Oral Medicine 526: General Medicine Winter Quarter, 2008

Goals and Objectives

Clinical Segment of Oral Medicine 526

The clinical segment of the course consists of 2 rotations in the Basic Assessment/ Emergency Clinic. These will take place Tuesday and Friday mornings from 8:00 AM to 9:20 AM.  A schedule is attached below which integrates the Radiology and Clinical Medicine rotations for your convenience.                  

 Objectives

1. To continue to develop clinical skills in patient interviewing and physical examination.
2. To apply knowledge gained in the lecture portion of the course regarding medical conditions and implications for dentistry to evaluation of patients in the Oral Medicine Clinic.

 Clinical Assignment

1.  You will be assigned to work in pairs with each patient.  However, to accommodate the possibility of patient cancellations and "no shows", the clinic schedule will be overbooked with both basic assessment patients and emergency patients.  Eight students will be assigned to each session.  If there are more than four patients who arrive at 8:00 AM, then student pairs will be split up as much as needed to start interviews and examinations of patients.

2. The clinical task for each student, regardless of whether he or she is working in a pair or alone, is to interview the patient and perform a physical examination relevant to the patient's needs.

3. You should gather the information needed to complete a medical history on each patient, whether the patient is presenting for a basic assessment or emergency care.  Use the information to enter data on the medical history summary sheet (pink) in the chart.  Also enter the medical summary information on the blank form provided in the clinic as "Oral Med 526 Clinical Rotation Write-up" " form for this course.

4. If the patient is presenting for emergency care, conduct a problem history as well (using the emergency dental record sheet in the chart, not to be turned in as writeup).

5. Perform a physical examination on each patient.  Include pulpal testing, if indicated, for ER patients.

6. For basic assessment patients, complete the problem list on the last page of the initial assessment forms.  With the help of the attending faculty, determine which radiographs are necessary to complete the examination.  If your patient requires a full mouth survey, he or she is a candidate for your radiology rotation and thereby eligible for a reduced fee for the survey.  It may be possible to obtain a panoramic radiograph at the basic assessment appointment to determine if a full mouth survey is indicated.  You can then schedule the patient for the Oral Med 520 class either with yourself or for a classmate.

7. Once you have interviewed and examined your patient and completed chart documentation, you may leave your patient in the chair.  An upperclassman who is assigned to follow-up on the patient will be seeing your patient at 9:30 AM.

8. Do not make any copies or take any part of the patient's chart with you.  If the medical history is extensive and you wish to have a copy for later reference in completing your write-up, let the ER staff know.  A copy of the medical history summary form (See appendix) of your patient will be made by clinical staff and be available for pick-up later in the day or the following day.  For patient privacy, it is very important that all identifying patient information be blocked out (e.g. name, address, previous doctors, signatures, etc.) on copies that leave the clinic.

9. For your write-up, please complete the sections concerning dental care implications using any of the course resources available to you (eg, textbook, syllabus, drug references, lecture material).  It is likely your patient will have a condition or medication which has not been covered yet in a lecture.  Don't let that be an obstacle, use your resources to get the information you need (this is good training for the rest of your professional career).

10. Turn in completed medical history summary forms within two weeks after completion of each clinical session into a designated box located in the ER clinic (in the instrument preparation area to the right of the entrance into the clinic).  Late forms will lose points (5% per day of clinical segment grade).

 General Clinical Protocol

1. Arrive on time at 8:00 am
2. Bring and use protective gear (safety glasses, mask, gloves, clinic gown)
3. Maintain a professional demeanor.  In most cases, you will be the first contact patients have with dental students.
4. Dress appropriately in clean clothing in good condition.  No open toed shoes or sandals are allowed.  Long hair should be tied back.
5. Make sure chart documentation is neat and accurate.  Black or blue pen must be used for chart entries.  Please remember that chart entries and forms are medico-legal documents.

Attendance

If you have a conflict in your schedule and wish to trade with another classmate, please let us know at least one week in advance of the date.  Let us know who you will be trading with.  These requests should be emailed to Paula Petzold at petzold@u.washington.edu.  

Questions?  Problems? with clinical portion of the course: Please contact Dr. Beatrice Gandara at 206-616-6010 or email at bgandara@u.washington.edu.

Clinical Segment Grading: 10 % of Final Grade

1.       Ten percent of your grade in the whole course will be earned for attendance at the two clinical sessions and turning in completed health history forms on time.

2.       If your patient has very few or no medical problems, you will be assigned a medical disorder to address as an adjunct to your patient's summary.

3.       If you miss your assigned clinic session without a valid excused absence (illness or family emergency registered with Student Affairs Office), you will lose 50% of your clinical segment grade (5 % of your overall grade) and you will be required to make up the missed clinic session in order to complete the course.

4.       Late arrivals to clinic will result in a 10% reduction in your clinical segment grade for every 10 minutes you are late (1 % of your overall grade).