be worn outsidethe hospital.

PSD Community Preceptor Program

PSD– CommunityPreceptorProgram–Year 1 orYear 2: PreceptorEvaluation byStudent

Please complete yourPreceptorEvaluationon yourone45account;do notsubmitthe papercopytothe UGME office.

PoorFairGoodVery GoodExcellent

PSD Community Preceptor Program

PSD Community Preceptor Program

1.Thepreceptorunderstoodtheobjectivesfor the course

□□□□□

PSD Community Preceptor Program

PSD Community Preceptor Program

2. Ihad opportunityto practice afocused history orphysical

□□□□□

PSD Community Preceptor Program

3. Ihad opportunityto observe mypreceptor.□□□□□

4. Ihad feedbackfrompreceptor□□□□□

5. The preceptoractedinaprofessionalmanner□□□□□

6. Overallratingforthis preceptorasateacher□□□□□

7. Do you have specific constructive feedbackforyourpreceptor?

Thisfeedbackisveryhelpfulingivinggeneraltipstoallpreceptorsonhowtomakethisabetterexperienceforallstudents. You and yourpreceptorwillnotbeidentified.

8. Whatdid you appreciatefromyourpreceptor?

9. Whatsettings were you exposed tore: office,home visits, NursingHomesetc?

Iwould nominateforteachingaward

oNo

oYes

Thebox marked “Nominate forteachingaward” should be completedbystudentsif:

Supervisor-asa preceptor-(enthusiasm, teachingability,and dedication)is inthetop15th percentile ofallthesupervisors with whomthe studenthasworked.

Ifyou have concerns abouta lackofprofessionalismby yourpreceptor, you mustadvisethe Associate Dean,Dr. Melissa Forgie, byphoneat613-562-5800, ext. 8561,.

Atyour request, yourconcerns willbe keptcompletelyconfidentialunlessthereisan immediate threattothesafetyand orhealth ofpatients orothers.

PSD Community Preceptor Program

UniversityofOttawa FacultyofMedicineProfessionalismConcern Form

Should you need to filloutthis form, please followthe link: as thisisa sample.

Thisformcan becompleted byanypersonin contact with a medicalstudent in anyofficialcapacityincludingfaculty, staff, alliedhealth, patients, students and community members.

Thepurposeofthis formisto initiatea meetingbetween amedicalstudentandtheAssociate Dean, UndergraduateMedicalEducation.

Studentname (pleaseprint):Date eventoccurred:

Amedicalstudentof the UniversityofOttawa, FacultyofMedicine is expectedto live bythetenetsofthe Declaration of

Professionalismand demonstratein her/his behaviors as amedicalstudent

Honestyand Integrity

Altruismand Respect Responsibilityand Accountability Compassion and Empathy Dedication and Self-Improvement

Inmyopinion, the student named above has demonstratedbehaviors(s)thatfallbelow the expectedstandards of professionalismofourFacultyofMedicine, as indicated duringtheeventdescribed below:

Detailsofunprofessionalbehavior:

This eventwasdiscussed withthestudent: YES □NO □

Formcompleted by(pleaseprint)

Title (ifapplicable)

Contactinformation(if furtherdetails required):

THISFORM SHOULDBESENT(markedconfidential)TO: Dr.M. Forgie, Associate DeanUndergraduateMedicalEducation,FacultyofMedicine, UniversityofOttawa,451 Smyth Road room2037A, Ottawa,ON,K1H8M5PHONE:613-562-5800 ext. 8561

PSD Community Preceptor Program

PSD– CommunityPreceptorProgram–Year 1 orYear 2:EVALUATIONOFSTUDENTBYPRECEPTOR

Dearpreceptor, pleasecomplete thisformatthelastsession. It is alsorequested thatyou meetwiththe student todiscuss their performance. Pleasecomplete yourStudentEvaluationon yourone45account;donotsubmit thepapercopyto the UGMEoffice.Ifyou have anyproblems accessing yourone45 account,pleasecontactDonna Williams, r613-

562-6335 x 1441

StudentName:PreceptorName:

