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ATENEO SCHOOL OF MEDICINE AND PUBLIC HEALTH

YEAR LEVEL 9 CURRICULUM Family and Community Health Management

Course Description
The Family and Community Health Management rotation of the Internship Program (Year Level 9) is an integration of the knowledge and skills acquired from Year Levels 5 to 7 and an extension of the core experience from Year Level 8 with particular focus on the application of the bio-psychosocial patient care, management and public health geared towards achieving sustainable health goals in both hospital and community-based facility. The primary training objectives of the program are focused on the development of core competencies identified as being essential to the practice of family medicine and public health in both hospital and community settings. Likewise, the rotation will also allow the interns to have an active participation in the strategic management of the community from which they will be assigned. The integration of the three disciplines: family and community medicine, public health, and management, is a unique experience crafted to develop a physician who have a holistic view of an individuals medical condition and its impact to his family and community using the biopsychosocial approach and applying the demographic profile of combine patient data to address the concern of the community, not only of health but its association with education, environment and livelihood towards a sustainable community-managed program.

Course Pre-requisite
The student must have sufficiently fulfilled the course in family medicine and public health at Year Level 8. Likewise, the student must have passed the requirements for the MBA program and have achieved a satisfactory rating.

Course Duration
The Family and Community Health Management is a two-month rotation that will be conducted in three sites (Trese, Molave and Lupang Pangako) in Barangay Payatas in Quezon City. During this period, the student will be required to undergo clinical rotation either in Payatas B Health Center or Lupang Pangako Health Center at specified schedule interspersed with group-based intervention activities and strategic management sessions on flexible schedules. An average of 80 hours will be spent by an intern at the Health Center while an average of 240 hours combined will be spent for the immersion at his/her respective area of assignment.

Grouping
There will be at least 10 interns rotating at any given period. The interns will be divided into three (five interns) and will be assigned either in Trese, Molave or Lupang Pangako in Barangay Payatas. Each group will be further subdivided into two or three interns per subgroup to facilitate the tasking in the health center duty and the assignment of clusters in the community. While one group is at the clinic, the other group will be assigned either to a field work (group-based intervention or strategic management) or conduct home visits.

Learning Activities
A. Facility-based Patient Consult The Facility-based Patient Consult will allow the intern direct patient care, performing a complete clinical history and focused physical examination, developing a primary working impression and initiating appropriate and cost-effective diagnostic and therapeutic (pharmacologic and non-pharmacologic) management. Continuity of care is also emphasized as the intern will have enough time to have the patient come for follow-up consult. There will be two areas to facilitate this activity the local health center (Payata B Health Center or Lupang Pangako Health Center) and the health hub in their respective areas of assignment. A1. The Local Health Center The intern will undergo clinical rotation at a local health unit during the duration of his/her rotation. He/she will attend to clinic consults following the prescribed schedule. The intern will be required to sign in at 7:30 am and sign out at 5:00pm in the Attendance Logbook. Using the biopsychosocial framework, he/she will conduct clinical interviews and fill up completely the patient data base (may use the Patient Encounter form in Appendix K). The intern must be able to perform a complete clinical history and physical examination. Based from the information he/she had obtained, the intern must be able to arrive at a primary working diagnosis and recommend the appropriate management (diagnostic and therapeutic, including non-pharmacologic advises and follow-up). The intern will have to affix his/her name and signature at the end of the chart. The intern will then instruct the patient to stay at the waiting area until his/her name be called for checking by the medical officer and final disposition. For patients on follow-up consult, the intern is required to evaluate the patients condition with a complete clinical history and physical examination, noting new symptoms or improvement of complaints and be able to interpret laboratory results as needed. The intern is expected to write the patients present working diagnosis and give recommendation for management. Table 1. List of symptoms that must be seen by the intern. Cough Low back pain Colds Joint pains Elevated blood pressure Difficulty of breathing Abdominal pain Dysuria Headache Weight loss Dizziness Vomiting Chest pain Skin rashes

Loose bowel movement Sleeping difficulty Blurring of vision Hemoptysis Ear discharge Fever Seizure

