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Interclinic Council (ICC) Student-Led Clinic Orientation

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1 Interclinic Council (ICC) Student-Led Clinic Orientation

2 Precepting Basics 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 Complete all pertinent information Take ownership of documentation: If you don’t write it, no one else will Sign and date all documentation If you have questions, ask! Precepting Basics Overview As the year progresses, first years will be expected to do more of the history and physical exam independently

3 Precepting Basics Chief Complaint History of Present Illness (HPI)
Review of Systems Medical History Surgical/Hospitalization History Allergies Medications Family History Social/Sexual History Review these before coming to clinic, and it will save you a lot of time Resource: Tulane Clinical Skills Guide Precepting Basics History Components

4 Precepting Basics General
Head, neck, eyes, ears, nose and throat (HEENT) Cardiovascular Pulmonary Abdominal Genitourinary (Optional) Extremities Skin Neuro Psych Review these before clinic to save you time Resource: Tulane Clinical Skills guide Precepting Basics Physical Components

5 Precepting Basics 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 Precepting Basics Assessment and Plan

6 What to wear and what to bring
Professional attire White coat Tulane Clinical Skills Guide Stethoscope Watch that can measure seconds Preparing for Clinic What to wear and what to bring

7 Do’s and Dont’s DO show up on time
DO come prepared; take a minute to review your history-taking and physical exam skills before your shift DO keep track of days that you are scheduled for clinic, don’t rely on reminder s DO ask questions- clinic is a great opportunity to interact with upperclassmen and attendings, take advantage! 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 Do’s and Dont’s

8 Bethel Colony South TB About Us:
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 Required TB training: You should have already attended a training last week, 8/22 and 8/24 at 4:30pm Volunteering at BCS Mondays and Wednesdays from 5-6 pm Professional dress or scrubs with white coat and Tulane ID Contact Info: Clinic Coordinators Nina Hooshvar Kartik Kansagra Jennifer Wall Darin Williams

9 Bridge House Clinic Bridge House provides a long-term residential treatment program for men with drug and alcohol addictions. 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 When: Every Wednesday, 4-8pm Clinic Coordinators: Christina Sensabaugh Eric Katz William McEachern Allison Posta Volunteer Coordinator

10 Bridge House TB Clinic When: Give tests from 4 – 6pm on Wednesday AND read them from :30pm that Friday (you must commit to both times) Where: Bridge House, 4150 Earhart Blvd (the same location as the clinic and HIV testing) 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. If you have any questions about BH TB, please

11 Bridgehouse HIV Testing
Volunteer Wednesday afternoons (between 4 – 7pm) at Bridge House Volunteer Saturday mornings at Fleur de Vie Volunteer weekdays at Ozanam Inn 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. You must commit to testing at least once every two months. A great way to get your clinical hours, learn about the clients at the different clinics, and get comfortable taking a sexual history! Only 18 spots Please if interested. Put “T1 Tester” in the subject line. Leaders: Craig Audin (Bridge House Leader) Sara Gore (Tulane Liaison) Moira Carroll (Ozanam Inn Leader) Yassi Goksenin (NO/AIDS and OPH Liaison ) Bridgehouse HIV Testing

12 Solidarity Not Charity
Common Ground 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. Solidarity Not Charity Students will conduct intake by obtaining patients’ vitals, chief complaint, and medical history Wednesdays 1-4pm and Thursdays 8am-12pm Clinic Coordinators Contact Person: Ashley Kiefer at Kaitlin Brooke Julie McCaw Nina Hooshvar Danielle Coleman

13 + Fleur de Vie Clinic NOLA East 1st and 3rd Saturday (subject to change) 4626 Alcee Fortier Blvd, New Orleans, LA 13 What do we do? Specialty clinics (Immunology, Endocrinology, Nephrology) Hep B clinic with Dr. Nguyen Patient Demographics - great chance to work with interpreters! 65% – Vietnamese 15% – Latino In the neighborhood… Vietnamese sandwiches (banh mì), Dong Phuong Bakery Clinic Coordinators Patient Education Coordinators Tara Kimbrough Smitha Neerukonda Mingyang Liu Marin McCutcheon Volunteer Coordinator Adrienne Krebs

