The Clinical Skills Curriculum helps place students into realistic clinical environments that test and shape their ability to practice and learn how to handle specific patient cases and procedures. The teaching venues include standardized patients (actors trained to simulate real patients) and a full-sized computer-controlled simulator. Neither is viewed as being a replacement for real patients but rather as a way to provide a safe, comfortable, and controlled “real” environment in which students can practice and, in turn, receive formative and summative feedback from faculty.
Examples of courses and venues for these various clinical skills activities include:
- In MPS I, students are asked to perform a history with a standardized patient;
- In the Human Structure and Function Course (Year I), students use the simulator as follow-up to the PBL case that has been evolving in the classroom;
- In Brain and Mind, students perform a complete neurological exam on a standardized patient;
- In MPS II, students perform a history and physical with a standardized patient;
- During each clerkship, students interact with a standardized patient (e.g., a smoking cessation case in the Primary Care Clerkship);
- Between the third and fourth year, students participate in a 10-station OSCE with standardized patients that simulates one they will encounter during the clinical skills part of USMLE Step II (the Boards).
For more information, contact Michael Slade at mbs2003@med.cornell.edu or 646-962-5514.
Communication SkillsPatients value the communication skills of their doctors highly – having a doctor who answers their questions and understands their illness. Yet in our current health care system, doctors often have little time to spend with patients. Doctors need to learn how to work with patients efficiently but still allow their patients to feel understood.
Through our Oates Communication Skills Curriculum, students focus on communication throughout the four years - in the MPS I and II courses, as well as each clinical clerkship. Students learn and practice their communication skills through lecture, role-play, standardized patients/patient educators, OSCEs, and direct observation of medical encounters in vivo. Specifically, in MPS I, students focus on building rapport and gathering information through role plays and with standardized patients in the classroom setting and basic interviewing skills in the clinical setting. In the second year, in MPS II and Brain and Mind, students role-play the mental status exam and practice psychiatric history taking and performing the mental status exam on patients with mental illness in psychopathology clinics; in neurological physical diagnosis, students have clinical encounters on the floors and also conduct physicals with standardized patients. During their clerkships, students build on the curriculum of the first two years in building rapport and gathering information (i.e., history-taking), but now the focus is on managing the patient’s problems and giving information to the patient. Communication skills are taught in many clerkships, in the classroom as group OSCEs and in the clinical setting as direct observation of medical encounters, with feedback. Students in each clerkship also individually participate in an OSCE with clinical scenarios relevant to each specialty, utilizing standardized patients in our Clinical Skills Center.
For more information on this evolving curriculum, contact Kevin Kelly, MD, kvk2001@med.cornell.edu or 212-348-9661.
GeriatricsGeriatrics is one of several longitudinal themes integrated throughout the four-year medical student curriculum. Topic areas include but are not limited to chronic illness; doctor-older patient communication; ageism in the medical setting; medical and social history and physical on an older patient; chronic illness; the interdisciplinary team, palliative care; functional assessment and rehabilitation; “gerontological” design”; discharge planning/transitional care; and various geriatric syndromes (e.g., dementia, deliria, urinary incontinence). The overall goal of this curriculum is for students to have the knowledge and skills needed in treating older patients, who will more than likely make up a large percentage of their future patient population.
By the end of the four years, students should be able to
- Identify ageist behaviors that might occur in the doctor-older patient relationship and how they may lead to misdiagnosis
- Conduct a medical and enhanced social history, functional assessment and physical of an older adult
- List key interventions that might enhance doctor-older patient communication
- Explain how disease can present atypically in the elderly
- Discuss the heterogeneity of the aging process
- Describe the importance of chronic illness care, in particular the impact of psychosocial issues on health and quality of life and the collaboration of an interdisciplinary team in helping the older patient manage illness;
- Involve the patient in the development of a comprehensive care plan and communicate that plan to the medical professional(s) who will provide care in the post-hospital setting
Diverse activities, led by interdisciplinary faculty, help students achieve these objectives in MPS I (Introduction to the Older Patient and Chronic Illness modules during the Life Cycle segment) and MPS II courses, in the basic science courses, and in the Medicine and Primary Care Clerkships. Activities include interactive lectures, PBL case discussions, dramatic re-enactments, wheelchair navigation, rotating at a clinical geriatrics site, blood pressure screenings at a senior center, house call visits, arts-based self-reflection, a multi-media on-line course on environmental geriatrics, and a telephone OSCE at the Clinical Skills Center.
For more information, contact Veronica LoFaso, MD, at vel2001@med.cornell.edu or 917-734-3227.
Global HealthThe WCMC global health program provides students with skills and knowledge to help them make life-long contributions as physicians in a global world. It is incorporated into the medical school curriculum in both required courses and electives.
Required coursework on global health is found in the first year (MPS I), second-year (BOD, Infectious Disease module), and fourth-year (Public Health Systems Clerkship).
A comprehensive elective program, the newly launched Global Health Curriculum provides both coursework and hands-on experiences for students who are particularly interested in this area.
Other electives include an 8-week course in Medical Spanish for first-year students and a fourth-year elective on Wilderness Medicine and Environmental Preparedness.
For more information on the overall global health program for medical students, visit
http://weill.cornell.edu/globalhealth/education
