INTRODUCTION TO PATIENT CARE II

CLEVELAND FOOT AND ANKLE INSTITUTE

SYLLABUS

CLI 201

2011 - 2012

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DIRECTORY INFORMATION Assistant Dean of Clinical Education: Dr. Caldwell Clinic Manager: Stephanie Starks-Anderson Department Secretary: Amy Onesky 916-7484

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RATIONALE The Introduction to Patient Care II clinical rotation provides the second year student an opportunity to directly observe patient care at the Cleveland Foot and Ankle Institute and assist in the performance of history-taking and physical examinations. ALL STUDENTS SHOULD REVIEW THE ONLINE MEDIASITE INTRODUCTION LOCATED ON THE STUDENT INTRANET UNDER CLINICAL VIDEO FILES. Relevance The relevance of this rotation is for students to have the opportunity to become familiar and utilize fundamental concepts of primary podiatric care. This includes developing skills in taking patient histories and performing physical examinations, developing differential diagnoses, and patient management. Students are expected to exhibit knowledge gained from classroom courses. It is recommended the student review any materials as necessary to benefit their rotation experience. ATTENDANCE Attendance is MANDATORY. A pass or fail grade will be given and be based on attendance. It will also be based on the student exhibiting behavior in a professional manner while in clinic. Tardiness Policy You are expected to arrive for clinic at least 5 minutes prior to the start of clinic session. Sign-in sheets will be posted 30 minutes prior to the start of clinic and removed at the start of clinic. Consistent tardiness which is defined as more than 2 offenses for clinical sessions will result in a professional deficiency under section of Reliability and Maturity. ANY STUDENT WHO RECEIVES A PROFESSIONAL DEFICIENCY DURING THE ROTATION WILL FAIL THE ROTATION AND WILL REMEDIATE THE ROTATION. Request for an Excused Absence A request for absence form needs to be completed for all planned absences. This form is available in clinic. The student should complete a request for absence form with the intended date of absence indicated and reason for the excuse. The rotation coordinator must approve all requests for absences. If approved, a copy of the form will be kept in the student's file and a copy given to the student. On the day that the student completes the clinical obligation, he or she should bring the copy of the form. The attending physician will sign the absentee form the copy in order to verify the day has been made up. After all the days are completed, the student should submit the form to the 2nd floor so that it can be placed in the student's record. If an absence is not approved the student will be expected to fulfill clinical obligation.

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Examples of excused absences:

Illness Family emergencies Family wedding/wedding party participant Court date Examinations/interviews

Examples of non-approved requests for absences: Vacation Prior travel plans Moving

Sickness If a student is sick and requires an absence from clinic, the student must call the secretaries (Barb Strong 916-7482) prior to the start of clinic in order for the absence to be excused (on Saturdays, students must call the attending physician at the Euclid Ave Clinic). If the student fails to notify the secretaries’ office of the sickness then it will be considered as an unexcused absence. The rotation coordinator will complete a request for absence form. After two consecutive days of sickness the student will need to provide a doctors excuse for the additional sickness days. The student will make up any days missed after returning to clinic. Make up dates must be approved and arranged with the rotation coordinator upon returning to the clinic. The student will be given a copy of the request for absence form and will follow procedures for verification of make up day as stated with an excused absence policy above. Unexpected Emergencies Unexpected emergencies are situations which may prevent the student to be in clinic on scheduled days which were not planned excuses or may be tardy due to unforeseen circumstances. Unexpected emergencies are not planned and will be only be considered in special circumstances which would prevent the student to be in clinic on time such as flat tire, stalled car, or car accident, or extreme family emergency. In this event the student must call the secretaries at OCPM. If the student fails to notify the secretary’s office of the situation then it will be considered as an unexcused absence. The rotation coordinator will review the circumstances and will either approve the absence as an excused absence if it is a legitimate unexpected emergency. The absence may be considered unexcused by the discretion of the Rotation Coordinator if the situation is NOT of an emergency nature. If the absence is approved the rotation coordinator will complete a Request for Absence form and will follow procedures for verification of make up day as stated with an excused absence policy above. If the absence is not approved then it will be equivalent to an unexcused absence. Unexcused Absences Any time a student misses a clinical session without prior approval or fails to notify the secretaries as in the situations for sickness or unexpected emergencies is considered an unexcused absence. Any unexcused absence will require a 3 day make up per unexcused absence. These days will be made up on Saturday clinic days. The student will also receive a professional deficiency under section of Reliability and Maturity for each unexcused absence. Unexcused absences will not be tolerated and may result in cause for failure of the rotation especially if there is a pattern of unexcused absences. ANY STUDENT WHO RECEIVES 2 SUCH PROFESSIONAL DEFICIENCIES DURING THE ROTATION WILL FAIL THE ROTATION AND WILL REMEDIATE THE ROTATION. Remediation will be completed as directed by the Rotation Coordinator and Department Chairperson.

