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Outpatient Family Medicine I

Goal:  The goal of the Outpatient Family Medicine rotation series is to give every resident the knowledge, skills and attitudes to provide a lifetime of comprehensive, cost-effective, and caring service to families in the outpatient setting. 

The AFP curriculum committee (3 residents, 2 faculty) with input from other faculty and residents, devised a new, three month series of rotations (one in each year).  This allowed us to rearrange some curricular elements to the most appropriate year of the curriculum and to add some innovative elements.  This curriculum started 7/03.

Community-Oriented Family Medicine I

This is a one-month rotation during the first half of the first year. Ernie Stump coordines the Outpatient Family Medicine I curriculum. 

Objectives:  By the end of Outpatient Family Medicine I, the resident will:

1.      Organize and conduct an effective outpatient visit, demonstrating effective listening skills, non-verbal communication skills, and questioning skills. (Skills, attitudes; Interpersonal and Communication Skills)

Potential instructional methods.

a)      Discussion of videotaped interactions with the Behavioral Scientist.

b)     Development of an “interview template”

c)      Illustrative videotape.

d)     AFP office hours two half days a week.

2.      Develop appropriate attitudes and patterns of interaction with patients, staff, peers and faculty. (Attitudes; Professionalism, Interpersonal and Communication Skills)

            Instructional methods. 

a)      Myers-Briggs analysis and discussion with Behavioral Scientist (confidential and voluntary).

b)     Readings on personal interactions

3.      Assess psychosocial needs efficiently and manage patients’ needs using practice and community resources. (Knowledge, Skills, Attitudes; Systems-based Practice, Patient Care)

            Instructional techniques. 

a)      Instruction on the BATHE technique.

b)     Discussion of challenging patients with Behavioral Scientist.

c)      Visits to Home Nursing, Hospice, Early Intervention, Family Services, Children and Youth, Crisis and Office of Aging.

4.      Analyze family structure and relationships and how they interact with patient’s medical, social and psychological needs. (Attitudes, Knowledge, Skills; Patient Care, Interpersonal and Communication Skills, Practice-based Learning)

            Instructional technique. 

a)      Joint home visit with the Behavioral Scientist focusing on family structure and relationship styles.  This would be followed up with discussions and perhaps a presentation. 

5.      Practice approaches to the difficult patient and begin to develop insight into their own emotional reaction to patients and visits.

(Attitudes, Skills, Knowledge; Patient Care, Practice-based Learning and Improvement, Professionalism)

            Instructional technique.

a)       Discussion with the Behavioral Scientist of difficult interactions during the month.  

b)     Discuss Myers-Briggs profile and how it affects interactions with patients.

6.      Demonstrate respect, compassion and integrity in responding to the needs of patients and society that supercedes self-interest.  (Knowledge, Attitudes, Skills; Professionalism, Systems-based Practice)

Instructional techniques

a.      Sees patients at Partnering for Health Care Clinic once a week.

b.      Readings or articles?

7.      Internalize the values and cultures of Family Medicine.

(Knowledge, Attitudes; Professionalism, Systems-based Practice)

Instructional techniques

a)        We provide a “bookshelf” of classic books on Family Practice and ask the resident to read one and discuss it with a faculty member.  We may also ask a resident to explain the values of family practice to a student.

8.      Recognize the distinctives of a “private” rural practice.

(Attitudes; Systems-based practice)

            Instructional techniques. 

a)      The resident will spend one day at Williamsburg and one day with Drs. Hall and Robinson.

9.      Code and bill outpatient family medicine family medicine visits, procedures and tests accurately. (Skills; Systems-based practice)

            Instructional technique: 

a)      Readings, discussions and chart audits - meetings with Dr. Beckstead.

10.  Become proficient in running the basic tests available in our outpatient lab. (Knowledge, Skills; Patient Care, Medical Knowledge)

            Instructional technique:

a)      One-on-one teaching with the Laboratory Scientist.

11.  Become acquainted with GYN procedures. (Knowledge; Patient Care)

    
              Instructional technique:

                   a)   Observe one half day of colposcopy clinic.

 Go to Community Oriented Family Medicine II