It is suggested that filing of the patient data base forms follow the heads of the family. The student will be required to fill up the daily census and file accordingly. Interns are also encouraged to perform clinical procedures as needed, initially to be assisted by the nurse or midwife. This will enhance their clinical skills that are essential in the primary health care. Table 2. List of clinical procedures that may be performed by an intern at the health center. Taking blood pressure Prostate examination Cerumen extraction Fundoscopy Skin testing Simple ear irrigation Visual acuity testing Vaccination Circumcision Otoscopy Blood extraction Incision and drainage Tuning fork test Foley catheter reinsertion Wound dressing Breast examination Nasogastric tube reinsertion Cyst excision Internal examination Torniquet test Suturing Digital rectal examination Pap smear Suture removal The interns assigned in the clinic may be assigned to (1) attend to the regular patient consult, (2) attend to outreach activities of the clinic (immunization at satellite clinics, etc.), (3) facilitate public health lectures or (4) partner with a barangay health worker as assigned by the MHO and conduct field visits. All interns report to the municipal health officer of the local health unit and endorse all patients seen for final disposition. The intern will also be responsible in providing and filling of the laboratory request forms and prescriptions that will be given to the patient with proper instructions. The interns may be requested to conduct emergency cases as accompanying medical personnel to the referral hospitals and endorse properly to the receiving physician. The interns can also assist in the preparation of monthly health reports. The interns are expected to maximize their learning opportunities through discussions with the MHO and the HC staff. Interns are expected to learn and understand the processes involved in the management of a barangay health unit, the administrative and operational issues of concern and the relationship of all stakeholders in relation to health care delivery and its referral system. A2. The Health Hub A health hub is a facility provided in each of the areas in the community. The intern will be required to sign in at 8am and sign out at 4:00pm in the Attendance Logbook. He/she will attend to clinic consults following the prescribed schedule (recommended is 9am-12noon). Using the biopsychosocial framework, he/she will conduct clinical interviews and fill up completely the patient data base (may use the Patient Encounter form in Appendix K). The intern must be able to perform a complete clinical history and physical examination. Based from the information he/she had obtained, the intern must be able to arrive at a primary working diagnosis and recommend the appropriate management (diagnostic and therapeutic, including non-pharmacologic advises and follow-up). All prescriptions and laboratory requests should be properly filled-up and signed. The intern will have to affix his/her name and signature at the end of the chart. If a faculty is present, he/she may be required to present the case prior to discharge. For patients on follow-up consult, the intern is required to evaluate the patients condition with a complete clinical history and physical examination, noting new symptoms or improvement of complaints and be able to interpret laboratory results as needed. The intern is expected to write the patients present working diagnosis and give recommendation for management.

B. Home Visit The home visit will be conducted either at the GK-Trese, GK-Molave, or GK-Cox, depending to where the intern will be assigned. Both areas are established GK-Ateneo villages. Each intern are required to have three families all thru out his/her rotation. The home visit will be conducted on a once a week basis per family, unless where a more regular schedule is needed. The following is a suggested template of activities in relation to the conduct of home visits: Weeks 1-2: Family profile (biomedical) Weeks 3-4: Family assessment tools genogram, SCREEM, etc Weeks 5-6: Family wellness plan Weeks 7-8: Endorsements The intern will fill up the family profile charts and update it every follow up visit. Table 3. Template of schedule of home visits. Monday Tuesday Week 1 Subgroup B Subgroup C Week 2 Subgroup C Subgroup D Week 3 Subgroup D Subgroup A Week 4 Subgroup A Subgroup B Week 5 Subgroup B Subgroup C Week 6 Subgroup C Subgroup D Week 7 Subgroup D Subgroup A Week 8 Subgroup A Subgroup B

Wednesday Subgroup D Subgroup A ----Subgroup D Subgroup A Subgroup B Subgroup C

Thursday Subgroup A Subgroup B Subgroup C Subgroup D Subgroup A Subgroup B Subgroup C ---

Friday Subgroup B Subgroup C Subgroup D Subgroup A Subgroup B Subgroup C Subgroup D ---

The intern may also perform clinical procedures as needed and facilitate referral to the health center if the case requires. Table 4. List of clinical procedures that may be performed by an intern during a home visit. Taking blood pressure Breast examination Vaccination Fundoscopy Internal examination Nasogastric tube reinsertion Visual acuity testing Digital rectal examination Torniquet test Otoscopy Blood extraction Wound dressing Tuning fork test Foley catheter reinsertion

C. Teaching-Learning Conferences All Wednesday afternoon (230-5pm, except the first Wednesday 1-5pm) of the rotation are reserved for the teaching-learning conference. This provides an opportunity for the faculty preceptors to discuss with the rotating interns their experiences during the rotation. The topics for discussion are categorized into two: the biopsychosocial rounds and the public health and management rounds.