PSD Community Preceptor Program

PartI:Skills andKnowledge

FAILPASS

PSD Community Preceptor Program

1. Thestudenthadadequateattendanceandwaspunctual.□□

2. Thestudentdisplayedenthusiasmin learning.□□

3. Thestudentdisplayedaprofessional attitude.□□

4. Thestudent'sinterviewingskills weredisplayed inaprofessional

manner,whilebeingrespectful andcourteous towards thepatient.□□

5. Thestudent’s physical examination wasdonein a professional

manner,whilebeingrespectful andcourteous towards thepatient.□□

Comments:

PSD Community Preceptor Program

PartII:Global Rating

FAILPASS

PSD Community Preceptor Program

Please chooseone ofthe followingasan overallrating.□□

PSD Community Preceptor Program

Did you have the opportunityto meetwiththe studentto discusstheirNO

performance?□

Yes

□

PSD Community Preceptor Program

Student’s Signature: / Date:
Preceptor’s Signature: / Date:

PSD Community Preceptor Program

PSD– CommunityPreceptorProgram–Year 1 orYear 2:Course Evaluation

Please complete yourCourseEvaluation on yourone45 account;do notsubmit the papercopyto the UGMEoffice.

To be completed by

On this form, you willbe evaluating

For dates:to:

PSD Community Preceptor Program

Strongly

Disagree

Somewhat

Disagree

NeutralSomewhat

Agree

Strongly

Agree

PSD Community Preceptor Program

1.The PSD CommunityPreceptor

Programsessions were useful

12345

PSD Community Preceptor Program

PSD Community Preceptor Program

Strongly

Disagree

Somewhat

Disagree

NeutralSomewhat

Agree

Strongly

Agree

PSD Community Preceptor Program

2. Pleaserate the PSD Community PreceptorProgramexperienceoverall between 1 and 5.

12345

PSD Community Preceptor Program

3. Whatdid you enjoyabout the PSD Community PreceptorProgram?

4. Whatsuggestions would you have aboutthe PSD CommunityProgram?

Thefollowingwillbe displayed onformswherefeedback isenabled...

(forthe evaluatorto answer...)

* Did you have an opportunityto meetwiththis trainee to discusstheirperformance?

Yes

No

PSD Community Preceptor Program

PSDCommunityHandbookLinks

  • PSDPreceptorProgramHandbookLinks-
  • Howto writeaSOAP (subjective objective assessmentand plan) -
  • Howto presenta history -
  • HistoryofPresentIllness/Facilitative Skills- s_facilitative_skills.doc
  • Earlyconcepts ofa differential diagnosis-
  • Earlyconcepts ofFIFE(feelings/fears,expectations,function impairmentandexpectations)–
  • Brown Interview Checklist -

OtherHelpfulLinksforPreceptors and Students

SHARC-FM – CanadianFM ClinicalCards- WM3Zjc

R-Scope-Resourcesand Support forCommunityPreceptorExcellence-

You mustuseyourfacultyaccount(username and password)toaccessthesome of the links above. Should you nothave one, pleaseuseeCurriculumCPP as yourusernameandPSD-contentasyourpassword.

PSD Community Preceptor Program

What a 1stYear Medical student Knows

What a1stYear medical student knowsandhascompletedby Januaryof Year1:(first year studentwillbewith youin the winter2017)

1. Howtotakea complete medical history(InterviewingSkills)

2. MSK physical exam (lower limb, shoulder,upperlimb,back,neck)

ThefollowingphysicalexaminationskillsaretaughtintheWinterof Year1startingin January

Takingvitals includingBlood pressure/Pulserate…

Cardiovascular exam

Peripheral Vascular Exam

RespiratoryExam

Basic approach to theAbdominalExam

Other (i.e. Skill learned duringan elective,rural weekinthecountryor self-directed experiences)

Personal LearningObjectives:

1)

2)

3)

PSD Community Preceptor Program

What a 2nd Year Medical student Knows

What a2ndYear medical student knowsandhas completedby SeptemberofYear2:(secondyearstudentwillbewith you inthefall2016)

SeeabovesectionforYear1

Thefollowingskills are taught in theFallofYear2startingin September

Sensitive issues

Interviewingskills Pelvic examination Breast examination Rectalexamination

Other (i.e.Skill learned duringan elective,rural weekinthecountryorself-directed experiences)

Personal LearningObjectives:

1)

2)

3)