Transition to Clerkship

• Practice a focused history and physical exam for a patient presenting with chest pain, dyspnea and nausea/vomiting, with a focus on the cardiac, respiratory and abdominal exam.
• Review the “can’t miss” diagnoses of chest pain.
• Practice 12-lead Electrocardiogram (ECG) Interpretation.
• Discuss initial in-office management for a patient with concern for a patient presenting with acute ST-Elevation Myocardial Infarction (STEMI) prior to transfer to hospital.
• Learn and practice the SBAR (Situation, Background, Assessment, Recommendation) tool for verbal handover of patient care.
• Learn and to practice the SOAP (Subjective, Objective, Assessment, Plan) tool for written handover of patient care.
• Practice holding a goals of care discussion with a capable patient using the Serious Illness Conversation Guide framework.
• Practice communicating serious illness news to a substitute decision maker over the phone.
• Review routine prenatal care visits, including questions to ask at each visit in the 3rd trimester.
• Practice a focused history and exam for a patient presenting with abnormal vital signs, with a focus on infection.
• Review intermittent auscultation as an in-office assessment of fetal well-being, including normal vs. abnormal findings.
• To discuss initial in-office management for a patient who is clinically unstable, including transfer to acute care.
• Review a differential diagnosis for fever.
• Practice a focused assessment of a patient over the telephone in coordination with a bedside nurse.
• Review non-verbal signs of pain for patients unable to communicate verbally (e.g. for patients with dementia).
• Review common medications used for control of symptoms in end-of-life care
• Practice holding a goals of care discussion with a substitute decision-maker for an incapable patient using the Serious Illness Conversation Guide framework.