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8/15/2019 Fammed intro

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Family Medicine Junior ClerkshipIntroductory Seminar & Orientation

Department of Family Medicineand Primary Care (FMPC)


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ims of the FM JuniorClerkship

• !o ena"le students to learn andpractice the skills of pro"lemidenti#cation and clinical pro"lemsol$in%

• !o ena"le students to %ain aninsi%ht into the ork of familydoctors in the community

• 'O! the mana%ement of speci#cdiseases


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earnin% Outcomes*+ ,e a"le to take a rele$ant history and

identify the reasons for consultation

-+ ,e a"le to descri"e the inter.relationship of psychosocial andphysical factors of the illness for eachindi$idual patient

/+ ,e a"le to e0plore ho family mem"ersmay in1uence a patient2s health

3+ ,e a"le to e0plore ho family mem"ersmay "e a4ected "y a patient2s illness


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5+ ,e a"le to adopt the hypotheticaldeducti$e method of clinical pro"lemsol$in% for the dia%nosis ofundi4erentiated symptoms presentin% toprimary care

6+ ,e a"le to identify the nature of thedoctor.patient relationship and itstherapeutic potentials

7+ ,e a"le to e0plain the di4erent roles offamily doctors

8+ ,e a"le to synthesi9e the dia%nosis:pro"lems of common illnesses presentin%to primary care

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earnin% Outcomes


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FM Junior Clerkship;and"ook

Do nload ;and"ook from Facultye"

• Pro%ramme & Schedule (


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FM Junior ClerkshipPro%ramme

• - 0 seminars (today)• 6 0 hole class sessions (>M;)• - 0 super$ised consultations at familymedicine clinics . at CC? "erdeen? S@P or

AP BOPC• - 0 $ideo re$ie sessions . at CC• - 0 - family practice attachments (FP ) inthe community

• FM orkshop (Pro"lem sol$in%) at Faculty• FM orkshop , ( orkin% ith Family) atFaculty

• De"rie#n%: sharin% session at Faculty


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F MI @MEDICI'E

;O E C SSSESSIO'S


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FM hole ClassSessions

Topic Date Speaker

Principles and concepts of Family Medicine 07-11-14 (Mon) Prof. Cindy LK lam

Clinical problem solving in Primary Care !-11-14 ("#e) Prof. Daniel TP Lam

Common problems in Primary Care $%Upper respiratory tract infections

&-11-14 ('ed) Dr. Colman !n"

Common problems in Primary Care $$%Differentiating the normal from theabnormal

7-11-14 (" #) Dr. #!lie C$en

Common mental ealt problems inprimary care

-11-14 (Fri) Dr. %en" &ee C$in

*ealt promotion and disease preventionin primary care

+-11-14 (,at)

Dr. %illiam %on"


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F MI @MEDICI'ECO'S ! !IO'S !E C;I'B


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Clinics

• !he addresses are sho n on yourtimeta"le ( CC? "erdeen? S@P?AP BOPC)

• Please remem"er to si%n yourattendance

• sk the nurse in char%e fordirections to the desi%natedconsultation rooms

• !eacher in char%e ill super$iseyour consultations

•


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Patient.centred inter$ie &Physical E0am

*+ E0plore the chief complaint &history of the presentin% pro"lem

-+ Find out the reason for consultation

/+ ssess the e4ect of illness on thepatient

3+ Identify & clarify the patient2sideas? concerns and e0pectations(ICE)

5+ Erect your hypotheses (physical?psycholo%ical and social) onpatient2s dia%nosis:pro"lems


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C!e*+Clinical, -e$a ioral, conte/t!al0

1ypot$e*i*+e*0+pro-a-ility * po**i-ility0

Searc$+ !rt$er 1i*tory, P , /0

Dia"no*i*

Management

e i*ene/pected

c!e*


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AIDEO=EAIECO'S ! !IO'S !E C;I'B


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Aideo =e$ie Consultations

• Please meet our sta4 mem"er inConsultation room * of CC at*+5Gpm for a "rie#n% session onho to ork the $ideo recorderand patient recruitment

• Please "e P 'C!

