Preceptor Handbook

Goal

The goal of this required course is to immerse students in primary care as practiced in a setting distant from immediate access to a tertiary care center. The focus is on the following themes:

1. Development of autonomy dealing with common and serious conditions in rural primary care.
2. Exploration of roles played by physicians in the community.
3. Service learning particularly as applied to rural underserved care.
4. Understanding referral and consultation relationships in a rural environment.

Objectives

Patient Care

Obtain history from patients with core conditions and symptoms. (CPR)

Perform an appropriate physical exam of patients with core conditions and symptoms. (CPR)

Propose appropriate strategies for evaluating and managing patients with selected conditions and symptoms. (CPR)

Select, interpret, and appropriately use diagnostic tests and procedures. (CPR)

Perform selected investigations and technical skills. (CPR)

Appropriately use common forms of medical documentation, data storage and retrieval, including security and confidentiality aspects. (CPR)

Medical Knowledge

Apply medical knowledge and analytic strategies to assess undifferentiated patients and solve clinical problems. (CPR)
 
Consistently integrate new scientific and clinical information into patient care. (CPR)

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Practice-Based Learning and Improvement

Use information technology to support clinical practice and personal education. (CPR)

Interpersonal and Communication Skills

Communicate effectively with patients and families, including situations involving sensitive, technically complex, or distressing information. (CPR)

Demonstrate adaptation of communication style to the individual needs of patients and urgencies of situation. (CPR)

Provide a concise, accurate, verbal summary of a patient situation to a faculty member, resident or peer, prioritizing the most significant factors for clinical decision-making. (CPR)

Create and maintain appropriate records of clinical encounters using standard terminology and formats. (CPR)

Prepare appropriate written and other communications between health professionals and organizations.  (assignment)

Systems-Based Practice

Demonstrate effective clinical participation in a health care team. (CPR)

Appropriately adapt to participate in patient care in rural communities, addressing priorities, opportunities, and constraints in that setting. (CPR special item)

Professionalism

Integrate altruism, respect, accountability, duty, honor, integrity and commitment to excellence into their clinical and educational activities. (CPR)

Demonstrate sensitivity and responsiveness to patient individuality, including the role of culture, ethnicity, gender, age, and other aspects in health practices and decisions. (CPR)
 
Accept and provide constructive feedback as part of a commitment to continuous learning and improvement. (CPR)

Instructional Methods

Students are assigned to the practice of a rural primary care (family medicine, general internal medicine, general pediatrics) preceptor in Kansas for four weeks. 

“Rural” for the purpose of this course is defined as anywhere in Kansas outside Wyandotte, Johnson, Douglas, Shawnee, and Sedgwick counties. 

Students are expected to live in their assigned community throughout the course. Under special circumstances when a student is allowed to commute from their assigned campus, they will be expected to stay overnight in the rural community for several nights of on call experience.

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Student Evaluation Methods

The Phase II Clinical Performance Rating (CPR), modified to address specific objectives of this course, is completed by the rural preceptor and reviewed by the course director. It is the basis for the student’s letter grade.

Students must satisfactorily prepare a written letter of consultation or referral between health professionals or organizations. The letter is submitted to the course director and graded pass/fail.   

Students must also satisfactorily complete a reflective assignment that compares and contrasts medical decision-making, physician roles, and referral/consultation relationships in the rural vs. urban practice, addressing priorities, opportunities, and constraints in the rural setting. The assignment is graded pass/fail by the course director.

Students submit patient encounter logs as a pass/fail component of their grade. 

Course directors may assign an additional service project as available and appropriate (Tar Wars®, office system improvement intervention, nurse/staff in-service presentation, other community talks or outreaches). The project is reviewed by the course director and graded as pass/fail.    

Course Evaluation Methods

Student feedback is solicited via Office of Medical Education surveys and other departmental methods as indicated.

Patient encounter log data is reviewed by the course director.

Course directors perform review of existing rural preceptor sites annually and site visits as necessary to assure a positive learning environment for students. Directors recruit new preceptors and sites as necessary to meet the course goals and objectives.