The suggested template of the topics as per week is as follows: Week 1 Skills session (CEA, facilitating skills, active listening skills,etc) Week 2 Mentoring/Coaching Week 3 Project cycle management and Impact monitoring/impact chains Week 4 Mentoring/Coaching Week 5 Clinical case discussion (cases seen at the health center and home visits) Week 6 Mentoring/Coaching Week 7 Family case presentations Week 8 Endorsements Interns are also expected to attend the staff conference facilitated by the municipal health officer every second and fourth Mondays of the month. They are also encouraged to provide feedback on the health programs and health status in their assigned communities. D. Community Field Visits The interns will be assigned either in GK-Trese, GK-Molave or GK-Cox. Table 5. Template of schedule of community field visits.
Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7 Week 8 Monday Subgroups C/D Subgroups A/D Subgroups A/B Subgroups B/D Subgroups C/D Subgroups A/D Subgroups A/B Subgroups B/C Tuesday Subgroups A/D Subgroups A/B Subgroups B/C Subgroups C/D Subgroups A/D Subgroups A/B Subgroups B/C Subgroups C/D Wednesday Subgroups A/B Subgroup B Subgroups C/D Subgroups A/D Subgroups A/B Subgroup C Subgroup D Subgroup D Thursday Subgroups B/C Subgroup C Subgroup D Subgroup A Subgroups B/C Subgroup C Subgroup A Subgroups A/B Friday Subgroups C/D Subgroup D Subgroup A/B Subgroups B/C Subgroups C/D Subgroup D Subgroups A/B Subgroups A/B/C Saturday Subgroups A/B/C/D

Activities for community field visits will be guided by the strategic plan or health agenda that will be developed with the partner community. Hence, they may observe and assist in the conduct consultative meetings with stake holders (i.e. Gawad Kapitbahayan of each community, Gawad Kalinga-Ateneo, local government units especially the barangay council, etc). The interns are encouraged to contribute their thoughts in community development such as in the design and implementation of group-based and skills-based education intervention. The interns are also expected to mobilize the community to participate in these interventions. The interns are also to review data source, gather and analyze information regarding the prevailing health status of the community. This will be interspersed with the information they obtain from the home visits that they conduct. They are expected to generate recommendations that will be consistent with the strategic plans of the community and the organization. E. Public Health Awareness Lectures Interns are encouraged to facilitate and conduct public health awareness lectures either in the Payatas B Health Center or in the respective areas where they are assigned (Purok Molave or Purok Trese). Topics for the lectures should be based on the community needs and information they have obtained during their community field visits. Interns should also be able to involve the community health workers in facilitating the lectures. Materials for the lectures will be on the discretion of the interns.

F. Strategic Management Activities As such that the strategic management activities is anchored in the strategic plan of the community and the organization, the interns are expected to participate in the on-going strategic assessment and planning and programs. The interns are expected to apply principles of change management and leadership in the implementation of community based programs. They are also encouraged to utilize basic management functions, such as planning, organizing and leading, in implementing these programs. The interns may conduct community focused group discussions (FGDs), join meetings with leaders and key stakeholders as well as interview key informants. They may also facilitate communication and marketing activities as necessary but still anchored in the strategic plan. The interns will be required to write a journal of learning and reflections regarding their experiences on the activities that they are involved in. The interns are required to accomplish the Report of Activity forms and submit it at the end of their rotation.

Course Requirements
At the beginning of the rotation, all interns are required to fill up two (2) copies of the Personal Data Sheet and attach two (2) pieces of their recent 2x2 ID pictures. One copy will be submitted to the Medical Health Officer during the clinic orientation while the other copy will be submitted to their respective faculty preceptors. A. Case Presentations The interns will be required to present two case presentations during their rotation: case discussion and family case. For the case discussion, each subgroup will present a case that they have seen during their health center duty and/or home visits. They will discuss the assessment and management of the case using the biopsychosocial approach. Each group will be given 20 minutes for the oral presentation and a 10-minute discussion will follow. The group will be required to submit a written report at the end of the session. For the family case, each group (Trese, Molave and Cox) will present one family using the biopsychosocial approach. The group must highlight the family profile, the family assessment tools used and the family wellness plan. Each group will be given 30 minutes for the oral presentation and a 10-minute discussion will follow. The group will be required to submit a written report at the end of their rotation incorporating the comments and feedback during the open forum. B. Patient Census Log All patients seen during the health center duty, health hub, outreach clinics and home visits should be logged. The patients name, age, sex, address, chief complaint, present working impression and summary of management should be logged following the format provided. It will be submitted as a course requirement at the end of their rotation. Table 6. Patient Census Log.
Date seen Name Age/Sex Address Chief Complaint Present Working Impression Summary of Management Signature

