Clerkship Learning Objectives

1. Biopsychosocial Model

• Patient-centered communication skills:

  • Demonstrate an empathic response to patients using active listening skills.
  • Demonstrate the ability to set a collaborative agenda with the patient during any patient encounter.
  • Demonstrate the ability to elicit, prioritize, and attend to the patient’s specific concerns.
  • Review patient’s history, physical examination, and test results using terminology that the patient can understand.
  • Clarify information obtained by a patient from popular media, friends and family, or the Internet.
  • Validate a patient’s feelings by naming emotions and expressing empathy.
  • Effectively incorporate psychological issues into patient discussions and care planning.
  • Use empathy and active listening skills to improve patient adherence to medications and lifestyle changes.
  • Explain treatment plans for prevention and management of acute and chronic conditions to the patients.
  • Reflect on personal frustrations and the patient’s situation to better understand why patients do not adhere to offered recommendations or plans. 

• Psychosocial awareness:

  • Explain why physicians have difficulty in situations such as patients’ requests for disability documentation, non-adherence, and chronic narcotic use.
  • Describe the influence of psychosocial factors on a patient’s ability to provide a history and carry out a treatment plan.

• Patient education:

  • Describe mechanisms to improve adherence to and understanding of screening recommendations.
  • Provide patient education tools that account for literacy and cultural factors (e.g., a handout on how to read nutrition labels.)
  • Describe the patient education protocols for core chronic illnesses at their assigned clerkship sites.
  • Identify resources in a local practice community that support positive health outcomes for diverse patients and families.
  • Promote the use of support groups and other community resources to assist patients with mental health needs.
  • Identify and distribute current resources for patients with substance abuse problems at their clinic sites (e.g., lists of treatment referral centers, self-help groups, substance abuse counselors, etc.)

2. Comprehensive Care

• Information gathering and assessment:

  • Apply critical appraisal skills to assess the validity of resources.
  • Formulate clinical questions important to patient management.
  • Conduct an appropriate and comprehensive literature search to effectively answer clinical questions.
  • Apply evidence-based medicine (EBM) to determine a cost-effective use of diagnostic imaging in the evaluation of core, acute presentations.
  • Demonstrate ability to discriminate between high and low-quality evidence when searching the medical literature.
  • Utilize high-quality Internet sites as resources for use in caring for patients with core conditions.
  • Curate a set of high quality mobile apps for quick reference when delivering patient care.

• Lifelong learning:

  • Demonstrate an appropriate level of meta-cognitive skills to assess and remediate one’s own learning needs.
  • Describe an individualized, evidence-based process on how to keep current with preventive services recommendations.
  • Create an evolving set of learning goals and measures of success for those goals that address areas for improvement.

3. Contextual Care

• Person in context of family:

  • Conduct an encounter that includes patient and families in the development of screening and treatment plans.
  • Demonstrate caring and respect when interacting with patients and their families even when confronted with atypical or emotionally charged behaviors.
  • Demonstrate interpersonal and communication skills that result in effective information exchange between patients of all ages and their families.

• Person in context of community:

  • Incorporate knowledge of local community factors that affect the health of patients into daily patient care.
  • Demonstrate awareness of local, regional, and national health disparities and their impact on patient care.
  • Practice interpersonal and communication skills that result in effective information exchange between patients of all ages and professionals from the other disciplines and other specialties. 

• Person in context of their culture:

  • Communicate effectively with patients and families from diverse cultural backgrounds.
  • Identify areas where a patient’s cultural context can impact health through comprehension, cultural perspective, access and utilization of health care.
  • Describe one’s own cultural influences and biases as they impact one’s ability to effectively deliver patient care.

4. Continuity of Care

• Barriers to access:

  • Define social determinants of health and their role in continuity of care.
  • Describe the social determinants that can affect a patient’s ability to access and utilize the health care system at multiple levels:
    • Individual patient barriers
    • Community barriers
    • Health care system barriers

5. Coordination/Complexity of Care

• Team Approach:

  • Describe the benefits of interdisciplinary health care teams in patient care (e.g., pharmacy, nursing, social work, and allied health).
  • Demonstrate skills in effective teamwork (e.g., sharing information, solving clinical problems as a team, etc.).

• Quality and Safety:

  • Define clinical processes established to improve performance of a clinical site.

• Complexity of Care:

  • Identify diagnostic uncertainty and the role of multi-systemic influence on a patient’s condition.
  • Adapt to changing patient presentation and needs.
  • Utilize effective patient care management strategies in patient’s presenting with complex conditions.
  • Describe the use of health information technology to enhance care coordination.
  • Summarize the importance of linking resources with patient and population needs.

Source: Society of Teachers of Family Medicine: National Clerkship Curriculum. Second Edition, 2018.