LSUHSC School of Medicine - Undergraduate Medical Education

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Direct Observation of Clinical Skills

In 2007, the Curriculum Oversight Committee (along with the clerkship directors) developed lists of core clinical skills to be directly observed by faculty in each year of undergraduate medical education. Once the list was developed, the committee developed specific "critical performance criteria" for the level of proficiency that a student is required to demonstrate before a faculty member attests to their competence. The skills (with links to the critical performance criteria) are listed in the table below.

These skills were cited by program directors as the most desirable skills for beginning interns. They are also in keeping with the core areas of clinical competence as defined by the ACGME. While not inclusive of all clinical competencies taught and evaluated at LSU School of Medicine, they represent milestones of clinical competence that are required at each stage of education. Compliance is monitored by the Office of Medical Education by use of a bar code scanning system and reported to the Curriculum Oversight Committee. We are confident that all students achieve these milestones of clinical competency regardless of the location of their clinical training.

	ACGME Core Area	Skill	Setting	Course
Year 1	Communication Skills
	Patient	Basic interviewing skills	Role-play with classmate	SPM 100
	Colleagues
	Patient Care
	History Taking	History Present Illness (HPI)	Role-play with classmate	SPM 100
		HPI #2	Role-play with classmate	SPM 100
	Physical Exam	Blood pressure	Skills Lab - classmate	SPM 100
		Retinal exam	Skills Lab - classmate	SPM 100
		Otoscope exam	Skills Lab - classmate	SPM 100
		Cardiac exam	Skills Lab - classmate	SPM 100
		Lung exam	Skills Lab - classmate	SPM 100
		Abdominal exam	Skills Lab - classmate	SPM 100
	Critical Thinking
	Procedures	Aseptic technique	Skills lab	SPM 100
		Basic Life Support	Skills lab	SPM 100
		Simple suturing (cadaver)	Skills lab	SPM 100
	Professionalism	Responsibility to colleagues	Clinical forums	SPM 100
		Ethical judgment	Clinical forums	SPM 100
	Practice-Based Learning
Year 2	Communication Skills
	Patient
	Colleagues	PowerPoint Presentation	Clinical forum symposium	SPM 200
		Patient Presentation	ICM rounds	ICM 200
	Patient Care
	History Taking
	Physical Exam	Identification of heart sounds and murmurs	Skills lab - simulator	SPM 200
		Pelvic exam	Skills lab - simulator	SPM 200
		Breast exam	Skills lab - simulator	SPM 200
		Prostate exam	Skills lab - simulator	SPM 200
		Cardiac exam	Hospital – ICM patient	ICM 200
		Lung exam	Hospital – ICM patient	ICM 200
		Abdominal exam	Hospital – ICM patient	ICM 200
	Critical Thinking	Problem list/ differential diagnosis	ICM write-up	ICM 200
		Problem list/ differential diagnosis	ICM write-up	ICM 200
		ECG/Arrhythmia interpretation	Skills lab - simulator	SPM 200
	Procedures	IV insertion (simulator)	Skills lab	SPM 200
		Lumbar puncture (simulator)	Skills lab	SPM 200
	Professionalism	Responsibility to colleagues	Clinical forums	SPM 200
	Practice-Based Learning	Effective literature search	Clinical forums	SPM 200
		Effective literature search #2	Clinical forums	SPM 200
Year 3	Communication Skills
	Patient	Patient education & counseling	Hospital or clinic	Peds 300
	Colleagues	Research Presentation	Classroom	Fam Med 300
		Patient presentation	Hospital or clinic	Peds 300
		Patient presentation (acute)	Hospital	Peds 300
		Patient presentation (acute)	Hospital	Med 300
		Patient presentation (outpatient)	Clinic	Med 300
		Patient presentation (chronic)	Clinic	Fam Med 300
		Patient presentation (acute)	Clinic	Fam Med 300
		Patient presentation (pregnant)	Hospital or Clinic	Ob/Gyn 300
		Patient presentation (postpartum)	Hospital	Ob/Gyn 300
		Patient presentation (gynecologic)	Hospital or Clinic	Ob/Gyn 300
		Patient presentation	Hospital or clinic	Psych 300
		Patient presentation (acute)	Hospital	Surg 300
	Patient Care
	History Taking	HPI (well child)	Hospital or clinic	Peds 300
		HPI (acute illness)	Hospital	Peds 300
		HPI (acute illness)	Hospital	Med 300
		HPI (outpatient)	Clinic	Med 300
		HPI (acute illness)	Clinic	Fam Med 300
		HPI (chronic illness)	Clinic	Fam Med 300
		HPI (pregnant patient)	Hospital or clinic	Ob/Gyn 300
		HPI (gynecologic illness)	Hospital or clinic	Ob/Gyn 300
		HPI (psychiatric illness)	Hospital or clinic	Psych 300
		History (mental status exam)	Hospital or clinic	Psych 300
		History (sensorium exam)	Hospital or clinic	Psych 300
		HPI (acute illness)	Hospital	Surg 300
	Physical Exam	Physical exam (infant)	Hospital or clinic	Peds 300
		Physical exam (child)	Hospital or clinic	Peds 300
		Cardiac exam (patient)	Hospital or clinic	Med 300
		Lung exam (patient)	Hospital or clinic	Med 300
		Head and neck exam (patient)	Clinic	Fam Med 300
		Breast exam (patient)	Hospital or clinic	Ob/Gyn 300
		Pelvic exam (patient)	Hospital or clinic	Ob/Gyn 300
		Abdominal exam (acutely ill patient)	Hospital	Surg 300
	Critical Thinking	Problem list/ differential diagnosis	Hospital or clinic	Peds 300
		Problem list/ differential diagnosis	Hospital	Med 300
		ECG interpretation	Hospital or clinic	Med 300
		Chest radiograph interpretation	Hospital or clinic	Med 300
		Problem list/ differential diagnosis	Clinic	Fam Med 300
		Problem list/ differential diagnosis	Hospital or clinic	Ob/Gyn300
		Diagnosis and treatment plan	Hospital or clinic	Psych 300
		AA or NA Meeting	Community	Psych 300
	Procedures	Suturing (patient)	Hospital	Surg 300
	Professionalism
	Practice-Based Learning	Evidence based medicine application	Pediatric forums	Peds 300
		Evidence based medicine application	Classroom	Fam Med 300

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