C. Family Profile Charts Each intern will be assigned five families under their care for the two-month rotation. The intern is required to accomplish the Family Profile Chart (Appendix __) and update necessary information during his home visits. The Family Profile Charts will be arranged based on the head of the family. Each intern will make recommendations and provide a Family Wellness Plan for each of the family he/she is assigned. The charts will be collated in a filing cabinet provided at the Payatas B Health Center.

D. Journal/Report of Activity Each intern will accomplish a Journal and Report of Activity form that will detail their learning and experiences in the activities they have been involved during their rotation. This will be used as part of the processing during the teaching-learning conferences as well as a feedback form that will be collated as accomplishment report to be submitted at the Quezon City Health Office and the Payatas B Health Center.

E. End-of-Rotation Examination At the end of the rotation, the interns will have a 100-points written Objective Structured Clinical Examination. Topics covered will be based on common diseases seen during clinic consults and home visits (including clinical practice guidelines, EPI, NTP, IMCI, etc), family and community medicine concepts, public health principles and management concepts. MPL for the examination is 70.

Course Evaluation
Interns will be evaluated based on their performance at the health center; involvement in the strategic planning and program planning and implementation; oral presentations and written reports requirements; the end-of-rotation examination; behaviour and attitude evaluation; and attendance. Performance evaluation (MHO, faculty preceptor, CO) 30% Participation and involvement in the strategic planning and implementation 25% Case report requirements 15% End-of-rotation examination 15% Behaviour and attitude evaluation 10% Attendance 5%

Suggested Readings
1. 2. 3. 4. Expanded Program for Immunization National Tuberculosis Program 2010 Integrated Management of Childhood Illnesses National Compendium 2011

ATENEO SCHOOL OF MEDICINE AND PUBLIC HEALTH


PERSONAL DATA SHEET
Group Number: ______ Date of Rotation: ___________________ Name: ________________________________________ Nickname: __________________________ Age : ___________ Birthday: _________
Attach latest 2x2/passport size photo here.

Contact information: CP number: ___________________________________ Email: ___________________________________ Address: __________________________________________________________________ __________________________________________________________________ Educational background: High school: _______________________________________________________ College/Course: _______________________________________________________

Hobbies/Skills/Special interests: _________________________________________________

Person to notify in case of emergency Name: _______________________________________________ Contact number: _______________________________________________

Specimen signature:

1. ___________________________________________

2. ___________________________________________

ATENEO SCHOOL OF MEDICINE AND PUBLIC HEALTH


PATIENT CENSUS LOG
Name of Intern: ____________________________
Date seen Name Age/Sex Address

Group No.: _____


Chief Complaint

Date of Rotation: ____________________


Summary of Management Checked by

Present Working Impression

ATENEO SCHOOL OF MEDICINE AND PUBLIC HEALTH


FAMILY CHART FORM
Name of Intern: _________________________ Group No.: _____ Date of Rotation: ___________ Name of Family : _____________________________________ Address: ______________________________________ Contact No. : __________________ Family Profile Name of Family Member Age/Sex Occupation

Genogram

Family Structure:____________________________________________________ Family Life Cycle Stage:_______________________________________________ Issues to be anticipated: _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________

Family Map

Indicate the following: Index Patient, Primary Breadwinner, Primary Caregiver

Family APGAR Family Member 1 ADAPTATION


I am satisfied that I can turn to my family for help when something is troubling me. Akoy nasisiyahan dahil sa nakakaasa ako ng tulong sa aking pamilya. I am satisfied with the way my family talks over things with me and shares problems with me. Akoy nasisiyahan sa paraaang nakikipagtalakayan sa akin ang aking pamilya tungkol sa aking problema. I am satisfied that my family accepts and supports my wishes to take on new activities or directions. Akoy nasisiyahan at ang aking pamilya ay tinatanggap at sinusuportahan ang aking mga nais gawin patungo sa mga bagong landas para sa aking ikauunlad. I am satisfied with the way my family expresses affection and responds to my emotions, such as anger, sorrow or love. Akoy nasisiyahan sa paraang ipinadadama ng aking pamilya ang kanilang pagmamahal at nauunawaan ang aking damdamin katulad ng galit, lungkot at pag-ibig. I am satisfied with the way my family and I share time together. Akoy nasisiyahan na ang aking pamilya at ako ay nagkakaroon ng panahon sa isat isa.

