FINAL ND Module 09-10.pdf - AaronsWorld.com

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PATIENT INTERVIEW GUIDELINES PRIMARY CLINICIAN The primary student needs to direct the interview. While it is important to hear the patient’s story, it is inefficient to let the patient run the interview. If a patient is not answering your questions, politely redirect them. This may mean that you do this several times during an interview. Remember that FOCs should actually take no more than 75 minutes and ROCs should take only 45 minutes. The interview portion of an FOC should generally be no longer than 30 minutes and for ROCs no more than 10-15 minutes. This leaves time to perform PE, formulate your diagnosis and treatment plan, discuss the treatment plan with your supervisor and to present it to the patient. Time management is one of the most important tools for managing a successful practice. It may not be possible to obtain all of the patient information in one visit. If the patient has a complicated history, let them know that another visit may be required in order to complete all the information. Their main complaint or urgent problems must be addressed in the first visit. Never discuss any treatment with a patient during the interview without consulting the supervising clinical faculty member. To do so is to practice medicine without a license and infraction of this policy is taken seriously as a matter of public safety and respect for the supervisor’s ability to practice medicine. Students who violate this policy are subject to sanctions. Repeated violation of this policy will result in failure of the shift and consideration for expulsion by the Academic Progress Committee. SECONDARY ND CLINICIAN The role of the secondary clinician during the interview is to support and learn from the primary clinician. You may ask questions when it is appropriate and help to fill in gaps that may have been overlooked by the primary. The expectation is that the secondary clinician assists the primary in maintaining the interview without disrupting the flow of the interview. It is also a secondary responsibility to help keep the interview on track. Remember that an FOC lasts 75 minutes and an ROC is no longer than 45 minutes. This means that the interview portion of an FOC should last no longer than 30 minutes and in an ROC no more than 10-15 minutes. Assist the primary in leaving time to perform PE, formulate a diagnosis and treatment plan, discuss the treatment plan with the supervisor and present the plan to the patient. Never discuss any treatment with a patient during the interview without consulting the primary and supervising faculty member. See the section above regarding sanctions. Secondary clinicians are responsible for completion of the patients’ paperwork. This includes the superbill, treatment plan and dispensary sheet. Please obtain blank copies of these forms before the shift so they are available. Each should be filled out completely and accurately. Treatment plans must be legible, with the provider’s full name. It must include a rationale for each treatment recommended to maximize patient compliance. You may request assistance in completing paperwork from other team members in order to maximize time management for the visit. MEDICAL RECORD KEEPING RESPONSIBILITIES - PRIMARY CLINICIANS Primary student clinicians are responsible for ensuring that all medical records are completed in accordance with clinic policy and that all forms are filed properly in the chart when generated. All corresponding recording must be completed by the primary student clinician within 1 hour and should be signed by the supervising physician within 2 hours after each patient shift. The supervisor will notify the student by note or email of any charting deficits. The supervisor will discuss the issues and assist the primary clinician with necessary information to ensure immediate correction. Clinicians who fail to correct such deficits in charting practices will be warned in writing of the deadline for the expected changes. If the chart is not corrected within that time, the student is eligible to receive a clinic sanction. 28
SCOPE OF PRACTICE OF A CLINICIAN The student must recognize at all times that they are practicing under the license of a supervisor. This means that any advice or recommendation made to a patient without the prior approval of a supervisor is practicing medicine without a license. By utilizing this behavior in the clinic, the student is placing themselves at risk for sanctions, up to and including dismissal. Students may not prescribe treatment that benefits their own business interests or refer a patient to their private practice or business. This constitutes a conflict of interest and is not tolerated by BCNH. GRADING HANDBOOK FOR CLINICIANS Grading criteria for primary and secondary clinicians in naturopathic medicine are outlined in this section. Achieved competency is reached by incorporating all skills into each shift. Secondary clinicians are evaluated