Field Observation Program

Transcription

1 STUDENT HANDBOOK Field Observation Program CLTR

2 Introduction The purpose of the Field Observation Program is to provide students with the opportunity to observe established health care practitioners in their private clinical practice. Field Observation hours are completed during the first two years of the Doctor of Naturopathic Medicine Program of Study. The Field Observation Program allows students to gain early clinical experience prior to starting their Clinical Clerkships during their third and fourth years. Educational Activities The educational activities of the Field Observation Program are to: Observe a variety of doctor-patient communication styles Observe diverse practice styles Observe a variety of therapeutic modalities Observe a variety of practice management techniques Observe the appearance of varied clinical pathologies Recognize skills/strategies for developing patient rapport, increasing patient compliance, and encouraging return visits Gain an understanding of how a physician handles difficult patient encounters Develop an understanding of therapeutic interventions prescribed by the physician Develop an understanding of business strategies for creating a successful practice Observe front office procedures including patient services Complete a reflective journal as a future naturopathic physician Eligibility Requirements Students must meet the following requirements to be eligible to earn Field Observation credits: Successfully complete the first three quarters of the Doctor of Naturopathic Medicine Program of Study at SCNM. Apply for and receive a Clinical Training Certificate from the State of Arizona Naturopathic Physicians Medical Board. The application process for the CTC occurs in Quarter 1, CLPR The instructor for CLPR 5010 will assist the student in this process. (Note: The Clinical Training Certificate must be renewed annually for the duration of a student s clinical training. Only students with current Clinical Training Certificates are allowed to participate in clinical training.) Attend mandatory Field Observation Program initial orientation and final review sessions 1

3 Field Observation Requirements All students are required to complete: 44 contact hours (4.0 credits) of Field Observation 40 documented patient contacts Field Observation hours must be completed in one quarter. Student may register for Field Observation any quarter between Quarter 4 and Quarter 8. Definition of Patient Contacts There are 3 types of patient contacts. Students may document patient contacts in any or all of the types. Examples of patient contacts for each type are listed below: 1) Direct Patient Contact Taking vitals Directly observing Field Observation Physician/patient interaction Observing a procedure in the lab, or an exam (e.g., IV therapy or physical manipulation) Students may NOT participate in any IV or acupuncture treatment. 2) Indirect Patient Contact Studying a case for an extended period of time Performing research related to a patient as requested by the Field Observation Physician (e.g., therapeutic diagnostics) Observing the Field Observation Physician prepare a treatment protocol (e.g., a botanical or homeopathic remedy) 3) Patient Services/Practice Management Calling a patient for an appointment Calling a patient with a lab result Observing or participating in a patient check-in/check-out procedure Observing the insurance procedure for a patient All Field Observation hours must be completed with a Naturopathic Doctor (ND), Medical Doctor (MD), Osteopathic Doctor (DO), or Doctor of Chiropractic (DC) who is practicing in a licensed state. 2

4 Note: All Field Observation hours must be completed prior to beginning the Clinical Clerkships in the third year of the academic program. Registration Process Students are registered for Field Observation credit hours through the Registrar s Office. The Field Observation Assistant and Coordinator are responsible for assigning students to specific Field Observation rotation sites. ND Students must be scheduled with Field Observation Physicians by the Field Observation Assistant or Coordinator to receive credit for CLTR Professional and Ethical Expectations of N.D. Students 1) General Expectations Certain codes of behavior and ethics are expected and enforced in the training of health care professionals. The student s behavior and demeanor must conform to the Field Observation Physician s needs and preferences. It is the student s responsibility to meet those needs and preferences. Students are covered by SCNM s professional malpractice liability insurance for Field Observation only. This means that students are only allowed to observe and may NOT participate in the examination, diagnosis or treatment of the patient. Students may NOT participate in any IV or acupuncture treatment. However, students may perform vitals, at the discretion of the Field Observation Physician. Students are not to give advice, comment on treatment protocol, or offer unsolicited suggestions to patients or physicians. Students should refrain from asking questions in the presence of a patient. Questions may be asked respectfully at a time when the student is alone with the physician. Students should refrain from taking notes in the presence of patients unless permission is granted by the Field Observation Physician in advance. SCNM should be checked daily. If for any reason you can no longer access this , please contact IT promptly. 2) Attendance and Punctuality Students are expected to arrive at the Field Observation site on time for their scheduled observation. In case of absence due to an illness or emergency, the student must notify the physician s office AND the Field Observation Assistant or Coordinator as soon as possible. Any absence due to an illness requires a physician s note of explanation and must be discussed with the Field Observation Assistant or Coordinator. In communications to both the Field Observation Physician and the Field Observation Assistant or Coordinator please include: 3

