Patient Care

Patient Care

This is the bread and butter of why we are here and of what you will do everyday on the clerkship. When you are a resident, this competency will be evaluated globally. However, the clerkship directors believe that we can give you more constructive feedback if we break this competency down into the components of history taking, physical examination, clinical reasoning, and medical decision making. Several of the Entrustable Professional Activities (EPAs) are covered under this competency and are noted below.

The following are ways to demonstrate competency in Patient Care:

1. Medical write-ups (minimum 16 required but only 4 best included for summative evaluation at the end of the clerkship)

2. Observed physical examinations

3. Mini-CEX

 

EPA 1: Gather a history and perform a physical examination

Clerkship Patient Care Objectives

  • Obtain and record a patient’s history in a logical, organized, and thorough manner.
  • Perform and record a complete physical examination in a logical, organized, and thorough manner for new patients and an appropriately focused physical examination for follow up patients
  • Be able to recognize normal from abnormal physical findings and identify the following  abnormalities:
    • Abnormal thyroid size/goiter
    • Pulmonary dullness, crackles, and wheezes
    • Jugular venous distension
    • Extra heart sounds (specifically S3), systolic vs. diastolic murmurs, and specifically aortic stenosis and mitral regurgitation
    • Edema
    • Abnormal arterial pulses (bruit, irregular rhythm, absence)

EPA 2: Prioritize a differential diagnosis following a clinical encounter

Clerkship Patient Care Objective

  • Use clinical reasoning to synthesize data into a prioritized differential diagnosis that clearly states a working diagnosis, to guide initial diagnostic evaluation and disease management.

EPA 3: Recommend and interpret common diagnostic and screening tests

Clerkship Patient Care Objective

EPA 4: Enter and discuss orders and prescriptions

  • Although not a major objective of this clerkship, you are encouraged to pend orders for your patients and discuss them with the team.