Case studies

Case Studies in Family Medicine (CSFM) is a set of eight interactive case studies developed by VCU School of Medicine clinical faculty, covering common patient presentations in the family medicine setting. The goal of the program is to enhance instruction in basic clinical reasoning for third-year medical students. It is designed for students' self-paced study to standardize learning across geographically distributed clerkship sites. It is especially useful as content for faculty-moderated online discussions. Each case depicts a common medical problem with specific practical skills to be learned in a context that requires careful attention to cultural competency and other psychosocial factors. Text-based content is enhanced with video vignettes and images. Each case is divided into seven modules to simulate the steps of a patient encounter: Background, Differential Diagnosis, Patient History, Physical Examination, Labs & Diagnostic Tests, and Treatment. The program presentation is entirely user-driven, requiring students to practice critical thinking and initiative at each step. Students access information in the clinical modules via a database interface with a search window. Rather than selecting clinical activities from a provided list of discrete options, students must enter focused keywords in order to call up relevant points of inquiry. Nothing happens until the student begins to apply his/her existing knowledge to a novel situation.

Author: Dr. Carolyn Peel Virginia Commonwealth University School of Medicine

Links to Cases

 * Miguel - a case study dealing with gastrointestinal problems
 * Tammy - a case study dealing with STDs
 * Charlotte - a case study dealing with domestic violence
 * Alexander - a case study dealing with smoking cessation

Family Medicine M3 Clerkship Rotation
Part of the third year clerkships includes a 4 week rotation in Family Medicine. During this time, students are sent to various places within Virginia ranging from urban, suburban, and rural. Each student is required to fulfill requirements such as seeing certain types of cases, performing procedures, and responding to discussions on an on-line discussion forum moderated by the school. Several students each week are assigned to lead one of the cases and pose a question for the other students to answer.

Family Medicine Educational Goals

 * Advance the student’s knowledge in the management of common problems encountered in Family Medicine, as identified in the self assessment appendix.
 * Measured by student self-assessment forms of common problems signed off by preceptor, direct observation by residents and attendings, OSCE evaluation, and review of case encounters on PDA by the Clerkship Director
 * Increase the student’s proficiency in history and physical exam skills during patient encounters, being able to triage patients and recognize those needing immediate referral and treatment.
 * Measured by clinical observation and self assessment, done by the students themselves as well as residents and attendings via the self assessment modules, midpoint evaluation with the Clerkship Director, OSCE forms and endpoint preceptor evaluation
 * Demonstrate appropriate professional interpersonal and communication skills by orally presenting patient encounters in a concise and logical manner, by acting respectfully and courteously with staff, and by ensuring patient confidentiality.
 * Measured by direct observation of the student by attendings and residents and reviewed at midpoint and end of rotation with the midpoint evaluation form and preceptor evaluation form
 * Demonstrate the skills utilized by Family Physicians to deal with the biopsychosocial problems of patients and their families, specifically, listening, rapport, questioning technique, empathy, posture and eye contact, and use of motivational interviewing techniques, as well as assessing patient understanding.
 * Measured by clinical observation of the student done by residents and attendings, and the EVMS standardized OSCE patient, recorded on the midpoint evaluation form, OSCE evaluation form and preceptor evaluation form
 * Coordinate patient care by appropriately using consultants/referrals and other community resources when appropriate.
 * Measured by direct observation of student by residents and attendings reviewing patient progress notes weekly

World Health Wiki
On this website, you will find excerpts from discussions held by students of the Virginia Commonwealth University School of Medicine. These students share not only their thoughts regarding the cases, but also their impressions of how things will impact medical education, training, and doctor-patient relationships. They also share stories from their own experiences with patients and throughout the communities.

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