5 a. The date of your absence b. The time you are scheduled to attend and will be absent c. Reference to evidence (e.g., a note from a physician) d. Your anticipated return date The Field Observation Assistant or Coordinator should receive both an AND phone call detailing the reason for the absence. If a student fails to notify the Field Observation Physician AND the Field Observation Assistant or Coordinator, the absence will be considered unexcused and may result in a failing grade for the Field Observation Program. 3) Professional Dress Code While on a Field Observation rotation, students should observe the same dress code delineated in the Clinical Handbook for all SCNM Clinical Clerkships. Professional dress is described as a reserved, dignified, polished appearance. Students should avoid flashy or inappropriate dress in order to promote a professional environment. Photo IDs are to be worn on the first day of observation and at the discretion of the Field Observation Physician thereafter. Men must wear ties or bolos with a dress shirt, long pants, belt, shoes, and socks. Beards must be well groomed and neat, and long hair must be tied back. Closed-toe shoes are required per OSHA regulations. Women must ensure that necklines are not too low and hemlines are not higher than three inches above the knee. Midsections must be covered. Undergarments must be worn. Jewelry must be minimal to avoid hindering treatment. Long hair must be tied back. Closed-toe shoes are required per OSHA regulations. Scents and perfumes are not allowed because of environmentally sensitive and asthmatic patients. Personal hygiene must be appropriate for close contact (i.e. deodorant must be used, nails must be short and clean). Unnatural hair colors such as orange, blue, purple, green, etc. are not to be worn. All body piercings, except for no more than two pairs of small earrings, should be removed. Tattoos should be appropriately concealed. No denim, shorts, tight clothing, spandex, leggings, tee-shirts, crop tops (midriff or half shirts), spaghetti straps, gaping sleeveless shirts or sleeveless dresses that reveal undergarments, are to be worn at the clinical site. Students with gross inadequacies in appearance may be directed by the Field Observation Physician, the physician s management staff, or the Field Observation Assistant or Coordinator to correct these immediately, and the student will not be permitted to be present at a Field Observation site until they do so. 4

6 Students missing a Field Observation experience due to appearance will be sent home and will not receive Field Observation hours for the time missed. The absence will be considered unexcused, the student will be required to make up an additional 8 hours of Field Observation time, and the student may also be subject to a failing grade for the Field Observation Program. Note: Dress Code standards must be upheld at all Field Observation sites. 4) Professional Code of Behavior: Patients, peers, physicians, residents and staff are to be treated in a professional and courteous manner. All physicians must be addressed as doctor and their last name in front of patients. If granted permission to address a patient, students should ask whether the patient prefers to be addressed on a first or last name basis. Students are expected to comply with OSHA regulations. Students are expected to comply with HIPAA regulations. Students are expected to ask permission before entering areas of the Field Observation site (e.g., behind the front desk, charting room, lab area, or dispensary room). Students are not to remain at any clinical training site after being excused by the Field Observation Physician, or when they have completed their observation hours. Unprofessional conduct will result in any or all of the following: Failing grade in the Field Observation Program. Remediation through Clinical Skills Development Session (CSDS). Disciplinary action, up to, and including dismissal from the Doctor of Naturopathic Medicine Program. 5) Substance Abuse Policy Students are required to adhere to the Substance Abuse Policy outlined in the course catalog. All students must complete and pass a mandatory drug test prior to any clinical training and are subjected to random testing throughout their clinical training. 6) Code of Conduct Violations SCNM is required by law to report unprofessional student conduct that occurs during clinical training to the State of Arizona Naturopathic Physicians Medical Board. Any reported individual is subject to disciplinary sanctions from the board, up to and including, revocation of the student s Clinical Training Certificate. Students are subject to disciplinary action for the following reasons, but not limited to: 5