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Clinic Attire: Students are required to wear clinic attire as described in the Orientation Handbook/Student

Handbook. Men should wear ties and keep lab coats buttoned. Lab coats along with name tags are to be worn during patient care sessions. Lab coats should be kept clean and pressed. SCRUBS MAY NOT BE WORN. During non-clinic times students are expected adhere to the Dress Code Policy as outlined in the Student Handbook.

INSTRUCTIONAL STRATEGY During the course of patient care at the Cleveland Foot and Ankle Institute students will elicit and perform a history and physical, develop differential diagnoses, and follow through with a regime for patient management under the supervision of a residents and faculty members. Students will interact with other students, staff, residents, and clinicians. It is important during the course of patient care that the student understands the patient’s concerns, complaints, psychosocial status, past medical history, and medications. The student should also understand differential diagnoses, diagnosis, treatment, and future plans for the patient. Students will also develop skills with patient communication. The student should use this opportunity as a guide to become professional and ethical podiatric physicians and should act accordingly while following the guidelines outlined for Professional Traits in the Student Orientation Manual. Students will be evaluated by their attendance, professional traits and performance. Students must submit a log of the patients encountered during the rotation. Logs should be given to Jennifer Kenney on the last day that the student is scheduled in clinic. Logs should contain: Patient chart number (and initials of patient) Date of service Diagnosis Treatment plan This should be completed in the format on the next page and given to Amy Odesky at the end of EACH SEMESTER. Students are also expected to know medications which are utilized during the course of Patient Care and pertinent to Primary Care Medicine.

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HIPAA PRIVACY REGULATIONS Students should always remember and respect patient’s right to privacy as outlined in the HIPAA

Notice of Privacy Practices for CFAI and also outlined in the Student Orientation Manual.

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STUDENT EVALUATION Outstanding Absences: Students are responsible for completing clinical sessions for absences or penalties. Any student who does not complete make up days by the end of the junior year in clinic will receive an incomplete for the rotation until the days are made up. Assessment of Professional Traits: Each student will be evaluated on non-cognitive behaviors related to Professional Traits throughout the entire month of the rotation. Professional traits for a physician are essential in order to ethically manage patients. Students will be evaluated for their Professional Traits according to the areas as described in the Junior Orientation Manual and Student Handbook for Professional Trait behavior. Students will be evaluated in the following areas:

Areas of Assessment Reliability and Responsibility Maturity Critique (Ability to accept and respond to criticism) Communication skills Honesty and Integrity Respect for patients No signs of chemical dependency or mood disorder Follows procedures and policies

Students will be evaluated on their Professional Traits. Students will be evaluated by the attending clinician. Beginning the second week of the rotation, students after participating with a patient care case on the same day will submit an evaluation form to the attending clinician to complete for reviewing skills in Guided Patient Care and Professional Traits. The evaluation form will have the above noted areas for Professional Traits so the student will be in evaluated in those areas related to the patient case. The attending clinician will evaluate the student in the above noted areas for Professional Traits related to the patient case. The student will be evaluated on a pass/fail basis. Students will be evaluated in each section with the following grading scale: Students will be evaluated on a daily basis by the attending clinicians in the department as to their behaviors according to the Professional Traits Policy in the Junior Orientation Manual and Student Handbook. . Guided Patient Care: All students have the opportunity to participate in Guided Patient Care on assigned days. Students will be monitored by the attending physician and resident on an individual case basis. Students will be monitored as to following directions related to patient care, clinical skills, rapport with patients/staff/faculty, motivation, and compliance of clinic/department protocols. Students should not hesitate to ask for assistance and should enhance their podiatric education. Students will gain experience with each patient encounter throughout the month.

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Grading Scale: Pass

Fail FINAL ROTATION GRADE Passing Grade for the Rotation: A satisfactory grade is received when a passing score is obtained. Failing Grade for Rotation: An unsatisfactory grade is received when student does not attend assigned clinical sessions or exhibits unprofessional behavior.

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Required Reading List

Effects of Hallux Limitus on Plantar Foot Pressure and Foot Kinematics During Walking BV Gheluwe et al. Vol 96 No 5 September/October 2006 Journal of the American Podiatric Medical Association Scarf Osteotomy for Hallux Valgus Deformity: A Prospective Study with 8 Years of Clinical and Radiologic Follow-up JJK De Vil et al, Vol 100 No 1 January/February 2010 Journal of the American Podiatric Medical Association Clinical Practice Guidelines by the Infectious Diseases Society of America for the Treatment of Methicillin-Resistant Staphylococcus aureus Infections in Adults and Children Liu et al Clinical Infectious Diseases 2011:52 (1 February)