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Rural Medical Education
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Rural Clinic Clerkship


CE 9145

  1. General Description
    Course Title: Osteopathic Rural Clinic
    Course Length: 4 Weeks
    Course Format: Rural Community Office-Based Ambulatory Clinical Experience
    Student Level: 3rd Year Osteopathic Medical Students
    Course Coordinator: Duane Koehler, D.O., Assistant to the Associate Dean of Rural Health
    Course Contact: Vicky Pace, M.Ed., Director of Rural Medical Education
    Center for Rural Health Office Location (Phoenix Building): 1716 S. Phoenix Avenue
    Phoenix Building Office Hours: Monday – Friday, 8:00 am to 5:00 pm.
    OSU Holidays are observed.
    Coordinator Contact Information: Tulsa: Sherry Eastman (918-584-4375)
    Northeast: Xan Bryant, M.B.A. (918-401-0074)
    Northwest: Robert Sammons, M.A. (918-401-0799)
    Southeast: Danelle Shufeldt, M.B.A. (918-401-0273)
    Southwest: Nicole Neilson, M.S. (918-401-0073)
  2. Course Overview
    A 4 week required rotation that gives third-year students direct involvement and experience in a
    functioning rural practice under the direct supervision of a primary care physician, providing exposure to
    the role of the physician and their interrelationships with community health agencies and offers a wide
    variety of clerical and office management experiences.
    • Student's clinical experience is primarily in a physicians' office and may include hospital meetings,
      house calls, emergency room calls, and attending health or social events.
    • Students live in a rural community during the rotation. Housing is provided in most locations as a
      courtesy to students and is scheduled through the OSU Regional Coordinator.
    • Students participate in a seminar that provides statistics and resources to be incorporated into the
      Case Presentation.
    • Students complete a Procedure/Skills Card.
    • Students prepare and present a Case Presentation using PowerPoint and distance learning
  3. Student Responsibilities (See Clerkship Handbook for more details.)
    • Dress appropriately at all times, utilize College approved identification, and identify yourself as a
      non-graduate medical student not as a medical graduate or a licensed physician.
    • Meet with your preceptor for an office orientation. Be prepared to discuss your clinical strengths
      and weakness relative to the rotation objectives.
    • Attended the rotation orientation the first Monday of the rotation or at date and time indicated by email Instructions. Orientations are at the Center for Rural Health Conference Room (or through videoconferencing only if preapproved)
    • Rural Clinic checklist is provided for your convenience. Center for Rural Health will keep a signed
    • Seminars: Attend seminars, usually on Orientation day. Attendance will be taken and
      nonattendance, arriving late or leaving early must be preapproved and points may be deducted.
    • Case Presentation: Presented the last Wednesday of the rotation, unless notified by email of an
      alternate date. Email the Case Presentation PowerPoint to ruralhealth.clerkship@okstate.edu
      the day before the presentation. An evaluation of the case presentation is conducted by a
      designated physician and will count 10% of the grade. An evaluation of the Case Presentation is
      conducted by a Regional Coordinator and will count as 10% of the grade. All students will complete
      a Peer Evaluation.
    • Clinical Experience: Scheduled in a physician's office or health care facility. These hours may also
      include such out-of-office experiences as hospital staff and committee meetings, house calls,
      hospital emergency room calls, community and public health functions, and fraternal and social
      functions, as an integral portion of this program. Medical Conferences may be attend with
      physicians when available and will count as extra credit with documentation.
    • Procedure/Skills Card will be completed and should include physician initials, date and level for
      each procedure observed, assisted, or performed during rotation. Due the end of the rotation.
      Original required. Completed cards will go in the students file and student will be provided a report
      after graduation. Although a minimum of 5 different procedures/skills are required for the rotation,
      students can use as many cards as needed to add value to the report. These cards count 10% and
      are required for all Rural Health rotations.
    • OMM: Provide appropriate patient care under the supervision of the preceptor. Demonstrate
      appropriate indications and techniques in using OMM.
