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Clerkship Bootcamp Wednesday April 23, 2014

Clerkship Bootcamp Wednesday April 23, 2014. Welcome Package. Clerkship Bootcamp Schedule. 6:00pm – 6:20pm ( Amph E): Orientation and pre-test 6:20pm – 7:20pm (CBL rooms): Small group tutorial 7:20pm – 8:20pm (CBL rooms): Focused history/physical exam with SP

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Clerkship Bootcamp Wednesday April 23, 2014

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  1. Clerkship BootcampWednesday April 23, 2014 Welcome Package

  2. Clerkship Bootcamp Schedule • 6:00pm – 6:20pm (Amph E): Orientation and pre-test • 6:20pm – 7:20pm (CBL rooms): Small group tutorial • 7:20pm – 8:20pm (CBL rooms): Focused history/physical exam with SP • 8:20pm – 8:40pm (CBL rooms): Write progress note • 8:40pm – 9:30pm (CBL rooms): Practice handover • 9:30pm – 10:00pm (Amph E): Debrief, post-test, Q&A This powerpoint will cover the basic structure of progress notes and handover so that you’ll be prepared to practice these skills at Bootcamp.

  3. Daily Progress Note • Use the SOAP format • ID: 70 yo F with melena • Subjective: This section is where you record information gathered on history (e.g., is the patient’s pain control adequate?) • Objective: Physical exam findings and investigations • Assessment: A summary of what you think is going on. This section can be issue-based in patients with several ongoing problems. • Plan: A list of action items based on your assessment.

  4. Progress Note Pearls • People actually read what you write. Nurses, residents from services your team has consulted, and other members of your team when on call use progress notes to quickly get to know a patient. • People usually only read your assessment and plan. • It is common practice to have one section for both assessment and plan. However, this can easily degenerate into a list of tasks without any thoughtful assessment. Therefore, it is helpful to separate the two sections to force yourself to think about and summarize the patient’s condition.

  5. Patient Handover • Use the SBAR format • Situation: Identify the patient. Describe active issues. • Background: Reason for admission, course in hospital, relevant PMHx and investigations. This section can be less detailed if handing over to someone already familiar with the patient. • Assessment: What you think is the underlying reason for the patient’s active issues, how sick the patient is. • Recommendation: Tasks that are in progress and need follow up, next steps, contingency plans.

  6. Handover Pearls • Take some time to think about what you’re going to say. • Keep it short and to the point.

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