Science and Practice of Medicine 100
Isidore Cohn, Jr., M.D. Student Learning Center

COURSE DESCRIPTION

This interdisciplinary course begins the clinical education of medical students. There are three components of the course which are described below.

DxR Computer-based Cases (see grading and policies below)
Computer-based cases are assigned to all students on a weekly basis. These assignments ensure that students develop some skill at clinical problem solving. The cases are selected to reflect complaints that are commonly seen in clinical practice. They are also selected to enhance the teaching of basic sciences that students recently learned in their morning classes. Learning objectives focus on the history and physical findings that are pertinent to the patient’s complaint; the differential diagnosis for the patient’s clinical presentation; the underlying anatomy, physiology, or biochemistry that is pertinent to the case. After completing each case, the entire class meets for a discussion that is led by both a clinician and a basic scientist.
Over the year-long course, students are exposed to many clinical case scenarios and witness a variety of expert approaches to different clinical problems. Repeated active working of these cases allows students to develop their own problem solving skills.

Clinical Forums (see grading and policies below)
Medical ethics, professionalism, patient-physician communication, human development, social issues, cultural competency and healthcare policy lend themselves to discussion in a small group format. These and other topics are addressed in a longitudinal series of small group seminars with clinical faculty. Groups are limited to 10 -12 students and meet regularly throughout both semesters. Most seminars begin by examining a clinical scenario that stimulates discussion. Role-playing is often employed to illustrate important concepts about the patient-physician relationship and history taking. The continuity of discussions from one seminar to the next, outside reading, and active learning on the part of the students is encouraged. Didactic sessions are occasionally necessary, particularly when some topics are first introduced.

Clinical Experiences (see grading and policies below)
This component of the course provides hands-on experience and the opportunity for students to practice the skills of clinical medicine. Several training sessions are conducted in the Clinical Skills Lab (also see Skills Lab policies). This lab provides supervised practice and assurance of student competency in basic medical procedures. Physical examination skills are taught in small groups and students are expected to practice on one another in the presence of an instructor. Students have the opportunity to apply interviewing and exam skills in the spring. All students arrange a one-week preceptorship with a primary care physician at the beginning of the second semester; all students also spend 2 evenings in the emergency department where they see a variety of patients.

TEXTBOOKS

Bates Guide to Physical Examination and History Taking, 9th Edition. Lynn S. Bickley, Robert A. Hoekelman. 2007. Lippincott Williams and Wilkins, Philadelphia, PA.
The Medical Interview: Mastering Skills for Clinical Practice, 5th Edition; John L. Coulehan and Marian R. Block; F.A. Davis Company; 2006.
Resolving Ethical Dilemmas: A Guide for Clinicians. Bernard Lo. 2005. Williams and Wilkins, Baltimore, MD.
Basic Life Support for Healthcare Providers; American Heart Association, Dallas TX.

SPM 100 GRADING AND POLICIES

1. This is a pass/fail course. However, students must receive a passing grade for each of the three components listed above in order to pass the course. Students who fail the course will be discussed at a meeting of the Pre-clinical Sciences Promotions Committee in the spring. In some cases, remediation may require repeating the entire freshman year.
2. Professionalism is expected at all times. This includes your dealings with patients, faculty, staff, hospital staff and your classmates.
3. Notification of schedule changes and other important announcements regarding the course will be made by email.
4. DxR cases are graded and a passing average for the year will be determined based on class performance (an average of 70 is usually required). There are approximately 20 cases over the course of the year and a student’s lowest grade will be dropped.
5. All DxR cases must be completed by 5:00 AM on the morning that they are due. Failure to complete a case on time can result in a grade of 0 for that case.
6. Students are required to attend 75% of the DxR discussions to pass the course.
7. Attendance at and participation in ALL small group clinical forums is expected. Absence for a medical reason, family emergency or school related travel will be excused. It is your responsibility to notify your faculty group leader in advance if possible.
8. Unexcused absences and excessive numbers of excused absences will require remediation as deemed appropriate by the faculty group leader and course director (usually a written paper on a related topic). Excessive absences can result in a failing grade for the course.
9. Clinical forum and Ethics sessions will begin with a brief discussion of a quiz based upon the assigned reading.  It is required that you work the quiz on-line prior to class and bring your printed quiz with you to the session.  Reasonable performance on these quizzes is required.
10. All skills lab sessions must be completed in order to pass the course. (See separate Clinical Skills Lab policies)
11. The conscientious student who attends all required sessions and makes a reasonable effort to prepare ahead of time should have little difficulty passing the SPM 100 course
     

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