Internal Medicine Clerkship: Student Learning Outcomes

UNR Med Year 3 Structure

Upon successful completion of this course, you will be able to:

1. History and Physical Examination:
   • Students should be able to elicit the patient's chief complaint, history of present illness, past medical history, social, family, occupational histories and complete a review of systems.
   • Perform a physical examination in a logical, organized and thorough manner.
   • Demonstrate the ability to construct an assessment and plan for an individual patient organized by problem, discussing the likely diagnosis and plan of treatment.
   • Demonstrate the ability to record the history and physical in a legible and logical manner.
   • Demonstrate the ability to write daily progress notes on the ward and appropriate outpatient progress notes.
2. Case Presentation:
   • Orally present a new patient's case in a focused manner, chronologically developing the present illness, summarizing the pertinent positive and negative findings as well as the differential diagnosis and plans for further testing and treatment. Reading your H&P is not an adequate case presentation!
   • Orally present a follow-up patient's case, focusing on current problems, physical findings, and diagnostic and treatment plans.
3. Diagnostic Decision Making:
   • Formulate a differential diagnosis based on the findings from the history and physical examination.
   • Use the differential diagnosis to help guide diagnostic test ordering and its sequence.
   • Participate in selecting the diagnostic studies with the greatest likelihood of useful results.
   • Recognize that tests are limited and the impact of false positives/false negatives on information.
4. Test Interpretation:
   • Describe the range of normal variation in the results of a complete blood count, blood smear, electrolyte panel, general chemistry panel, electrocardiogram, chest X-ray, urinalysis, pulmonary function tests, and body fluid cell counts.
   • Describe the results of the above tests in terms of the related pathophysiology.
   • Understand the importance of personally reviewing X-ray films, blood smears, etc. to assess the accuracy and importance of the results.
5. Therapeutic Decision Making:
   • Describe factors that frequently alter the effects of medications, including drug interactions and compliance problems.
   • Formulate an initial therapeutic plan.
   • Access and utilize, when appropriate, information resources to help develop an appropriate and timely therapeutic plan.
   • Write prescriptions accurately.
   • Counsel patients about how to take their medications and what to expect when they take their medications, including beneficial outcomes and potential adverse effects.
   • Monitor patient response to therapy.
6. Communication:
   • Demonstrate ability to tailor approach to data gathering, synthesis, hypothesis generation and management plans for individual patients based on factors such as age, gender, ethnic background, financial situation and access to resources.
   • Demonstrate ability to effectively and empathetically counsel patients on healthy behavior, including lifestyle modifications related to tobacco, alcohol or drug use, obesity, medication compliance, etc.
7. Attitudes:
   • Medical students must demonstrate respect for patients, health care professionals and other students.
   • Students must also be able to communicate effectively with all members of the health care team: fellow students, residents, nurses, therapists, and secretaries.
   • Patient confidentiality must be respected at all times.
   • Students should be on time to all functions and dress and act in a professional manner (hospitals do not allow open toed sandals. It is a violation of hospital policy.)