Description
Book SynopsisWorking in the outpatient clinic is a key training experience for medical students. When they arrive at the clinic, students may discover that their time on the inpatient wards does not necessarily prepare them to perform well in the outpatient setting. Everything is different in the clinic, from the nature and context of the patient encounter to the student’s role in note-writing, oral case presentation, and case discussion with the attending physician. The purpose of this book is to guide students as they transition to the world of 15-minute appointments, telemedicine, cyberchondriasis, motivational interviewing, shared medical appointments, and real-time informatics. The aim is to give students a clear understanding of their role in a variety of clinic settings, to evaluate and present their patients well, maximize learning, and provide excellent care for their patients. Excelling in the Clinic explains the process of becoming an effective, efficient, and scholarly worker in the primary care clinic.
Table of Contents
1. The Importance of Primary Care
The Power of Incremental Care – Effects of High Quality Primary Care on Health Outcomes – The Long-Term Physician-Patient Relationship – Seeing the Big Picture
2. Medical Education in the Outpatient Clinic: Benefits and Barriers
Benefits: Role-Modeling, Mentoring, and One-on-One Teaching – Barriers: Stressed Clinical Preceptors, Student Preconceptions
3. Clinic Settings, Schedules, and Structures
Settings – Schedules – Structures – Other Clinic Experiences
4. COVID-19 and the Rapid Rise of Telemedicine
How COVID-19 Has Changed Primary Care – Telephone and Video Visits: Benefits and Limitations – Student Participation in Telemedicine – Telemedicine is Here to Stay
5. Role of the Student in the Outpatient Clinic
Active Versus Passive Clinic Experiences – What Your Clinic Attending is Looking For – Increasing the Level of Responsibility: the RIME Framework – Working with the Clinic Staff – Following Up on Test Results and Consults
6. Preparing to See the Patient
Chart Review and Creating an Agenda for the Visit – More Thoughts on the Agenda: “I Just Want to Know if I’m Healthy Enough for Bacon”
7. The Patient-Centered Interview
Basics of the Patient-Centered Interview – Greeting and Introduction – Begin with an Open-Ended Question, and Listen Carefully to the Answer – Look at the Patient, Not the Screen – Med Reconciliation – Evaluate New Symptoms with Pertinent Positives and Negatives – Review of Systems – Using Motivational Interviewing for Behavioral Change – Dealing with Talkative, Angry, and Distracted Patients – Cyberchondriasis – Shared Decision-Making
8. The Physical Exam
(Lack of) Evidence for the Routine Physical Exam – The Irrational Physical Exam? – Checking Your Exam Findings with the Attending – Point-of-Care Ultrasonography in the Primary Care Clinic
9. The Concise Oral Case Presentation
The SOAP-Style Oral Presentation – Schema for the Oral Case Presentation in the Clinic – Using the Problem List as a Guide – Examples of Oral Presentations
10. Discussing the Case
Identifying Key Learning Points from the Case – Using SNAPPS for Case Presentation, Discussion, and Teaching – Researching the Case and Reporting Your Findings – Questioning Dogma in the Clinic – Responding to Feedback
11. Writing a Clinic Note
The Classic SOAP Note and its Function – How Not to Write a Progress Note: Things to Avoid – Examples of Concise Clinic Notes
12. Service-Learning Clinics
Working in Shelters and Homeless Clinics – Student-Run Free Clinics – Challenges and Satisfactions of Caring for the Underserved – The Silver Chalice
13. Careers in Primary Care
Traditional, Non-Traditional, and Academic Practice Options – Finding Your Niche in Primary Care – Academic Careers in Primary Care: How to Get There – The Future of Primary Care
