Introduction to Medicine I: Patient/Doctor Relationship
Attendance policy / Course description / Course Objectives / Grading Policy
Instructor Randall Stevens, M.D. and James Turner, D.O.
Office Hours By appointment only
E-mail Dr. Stevens: rstevens2@medicine.indstate.edu
Dr. Turner: JTURNER@uhhg.org
Times Tuesday 1:00pm-5:00pm
The following is a REQUIRED Text for this course:
Saving Sickly Children: The Tuberculosis Preventorium in American Life 1909-1970 by Cynthia Connolly
"If the physician understands things exactly and sees and recognizes all illnesses in the macrocosm outside man, and if he has a clear idea of man and his whole nature, then and only then is he a physician. Then he may approach the inside of man; then he may examine his urine, take his pulse, and understand where each thing belongs. This would not be possible without profound knowledge of the outer man, who is nothing other than heaven and earth."
Paracelsus (1493?-1541)
THE PATIENT-PHYSICIAN RELATIONSHIP is a course designed to assist the first-year medical student in her/his initial development of the core competencies necessary for the effective practice of medicine. Class sessions will be used to explore the way medical-psychosocial factors interact to affect a given patient's response to disease processes and/or to the therapeutic endeavors of her/his attending physician and other members of the health profession.
Being a medical student should bear a relationship, ultimately, to the practice of medicine. In the past, the clinical experience, the actual contact with patients and their problems, was saved for the "clinical years", that time when the student had a solid information base for the diagnosis and treatment of the patient's complaints. Students often became frustrated with this approach. They wondered about the relevance of the basic sciences to their real goal, caring for patients.
The purpose of this introductory course to medicine is to bridge that gap and to provide the clinical exposure necessary to allow you, the student, to comprehend the overall framework of the study and practice of medicine. We want you to learn to enjoy your interaction with patients and the practice of medicine early in your training. We do not want you to have to overcome the feelings of frustration about the training process often expressed by students in the past. With that in mind, this course has been designed to maximize patient contact, small group discussion, and student-preceptor interaction and feedback.
It is a course in evolution. Comments of students and preceptors alike are welcomed. Recommendations for further modifications are also welcomed and appreciated.
This course is intended to provide basic information and experiences upon which future knowledge and experiences can be solidly based. We will employ the principles of interactive learning in the course; we will expect you to engage in the process. The many formats of the course (reading, lecture, panel discussion, direct patient contact, small group discussion, writing assignments, and personal meetings with preceptors) will allow you ample opportunity for reflection and questions.
COURSE EXPECTATIONS ARE:
To foster a broader understanding and appreciation of the core competencies of medicine, broadly defined as:
These are ambitious but realistic outcomes. By achieving early competence in these areas of clinical
medicine, you will be well prepared for future study. You will develop knowledge, skills, and attitudes upon
which you can build, not only during the rest of medical school, but for your entire career. Physicians learn
best when prompted by their patients; this is true problem-based learning. They also learn by reading,
talking to colleagues, attending meetings, and in a host of other ways. In this course only Competency I will be graded.
In order to promote clinical learning, the course is directed towards these outcomes:
What you should know:
What you should value:
What you should be able to do:
Through observations, participation, discussions, reading and writing assignments, each of the Competencies within the IUSM Competency Curriculum are covered. To aid in the student's development of these Competencies this course includes the following:
Students will be required to complete weekly written assignments. The first is a response to assigned reading materials. The second is a reflection on the student's experience while with their assigned clinical preceptor for that week. Each of these writing assignments should be AT LEAST 2 paragraphs in length and should not exceed one page. These assignments give the student the opportunity to comment on what they have seen or read during that week. These assignments will be submitted using the ANGEL TM Online Curriculum Management System within the Patient/Doctor Relationship course (/med/frames.aspx) as attachments in the assignment's corresponding "Drop Box" for that week.