7 Acting without permission from the attending physician on issues of patient care. Unsatisfactory clinical evaluations. Unprofessional conduct as defined by the Arizona Revised Statutes and/or in the SCNM College Catalog and/or as stated below: Sexual misconduct Inappropriate remarks Inappropriate or inadequate patient draping Breaking patient confidentiality Violations of Health Insurance Portability and Accountability Act (HIPAA) Violations of Occupational Safety Health Act (OSHA) Practicing medicine without a license 7) Practicing Medicine without a license In the State of Arizona, practicing naturopathic medicine without a license involves the diagnosis or treatment of any patient by an unsupervised naturopathic medical student or any other unlicensed person where money may or may not be exchanged. SCNM graduates are not allowed to use the title Naturopathic Physician or Doctor until they have been granted a license to practice naturopathic medicine by the State of Arizona. Naturopathic medical students are held to a higher standard than the general population. It is understood that naturopathic medical students must practice skills in order to become minimally competent for graduation. The practice of skills such as history taking or homeopathic case taking, are less concerning than the practice of skills such as digital rectal exams, gynecologic examinations, minor surgery, injections, manipulative therapies, and IVs. The difference lies within the relative risk to the public. For example, there is higher risk to the public with the practice of an IV as compared with the risk to the public with the practice of taking a history. Additionally, the quality of the educational experience is of the utmost importance. In general, supervision of skills enhances the quality of the learning experience. 8) Definitions: ARS "Direct supervision" means that a physician who is licensed pursuant to this chapter or chapter 13, 17 or 29 of this title: a) Is physically present and within sight or sound of the person supervised and is available for consultation regarding procedures that the physician has authorized and for which the physician remains responsible. b) Has designated a person licensed pursuant to this chapter or chapter 13, 17 or 29 of this title to provide direct supervision in the physician's absence. 23. "Naturopathic medical student" is a person who is enrolled in a course of study at an approved school of naturopathic medicine. 6

8 24. "Naturopathic medicine" is medicine as taught in approved schools of naturopathic medicine and in clinical, internship, preceptorship and postdoctoral training programs approved by the board and practiced by a recipient of a degree of doctor of naturopathic medicine licensed pursuant to this chapter. 27. "Practice of naturopathic medicine" is a medical system of diagnosing and treating diseases, injuries, ailments, infirmities and other conditions of the human mind and body including by natural means, drugless methods, drugs, nonsurgical methods, devices, physical, electrical, hygienic and sanitary measures and all forms of physical agents and modalities. 7

9 Field Observation Program Forms Form FO ND Student Acknowledgement and Agreement To be read and signed by ND Student A signed copy of this form will be kept in the Field Observation Coordinator s office. Form FO ND Student Time Sheet for Field Observation Hours To be filled out by ND Student and initialed by the Field Observation Physician Documents the student s Field Observation hours and patient contacts Authenticated by the Field Observation Physician s initials and the signature of the Field Observation Assistant or Coordinator One form for each site is required. Form FO ND Student Field Observation Site Evaluation To be filled out by ND Student Documents the ND Student s evaluation of the Field Observation experience One form for each site is required. Form FO ND Student Self-Evaluation To be filled out by ND Student Documents the ND Student s personal experience One form for each site is required. Form FO Field Observation Physician Evaluation of Student To be filled out by the Field Observation Physician Documents the Field Observation Physician s experience with the ND Student One form for each site is required. Journal Requirements Typed, double spaced, 11pt Tahoma font, with the ND Student s name on every page Minimum of two pages of journal writing documenting the ND Student s self-reflections as a future naturopathic physician Journal should address the requirements detailed below: 1) Critical analysis of the practice (e.g. strengths and challenges of the practice) 2) Description of the physical site and office 3) ND Student s perspective regarding business strategies observed 8

10 4) Description of the therapeutic modalities observed 5) Description of types of patient encounters (e.g., pediatrics, geriatrics, women s medicine, family practice) and the appearance of varied clinical pathologies 6) Aspects of the observed physician s practice that the ND Student would want to integrate into their future practice 7) List of ways in which technology and social media could be used and incorporated into ND Student s future practice These requirements must be printed with the journal, and reflections should be in an annotated bullet format. A sample is provided in each packet. One journal is required for each site. Grading Criteria for Field Observation Hours In order to earn credit for the Field Observation Program, a student must complete all of the following: 1) 44 hours of Field Observation with an approved Field Observation Physician 2) Document 40 patient contacts 3) Comply with the Professional and Ethical expectations 4) Comply with the Attendance Policy 5) Complete all required forms Clinical Grading System Satisfactory = Pass/Credit Earned Unsatisfactory= Fail/No Credit Earned Failing the Field Observation Program A failing grade of unsatisfactory, U, can seriously affect a student s academic progress. Upon receiving a failing grade for the Field Observation Program, the student is required to attend one of the Clinical Skills Development Sessions (CSDS) for remediation. The entire Field Observation Program must then be repeated and may be repeated one time only. If a second U is received for the repeated program, the student may be academically dismissed from the Doctor of Naturopathic Medicine Program. 9