Family Member 2

Family Member 3

PARTNERSHIP

GROWTH

AFFECTION

RESOLVE

OVERALL ASSESSMENT
Score: 0 hardly ever (halos hindi) 1 some of the time (minsan) Interpretation: 0-3: severely dysfunctional 4-6: moderately dysfunctional 2 almost always (palagi) 7-10: highly functional

SCREEM PARAMETER Social Cultural Religious Economic Educational Medical

RESOURCE

PATHOLOGY

FAMILY HEALTH CARE PLAN Family Member Screening Tests Immunizations/ Chemoprophylaxis Lifestyle Modification Counseling Needs

EPISODIC CONSULT SHEET Name of Family: _______________________________________


Date of visit Name Chief complaint Course of Illness/PE Assessment Management

ATENEO SCHOOL OF MEDICINE AND PUBLIC HEALTH

AS COUNSELOR Showed empathy to patients who are physically and/or emotionally in pain. AS EDUCATOR / LEARNER 1. Educated patients on the nature of their illness, its causation, management and prognosis. 2. Taught barangay health workers. 3. Actively participated in case discussions of cases.

_____

FAMILY AND COMMUNITY HEALTH MANAGEMENT Performance Evaluation (Health Center Duty)
Name of Intern: ____________________________________________ Date of Rotation: __________________________________________ Health Center (encircle one): Payatas B Lupang Pangako Rate according to the frequency with which the competency is manifested by the intern as observed by the evaluator 5 = 90% of the time (Outstanding) 4 = 75% of the time (Very Satisfactory) 3 = 50% of the time (Satisfactory) 2 = 25% of the time (Fair) 1 = very rarely seen, (Unsatisfactory) NO = not observed (No opportunity for observation) COMPETENCIES AS A DOCTOR 1. Got a pertinent clinical history. 2. Performed a thorough physical examination. 3. Gave a complete biopsychosocial diagnosis and differential. 4. Utilized a cost effective laboratory procedures. 5. Prescribed the most cost effective treatment intervention. 6. Gave medical advice and other non pharmacologic intervention to patients. 7. Referred appropriately when necessary. 8. Gave particular importance to preventive care and health promotion e.g., lifestyle modification and screening 9. Provided specific follow-up date. AS A RESEARCHER Utilized the most current and best research on diagnosis and treatment.

_____ _____ _____

AS MANAGER AND PUBLIC HEALTH ADVOCATE 1. Managed time and resources wisely. 2. Worked harmoniously with a team. 3. Maintained pertinent and updated patient records. 4. Recorded the most common causes of mortality and morbidity of the clinic. 5. Screened for diseases that can pose a threat to the family and community. 6. Reported notifiable diseases to proper authorities. 7. Recommended appropriate family or community intervention in relation to the diseases encountered.

_____ _____ _____ _____ _____

_____

_____ _____ _ ____ _____ _____ _____ _____ _____ _____

REMARKS: _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________

_____

___________________________
Name and Signature of Evaluator Date : ________________

ATENEO SCHOOL OF MEDICINE AND PUBLIC HEALTH

YL9 SKILLS RATING SCALE FORM


Date: ______ Rotation: ___________________ Name of Intern: _____________________________________

Made sure that the correct procedure was being done to the correct patient at the correct site. Maintained good rapport with the patient, including making an effort to put the patient at ease and to minimize discomfort and pain. Paid meticulous attention to basic asepsis and antisepsis techniques. Paid strict and meticulous attention to basic techniques throughout the procedure. Correctly used the proper instruments during the entire procedure. FINAL SCORE

Lowest N/A 0.25 0.5

0.75

1.0

1.25

1.5

Highest 1.75 2.0

N/A

0.25

0.5

0.75

1.0

1.25

1.5

1.75

2.0

N/A N/A

0.25 0.25

0.5 0.5

0.75 0.75

1.0 1.0

1.25 1.25

1.5 1.5

1.75 1.75

2.0 2.0

N/A

0.25

0.5

0.75

1.0

1.25

1.5

1.75

2.0

Evaluated by:

