Transcript ICCorientation Fall 2012

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Interclinic Council (ICC)
Student-Led Clinic Orientation
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
Precepting
Basics
Overview

Role of the medical student

Collect patient demographics, chief
complaint, history and physical

Complete as much as you can on your
own

Do not hesitate to ask upper level
medical students for assistance
Documentation

Each clinic has a unique history and
physical form that highlights the
information they require
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Complete all pertinent information
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Take ownership of documentation: If
you don’t write it, no one else will
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Sign and date all documentation

If you have questions, ask!
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Precepting
Basics
History
Components

Chief Complaint

History of Present Illness (HPI)
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Review of Systems
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Medical History

Surgical/Hospitalization History
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Allergies
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Medications
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Family History
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Social/Sexual History

Review these before coming to clinic,
and it will save you a lot of time

Resource: Tulane Clinical Skills Guide
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Precepting
Basics
Physical Components

General

Head, neck, eyes, ears, nose and throat
(HEENT)
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Cardiovascular
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Pulmonary
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Abdominal
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Genitourinary (Optional)
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Extremities
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Skin
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Neuro

Psych
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Review these before clinic to save you time

Resource: Tulane Clinical Skills guide
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Precepting
Basics
Assessment and Plan

Assessment
 Develop a differential diagnosis
based off CC, HPI, history and
physical
 Discuss with upper level medical
students before presenting to
attending
 Take a stand on a diagnosis – don’t
be afraid of being wrong
 Try to identify at least three problems

Plan
 Work with social workers, public
health students, and upper level
students to develop a contextually
appropriate plan
 Document everything you do for a
patient, counseling, medications
prescribed, referrals for care
 Attending should approve any and all
interventions
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Preparing for
Clinic
What to wear and what to
bring

Professional attire

White coat

Tulane Clinical Skills Guide

Stethoscope

Watch that can measure seconds
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Do’s and Dont’s
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DO show up on time

DO come prepared; take a minute to
review your history-taking and physical
exam skills before your shift
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DO keep track of days that you are
scheduled for clinic, don’t rely on
reminder emails
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DO ask questions- clinic is a great
opportunity to interact with
upperclassmen and attendings, take
advantage!
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DO get someone to cover your shift if
you can’t make it– the same rules apply
with clinics as with any service learning
project
+ Bethel Colony South TB
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About Us:
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Required TB training:
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BCS is an halfway house in East New Orleans. We provide TB testing for drug
addiction recovery program participants to ensure safety for all BCS complex
residents
You should have already attended a training last week, 8/22 and 8/24 at 4:30pm
Volunteering at BCS
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Mondays and Wednesdays from 5-6 pm
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Professional dress or scrubs with white coat
and Tulane ID
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Contact Info: [email protected]
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Clinic Coordinators
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Nina Hooshvar ([email protected])
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Kartik Kansagra ([email protected])
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Jennifer Wall ([email protected])
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Darin Williams ([email protected])
+ Bridge House Clinic
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Bridge House provides a long-term residential treatment
program for men with drug and alcohol addictions.
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Every Wednesday, T1s and T2s take the lead role in seeing
patients and are supported by T3s and T4s. As a team, you then
present to and work with the attending Family Med physician to
develop an assessment and treatment plan for each patient
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When: Every Wednesday, 4-8pm
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Clinic Coordinators:
 Christina Sensabaugh ([email protected])
 Eric Katz ([email protected])
 William McEachern ([email protected])
 Allison Posta ([email protected])
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Volunteer Coordinator
 Christina Sensabaugh ([email protected])
+ Bridge House TB Clinic
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When: Give tests from 4 – 6pm on
Wednesday AND read them from 4 4:30pm that Friday (you must commit to
both times)
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Where: Bridge House, 4150 Earhart Blvd
(the same location as the clinic and HIV
testing)
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What you have to do before you can
volunteer: You should have already
attended a training last week, 8/22 and
8/24 at 4:30pm.
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If you have any questions about BH TB,
please email [email protected]
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Bridgehouse
HIV Testing

