Curriculum Components

The student must complete all educational requirements of the clerkships and WRITE Program as well as participate in any activities planned by the WRITE Program. Additionally, students must complete the entire WRITE rotation during the specified academic year and scheduled rotation block; i.e., a portion of the rotation cannot be taken at a later date.

• Clinical Encounters are a list of diagnoses and procedures that students must encounter by the completion of both Patient Care & Explore and Focus clerkships.  Each department has a specified list that students must complete and that information can be found on the clerkship department’s website (linked below).  All clinical encounters will be logged in the E*Value system.Visit the Clinical Encounters page for links, helpful videos, and how-to manuals: https://sites.uw.edu/medevalu/clinical-encounters/
• Achieving stated program/curriculum goals and objectives and fulfilling specific course requirements for the UWSOM Family Medicine, Pediatrics, Psychiatry, and/or OB/GYN clerkships at WRITE (refer to the WRITE Canvas Page for full details).

• Healthcare Professional Checklist
• Community Service Project/Service (details below)
• The accomplishment of required readings (recommend 10 hours per week minimum) as detailed by respective UWSOM clerkship departments; additionally, students must utilize the current clerkship texts
• The completion of necessary examinations, assignments, and forms
• Attendance at and participation in:
  • Orientation (date to be determined prior to the start of new WRITE session)
  • Faculty Visits and Case Presentations

The WRITE Community Project or Service aims to engage the student with the community outside of the clinical setting. This project is not part of any Department Clerkship and will not be given separate credit or a grade, but is an important part of the WRITE program.

The extended longitudinal experience of WRITE gives you a unique opportunity to engage your community.  It also provides an opportunity to use the concept of Community Oriented Primary Care (COPC) during your WRITE experience. Please read the following article on COPC: Longlett SK, Kruse JE, Wesley, RM. Community-Oriented Primary Care: Historical Perspective (PDF). J Am Board Fam Pract 2001; 14:54-63.

The WRITE Community Project or Service can take one of two forms:

• Students can complete a Community or Clinic-based Project
  1. TRUST students and other students who participated in RUOP are encouraged to continue community projects started during RUOP, including applying for microresearch grants to help implement their projects
• A community service option for students
  1. Community service would be volunteering with a community service organization such as Free Clinic, Food Bank, Meals on Wheels, Hospice, or similar service programs
  2. Volunteer for 20 hours minimum (over a 16-22 week WRITE experience)

About one month into WRITE, the student is required to submit for approval a proposal describing either the project or service plan to their WRITE Site Director and to their WWAMI Regional Dean. Please answer the following questions when drafting the description:

1. What will be done?
2. How much time will be put into the project/service and what is the time frame?
3. What are the goals and objectives of the project/service?

The proposal form will describe a summary of the community, identify the community or clinic/hospital partner(s), provide 1-2 annotated sources reflecting the mission/outcome for the service or project.

At the end of the WRITE experience, students will submit a minimum written 500-word summary and reflection on their service or project.

The proposal and final summary and reflection will be submitted based on due dates within the student’s WRITE calendar and should be sent to both the WRITE Site Director and their WWAMI Regional Dean.

Listing of Community Service Project Titles 

Michelle Fleming
WRITE Administrator
flemingm@uw.edu

Link to Info for Student’s Website: https://familymedicine.uw.edu/education/courses/clerkship/

Read the FMC syllabus. This also includes our FMC Goals and Objectives and Curricular Requirements.

The Family Medicine Clerkship website is set up for the traditional 6-week clerkship. Taking into account the expanded nature of the WRITE program, it is not required that WRITE students complete at the same pace the weekly activities of the FM “Assignment Tracker,” but should integrate the “weekly” requirements into their clerkship experience as it makes sense to do so, making sure to complete everything by the time of the Family Medicine exam.

The FM Assignment Tracker is located within the WRITE Canvas Page.

Failure to update the form on a regular basis (~ every 2-3 weeks), will have an impact on your grade. All requirements must be logged and tracker must be complete by the end of WRITE. Any missing requirements will result in a make-up assignment to be determined by the Seattle FMC office. Be sure to document your encounters with Common Conditions.

Students are expected to participate in an online webinar orientation on the first Monday of the WRITE session, from 12 to 1 PM Pacific Time via ZOOM. You will receive an email from the Clerkship Manager with login details and exact time/date, roughly a week before the webinar.

Here is the link: https://canvas.uw.edu/courses/1249083/quizzes/1054933

This Clinical Reasoning Practice Test is composed of 14 multiple choice questions that are IDENTICAL IN FORMAT to the final exam and will be based on four FM CASES: Case 2 (Adult Prevention), Case 4 (Ankle Sprain and UTI), Case 6 (Diabetes), and Case 21 (Flu, Pneumonia, Pediatric Obesity). You should receive an email from the Clerkship Manager with details and exact time /date, roughly a week beforehand.

Attend conference call with clerkship Co-Director if you have questions about the Clinical Reasoning Practice Test.