________________________________________ Name and Signature of Evaluator Date: _______________

ATENEO SCHOOL OF MEDICINE AND PUBLIC HEALTH


YL9 RATING SCALE FOR PROFESSIONALISM

Date: _______________________ Name of Intern: _________________________________ Rotation: ____________________ Hospital: _______________________________________

Lowest Has good working relationship with other team members, enhances the value of the team Shows proper respect for patients, peers, faculty, and allied health personnel Shows sensitivity and compassion to patients culture, age, gender, and disabilities Maintains honesty and integrity at all times Demonstrates a commitment to ethical principles (confidentiality of patient information, informed consent, provision or withholding of clinical care, and business practices) Demonstrates initiative and a desire for excellence Accepts limitations and failings, open to feedback and criticism, shows desire for self-improvement Maintains a professional demeanor in manner, dress and action, and excludes self-confidence Demonstrates organizational ability, responsibility, dependability Punctual and complete attendance FINAL SCORE

Highest

0 0

0.1 0.1

0.2 0.2

0.3 0.3

0.4 0.4

0.5 0.5

0.6 0.6

0.7 0.7

0.8 0.8

0.9 0.9

1.0 1.0

0 0

0.1 0.1

0.2 0.2

0.3 0.3

0.4 0.4

0.5 0.5

0.6 0.6

0.7 0.7

0.8 0.8

0.9 0.9

1.0 1.0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1.0

0 0

0.1 0.1

0.2 0.2

0.3 0.3

0.4 0.4

0.5 0.5

0.6 0.6

0.7 0.7

0.8 0.8

0.9 0.9

1.0 1.0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1.0

0 0

0.1 0.1

0.2 0.2

0.3 0.3

0.4 0.4

0.5 0.5

0.6 0.6

0.7 0.7

0.8 0.8

0.9 0.9

1.0 1.0

Evaluators Signature Evaluators Name Evaluators Position

________________________________ ________________________________ Consultant Resident Faculty

ATENEO SCHOOL OF MEDICINE AND PUBLIC HEALTH


PEER EVALUATION FORM
Group Number: ______ Date of Rotation: ___________________

INSTRUCTIONS: Rate your co-interns under each criterion according to the following rating scale: 5 = 90% of the time (Outstanding) 4 = 75% of the time (Very Satisfactory) 3 = 50% of the time (Satisfactory) 2 = 25% of the time (Fair) 1 = very rarely seen, (Unsatisfactory) Name of Co-interns A B C D E F G H I J

Evaluated by:

________________________________________ Name and Signature of Evaluator Date: _______________


DESCRIPTION OF PERFORMANCE 4 3 2
Average knowledge which is usually applied appropriately without gross effort.

CRITERIA 5 A. ABILITY TO APPLY KNOWLEDGE IN CLINICAL SITUATIONS B. ABILITY TO OBTAIN HISTORY

1
Lacks/minimal fund of knowledge. Unable to apply knowledge in clinical situations. Incomplete histories. Disorganized recording. Superficial or incomplete physical examination. Misses pathological findings or fails

Has an unusual fund of knowledge which is applied effectively and promptly in clinical problems.

C. ABILITY TO PERFORM ACCURATE PHYSICAL EXAMINATION

Exceptional case histories. Complete clinical history. Asks the right diagnostic questions. Clearly and logically records data on chart. Asks permission to the patient. Excellent, careful thorough physical examination. Detects most pathological findings and assesses their importance accurately. Treats patient with utmost respect

Careful history with most significant issues covered. Reasonable clarity and organization in recording in chart. Careful physical examination. Most pathologies detected and significance usually understood.

and explains procedures.

D. QUALITY OF DIAGNOSTIC AND THERAPEUTIC MANAGEMENT E. COMMUNITY ORIENTATION

Appropriate diagnostic and therapeutic management guided by evidence and treatment guidelines. Cost-effective. Considered patients capacity to conform with the recommended management. Highly community-oriented, showing excellent analysis of the social conditions and deep understanding of root causes of community problems. Sees self as part of the community he/she is working with. Able to elicit active participation from the people in the community and together initiate appropriate solutions to identified problems. Chooses the most important topics needed by the community. Uses simple language. Excellent ability to integrate with topics previously discussed.

Suggested management is acceptable.

to understand their significance. Recommended management is variable.

F. LEADERSHIP

Compassionate towards the community. Sees self separate from the community and its effort at improving its lifestyle. Fair analysis of the situation. Does activities assigned to him/her. Adequate performance expected of the student.

