Clinical rotation - family medicine, 6 credits

At least 3 years of studies in medicine.

Students who fail a clinical placement (or equivalent) as a result of demonstrating such a serious lack of knowledge, skills or attitude that patient safety or the patients' confidence in medical care is at risk, will only be qualified for a new clinical placement once the individual action plan has been carried out.

Objectives
The aim of the course is for the student to acquire knowledge, skills and understanding of family medicine.

Learning outcomes
The students shall be able to:

• take a medical history and perform a clinical examination for conditions common in Swedish primary care
• evaluate and handle symptoms and diseases common in Swedish primary care
• use evidence-based guidelines when treating and investigating common conditions
• apply a patient-centered approach
• act respectfully towards patients, students, teachers and staff and take active responsibility for learning

The focus of the course is Family Medicine The main focus is on clinical practice with patient-based teaching and individual feedback, to facilitate further development of skills. The student will be given a schedule for participation in clinical training and will also have the opportunity for interprofessional learning by following a nurse in home care service.

Primarily clinical education, with personal supervision. Depending on the student's experience and knowledge, active independent clinical training will take place. The student shall keep a log book for reflections and search and evaluate scientific articles as a basis of evidence-based medicine. Students are scheduled 40 hours per week, during which time is allocated for literature studies and seminars.

In order to provide feedback on the student´s knowledge, skills and attitudes in their role as a doctor:

* the supervisor shall sit beside the student during an entire patient visit (sit-in) at least three times during the course
* after sit-in the supervisor will give feedback to the student by using the assessment tool; "Dialoginstrument for veckobedömning"
* when more than one student is at the same health centre,"peer-learning" can be used with structured feedback on each other's consultations.
* seminar with feedback on the student's video-recorded consultation will be given.

Compulsory elements during a clinical rotation. Formative assessment of log book by supervisor every week.

Examination

• Mid-course assessment by the supervisor at the end of the second week. The evaluation includes all learning outcomes to make possible adjustment of the remaining part of the course according to the individual student's needs.
• Final summative evaluation by the supervisor based on the self assessment tool "dialoginstrumentet". The supervisor files a written report to the examiner as a decision basis for grading.
• Examination comprising a presentation of a videotaped "own" patient encounter. The student present reflections according to a given structure regarding his/her own abilities, skills and attitudes. The assessment comprises all intended learning outcomes of the course.

The course coordinator decides if, and how, absence from compulsory parts can be compensated. Study results cannot be reported until the student has participated in compulsory course elements or compensated for any absence in accordance with instructions from the course coordinator.

Absence from a compulsory course element could mean that the student can not retake the element until the next time the course is offered.

Limitation of number of tests or practical training sessions
Students who do not pass a regular examination are entitled to re-sit the examination on five more occasions. If the student has failed six examinations/tests, no additional examination is given. Regarding clinical rotations, the student has the right to attend these two (2) times.

Termination of clinical rotation
The examiner may, with immediate effect, interrupt a student's clinical placement (or equivalent) if the student demonstrates such serious deficiencies in knowledge, skills or attitude that patient safety or patient confidence in healthcare is at risk. If a clinical placement is interrupted in this way the student is deemed to have failed that element and to have used up one clinical placement opportunity.

In such cases, an individual action plan should be set up stating which activities and tests are required before the student is qualified for a new clinical placement on the course.

If a course has been cancelled or has undergone major changes, at least two additional examinations (excluding regular examinations) on the previous contents will be provided within a year of the date of the change.

Course evaluation is implemented according to guidelines established by the board of education for Medicine at Karolinska Institutet.