FAMILY MEDICINE CLERKSHIP MODULE ORIENTATIONAY 2012-2013 Helen S. Sigua, MD, MHA, FPAFP, BFEF
General Orientation • Bird’s Eyeview of Course– Dr. Sigua (0.5 hr) • Smaller Group Sessions-Dr. Martha Umali, Dr. Marilyn Anastacio, Dr. PapikOliveros, Dr. Sigua (2 hrs • Critiquing of 4 cases on various scenarios on how tools were used, analyzed, and presented—Plenary ( processing of one intervention tool videotaped role-played family meeting- Dr. Sigua (1 hr) • Planning and doing a family meeting, trying out all the forms and documenting • Planning out a home visit, trying out the forms
MODULE HOURS • 24 classroom HOURS of family skills preceptorials 20 –hospital-based (various clinical rotations)- (in vitro processing) 4- community-based (Ilugin, Pasig) (in vivo processing) Should be 40 hours actually- so protected time is 40 minus 24 thinly spread out across other departments-know how to do due subtle ‘seamless integration’
Family Descriptive (Analytical) Tools • Profile • Lifecycle • Timeline • Genogram • APGAR • Family Map • SCREEM/ ECOMAP • Others- culturagram, etc
Family Intervention Tools Family Meeting Home Visit Specific Tools & Techniques ( CEA, risk assessment, safety assessment, advance life directives, etc) Forms: pre- meeting/visit worksheet meeting process checklist /home visit checklist progress notes evaluation Reflection- narrative, drawing, bullet thoughts ( personal , creative, affective)
Family Case Presentation (formal & informal) Documentation Clarity Organization Equity on input
Family meeting • Can be done in any rotation • Document it with permission of all concerned(default is reenactment of actual event) • Accomplish generic forms: pre and outcome • Do not forget to get written consent for the activity/ documentation • In vitro processing during quarterly preceptorial (using checklist, outcome & evaluation sheets) • Actual group evaluation –only in Ilugin • Do not forget to give family a copy of outcome
Quarterly preceptorials , hospital-based, theme-driven • May 12– GENERAL ORIENTATION, REFRESHER, PRACTICE SESSION • July 18—PROMOTIVE CLINICAL SCENARIOS • September 29—ACUTE CLINICAL SCENARIOS • December 22—CHRONIC CLINICAL SCENARIOS Individual evaluation will be due at each end.
Community-based family preceptorials • First week (Sat AM) –determine patients for referral to Family Medicine Clinic from Pediatrics residents; information gathering Patient Chart Pre-Family Meeting Worksheet- determine at least 2 foremost agendas • Second week (Tue 1-3 PM)-clinical assessment; group case; present case using tools; first agenda-preceptor demos; second agenda-group performs the family meeting and is graded; processing and feedback; documentation
SESSION MECHANICS • Plenary didactics on theme • SGD -2 LEC per preceptorial group One case presentation per LEC family descriptive(analytical) tools family intervention tools • Plenary Wrapping up
Community-based output • Immediately after the session—group effort pre-family meeting worksheet family meeting outcome sheet One incorporated in Ilugin Health Center chart One to be submitted to the preceptor
Preceptorial evaluation-both group & individual scope • Family Assessment/Analysis 20 pts • Application of communication & family intervention skills 40 pts • Group discussion participation 20 pts
Reference materials Family Medicine Digital Library—www.fmdrl.org McDaniel Susan. 2005. Family-Oriented Primary Care Taylor Rakel Sloane All available in the library and online. You can try doing it now in your practice sessions. Sigua’s Family Skills for Health Care Providers with demo CD– WIP—scholarly project
GRADED OUTPUTS • Group: minimum of 4 cases 3 hospital-based (adult) 1 community-based (pedia) 1 grand case (can be above) • Individual: toolwork for each case 5 activity-end/year-end reflections-each scenario, family meeting, and home visit
Grand Family Case Conference • Deadline of cases- end of February • 5 best will be chosen for presentation for the contest • 30-minute presentation • 3L x 2W paper poster • Winners to be given merits on final grade
Evaluation of Any Family Case Presented • Grasp of presenting biomedical clinical scenario • Application of appropriate family descriptive tools and manner of presentation & analysis • Conduct/Critique/Plan of necessary family intervention tools • Conceptualizing appropriate contextual care for patient & family
Final Exam • Date to be announced • No exemptions • One hour • 50 MCQs about biopsychosocial approach based on the learning framework
House rules • Be original, neat, and legible. • Do not disintegrate your workbook for any reason. Put your name on every hard copy submission, surname first, and first name initial. • Physical absence during preceptorials without valid reason will get zero grade. • Any material submitted beyond announced deadline will not be accepted. • Get in touch with me through email , cellphone for any concern 24/7. • Grades will be posted quarterly for proper self-feedback
PRACTICE SESSIONS—given your case… • Critique the tools used and how they were done and interpreted. • Do other tools you deem appropriate. You can surf the web if you need to. Practice using www.fmdrl. • Roleplay a family meeting taking up what you think is the most urgent issue. Video-tape it. Accomplish all the necessary forms. • Design a pre-home visit worksheet. • Relax, you need not perfect it; goal is to know you are weak at so we know where to focus on didactics later; and, you have the years ahead of you to use them! • Give your suggestions for further sharpening & finetuningof these tools • Tools are only as good as the thing you create using the right materials.
Took Kit Inventory (know the what, when, where & how) • DESCRIPTIVE (analysis-driven) • Family chart—profile(age, gender, developmental, occupational)family lifecycle, timeline, genogram , APGAR, SCREEM/ECOMAP • INTERVENTIONAL (activity-driven) • Family meeting • Home Visit • Wellness Plan
Last directives for compliance • Final workbook to be sent for you to download before may 15, 2012. • Have it hardbound with your name, surname first, and LEC number. • It is where you will work on your tools individually even as your case is group. • It is where you will write your individual reflections. • It should be brought with you for EVERY PRECEPTORIAL. Without the signature on it by every preceptor with date, any input will not be declared valid.
PLENARY • Processing of difficulties, questions