Apathetic. Underinterested in working for or with the community.

G. CHOICE OF TOPIC FOR DISCUSSION DURING LECTURES

Performs adequately. Sometimes include topics which are unclear or irrelevant to the audience.

H. USE OF VISUAL AIDS IN LECTURES I. ABILITY TO ELICIT AUDIENCE PARTICIPATION J. RELATIONSHIP WITH PRECEPTORS

Uses appropriate and clear visual aids, more for the lay audience rather than as visual cues for himself. Well-prepared and creative. Audience lively and highly participative. High enthusiasm among the participants. Exceptionally cooperative. Open to teaching efforts. Accepts constructive criticism well.

Adequate visual aids with occasional lapses in language.

Needs prodding and constant urging to do assigned tasks. Poor performance. Talks about topic without regard for the participants or the community context. None or haphazardly done visual aids. Audience silent, lacks enthusiasm. Displays little interest in the subject. Defensive. Resistant or passiveaggressive.

Moderate participation from the audience.

Good attitude. Average receptiveness to teaching efforts.

ATENEO SCHOOL OF MEDICINE AND PUBLIC HEALTH


YL9 RATING SCALE FOR PERFORMANCE (Small Group Discussion/Case Presentation) Date: ______ Rotation: ___________________ Name of Intern: ____________________________ Group: __________
Lowest 5 6 Highest 10 11 12

Did the intern carry out a rational diagnostic approach? Obtained pertinent data and also sought to exclude other possible diagnosis. Obtained accurate and complete history in a logical manner. Performed a complete and systematic physical exam. Did the intern describe the patients clinical manifestations clearly, concisely and accurately? Did the intern arrive at a good clinical impression? Was the intern able to recognize salient features and correlate data to make a diagnosis? Did the intern rule in/out pertinent and plausible differential diagnosis? Did the intern recommend/request appropriate tests? Was the intern able to rationalize the use of such test? Was the intern able to explain the underlying pathophysiology of the patients illness? Was the intern able to discuss/suggest/ carry out a rational and appropriate treatment plan for the patients? Was the intern able to analyze the patients clinical course/response to treatment? Was the intern able to explain appropriate preventive health care measures that may be recommended to the patient and family? Was the intern able to make a concise yet fairly complete contextual analysis of the patients over-all biologic, physiologic, socioeconomic and spiritual status? FINAL SCORE

5 8

10

11

12

10

11

12

13

14

15

16

10

11

12

1 8 5 5

10

11

12

13

14

15

16

10

11

12

10

11

12

Evaluated by:

________________________________________ Name and Signature of Evaluator

ATENEO SCHOOL OF MEDICINE AND PUBLIC HEALTH


YL9 Rating Scale for Family Case Presentation

Date: _________ Name of Interns: ____________________________


5 = Fulfills task beyond expectation 4 = Fulfills tasks; no deficiency 3 = Fulfills with minimal deficiency 2 = Needs improvement 1 = Unable to fulfil task

Rotation: _________________ Group: __________

CONTENT Presented the patient and profile of his/her family. Provided a rationale why it was chosen for presentation. Analyzed appropriately the family dynamics of the patient as it relates to the biopsychosocial concern identified. Analyzed the impact of illness in the family. Utilized appropriately family interventions in the biopsychosocial problems of the family. Evaluated the effects of the family interventions done. PROCESS Organized the content and presented it systematically. Held attention of audience by making voice loud and clear. Used relevant and properly proportioned audiovisual aids. Adequately answered questions asked during the open forum. 1 1 1 1 1 1 2 2 2 2 2 2 3 3 3 3 3 3 4 4 4 4 4 4 5 5 5 5 5 5

1 1 1 1

2 2 2 2

3 3 3 3

4 4 4 4

5 5 5 5

Evaluated by:

________________________________________ Name and Signature of Evaluator

ATENEO SCHOOL OF MEDICINE AND PUBLIC HEALTH


Family and Community Health Management Activity Report: _______________________________
Name of Intern: _________________________________ Site Assignment: ________________________________ Name of Activity: ______________________________________________________________ Date and Venue: _______________________________________________________________ Activity Objectives: Sponsoring and Partner Agencies: _____________________ Task as Intern:

Program of the Activity:

Key Issues Identified:

Comments on the Activity:

Personal Learning:

Next steps/recommendations:

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