• ear your clean hite coat ithyour name "ad%e & a sur%icalmask


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Aideo =e$ieConsultations•Each student ill inter$ie apatient for 6 minutes? hich ill"e $ideo.taped+

•Please do not e0amine or mana%epatient

•Patient ill "e seen "y the doctorafter student ’ s inter$ie


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;istory. takin% form• Patient identi#ersH a%e? se0? initials• ey history of presentin% pro"lemH

presentin% pro"lem and ;PC• =eason for consultation ( hy has the

patient really come )• intolerance of symptoms?• intolerance of an0iety?• pro"lems of li$in% (en$ironmental stress? una"le

to cope or social pro"lems)• administrati$e reasons

• ICE• Pro"lem list includin% DD0• Most likely d0 : important pro"lem• 'e0t step ( hat PE? I0)

• earnin% issues


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Aideo =e$ie ofConsultations

• Complete the history-taking form immediately after your consultation

• rite a summary of the consultation

on the hite "oard in the rooms

• @our teacher ill arri$e at /+GG 5HGGpm in Consultation rooms *K- of p

ei Chau Clinic• =e$ie the $ideotaped consultations

ith a teacher to analyse thepro"lem sol$in% process and recei$efeed"ack on your consultation


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Aideo =e$ie Consultations

• ;I E atchin% the consultationsof your %roup.mates? complete the

peer assessment form

• ;I E atchin% the play"ack of one%roup mem"er2s $ideo consultation?you can also complete an additionalhistory-taking form for practice

• @ou are e0pected to ha$e thereLuired CIPS


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P=O, EM

SO AI'BO= S;OP(FM

O= S;OP )


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2)

Clinical Pro"lem Sol$in% +• Identi#cation of the reason forconsultation

• Clari#cation of the chief complaint

and presentin% pro"lem• Interpretation of key information• Beneration of dia%nostic hypotheses


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+Clinical Pro"lem Sol$in%

• Elicitation of rele$ant history tocon#rm the dia%nosis and e0cludeother DD0

• Synthesis of pro"lems • Medical record keepin%• Communication of information to

another health professional


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O= I'B

I!; F MI IESO= S;OP(FM

O= S;OP ,)


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orkin% ith Families• Systemic perspecti$es in carin% forindi$iduals and their families

• Di4erent le$els of doctors familyin$ol$ement for di4erent health pro"lems

• Important concepts in orkin% ith families?such as family life.cycle sta%es and familyor%ani9ation (su"systems? "oundaries?hierarchy? coalitions? etc+)

• !he essentials in inter$ie in% indi$idualsand their Nfamilies

• =ole.plays? case $i%nettes? and $ideos ill "eemployed

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P= C!ICE

!! C;ME'!:P=ISO';E !;SE=AICE AISI!


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FP : prison health $isit• Consolidate pro"lem sol$in% skills

• Complete * history takin% form perattachment to "e handed in to each FPteacher for assessment (super$isedconsultation)

• May "e "ased on self conducted patientinter$ie s or o"ser$ation ofconsultations done "y the FP teacher


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Inter$ie one patient: FPComplete $i*tory takin" form

ame 9 Date 9 St!dent o. 9C$ief complaint pre*entin" pro-lem 9

ea*on for con*!ltation 9Key information in $i*tory 9Differential and pro-lem li*t9

:o*t pro-a-le dia"no*i* 9Learnin" i**!e* 9

P i lth S $i


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Prison ;ealth Ser$icesAisit• 1 pair of male students and 1 pair of femalestudents will have the opportunity to havean attachment with the Correctional ServicesHealth Service as one of their FPAattachments

• Students will be expected to share their

experience with their group members duringthe debrie ng session


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Student E$aluation on FP• Please complete the pinke$aluation form? one for each FP

• Please "rin% alon% and hand inthe form at the de"rie#n% session• May mark the form con#dential ifyou do not ish the form to "e

returned to the doctor


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E !E'DEDC SECOMME'! =@


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E0panded CaseCommentary• One patient seen durin% the FP :consultations to illustrate theprinciples of family medicine in

one or more of the follo in%H.• primary care• continuin% care•comprehensi$e care• hole person care


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E0panded Case Commentary (Instruction and template do nloaded from FM ;and"ook)

• 'o more than *GGG ords• ,rief summary of patient2ssi%ni#cant medical & psychosocialhistory

• Discussion on ho the principlesof family medicine are: can "eapplied to this speci#c patient

• conclusion on hat you ha$elearned from this patient? esp theroles of FP

• Su"mit $ia !urnitin


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Turnitin Pla%iarismSoft are• ou have all been enrolled on the Turnitin under your ; portal email address!

• Please chec" your H#$ portal e%mail to

ma"e sure that you have received an e%mail from Turnitin con rming that youhave been registered!

