This quarter we will continue to build and work on your basic clinical skills.  We will have sessions on the advanced physical examinations with lectures and tutorials on the neurological and musculoskeletal exams.  You will continue to work on medical interviewing, physical examination, case presentation and documentation, and clinical reasoning in your clinical tutorials (two complete patient evaluations for each student this quarter).  You will continue your clinical tutorials with your College mentor and the same group of students.  However, you will move to a different hospital and be paired with a different group, in order to get to know and work with another faculty member and group of students within your College.  The clinical tutorials will be structured as they were in autumn quarter.In addition this quarter, we will add sessions dealing with a group of special topics that involve particular aspects of your clinical skills and professionalism.  These include alcohol and substance abuse, in which you will have a lecture and panel discussion on making and communicating the diagnosis of substance abuse problems, followed by a self-scheduled "tutorial" in which you will attend an AA meeting and obtain an HPI of a substance abuse problem; culture and medicine, in which you will have a lecture on working with interpreters, and a chance to reflect on these issues depending on your clinical opportunities; and two topics in the area of ethics and professionalism - one dealing with uncertainty and mistakes in medicine which will be a single lecture/panel discussion, and the other a two day seminar/workshop on caring for patients with life-threatening and terminal illness.  In addition, in spring quarter there will be "special skills" practice interview sessions which will include taking sexual histories, interviewing with interpreters, and interviewing patients about alcohol and substance abuse.

For some of these special topics, you will be asked to write your "reflections" (described at the beginning of the year) and your feedback on the goals, content, and structure of the sessions.  These written reflections were described in the general information of the syllabus (section 1, page 20).  The exercise of self reflection and writing is intended to focus your attention on the topic and bring your learning to a more conscious level.  For each of the reflections there is a form on the website with several questions to "get you thinking", but you do not need to specifically address all or any of them.  Write about what you learned and what the learning experience did (or didn't do) for you.  The reflections are to be brief, one or two pages.  The portfolio contains forms for both required and optional reflections.

We also appreciate your feedback on these specific teaching activities.  This feedback is very important in helping figure out if these learning experiences are of value and if and how they might be improved.  Your feedback can be submitted with your reflections or sent directly to Dr. Goldstein.

Reflections are required for the session on alcohol and substance abuse visit to AA/NA meeting (due on the last day of winter quarter classes, Friday, March 6), and the care of the terminally ill patient seminar (due at the end of the first week of Spring Quarter, to give you additional time for meaningful reflection). If you have any questions about the reflections assignments or feedback requests, please contact Dr. Goldstein to discuss them or any other aspect of the course.