14 Fleur de Vie Covenant House
Covenant House delivers primary care and extended services to an underserved patient population in the New Orleans community 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. T1s and T2s also serve as patient educators and perform mental health screenings. When: 2nd and 4th Saturdays of every month Clinic Coordinators: Kelly Nichols Jessica Provo Patient Education and Mental Health Coordinators Courtney Devin Prerana Baranwal Patient Volunteer Coordinator Adrienne Krebs

15 FdV: Patient Education
Takes place at Covenant House and NOLA East 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 Topics include: Nutrition Exercise Diabetes management Hypertension Smoking cessation Sexual Health Resources Tulane SOM’s Pocket Guide to Clinical Skills ICC website

16 FdV: Mental Health Screening
Takes place at Covenant House 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 If they answer yes to 3 of the questions, T1s and T2s follow-up with a focused questionnaire. This information is presented to the precepting team and attending physician to be a part of the assessment and treatment plan.

17 Grace House Grace House is a residential treatment center for women who have a history of substance abuse. The clinic provides intake physicals and primary care for Grace House residents. We are working to establish a comprehensive women’s healthcare clinic. When: One to two Tuesdays each month, from 4 to 8pm. Location: 4150 Earhart Boulevard (Bridge House Clinic) Clinic Coordinators: Purva Amar Maggie Black

18 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: Clinic Coordinators: Amy Lawrence, Ron Nelson, & Tim Richardson Volunteer Coordinator: Sabrina Camp

19 Ozanam Inn TB Clinic Volunteer Monday-Friday 6:30-8:00 PM at Ozanam Inn men’s homeless shelter Administer and read Orleans TB tests for each new guest at the shelter Learn about the needs of New’ homeless population YOU GET TO USE NEEDLES ON YOUR FIRST DAY!! A great way to practice interacting with people from all walks of life Lots of volunteer opportunity!! We need two people every night!! Clinical SL hours Located in the Warehouse District Coordinators: Christina Thorngren Natalie Gukasyan and Jonathan Sachs You should have already attended a training last week, 8/22 and 8/24 to participate in TB testing.

20 Ozanam Inn Vaccination Program
What: Administer seasonal influenza vaccines Thursday evenings Oct-April and at clinic To volunteer: ~30 T1 volunteers will be selected and trained in late September/early October Requirement: you MUST a trained TB volunteer to be eligible to give vaccines Leadership opportunity: T1 vaccine program coordinator Vaccine Coordinator: Kaitlyn Hardin

21 Other Clinic-Related Opportunities
Healthcare for the Urban Underserved elective Research (e.g. chart review) Public health initiatives (e.g. health education and disease prevention campaigns) Case presentations Quality improvement projects *Note: These additional opportunities do not award service learning hours. Elective: Available for SOM or SPH&TM credit Offered January 13, 2012-March 2, 2012 Contact Casey for more information: Features lectures from community leaders and community-engaged faculty members Community-based project is a component of the course Research Opportunities: Interclinic council has applied to the IRB to analyze medical record data from all clinics (BH, FdV, OIWC), thus allowing for chart review studies. You may propose an original research project to the interclinic council and individual sites. Student leaders have presented clinic data at various venues at Tulane and national conferences. Public Health Initiatives: All clinics are interested in increasing efforts to encourage disease prevention and improve health literacy. Past public health initiatives include: group-based discussion on nutrition. Current public health initiatives include: development of HIV prevention program. Case Presentations: Case presentations at individual sites (SL hours are awarded). At Oz, if you see an interesting patient that you would like to present, mention it to the on-duty clinic manager. School-wide case presentations will be organized by the interclinic council (SL hours are not awarded). Check the MSG calendar and your for announcements about school-wide case presentations. Quality Improvement Projects: [ADAM JOHNSON] NB: These additional opportunities do not award service learning hours.

22 Clinical Skills Feedback Pilot Program @ FDV clinics
+ 22 Clinical Skills Feedback Pilot 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

23 FAQs Why is everyone getting a clinic spot and I’m not?
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. What if I can’t make it to clinic? 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

24 Interclinic Council Website
Check out the ICC Website on tmedweb for additional information, resources and the clinic calendar!

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