This time is when you can call to discuss the material with one of the clerkship directors. If you choose to call, make sure to schedule this with your site. The clerkship Co-Director will be available to help answer questions about any of the 14 multiple choice questions in the Clinical Reasoning Practice Test. Calling in for this conference call is optional, it is only intended to answer questions about the Clinical Reasoning Practice Test.

This exam will test your application of the clinical knowledge you have gained from the clerkship, as well as from the recommended study guide. More information in FMC Syllabus.  It is typically taken at week 12 during your WRITE experience.  Exact date and time will be confirmed during the WRITE Student Orientation held prior to the start of WRITE.

The purpose of these reviews is to provide you with formative and summative feedback on your performance and track your completion of the clerkship curriculum. Reviews are held with your Primary Preceptor or the Site Director. Print out two copies of your Assignment Tracker to bring to each review session. Your Mid-Clerkship Review (PDF) should be held during the sixth week of your WRITE experience.  Your End-of-Clerkship Review (PDF) should be done in the last week of WRITE. In both review meetings, your Site Director will share feedback about your performance in the rotation. Feedback may include things you did well and things that you should focus on for future rotations. You are encouraged to ask questions during these meetings if it is unclear or if you need further guidance about improving your performance.

Josh Nelson
Clerkship Administrator
UW Department of Family Medicine
Tel: (206) 616-7890
Email: fmclerk@uw.edu

WRITE Students earn 3 weeks of Pediatrics credit during the on-site portion of the WRITE program while working with the family medicine preceptors and/or a faculty-appointed pediatrician in the community. Students will be given a Peds Clerkship Manual which covers pediatric clerkship requirements and will have the opportunity to complete portions during their first 3 weeks of their inpatient pediatric rotation or during their first few weeks at WRITE. Students are responsible for entering and logging assignments in the Pediatric Tracker upon completion of the clerkship. Students are asked to complete all Aquifer cases by time of pediatric exam.

The student will be responsible for successfully completing a Pediatrics exam (either at the WRITE Site if the student has completed the inpatient portion of pediatrics or at the end of the inpatient portion of the clerkship away from the WRITE site). For students taking the exam during WRITE, it will be scheduled about mid-way through WRITE. The exam is ONLINE and will need to be proctored–more details to come. The exam is based on Aquifer cases.

Click to view the Peds Mid-End Clerkship Review Form

The purpose of these reviews is to provide you with formative and summative feedback on your performance and track your completion of the clerkship curriculum. Reviews are held with your Primary Preceptor or the Site Director. Your Mid-Clerkship Review will always take place during the inpatient portion of your clerkship experience (not during WRITE). Your End-of-Clerkship Review should be done in the last week of WRITE. In both review meetings, your Site Director will share feedback about your performance in the rotation. Feedback may include things you did well and things that you should focus on for future rotations. You are encouraged to ask questions during these meetings if it is unclear or if you need further guidance about improving your performance.

The UWSOM Department of Pediatrics Clerkship website has information regarding the curriculum requirements including Aquifer and ethics & professionalism cases: www.med-u.org. The Pediatrics Clerkship Manual lists the educational objectives. It is suggested that students and preceptors review this guide to determine if basic pediatric competencies are being met.

Click to view the Clinical Encounters: Pediatric 3rd Year WRITE Clerkship Form (PDF)

Please contact the Pediatric WWAMI Program Coordinator, My Linh Nguyen, with any questions about your pediatric WRITE requirements, to obtain a clerkship preceptor manual, or to gain access to the Pediatric Tracker.

Email: mylinh.nguyen@seattlechildrens.org
Phone: (206) 987-2869

The Department of Psychiatry Clerkship website includes Forms (grading, Mini-CEX, and evaluation), cases, clerkship objectives, and requirements. There is a WRITE tab on the website. Check the Psychiatry website for links to lectures and information about electives.

The primary goal of the Psych experience is for students to see patients with psychiatric issues in the outpatient setting with longitudinal exposure and to increase their comfort level with this patient population. WRITE Students earn a total of six weeks of credit by merging the three-week evaluation from the formal clerkship site and the experience of seeing and working with patients with psychiatric or behavioral problems at the WRITE Site.

Students who complete the inpatient portion of their psychiatry clerkship prior to going to their WRITE sites will have had three weeks of inpatient psychiatry and will have completed their core requirements. These students will take their PBSCI exam while at their WRITE sites.

Students who do not complete the inpatient portion of the Psychiatry clerkship prior to WRITE will be given the opportunity to complete curriculum readings and lectures during their first few weeks of WRITE. They will take their exam during the inpatient portion of their psychiatry clerkship.

Margie Trenary
Clerkship Administrator
UWSOM Department of Psychiatry
trenam@uw.edu
(206) 744-4564

The Ob/Gyn clerkship is offered at some WRITE sites. At those sites, it is integrated throughout the WRITE experience. The Ob/Gyn Clerkship website includes the clerkship objectives, assignments, and other important information.

