Overview of Winter Quarter

Welcome to winter quarter and the continuation of the Introduction to Clinical Medicine I.  In the fall, you began to explore the doctor-patient relationship and to learn techniques of medical interviewing.  You completed four interviews:  the pre-interview on a classmate; the social history of a hospitalized patient; the next exploring the patient’s illness story; and the more formal “History of the Present Illness.”  One of these interviews may have been videotaped.

This quarter, you will build on what you have already begun to develop.  You will complete your fourth patient interview, again focusing on the History of the Present Illness and the Social History.  You will do a fifth interview and a sixth interview collecting the complete medical database, which we will discuss and demonstrate in class.  One of these interviews will be with a standardized patient, discussed below.  As before, write ups are due in your portfolio within 48 hours.

Class discussions and lectures will focus on interviewing skills to handle special topics (difficult interviews, controversial topics, sexuality, substance abuse) and special populations (pediatric patients, adolescents, geriatric patients, sexual minority patients).  As in autumn quarter, you will continue to meet weekly with your small group to further explore and reinforce what you are learning in class and during the interviews.  Attendance at the small group meetings is required.

Standardized Patients

The Standardized Patient Teaching Program provides a rare opportunity to get direct, specific, and personal feedback from a “patient” you have just interviewed.  Standardized patients are actors or medical professionals who have been trained to present a specific medical condition, which they may or may not actually have, and to evaluate the student interview.  You will interview the patient and then receive immediate feedback about your interviewing style, the appropriateness of specific questions you asked or might have asked, completeness of the interview, and suggestions for improvement.  There may be the chance to practice certain questions again with the standardized patient.  This feedback is between you and the “patient”; it is not part of your file or grade.  Write ups are to be done as you would when you see a hospital patient, and then uploaded into your portfolio along with your interview self-critique form within 2 days of the interview.  In addition, you and the standardized patient will both fill out evaluation forms that should be handed to your small group leaders. Most medical schools now provide this opportunity, and you will have standardized patient interviews again in the second and fourth years.  These future interviews will include both history and physical exam.

The standardized patient interview program spans 5 weeks and will count as your interview #4 or #5.  Times for standardized patient interviews will be assigned and scheduling is very tight, so please show up when you are scheduled; if you cannot be there at the scheduled time, please find a classmate to switch with you, and let us know of the change.

Winter Quarter Course Goals

• Professionalism
  • continue to work on issues of professional development, including issues related to diversity in medicine, challenging or controversial topics, and issues related to special populations

• Medical interviewing
  • continue to work on understanding the functions of the medical interview and the concept of patient centered interviewing
  • learn the remaining elements of the complete medical database
  • participate in an interview of a “standardized patient”
  • develop questioning skills in relation to specific populations and situations
    • pediatric patients
    • adolescents
    • geriatric patients
    • difficult interviews
    • human sexuality/sexual minorities
    • substance abuse

• Medical database/Documentation
  • learn to organize and write-up a complete medical database
  • learn to construct a problem list
  • understand the “problem oriented medical record”