• If you ha$e not recei$ed an e.mail

from !urnitin ithin * eek? pleasee.mail Dr+ en% Chin atchin yQhku+hk

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Dear student name ?

ou have been enrolled in the &urnitin class '()1(%()1*+,C-C +F.+/n0 by your instructor Family .edicine$nit!

&o start using this class go to http233www!turnitin!com andlog in using the following temporary information2

4mail address2 HKU email addressPassword2 (r56)768

9nce you log in you will be ta"en through a step%by%stepstart%up process and you will also have the chance tochange your password and any other personal information !

#eep in mind that the temporary password above is case%sensitive2 we recommend that you paste it directly intoyour browser !

&han" you for using &urnitin

&he &urnitin Sta:


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Clic t e class t e name

014- 01!./C C.FM. 1


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Click ;*!-mit<

23tended Case Commentary

01 - 01 /C C FM 1

01 - 01 /C C FM 1


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Step (9 Type in /tended Ca*e Commentary

Step 29 =ro>*e for yo!r*a ed doc!ment

Step 39 Click ;!pload<

Case Commentary


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Step (9 e ie> t$e doc!ment

Step 29 Click *!-mit if ?K


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f yo! for"et or lo*e yo!rpa**>ord, lo" onto9>>>.t!rnitin.com and click; etrie e Pa**>ord .5

6 lin ill be sent to yo#r *89

portal email allo ing yo# to create ane pass ord:


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•9nce submitted thehomewor" cannot be re%submitted

•;ue dates for submission


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4)

DE,=IEFI'B:S; =I'BSESSIO'


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De"rie#n% & Feed"ack (Aenue addresses on timeta"le)

•=e1ection on the learnin% ande0perience of the FP• the roles & limitations of family doctors

in primary care• the importance of Dr.Patient

relationship

• ppraisal of $ariations infamily practices

•Discuss the ethics of familypractice

•Feed"ack and su%%estions


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… De"rie#n% & Feed"ack Please su"mit the follo in% at thissessionH

• - 0 pink FP e$aluation forms (one foreach doctor)


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JC,COB,OO


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o%"ook Identi#es the e0pected learnin%outcomes (helps identify learnin%%aps)

=ecord of clinical encounters

=e1ection consolidates learnin% (askhy)

ritten self re1ection encoura%esdeeper and: or ider thou%ht

Faculty ORce to assess e4ort onre1ecti$e thou%ht only (part of,lock C continuous assessment)

Information on learnin% %aps?


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>>>.$k!.$k fm!nit 47

SSESSME'!S


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Continuous ssessment•*GG ttendance

• a"sence due to sickness needs to "ecerti#ed

• a"sence due to other reasons should"e e0plained in ritin% & su"Tect toappro$al

•Aideo =e$ie of

Consultations•Family Practice ttachments•E0tended Case Commentary

•FM OSCE station 0-


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OSCE• ( stations2Station *H (6 min)• &a"e a history from a simulatedstandardi8ed >patient?

• &a"e a focused history directed atidentifying the reason for consultation@C4 problem list ;!;x and most li"elydiagnosis

Station -H (8 min)• Complete a history ta"ing form andanswer the uestions


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S! DE'!P=OFESSIO'ISM


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Medical Professionalism

• Honesty B personal integrity• /espect to patients


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=ecommended !e0ts &=eferences

• Fraser =+ Clinical MethodH Beneral Practice pproach

• Mc hinney I+=+ Clinical pro"lemSol$in% in Family Practice? Chapter*U in? =akel =+E+ (Ed)+ !e0t"ook ofFamily Practice


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Infection Control . @ellolert

• ear a clean hite coat in allclinical sessions

• ear a sur%ical mask in all

clinical sessions? please "rin%your o n mask and dispose itproperly

• ,e alert if patient has fe$er and

tra$el? occupation? contact orcluster (!OCC) risk


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>>>.$k!.$k fm!nit 54

after eachpatient

contact?earin%:

remo$in%your mask ? and "eforelea$in% aclinic

%a*$ yo!r $and*


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Infection Control• DO 'O! come to class and consult adoctor if you ha$e any of thefollo in%H•Fe$er or chills• =espiratory symptoms

• Diarrhoea• Suspected or kno n contacts ithany serious infectious diseases


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Bround =ules


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Dr Esther @u(JC,C coordinator for FM)ytyuQhku+hk

Ms Crystal on%( dmin sta4 for FM JC,C)sau aiQhku+hk !el -5*8 5653

'@ > E=IES
mailto:[email protected]:[email protected]:[email protected]:[email protected]

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