Elective Capstone Rotation
Continuity in Family Medicine:
Longitudinal Integrated Clerkship
Academic Year: 2024-2025
Course Name: OCOM 8202
Instructors of Record: Sharon Casapulla, EdD, MPH
Scott Rogers, MD
Credit Hour: 2 credits
Rotation Length: 1 week
Instructors of Record Contact Information:
casapull@ohio.edu
and srogers@ohio.edu
Course Description:
The Continuity in Family Medicine: Longitudinal Integrated Clerkship program runs the length
of the third year of medical school and is only available by special permission. The student
is situated within a rural or urban underserved family medicine practice to ensure they are
exposed to the continuity of primary care across the continuum of the inpatient and
outpatient settings. It exposes the student to the breadth of family medicine including
medical care of all ages, as well as enhances the student's ability to provide continuity in
care. This rotation also exposes the student to the collaboration of health care entities in
the community, practice, management, practice quality improvement, and possibly
research. It also provides exposure to the role of the physician on the care team, including working with nurse practitioners, physician assistants, medical assistants, nurses, and other health professionals in and outside of the clinic setting. Overall, the goal of this rotation is to allow the student to develop rural/urban primary health care training by developing a continuity practice of their own under the direction of their supervisory site director. With this knowledge and experience, a better understanding of the scope of rural/urban underserved primary health care is achieved.
Course Outcomes
1. The student will be able to care for ambulatory patients along with the site preceptor.
2. The student will be able to adapt and provide alternative care options based on
resource availability.
3. The student will develop continuity relationships with a subset of practice patients which have been followed.
4. The student will be able to show improvement in their history taking, note production,
and development of their differential diagnosis abilities.
5. The student will be able to show improved skills using electronic health recordEHR, documentation of encounters and developing coding practice with each encounter.
6. The student will be able to demonstrate their understanding of the practice's business
model.
7. The student will be able to articulate the value of quality improvement in the family medicine setting.
8. The student will be able to reflect on community health priorities and gain awarenes of local community resources that intersect with the family medicine office.
Course Schedule and Materials
Please visit eMedley to find your coursework materials on the first day of course.
Optional ReadingResources relevant to longitudinal integrated clerkships:
Hirsh DA, Ogur B, Thibault GE, Cox M. “Continuity” as an Organizing Principle for Clinical Education Reform. NEJM 2007; 356;8:858-866.
Rural longitudinal integrated clerkships: changing interests and demographics of medical students. Can J Rural Med 2015;20:83-91. https://www.srpc.ca/PDF/cjrm/vol20n3/pg83.pdf
Latessa R, Schmitt A, Beaty N, Buie S, Ray L. Preceptor teaching tips in longitudinal clerkships. The Clinical Teacher 2015; 12: 1–6. http://onlinelibrary.wiley.com/doi/10.1111/tct.12416/epdf
Optional Readings relevant to the concept of continuity in patient care:
Stewart M. Continuity, Care, and Commitment: The Course of Patient-Clinician Relationships. Ann Fam Med 2004;2:388-390.
An editorial associated with a theme issue of the Annals of Family Medicine, September/October 2004: http://www.annfammed.org/content/2/5.toc
Stokes T et al. Continuity of Care: Is the Personal Doctor Still Important? A Survey of General Practitioners and Family Physicians in England and Wales, the United States, and the Netherlands. Ann Fam Med 2005;3:353-359. http://www.annfammed.org/content/3/4/353.full
Saultz J, Lochner J. Interpersonal Continuity of Care and Care Outcomes: A Critical Review. Ann Fam Med 2005;3:159-166. http://www.annfammed.org/content/3/2/159.full
Andres C, Cook L, Spenceley S, Wedel R, Gelber T. Improving primary care: Continuity is about relationships. Can Fam Physician 2016;62:116-9. http://www.cfp.ca/content/62/2/116.full.pdf+html
Weir SS, Page C, Newton WP. Continuity and Access in an Academic Family Medicine Center. Fam Med 2016;48(2):100-7. http://www.stfm.org/Portals/49/Documents/FMPDF/FamilyMedicineVol48Issue2Weir100.pdf
Tandeter HB, Vinson DC. Transcient Discontinuity of Care: Others Seeing What We Have Missed.Howard B. Journal of Family Practice 1998;47:423.
Student Performance Standards
Satisfactory completion of the following activities is required for the student to receive academic credit for this course:
1. Summary reflection 25%
2. Quality Improvement or Community Engagement project 25%3. Summary evaluation from the supervising preceptor 40%
4. Participation (including attendance at cohort meetings) 10%
Attendance and Absence Policy and Procedures
Years 3 and 4 (Clinical) Absence Policy (note: Personal Days do not apply to Clinical Year Students)
1. Excused Absence - Single-Day Rotation Course: Preceptor-approved excused absences from clinical rotations are permitted for emergencies only when the absence will not jeopardize the student's ability to meet the minimum duty hours of 32+ hours per week in the same 7-day period (Monday – Sunday). a. In rare instances when a student needs to miss a single day of a rotation course for a Residency Interview in Year 4 and cannot meet the minimum hours of duty later in the same 7-day period, students may request an exception from Clinical Education through their Academic Program Administrator (APA).
