Dear PCC Preceptor,

Key Task: Practicing life long learning skills

This is one of the 6 major goals of the clerkship. In addition to role-modeling how you keep up on new developments, we would like you to help the students enhance their skills in asking clinical questions. And, the students may well be able to teach you things about searching medical literature and using electronic resources.

Strategies:

• Don’t be afraid to say “I don’t know.” One of the myths about primary care is that you have to know everything about everything; it is important for students to hear that there are issues that you need to read up on, consult with a specialist, or learn in some other way. I would also be interested in your thoughts about an article I wrote on 'Hand'ling Uncertainty.
• Push the student to define their question in the PICO format. http://ebling.library.wisc.edu/portals/ebhc/pico.cfm It’s important for the student to keep in mind patient-oriented outcomes; that new drug might reduce cholesterol, but does it actually reduce the risk of a heart attack or stroke?
• Assign your student to look something up and report back to you. You can then talk about how you would incorporate that knowledge into patient care.

What's Going On: Problem Based Learning Case 5: elderly patient with multiple issues
The major learning objective of the case has less to do with the medical issues and instead concentrates on challenges many elderly patients face.

Primary Goals for this PBL Case:

• Management of patients with multiple medical issues
• Depression, back pain, barriers to care, osteoporosis, prevention in the elderly

To supplement this session you could:

• have your student spend time with a few geriatric patients if they have not already had the opportunity to do so.
• If you provide care to nursing home patients it may be helpful to have your student accompany you the next time you go to the nursing home to visit a patient.
• Discuss how you approach elderly patients regarding screening

Dr/Pt Communication session 3:
Students will be reviewing their videotapes. The small group leader will use these tapes to use the tapes to trigger discussion about communication issues.

Reminders: Evaluation
Start to think about your evaluation of the student. The evaluation form is online at http://www.fammed.wisc.edu/files/webfm-uploads/documents/med-student/pcc...

Resources: Evidence Based Resources

• http://www.med.wisc.edu/education/md/curriculum/patient-doctor-society/2... This is the curriculum that the students used in their M1 & 2 years.
• The National Guidelines Clearinghouse (NGC) is an Internet Web site intended to make evidence-based clinical practice guidelines and related abstract, summary, and comparison materials widely available to health care professionals: http://www.guideline.gov
• Welch Medical Library of Johns Hopkins University
  An excellent portal for EBM resources, PDA programs and resources, tools and tutorials: http://www.welch.jhu.edu/internet/ebr.html
• Agency for Healthcare Research & Quality
  Includes US Preventive Services Task Force recommendations and rationale; patient education materials, research & database resources, information on vulnerable populations: http://www.ahrq.gov
• The Cochrane Library Widely quoted EBM resource: http://www.cochrane.org
• Point of Care Patient Education and Evidence Based Medicine, A PowerPoint presentation by Derek Hubbard, MD: http://www.fmdrl.org/index.cfm?event=c.beginBrowseD&clearSelections=1&cr...

Thanks again.

John Brill, MD
Director, Primary Care Clerkship
John.brill.md@aurora.org