11 Form FO ND Student Acknowledgement and Agreement The Field Observation Student Handbook of the Southwest College of Naturopathic Medicine (SCNM) is published to provide students with information about the Field Observation Program. The SCNM Student Handbook does not constitute a contract. SCNM reserves the right to make changes in the terms, conditions, regulations, rules and policies set forth in this publication at any time and without notice; however, SCNM will try to communicate those changes with reasonable notice to all interested parties. Students are responsible for understanding and complying with all policies and procedures contained in the Student Handbook and in other publications distributed by SCNM. This handbook ( CLTR ) supersedes all previous editions. By signing this form I acknowledge that I have received a copy of the Field Observation Program Student Handbook and that I am responsible for reading and understanding all the information contained within this handbook. ND Student Name (Please Print): Signature: Date: (A signed copy of this Acknowledgment and Agreement form is kept in the Field Observation Coordinator s office.) 10

12 ND Student Checklist for Completion of Field Observation - CLTR Please check-off each item when completed and return this form with all the required documentation to the Field Observation Assistant or Coordinator. A. Required Field Observation Hours 44 contact hours of Field Observation (documented) 40 patient contacts (documented) B. Acknowledgement and Agreement Form FO To be signed and turned in on the first day of CLTR C. Required Field Observation Program Forms. A complete packet must be completed for each site and includes: Form FO Form FO Form FO Form FO Journal ND Student Time sheet for Field Observation Hours ND Student Field Observation Site Evaluation ND Student Self Evaluation Physician Evaluation of ND Student (See Student Handbook and sample provided for requirements.) ND Student Name (Please Print): Signature: Date: 11

13 Signature: Date: 12

14 Form FO ND Student Time Sheet for Field Observation Hours One form for each site is required. ND Student Name: Field Observation Physician Name: Date In Out Total Hours Patient Contacts Physician s Initials TOTAL : Physician or Office Administrator Signature: FO Assistant/Coordinator Signature: Date: 13

15 Form FO ND Student Field Observation Site Evaluation One form for each site is required. 1) How well did the Field Observation Physician: Excellent Above Average Average Below Average Poor N/A Provide mentoring to you as a student N/A Explain medical procedures N/A Maintain patient rapport and support N/A Manage time with each patient N/A Integrate ND philosophy into practice N/A Please describe your experience at the Field Observation Site by answering the following questions. Circle the most appropriate answer and add your comments after each question. 2) How well did the experience meet your learning expectations? All of my expectations were met and even exceeded. 5 Most of my expectations were met on many levels. 4 Most of my expectations were met on a basic level. 3 Some of my expectations were met on a basic level. 2 My expectations were not met. 1 Must describe specifics below to receive full credit: 14

16 3) How well were you able to observe a variety of doctor-patient communication styles? Communication was adapted to each patient and physician demonstrated genuine empathy for each patient s needs. 5 More than adequate variation in communication styles that kept patient engaged. 4 Adequate variation in communication styles and patients seemed satisfied with care. 3 Some variation in communication styles. 2 No variation at all. 1 Must describe specifics below to receive full credit: 15

17 4) How well were you able to observe diverse practice styles? I consistently observed many diverse practice styles with several different patients throughout each day. 5 There was diversity with several patients but not consistently. 4 There was occasional diversity with patients. 3 There was diversity with one or two patients. 2 There was no diversity. 1 Must describe specifics below to receive full credit: 16

18 5) How well were you able to observe a variety of therapeutic modalities? I observed at least 5 or more different therapeutic modalities each day I observed. 5 I observed at least 3 different therapeutic modalities each day I observed. 4 I observed at least three different therapeutic modalities on one given day. 3 I observed at least two different therapeutic modalities. 2 I only observed one therapeutic modality. 1 Must describe specifics below to receive full credit: 17

19 6) How well were you able to observe a variety of practice management techniques? I was able to observe, participate and ask questions regularly, and the management staff frequently included me in their routines. 5 I was able to observe, participate, and ask questions on occasion. 4 I was able to observe and ask questions when the management staff was available. 3 I was able to observe quietly from afar. 2 I did not have access to practice management techniques. 1 Must describe specifics below to receive full credit: 18

