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Learning Objectives

ACGME Core competencies:

  • PC-Patient Care: What the student does
  • MK-Medical Knowledge: What the student knows
  • ICS-Interpersonal/Communication Skills: How the student treats others
  • Prof-Professionalism: How the student acts
  • SBP-System Based Practice: How the student works within a system
  • PBLI-Practice-Based Learning& Improvement: How the student gets better

The Learning Objectives constitute the PCC curriculum for which you may be tested. Collectively, they are the most frequent issues enountered in primary care.

Symptomatic Conditions

  1. Abdominal Pain
  2. Back Pain
  3. Chest Pain
  4. Vaginal/Urinary Symptoms
  5. Headache
  6. Musculoskeletal
  7. Acute Respiratory Infections
Objective Where Taught Where Evaluated
Obtain history to generate a complete description of patient's symptoms, identifying any 'danger' symptoms (PC, MK)
Find out what's bothering the patient 		Preceptor
PBL		 Preceptor
OSCE
Ascertain patient/family beliefs regarding symptom causes and home treatment efforts (Prof, ICS, PC, PBLI)
See what they think and have tried		 Preceptor
PBL		 Preceptor
OSCE
Perform appropriately focused physical exam, noting any 'red flag' signs (PC, Prof, MK, ICS)
Check for problems on exam		 Preceptor Preceptor
OSCE
Succinctly present patient case to Preceptoreptor, applying knowledge of epidemiology to generate & defend weighted differential diagnosis (ICS, MK, PC)
Tell your Preceptor what you found and what you think		 Preceptor Preceptor
Present assessment in patient-centered manner, integrating diagnostic probabilities and evidence-based treatment recommendations (PC, MK, ICS, PBLI)
Tell the patient what you think is going on so they can understand it 		Preceptor
DrPt		 Preceptor
OSCE
Written
Appreciate process of negotiating management plan and incorporating patient preferences into care (ICS, PC, SBP, PBLI, Prof)
Figure out what patient will do		 Preceptor
PBL
DrPt		 Preceptor
OSCE
Educate patient and family regarding monitoring, danger signs, self-cares, & community resources (PC, MK, Prof, ICS, SBP, PBLI)
Tell them what to expect and watch for		 Preceptor
PBL		 Preceptor
OSCE
Check for understanding of follow-up plan, including treatments, testing, referrals, & continuity of care (ICS, SBP, Prof, PC)
Make sure they understand		 Preceptor
PBL		 Preceptor
OSCE

  • Chronic Diseases

    1. Hypertension
    2. Asthma
    3. Depression
    4. Diabetes
    Objective Where Taught Where Evaluated
    Apply knowledge of prevalence, risk factors, and outcomes to make informed recommendations for screening of common chronic diseases (PC, MK, PBLI, SBP)
    Decide who to check for these    		 Preceptor
    PBL    		 Preceptor
    Write Up
    PBL
    Differentiate among various levels, stages and complications of chronic disease, e.g. pre-hypertension, Stage 1, Stage 2, Malignant hypertension (MK, PC)
    Figure out how bad out is    		 Preceptor
    PBL    		 Preceptor
    Write Up
    Generate list of conditions that might mimic or secondarily cause chronic diseases, and understand when to consider these (MK, PC, PBLI)
    Think about whether it could be something else    		 Preceptor
    PBL    		 Preceptor
    Write Up
    Assess patients' abilities to participate in treatment planning and integrate patient preferences into management (PBLI, PC, Prof, ICS)
    Find out what they're willing to do    		 Preceptor
    PBL    		 Preceptor
    OSCE
    PBL
    Systematically monitor for disease control and complications (MK, PC, PBLI, SBP)
    See how it's going    		 Preceptor
    PBL    		 Preceptor
    PBL
    Investigate barriers to chronic disease management and overall health and assist patients in recognizing and overcoming (Prof, SBP, PBLI)
    Think about what's not working and why    		 Preceptor
    PBL    		 Preceptor
    Analyze public health impact of chronic disease, effectiveness of population-level interventions, and risk factor reduction programs (SBP, MK)
    Think about broader effect of these    		 PBL Write up

  • Systems of Care & Learning

    1. Evidence-Based Medicine (EBM)
    2. Doctor Patient Communication
    3. Preventive Services
    4. Primary Care and Public Health
    Objective Where Taught Where Evaluated
    Create your own learning goals; self-assess your own skills, behaviors; and seek and respond appropriately to feedback (Prof, PBLI, ICS, SBP)
    Seek to learn    		 ILP Preceptor
    Mid
    Formulate answerable clinical questions from your patient interactions, and answer these questions in the exam room whenever possible (MK, PBLI, SBP)
    Ask good questions & figure out how to answer    		 PBL
    Preceptor    		 Preceptor
    Incorporate understanding of patient's state of mind, beliefs, preferences and background into verbal and written communication (ICS, PC, Prof)
    Be open to what's going on with patient and don't give them more than they can handle    		 PBL
    Preceptor    		 Preceptor
    Differentiate preventive service guidelines from various organizations and critique recommendations (MK, PBLI, SBP)
    Consider the source    		 PBL
    Preceptor    		 PBL
    Recognize work of primary care physicians to improve population health, and suggest ways to enhance these efforts (PBLI, SBP)
    What can the system do better?    		 PBL PBL

  • Other

    1. Electrocardiogram
    Objective Where Taught Where Evaluated
    Systematically interpret electrocardiogram (MK) EKG ?
    Explain the utility of EKG in diagnosis of cardiac conditions (MK, PC, ICS, SBP) Preceptor
    PBL    		 Write Up