2. Excused Absence - Extended Rotation Course: Preceptor-approved excused absences from clinical rotations are permitted for emergencies only when the absence will not jeopardize the student's ability to meet the total minimum duty hours for the rotation (32 hours per week x the # of weeks of the rotation).
3. Excused Absence - Didactic: Excused absences from required didactic events may be requested if they will not jeopardize the student's ability to make up the missed didactic work within the rotation start and end dates.
4. Excused Absence – Assessments (COMAT, OSCE, GME Readiness): Excused absence requests should only be made for emergencies (external documentation, such as a doctor’s note would be required). Note: Excused absence from a Required Rotation COMAT applies only when the student receives prior approval to take a Required Rotation COMAT up to three days earlier than the scheduled date. Any concerns about COMAT dates should be addressed to the student's APA.
5.Note Regarding Holidays during Years 3 and 4: Preceptors typically expect clinical year students to work on holidays. The student is responsible for collaborating with their individual preceptor/rotation course site regarding the preceptor's holiday schedule. If a preceptor works on a holiday, the student must also work unless the preceptor approves otherwise. The student must ensure they meet their minimum duty hours for the week if their preceptor excuses them from work on a holiday. Heritage College advises students that asking to be released from clinical service on a holiday is not in their best interest. The clinical education site is the arbitrator for any questions, concerns, or disputes related to Holiday work in Years 3 and 4. The Director of Clinical Education Operations will intervene with problems or difficulties resulting from noncompliance with Holiday work protocols.
Dress Code
The dress code can be found at https://www.ohio.edu/medicine/
Inclusion and Accessibility
Ohio University is committed to supporting the inclusion of diverse people and populations within and beyond our campus community. It is crucial that we commit to learning from one another in our classroom and provide an environment where if something is occurring that prevents us from being able to succeed, please talk about so it may be addressed. Discrimination has a negative impact on one’s learning, and our hope is that we can create a classroom environment in which all are able to learn and succeed. To report an issue please use this tool: Bias Reporting Tool .
Any student who feels they may need an accommodation based on the impact of a disability should contact me privately to discuss your specific needs and provide written documentation from Accessibility Services. If you are not yet registered as a student with a disability, please contact Accessibility Services at 740-593-2620 or visit the office in Alden Library, Suite 230 or via https://www.ohio.edu/accessibility . This office makes the decision as to whether there is a disability based on the professional documentation provided. Once the Office of Medical Education has received notice of approved accommodation from the Student Accessibility Office, they will reach out to the student to collaboratively determine whether the accommodation(s) can be made in the curriculum and how they will be implemented. Educational software may not be accessible to individuals with disabilities and some students may experience barriers accessing or utilizing some of our technologies. If you experience any difficulties, or if you require an alternative method, please contact phwc@ohio.edu . Please allow up to 48 business hours for us to respond.
Wellbeing Resources
As students and professionals, we are fully aware that you have more going on in your life than this course. If there is ever something that is happening outside (or inside) our classroom that is impacting your ability to learn to your full potential, we urge you to reach out to one of these resources .
Expectations of Professional Behavior
OHIO Code of Conduct
Heritage College Code of Professional Standards
Heritage College Code of Professional Standards
Student Responsibility
Critical information concerning course requirements, grading, scheduling, and testing is often communicated via e-mail and eMedley course feed. It is every student’s responsibility to check their e-mail regularly. Students are held responsible for obligations communicated via these systems.
Use of Electronic Devices
We welcome the use of electronic devices for class purposes (i.e., note taking, online academic resources); however, we expect that students who bring electronic devices to class or clinical experiences will use them for academic purposes only. The use of electronic devices for non-academic activities during classroom or clinical experiences, such as listening to music, surfing the internet, updating social networking pages, or engaging in any other extracurricular activities, is disruptive to fellow students and disrespectful to faculty, and therefore constitutes unprofessional behavior.
Remote Learning Standards
Students are expected to meet the same professional standards for attendance and engagement in remote -learning as they are for in-person sessions. These standards serve to enhance the student’s individual experience as well as protect the experience of student and faculty colleagues. Attendance and active participation in all elements of team leaning are assessed in peer and coach evaluations.
Sexual Misconduct and Mandatory Reporting
In addition to participation/attendance/absence policies already listed, students/you may be absent for up to three (3) days each academic semester, without penalty, to take time off for reasons of faith or religious or spiritual belief system or to participate in organized activities conducted under the auspices of a religious denomination, church, or other religious or spiritual organization. Students/You are required to notify the instructor/me in writing of specific dates requested for alternative accommodations no later than fourteen (14) days after the first day of instruction. These requests will remain confidential. For more information about this policy, students/you may contact the Director and Title IX Coordinator, Equity and Civil Rights Compliance, Lindley Hall, 006, 740-593-9140, Equity@ohio.edu .
Health Insurance Portability and Accountability Act (HIPAA)
Since actual medical information may be exchanged and actual physical finding may be evident during a simulated/standardized patient encounter and/or in a clinical setting, all patient information must be held in confidence. This does not, however, preclude the discussion of case findings in the classroom or learning environment.
Intellectual Property
The lectures, classroom activities, and all materials associated with this course and developed by the instructors are copyrighted in the name of the faculty who teaching as part of this course.