20 7) How well were you able to recognize skills and strategies for developing patient rapport, increasing patient compliance, and encouraging return visits? You may have more than one answer for this question. I was able to observe skills for encouraging patient return visits. 5 I was able to recognize skills and strategies for developing patient rapport. 4 I was able to observe skills for increasing patient compliance. 3 I was not able to recognize any strategies for developing patient rapport or encouraging return visits. I was not able to recognize any skills or strategies that I felt would increase patient compliance. 2 1 Must describe specifics below to receive full credit: 19

21 8) How well did you gain an understanding of how a physician handles challenging/difficult patient encounters? I gained a great deal of understanding of how a physician handles difficult patient encounters because the physician embodied professionalism in each aspect of the clinical encounter. I observed how a physician handles a difficult patient encounter and felt I could apply that experience and understanding to my own practice. 5 4 I observed a difficult patient encounter, but the physician did not handle the situation well. 3 I observed difficult patient encounters but felt destabilized by the situation. 2 I did not observe any difficult patient encounters. 1 Must describe specifics below to receive full credit: 20

22 9) How well were you able to develop an understanding of therapeutic interventions prescribed by the physician? I understood most of the therapeutic interventions and why they were prescribed. When I did not understand, the physician took time to explain the intervention to me. I understood most of the therapeutic interventions prescribed by the physician and I was able to understand why they were prescribed. I understood many of the therapeutic interventions prescribed by the physician but was not clear why those interventions were prescribed I understood only a few of the therapeutic interventions prescribed by the physician. 2 I did not understand any of the therapeutic interventions prescribed by the physician. 1 Must describe specifics below to receive full credit: 21

23 10) How well were you able to observe and understand business strategies for creating a successful practice? I observed and understood all of the business strategies used and felt inspired and excited to use some of these tools in my own future practice. I observed and understood all of the business strategies that were available to me, but felt they were out of my reach. I observed and understood some business strategies used but could not imagine using them in my own practice I observed some business strategies but did not understand the relevance of any of them. 2 I did not observe any business strategies. 1 Must describe specifics below to receive full credit: 22

24 11) Would you recommend this Field Observation Site Physician to other students? I would strongly urge other students to experience this Field Observation Site. It had a very positive impact on me as a student. 5 Yes, this Field Observation Site would be beneficial to other students. 4 Yes, I would recommend this Field Observation Site, but with some reservations. 3 I would not recommend this Field Observation Site. 2 I would strongly discourage other students from this site. 1 Must describe specifics below to receive full credit: 23

25 Other comments or observations? Total number of hours at this site: Total patient contacts at this site: ND Student Signature: Date: FO Assistant/Coordinator Signature: 24

26 Form FO ND Student Self Evaluation One form for each site is required. ND Student Name: Name of Field Observation Physician Title/ Degree Name of Clinic: Address: Street City State Zip code Dates completed at Field Observation Site: From: To: 1) In your opinion, were you in compliance with the professional dress code described in the Student Handbook? If not, please explain. 25

27 2) In your opinion, how professional was your demeanor on your first day at the site. Please explain. 3) What aspects of being in a physician s office did you find challenging? What aspects were easy? Please explain both: 4) How do you feel you related with the physician at the field observation site? Please explain. 5) How do you feel you related with the office staff at the field observation site? Please explain. 26

28 6) How do you feel you related with the patients at the field observation site? Please explain. 7) Describe a few ways you could improve your experience at a field observation site. Other comments. 27

29 Form FO Field Observation Site Physician Evaluation of Student (To be filled out by physician) ND Student Name (Please print): Please evaluate the professional performance and ethical behavior of the ND Student based on the following scale: 4 Excellent 3 Adequate/ Competent 2 Needs Improvement 1 N/A Professional appearance Professional behavior Attitude toward learning process Ability to communicate with physician Ability to communicate with staff Ability to communicate with patient General comments about and recommendations to student: Physician Name (Please print): Physician Signature: Date: Please complete and return this form in a sealed envelope provided by the student, or fax or to the Field Observation Assistant or Coordinator. Crystal Lopez Field Observation Assistant Southwest College of Naturopathic Medicine 2140 E. Broadway Rd. Tempe, AZ O: F: E: c.lopez@scnm.edu Deborah L. Turner Offsite Program Manager Southwest College of Naturopathic Medicine 2140 E. Broadway Rd. Tempe, AZ O: F: E: d.turner@scnm.edu 28

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