    • Meet with your preceptor:
      • Midway for a verbal evaluation of your clinical performance and areas to improve. You are
        responsible for scheduling this meeting
      • At the end of the rotation to review your clinical performance. You are responsible for
        scheduling this meeting
    • Community Experience: A community experience should be set up during the first week of your
      rotation. This experience can be arranged by your preceptor, the CRH Coordinator in your area or
      you. You will be representing OSU-COM and may be presenting to a local middle school, high
      school or organizational group, volunteering at a Free Clinic, or teaching a youth group about first
      aid. Both parties should benefit from the medically related experience. You are required to provide
      information to the Coordinator prior to your experience. Detailed information about your
      community experience must be included in your final article (see below under grading)
    • Complete the site evaluation on E-Value. All paperwork is due within 7 days (postmarked by
      the 5th day) of the end of the rotation. If forms are not received within 7 days of the end of the
      rotation, the student’s grade may decrease up to one letter grade. A grade of “I” (incomplete) may
      be issued until all the paperwork has been received.
  4. Clerkship Calendar
    1. For guidelines on Times, Holidays, and Attendance: The specific scheduling of days and hours shall be made by the preceptor, with approval by the OSU-COM Course Coordinator, and shall generally conform with the student clerkship handbook.
    2. Delays and Absences: If there is a reasonable explanation for a delay in reporting (e.g., auto accident, illness, or similar reason), the student is to contact the preceptor and the OSU Rural Health Office immediately. If a student is absent for any reason (or multiple reasons) or will be missing a required event he/she is required to complete an Exception to the Rotation Application with the preceptor's signature and submit it to the Center for Rural Health for the course coordinator's approval. If approved, make up may be required.
    3. Rotation Changes: Students may trade rotation assignments, under approved special circumstances only. A Change of Rotation Form is required. Completed, dated, and signed Change of Rotation Forms should be in The Center for Rural Health Office at least 60 days prior to the rotation start date to allow for processing time. Final Approved Changes must be complete and in the Clinical Education Office at least 6 weeks prior to start of the rotation. Change of Rotation Forms are available in Clinical Education, online or in the Center for Rural Health Office. Completed Forms can be faxed to 918-582-8938, email to sherry.eastman@okstate.edu or delivered to The Center for Rural Health Office. Students in the Rural Medical Track program should contact the Rural Medical Education Director (918-584-4332) for their site options or to request a site change.
  5. Grading
    This Rotation is worth 5 credit hours. The student's overall performance (grade) is weighed using the
    following criteria:
    50% = Student Performance Evaluation by preceptor
    10% = Community Experience
    10% = Article/Picture
    10% = Procedure/Skills Card (minimum of 5 different signed procedures or skills)
    20% = Case Presentation

    1. Course requirement: Must be passed with a 70 percent or higher to pass this course. Letter
      grades of A, B, C, or U will be assigned according to procedures outlined in the student handbook.
    2. Student Performance Evaluation: At the completion of the Rural Clinic rotation, the preceptor
      will evaluate the student's performance on clinical activities and other activities of the rotation on
      the student performance evaluation in E-Value.
    3. Article/Picture: At the end of the rotation, write a two page summary of the rural experience and
      include any appropriate pictures (no copyrighted pictures please). Article should contain your first
      and last name, your rotation, location, preceptor’s name and information about your clinical
      experience and your community experiences. Include the following at the bottom of your article:
      “I give OSU-CHS and/or the Center for Rural Health permission to publish my article and/or
      photos” along with your signature and date. Permission/signatures are needed for anyone in your
      picture. It must be E-mail to ruralhealth.clerkship@okstate.edu
    4. Final Grade: The final (overall) grade will be determined and issued by the Course
      Coordinator following the completion of the rotation. Students are responsible for ensuring that all
      paperwork for Rural Clinic is completed and received by the OSU-COM Center for Rural Health. If
      paperwork is not received within 7 days of the end of the rotation, the student’s grade may be
      decreased up to one letter grade.
