The University of Kansas School of Medicine: FAPR 900 Rural Preceptorship Orientation

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The University of Kansas School of
MedicineFAPR 900 Rural Preceptorship
Orientation

• Michael Kennedy, MD
• Course Director
• Debra Lea
• Course Administrator

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Medical Education Network Sites
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Goal of Rural Preceptorship

• Provide students with an opportunity in rural
  primary care practice outside significant
  influence of a tertiary care center.
• The focus is on the following themes
• Development of autonomy when dealing with common
  and serious conditions in rural primary care
• Exploration of other roles played by physicians
  in the rural community
• Service learning particularly as applied to rural
  underserved care
• Understanding referral and consultation
  relationships in a rural environment

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Rural Definition

• Rural for the purpose of this course is defined
  as anywhere in Kansas outside the counties of
• Wyandotte
• Johnson
• Douglas
• Shawnee
• Sedgwick
• A distance of 45 miles (per map software) from
  the nearest tertiary care medical center will
  also be used to eliminate the urban influence.

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Excluded Counties
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To Accomplish the Rural Preceptorship Goals

• Students should expect to see patients in a
  variety of settings
• Ambulatory clinic
• Acute inpatient (hospital)
• Emergency department
• Nursing home
• Home Visits
• In addition to direct patient care, the student
  will participate in all related patient care
  activities as requested by the preceptor, for
  example
• Hospital committee meetings
• Medical supervision at sporting events
• The student is strongly encouraged to participate
  in non-medical community activities with their
  preceptor.
• Local service organization meetings
• Chamber of Commerce events
• School Board meetings

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Live in the Community

• Students are expected to live in their assigned
  community throughout the month-long course.

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Student Activities

• Participate in all clinical activities with your
  preceptor including
• Ambulatory clinic
• Hospital rounds
• Surgeries
• Other procedures
• Nursing home visits
• Committee meetings
• Participate at least one weekend in your rural
  community on call.

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Student Evaluation Based on

• Divided into subsections parallel to the
  evaluation of competency form for the School of
  Medicine
• There are six areas in which the student will be
  evaluated.
• Patient Care
• Medical Knowledge
• Professionalism
• Interpersonal and Communication Skills
• System-based Practice
• Practice-based Learning and Improvement

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There are 2 objectives in Phase II that are
specific to the Rural Preceptorship.

• 1. Prepare appropriate written and other
  communications between health professionals and
  organizations.
• 2. Appropriately adapt to participate in patient
  care in rural communities, addressing priorities,
  opportunities, and constraints in that setting.

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Student Evaluation

• To complete the requirements for the Rural
  Preceptorship the student will fulfill
  requirements in 5 areas. They are
• 1. Clinical Performance Rating -Graded by the
  Preceptor (US to Sup) per SOM standards
• PLUS
• 2. Letter of consultation pass/fail
• 3. Reflective assignment pass/fail
• 4. Patient encounter logs pass/fail
• 5. Service project pass/fail

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Paperwork Requirements

• Website has links to the needed forms
• http//www2.kumc.edu/orme/required_rural.html
• Absence Request forms
• Mileage Forms
• Mid-Rotation Feedback Form
• Due by Third Wednesday
• May fax or e-mail
• Final Evaluations
• Student evaluation of FAPR 900 Rural
  Preceptorship
• CPR form by Preceptor (Please fill this out with
  them on your last few days, remember, you will
  not be there Friday.)
• All Paperwork needs to be completed and turned in
  to the RP Office during the last day of the
  rotation at the Friday debriefing.

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Letter of Consultation

• Write a letter of consultation for one of the
  patients referred to a specialist. It is up to
  the Rural Preceptor to decide whether the letter
  is to be actually used for the referral. The
  letter should be copied and de-identified for
  submission to the Office of Rural Medical
  Education. It can be faxed or delivered to the
  office otherwise. It MUST be de-identified to
  remain HIPPA compliant. Letters that are not
  de-identified will be shredded and the student
  notified to resubmit a letter that has been
  de-identified. The letter should include
• - An introduction
• - A brief synopsis of the appropriate patient
  history
• - A description and summary of the evaluation
  of the problem in question
• to date
• - Specific questions that you would like the
  consultant to address
• - Closing
• The letter of consultation will be graded
  pass/fail but is a requirement for credit in the
  Rural Preceptorship. There is no length
  requirement. The letter will be due at the
  debriefing.

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Reflective Assignment

• The purpose of this paper is to have the student
  examine their rural experience in retrospect.
  Even though most students are not going to return
  to rural areas to practice medicine, the personal
  growth and the professional perspective gained by
  the Rural Preceptorship can be extraordinary.
• There is no minimum length requirement. Due date
  for all of the above is at the end of your Rural
  Preceptorship.
• The paper is graded pass/fail and is required for
  credit in the Rural Preceptorship.
• The reflective paper should include the areas
  listed below
• Compare/contrast medical decision-making in the
  rural vs urban setting
• Describe an episode that represents resiliency of
  rural physicians or people
• Describe the physician roles by your preceptor in
  a rural setting
• Describe the referral/consultation relationships
  in the rural vs. urban practice
• What are the priorities, opportunities, and
  constraints in the rural setting compared with
  urban settings.
• Provide an overview of your project, please
  attach any slides or material you created to
  supplement your project (packaged presentations
  do not need to be included- ie Tar Wars).
• Additional suggestions can be found on the
  website.

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Service Project

• In order to fulfill the requirements of the Rural
  Preceptorship, all students will be required to
  complete a community-based project. The are
  several suggestions for a service project on the
  website. You should work with your Rural
  Preceptor to find out which of these projects
  would be best for you and the community.
  Participation in this experience should be
  discussed in the Reflective Assignment
• This is a pass/fail project which must be
  completed to receive credit for the rotation.

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Patient Encounter Logs

• As with the other clerkships, during the Rural
  Preceptorship you will be asked to keep a log of
  your patient encounters. This will be done in the
  same manner as the other clerkships. The
  submission of the log is a requirement for
  completion of the Rural Preceptorship.
• It is graded pass/fail.
• The log will be reviewed by the Course Director.

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Course Grades

• The grade for your Rural Preceptorship will be
  based on the following
• CPR form that your Preceptor uses to assign your
  grade
• The 4 other areas will need to be completed
  before credit is given
• Unsatisfactory or incomplete grades will require
  repeating the rural preceptorship

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Questions?