The reading assignments are included in the same folder as the "Reading Assignment Response Drop Box" they correspond to and are DUE on the date listed on that folder. Students should read the assignments BEFORE the class period they are assigned for. The reading assignment .PDF documents are accessible to the students from the first day of classes at IUSM-TH therefore working ahead on these assignments is possible, however students are encouraged to check for any additions or modifications to the reading assignments one week prior each due date. If a Reading Assignment Response Drop Box is present in a folder, there are no .PDF files in the same folder, and there is a week or less before the reading assignment is due, the Students should contact their Class Representative as soon as possible who should send an email to KristyNicoson (knicoson@isugw.indstate.edu) and cc. it to Dr. Stevens (rstevens2@medicine.indstate.edu) to have the .PDF files made available to the Students.
Preceptor Reflection writing assignments are due no later than the Monday after each weekly Preceptor meeting. Each student is required by IUSM to enter data about the patients they have seen each week in the Clinical Encounters Real-Time Tracking System (CERTTS) section of ANGELTM Umed/frames.aspx). To access the forms, click on the "Choose" button next to "Enter data on forms" under the Clinical Encounters Tracking heading in the "My Page" (this is the first page that comes up when you log in) section of ANGEpM. Once there click on ICM I and enter the data on the form. This tracking has been set up by IUSM in an effort to discover the types of clinical experiences that all of the students within a course have been exposed to.
At the end of the semester and again at the end of the year, a one to two page reflection covering the entire course up to that point is due. This is to give the student the opportunity to review the submissions they have made up to that point and reflect on how they have changed (or not) because of the content and experiences included within this course. Submissions will be made via ANGELTM Umed/frames.aspx) within either the Semester Reflection (fall) or Course Reflection (spring) Drop Box located in the "Finals Week" folder and are DUE by the date listed on that folder. Students may find it helpful to have these submitted by the beginning of "Study Week" so as not to conflict with studying for final exams. These Reflections should also include suggestions on how to improve the course if the student has any.
With time permitting (and available faculty), students will spend more contact time with an area physician in more of a mentoring (one-to-one) approach. Student will also participate as intake evaluators in health clinics and perform simple clinical procedures. Students will also participate with standardized patients. Rural students may be given additional reading assignments.
Introduction to Medicine I is graded on a Pass-Fail level upon completion of the spring semester.
Assessment of performance includes joint quizzes with other classes and a final exam along with short weekly writing assignments, an end of the semester and end of year reflection writing assignments, and a one page book report due at the end of the year covering the book assigned in class.
Ultimately your final test will be your ability to interact professionally with patients from all walks of life and address their medical and psychological concerns. To obtain a Pass level for this course, each student must submit all of the assigned "Weekly Reading Assignment Response", all of the "Preceptor Reflection" assignments, the "Fall Semester Reflection" writing assignment, the "ICM I Course Reflection" writing assignment, as well as attend all class periods in accordance with the Attendance Policy for this course. The student's interactions with their assigned preceptor will also be evaluated by their assigned preceptor for consideration during the grading process.
Students will need to take a copy of the ICM I: Patient-Doctor Relationship Preceptor Evaluation Form (found in the Week 1 folder for each semester) with them to their final Preceptor meeting for that semester.
A note about writing assignment scores:
Most submissions will receive a score of 90-100 provided they accomplish the goals for the assignment. For outstanding submissions a score of 100 will be given. While these scores will not be added together to compile a composite score for the course, they will be given along with instructor feedback to allow the student to develop their skills in the Competencies.
Attendance is mandatory for all class periods.
Absences due to illness or UNUSUAL circumstance should be communicated to the IUSM-TH departmental office (812.237.2777) and an email sent to Dr. Stevens (rstevens2@medicine.indstate.edu) as soon as possible.
In the case of an absence during a week where the student is assigned to meet with their Preceptor, the STUDENT must contact their assigned Preceptor's office in advance to let them know they will not be present for that week.