MedEdPORTAL (Jul 2014)
Medical Skills in a Clinical Presentation-Based Curriculum – Approach to the Patient With Acute Fever
Abstract
Abstract Introduction During the first semester of medical school, most medical students have their first precepted clinical experiences. For medical students to participate effectively in these experiences, they need a set of basic clinical skills coupled with a fundamental understanding of how to apply those skills to a clinical problem. The problem of the patient with acute fever is a good platform for building this basic set of skills as it is a problem that students will encounter many times. Methods The first session is a small-group learning activity with clinical faculty members and demonstration patients. Students are coached as they practice the steps of the focused physical examination of the acutely febrile patient. The preparatory physical exam worksheet and accompanying video are included. During the second session, students individually (or in pairs) work through the interview and perform the examination of a standardized patient (SP) presenting with acute fever. The readiness assurance quiz, preparatory exam room guide and video, student summary outline, peer observer feedback guide, and a SP case blueprint are included. There is an optional Spanish-language translation of the patient interview. After the SP encounter, students write a SOAP note, receive feedback from the SP (and from their peer observer, if present) and debrief in a group discussion with a faculty member. Results These session materials have been used for 5 years with 500 students. With 100 students in each class, the activity is presented six times over the course of a day to groups of 17 students. Discussion These materials would be of interest to preclerkship clinical skills instructors who would like to teach a presentation-based, focused history and physical exam to their trainees. The preclerkship curriculum at the Texas Tech University Paul L. Foster School of Medicine is a fully integrated, clinical presentation-based curriculum, which allows clinical skills instruction to be tightly integrated with basic science content. Therefore, it is important to situate these two sessions at a point in the curriculum when appropriate basic science content has been covered.
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