Volunteer Wednesday afternoons (between 4 – 7pm)
at Bridge House
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Volunteer Saturday mornings at Fleur de Vie
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Volunteer weekdays at Ozanam Inn
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Office of Public Health Training: September 24th-25th.
You will get EIGHT service learning hours for this and
will be certified to test anywhere in Louisiana.
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You must commit to testing at least once every two
months.
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A great way to get your clinical hours, learn about the
clients at the different clinics, and get comfortable
taking a sexual history!
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Only 18 spots
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Please email [email protected] if interested.
Put “T1 Tester” in the subject line.
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Leaders:
 Craig Audin (Bridge House Leader)
 Sara Gore (Tulane Liaison)
 Moira Carroll (Ozanam Inn Leader)
 Yassi Goksenin (NO/AIDS and OPH Liaison )
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Common Ground
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Common Ground is a nationally recognized
patient-centered medical home committed to
meeting the primary care needs of the uninsured
and underinsured members of our community.

Students will conduct intake by obtaining
patients’ vitals, chief complaint, and medical
history
Solidarity Not
Charity
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Wednesdays 1-4pm and Thursdays
8am-12pm
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Clinic Coordinators
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Contact Person:
Ashley Kiefer at
[email protected]
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Nina Hooshvar
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Danielle Coleman
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Kaitlin Brooke
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Julie McCaw
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Fleur de Vie Clinic NOLA East
1st and 3rd Saturday (subject to change)
4626 Alcee Fortier Blvd, New Orleans, LA
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What do we do?
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Specialty clinics (Immunology, Endocrinology, Nephrology)
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Hep B clinic with Dr. Nguyen
Patient Demographics - great chance to work with interpreters!
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65% – Vietnamese
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15% – Latino
In the neighborhood…
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Vietnamese sandwiches (banh mì), Dong Phuong Bakery
Patient Education Coordinators
Clinic Coordinators
Smitha Neerukonda
Tara Kimbrough ([email protected])
([email protected])
Mingyang Liu ([email protected])
Marin McCutcheon
([email protected])
Volunteer Coordinator
Adrienne Krebs ([email protected])
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+ Fleur de Vie Covenant House
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Covenant House delivers primary care and extended services to
an underserved patient population in the New Orleans
community
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T1s and T2s work one-on-one with a T3 or T4 as a precepting
team. After seeing a patient, they present to the attending and
work together to develop an assessment and treatment plan.
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T1s and T2s also serve as patient educators and perform mental
health screenings.
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When: 2nd and 4th Saturdays of every month
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Clinic Coordinators:
 Kelly Nichols ([email protected])
 Jessica Provo ([email protected])
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Patient Education and Mental Health Coordinators
 Courtney Devin ([email protected])
 Prerana Baranwal ([email protected])
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Patient Volunteer Coordinator
 Adrienne Krebs ([email protected])
+ FdV: Patient Education
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Takes place at Covenant House and NOLA East
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After being debriefed by the Precepting team, Patient Ed
volunteers have a discussion with the patient to empower them
to take control of their health
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Topics include:
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Nutrition
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Exercise
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Diabetes management
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Hypertension
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Smoking cessation
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Sexual Health
Resources
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Tulane SOM’s Pocket Guide to Clinical Skills
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ICC website
+ FdV: Mental Health Screening
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Takes place at Covenant House
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After being debriefed by the Precepting team, Patient
Ed/Mental Health volunteers evaluate the initial mental health
screening questionnaire completed by the patient, covering
depression, PTSD, mania/bipolar disorder, and anxiety
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If they answer yes to 3 of the questions, T1s and T2s follow-up
with a focused questionnaire.
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This information is presented to the precepting team and
attending physician to be a part of the assessment and
treatment plan.
+ Grace House
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Grace House is a residential treatment center for women who
have a history of substance abuse.
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The clinic provides intake physicals and primary care for Grace
House residents. We are working to establish a comprehensive
women’s healthcare clinic.
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When: One to two Tuesdays each month, from 4 to 8pm.
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Location: 4150 Earhart Boulevard (Bridge House Clinic)
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Clinic Coordinators:
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Purva Amar ([email protected])
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Maggie Black ([email protected])
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Ozanam Inn is a homeless shelter located at 843 Camp Street
in the Warehouse District. It offers 3 meals a day, legal
counseling, social work services, and job placement for
homeless men.
Ozanam was founded in 1955 by the Saint Vincent de Paul
society.
The clinic closed down after Katrina, but was reopened by
Tulane medical students in 2010.
All services are provided at no cost- social work, public
health, primary care.
Clinic Hours- 11:45am to 5:00 pm about two Sundays per
month.
How to get involved- volunteering, fundraising, quality
improvement projects, public health research.
Contact: [email protected]
Clinic Coordinators: Amy Lawrence, Ron Nelson, & Tim
Richardson
Volunteer Coordinator: Sabrina Camp
+ Ozanam Inn TB Clinic
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Volunteer Monday-Friday 6:30-8:00 PM at Ozanam Inn men’s homeless shelter
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Administer and read Orleans TB tests for each new guest at the shelter
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Learn about the needs of New’ homeless population