as early secondary and late secondary clinicians. Primary Clinicians are evaluated as early, middle and late primary clinicians. An early primary is a clinician who has been a primary in patient care for 0-2 quarters, usually corresponding to patient care shifts 5-8. A mid-primary clinician is enrolled in patient care shifts 9-12 and a late primary is enrolled in shifts 13-17. Naturally, an early primary clinician will demonstrate less skill in all areas than a late primary, and the grading system takes this into account. Please see the table below for a visual of the grading system used at the clinic and the performance differences between the grades of AC, PC and F. Clinic Grade Earned Level AC PC F Early Primary All skills w/coaching on at least 80% of cases All skills w/coaching on at least 70-79% of cases All skills w/coaching on less than 70% of cases All skills w/ minimal All skills w/ minimal All skills w/ minimal Mid coaching on at least 80% coaching on at least coaching on less than 70% Primary of cases 70-79% of cases of cases Late Primary Early Secondary Late Secondary All skills w/out coaching on at least 80% of cases All skills w/ assistance on at least 80% of cases All skills w/out assistance on at least 80% of cases All skills w/out coaching on at least 70-79% of cases All skills w/ assistance on at least 70-79% of cases All skills w/out assistance on at least 70-79% of cases 29 All skills w/out coaching on less than 70% of cases All skills w/ assistance on less than 70% of cases All skills w/out assistance on less than 70% of cases The student must receive an AC grade to obtain credit for each of the quarterly shifts. The skills necessary to demonstrate competence are raised each quarter to ensure that students attain all necessary basic skills to be a safe and effective naturopathic physician. If a student is performing under the level of competence, a letter will be sent to them that indicates the area(s) of deficiency and makes recommendations for improving their performance. If the student cannot raise their level of performance by the end of the quarter a grade of PC or F will be given. When a student receives a PC grade for a quarterly shift, the student must follow all recommendations listed by the supervisor to change the PC to an AC by the fifth week of the following quarter. This policy differs from the time line of didactic courses. If the student cannot rectify those inadequacies, the grade will change to an F, and the student will lose credit for all hours and patient contacts. When a student receives an F grade for the quarterly shift, they will lose all patient contacts and hours attained during the quarter. The entire shift must be repeated, and the date of graduation will be set
Page 1 and 2: TABLE OF CONTENTS MISSION STATEMENT
Page 3 and 4: PROCEDURAL SECTION 3
Page 5 and 6: UNEXCUSED ABSENCES An unexcused abs
Page 7 and 8: 2. HOUR REQUIREMENTS Clinic Entry I
Page 9 and 10: APPOINTMENTS WITH THE CLINIC REGIST
Page 11 and 12: MIDWIFERY All midwifery student cli
Page 13 and 14: ND CLINIC ENTRY II Prerequisites:
Page 15 and 16: PRECEPTOR BASTYR UNIVERSITY’S NAT
Page 17 and 18: BASTYR UNIVERSITY’S NATUROPATHIC
Page 19 and 20: RESIDENCY PROGRAM Bastyr University
Page 21 and 22: STUDENT ACADEMIC ISSUE RESOLUTION P
Page 23 and 24: CLINICAL SECTION 23
Page 25 and 26: HOURS/PATIENT CONTACTS Students are
Page 27: intervention; any medication (herba
Page 31 and 32: SECONDARY SKILLS 1. Professional Sk
Page 33 and 34: A PC grade in this skill is rectifi
Page 35 and 36: C. Motivation, Initiative and Respo
Page 37 and 38: The student will demonstrate profes
Page 39 and 40: • The student will use the curren
Page 41 and 42: Contract for Blood Borne Pathogen a
Page 43 and 44: L/B HOW TO: INJECTIONS AND FINGERP
Page 45 and 46: PRINCIPLES OF NATUROPATHIC MEDICINE
Page 47: SECONDARY COMPETENCIES PATIENT CARE
Page 50 and 51: change 4. Continues to research and
Page 52 and 53: ND PRIMARY CLINICAL COMPETENCIES -
Page 54 and 55: SPECIAL PROCEDURES/PROTOCOLS GYNECO
Page 56 and 57: ND PHYSICAL MEDICINE COMPETENCIES M
Page 58 and 59: Student Name: Supervisor Initial/Da
Page 60 and 61: Student Name: Supervisor Initial/Da
Page 62 and 63: Demonstrate Competency in Assessing
Page 64 and 65: The project is required to increase
Page 67 and 68: HOMEOPATHY CLINICAL COMPETENCIES -
Page 69 and 70: BUSINESS SECTION 69
Page 71 and 72: RETURN PATIENTS: Requires 2 of the
Page 73 and 74: FEES AND PAYMENT •Three component
Page 75 and 76: When a supervisor needs to do a wai
Page 77 and 78: APPENDICES 1. Student Clinician Abs
Page 79 and 80:
Appendix 2 BASTYR CENTER FOR NATURA
Page 81 and 82:
Fluid Wave: Have the patient place
Page 83 and 84:
Cardiac Exam Benchmark Basics: Plac
Page 85 and 86:
Head & Neck Examination Benchmarks
Page 87 and 88:
The Pelvic Examination Benchmark I.
Page 89:
E. Examine, Palpate, Percuss and Au
Page 92 and 93:
Patient Seated 39. Test ROM of uppe
Page 94:
INDEX A absence · 4, 12, 33, 36, 7
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