Students are required to receive formal mid-clerkship feedback in week 9 of the WRITE ob/gyn experience. The form can be accessed here. The final evaluation for preceptors to evaluate students for ob/gyn comes from Catalyst rather than E*Value.

Sonya Fukeda
Clerkship Administrator
UWSOM Department of Obstetrics & Gynecology
obclerk@uw.edu
(206) 685-9640

WRITE Advanced Outpatient Clerkship
GOALS:
1. Take on primary responsibility for patient care with appropriate supervision
2. Refine core clinical skills
3. Improve clinical reasoning and expand medical knowledge
4. Work as an integral part of the clinic team

Students will achieve the following skills through patient care, simulation and/or other instructional methods.

1. Gather a history and perform a physical examination
   1. History-taking skills
      i. Obtain both comprehensive and focused histories in an organized and timely fashion.
      ii. Demonstrate patient-centered skills, cultural awareness, and humility.
      iii. Demonstrate clinical reasoning in gathering focused information relevant to patient care.
   2. Physical examination techniques
      i. Perform both comprehensive and clinically relevant focused physical exams
      ii. Demonstrate patient-centered exam skills that respect privacy, comfort, and safety
      iii. Identify abnormal findings
2. Develop a prioritized differential diagnosis and select a working diagnosis following a patient encounter
   1. Collect and synthesize pertinent information based on prior records.
   2. Integrate new information as it emerges.
   3. Utilize evidence-based concepts for diagnosis and treatment.
   4. Discuss and document clinical reasoning contributing to the working diagnosis.
3. Recommend and interpret common diagnostic and screening tests
   1. Incorporate high-value care principles as part of a care plan
   2. Interpret basic test results
   3. Elicit and incorporate patient preferences into recommendations
4. Enter and discuss patient orders/prescriptions
   1. Compose orders efficiently and effectively (eg. Selective use of order sets).
   2. Write prescriptions and attend to patient-specific factors (eg. Age, weight, allergies).
   3. Discuss orders and prescriptions in a patient-centered manner.
5. Provide documentation of a clinical encounter in written or electronic format
   1. Organize and prioritize information using a clear narrative.
   2. Update and organize problem list, working and differential diagnosis and plan.
   3. Document in a timely fashion.
   4. Document patient preferences into clinical decision-making.
6. Provide an oral presentation/summary of a patient encounter
   1. Present accurate, concise, and well-organized information and acknowledge uncertainty.
   2. Adjust presentation to meet the needs of the listener.
   3. Assure closed-loop communication between presenter and receiver of information to confirm shared understanding.

EPA Assessment Sheet (PDF)

Michelle Fleming
WRITE Administrator
flemingm@uw.edu

WRITE Pain Medicine Elective (CONJ 696)
https://canvas.uw.edu/courses/1457601

This elective will allow WRITE students to achieve a foundational understanding of chronic pain as a common and challenging biopsychosocial chronic medical condition. Allow students to assess pain multidimensionally and understand the concept of treating chronic pain in a multidisciplinary context.

Students will participate in the active management of select patients needing pain management. Students will be able to follow pain patients longitudinally over the course of WRITE and have the opportunity to present patients at the weekly Telepain conferences. Students gain insight into a multidisciplinary approach to the management of patients with chronic pain diagnoses.

Course syllabus and assignment information can be found on the course canvas page.
…

1. Differentiate between pain as a sensory experience and as an emotional (sociopsychological) experience.
2. Compare and contrast the goals and strategies for pain management in acute, chronic and palliative settings.
3. Recognize the differences in presentation, pathophysiology, and treatment of nociceptive, neuropathic pain, and central sensitization.
4. Describe characteristics of a range of chronic pain syndromes; including peripheral neuropathy, radiculopathy, chronic low back pain, inflammatory arthritis, headache, fibromyalgia and other disorders of central sensitization, and complex regional pain syndrome.
5. Use evidence-based tools for assessment and tracking of effects of interventions to reduce pain intensity, functional interference, mood, sleep, and other health risks.
6. Appropriately recommend non-pharmaceutical multi-modal analgesia strategies, including sleep hygiene, behavioral health, physical activation, and complementary and integrative treatments.
7. Delineate how to determine when opioids are indicated and under what circumstances; including defined treatment goals, expected benefits and known risks, and implications of national and state guidelines.
8. Appropriately recommend anti-inflammatory medications when they may be indicated for chronic pain.
9. Recommend appropriate categories of antidepressants medications when they may be indicated for chronic pain.
10. Recommend appropriate categories of anticonvulsant drugs when they may be indicated.
11. Propose circumstances when a procedural intervention may be indicated for chronic pain.
12. Demonstrate appropriate interactions and determine the role, scope, and contribution of other members of the interprofessional pain management care team.

• Grading will be Pass/Fail
• Mid-clerkship evaluation documented with WRITE Interval Feedback Form (Week 9 of WRITE experience)
• Final Evaluation will be completed by WRITE primary preceptor and submitted one week after WRITE ends.

Michelle Fleming
WRITE Administrator
flemingm@uw.edu