    5. Academic Standards: Students are held accountable for the non-cognitive academic
      as the standard of professionalism for their conduct. A grade of S (satisfactory) or N
      (needs improvement) is determined by the Course Coordinator based upon evaluation of the
      student by the preceptor and other course participation factors.
    6. Site Evaluation: Students are required to complete a Site Evaluation in E-Value at the end of each
      rotation. This tool is used to evaluate the course curriculum, faculty (preceptors) and student
      experiences at that site. The individual site evaluations and responses will remain confidential.
    7. A grade of "I" (Incomplete) may be assigned if: A student is unable to complete the course
      requirement of approved 100% attendance. The Course Coordinator recommends an extension of
      the student's Clerkship and sets forth reasoning for the recommended extension. The student fails
      to submit the required paperwork.
    8. Grievance Authority: Grievance of a rotation, performance evaluation, or course grade should
      start with the Course Coordinator. The final grading authority will be with the Course Coordinator.
  6. Rotation Goals and Objectives:
    • Observe and demonstrate knowledge in telehealth and videoconferencing technology.
    • Connect, participate and demonstrate videoconferencing skills by presenting PowerPoint Case
      Presentation from your rural site.
    • Demonstrate presentation skills through a PowerPoint presentation which requiring the use of
      medical literature searches and EBM references.
    • Demonstrate presentation skills and professionalism during scheduled community experiences.
    • Gain an appreciation of the rural Osteopathic family physician’s role as the physician of first contact
      that delivers family-oriented medical care to patients.
    • Acquire an understanding of differentiating factors in rural and urban medical settings.
    • Demonstrate appropriate clinical and interpersonal skills.
      Construct a differential diagnosis and develop treatment/management strategies for common
      diseases and conditions seen in family practice.
    • Develop an understanding of community leadership by attend community events and meetings
      with the preceptor.
    • Evaluate the non-physician clinicians' role in osteopathic medicine and the rural community.
    • Apply clinical skills in physician's offices in a small community.
    • Exhibit interpersonal skills with patients and their families to facilitate the communication process
      between physicians and patients through active listening, empathy and sensitivity, appropriate eye
      contact, proper closure of interaction, attentiveness and concern, proper greetings and
      introductions, confidence, and respect.
    • Perform adequate history and physical examinations under direct preceptor observation.
    • Demonstrate competence in common clinical procedures: laboratory, diagnostic and therapeutic.
    • Display knowledge about drugs commonly prescribed for patients.
    • Explain how to prevent, diagnose, treat and manage medical diseases/conditions.
    • Demonstrate appropriate skills in patient care to include assessment and management in the
      context of family and community.
    • Experience out-of–office routines such as hospital rounds, surgical assistance, labor and delivery
      management, hospital staff and committee meetings, house calls and hospital emergency room
    • Demonstrate appropriate techniques and indications in knowledge of uses of OMT.
    • Identify community referral resources and acquire knowledge and skills in appropriately accessing
      community resources for medical care plan and patient care.
    • Describe barriers to patient compliance.
    • Develop an appropriate treatment plan.
    • Design a case management plan.
  7. Professionalism:
    1. Students are expected to exhibit professionalism and behave in an ethical manner which includes but is not limited to:
      • Demonstrating reliability and dependability by arriving prior to the start of schedule or class.
      • If you are unable to attend class you, must contact the Course Contact prior to class.
      • If you are unable to get to your scheduled time, you must contact your Preceptor prior to expected
        arrival time.
      • Make-up work is at the discretion of the Preceptor or Course Coordinator.
      • Preparing for and participating in course activities
      • Students are expected to participate in class discussions based on the reading assignments.
      • Communicating respectfully (Disruptive or disrespectful behavior will not be tolerated.)
      • Engaging in active learning through participation.
      • Assignments must be turned in on time to receive full credit.
      • Students are expected to attend all lectures and 100% of the rotation.
      • Accepting and applying constructive feedback.
      • Demonstrating a desire to exceed expectations.

University policies will be strictly enforced