YOU GET TO USE NEEDLES ON YOUR FIRST DAY!!
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A great way to practice interacting with people from all walks of life
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Lots of volunteer opportunity!! We need two people every night!!

Clinical SL hours
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Located in the Warehouse District
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Coordinators:
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Christina Thorngren ([email protected]),
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Natalie Gukasyan ([email protected]), and
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Jonathan Sachs ([email protected])
You should have already attended a training last week, 8/22 and 8/24 to participate in TB
testing.
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Ozanam Inn
Vaccination Program
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What: Administer seasonal influenza vaccines Thursday
evenings Oct-April and at clinic
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To volunteer: ~30 T1 volunteers will be selected and trained
in late September/early October
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Requirement: you MUST a trained TB volunteer to be
eligible to give vaccines
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Leadership opportunity: T1 vaccine program coordinator
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Vaccine Coordinator: Kaitlyn Hardin ([email protected])
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Other Clinic-Related
Opportunities
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Healthcare for the Urban
Underserved elective
([email protected])
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Research (e.g. chart review)

Public health initiatives (e.g.
health education and disease
prevention campaigns)
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Case presentations
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Quality improvement projects
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thigprojectconnect.tmedweb.tulane.edu
NB: These additional opportunities do not award service learning hours.
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Clinical Skills Feedback Pilot
Program @ FDV clinics
 New
this year!
 Student-run clinic precepting skills
feedback and reflections
 Objectives:
Bridge the gap between FIM curriculum and
the clinic experience
 Provide formal constructive feedback for
T1/T2s
 Measure growth in clinical skills over time
(hopefully)
 For purposes of personal growth and will
NOT impact FIM grades
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22
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FAQs
Why is everyone getting a clinic spot and I’m not?
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What if I can’t make it to clinic?
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Be patient. The volunteer coordinators have a system where they are
aware of how many clinic spots each student gets. As the year
progresses and T1s have more opportunities to volunteer, the spots
will be reviewed based on how many clinic spots you have had in the
past.
You are responsible for finding a replacement. You must forward the
clinic info to your replacement and notify the volunteer coordinator of
your replacement. Failure to do this will result in a deduction of
service learning hours.
What if I don’t know how to do something?

Please ask! Ask your partner, upperclassmen, clinic coordinator,
attending physician. We understand this is a learning process and
want to facilitate your understanding while provide care for members
of the community
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Interclinic Council Website
 Check
out the ICC Website on tmedweb for additional
information, resources and the clinic calendar!
http://tmedweb.tulane.edu/mu/icc/