Visit Summary 1 (Module 1)

Recognition, Theraputic Relationship, and Setting the Context

Hard Copy for Notes Only: Summary Form 1

Visit Summary Form: submission

  • Due Wednesday of the 2nd week.
  • You will receive an e-mail copy of your assignment.  Please print this out for a discussion with one of your clinical site preceptors.


A major goal of the Palliative Care Clerkship is for you to critically assess clinicians delivering palliative care to patients and families. In particular for you to pay close attention to:

  • What behaviors did the clinician use during the visit?
  • How well did these behaviors solicit the patient/family story (expressed values and goals)?
  • How did these behaviors affect the patient/family/clinician/you as an observer?
  • How these behaviors promoted or inhibited the integration of palliative/hospice care into the care plan.
  • Developing the skill of summarizing the patient/family story (expressed values and goals).
  • Discussing with your preceptors what occurs during the clinical encounter.
  • Providing feedback to your preceptors on the encounter.

To assist you in meeting the above goals, you should summarize one clinical encounter using the week-one visit summary form and submit it on-line.

Your required Visit Summary Form should be submitted on-line no later than the 2nd Wednesday of the clerkship. A copy will be sent to your site preceptor and you will receive written feedback or have an in person discussion.

Please note that the Visit Summary Form asks you to use a grounded likert scale to rate aspects of the visit that relate to the Best Practice Model.





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