Clinical Skills Learning Objectives by unit

MD 1 - Health and Wellness 

1. Basic medical communication skills

2. Medical data gathering (the standard components of the patient “history”)

3. Basics of documenting and orally-presenting clinical cases

4. The basic physical examination sequence (BPES): This is what we introduce and teach our pre-clerkship students (see separate page)

5. Introduction to basic elements of professional identity formation as a physician

MD 2- Cardiovascular and Pulmonary Health Problems

1. Identify components of the EKG

2. Understand the basics approach and organization to reading a 12 lead EKG

3. Obtain a chest pain history (lecture, practice, SPE)

4. Recognize illness scripts

5. Apply a systematic approach to reading CXRs

6. Participate in the clinical reasoning process

7. Practice specific cardiopulmonary exam skills:

BPES of cardiopulmonary

Inspect, palpate and describe jugular veins, arterial pulses including palpation of abdominal aortic pulsations

Measure JVP, pulsus paradoxus

Determine respiratory excursion by palpation

Measure diaphragmatic excursion by percussion

Understand how to assess tactile fremitus, egophony, respiratory distress, heart murmurs, adventitious cardiopulmonary sounds

8. Identity components of oral case presentation

9. Organize and recite opening statements

10. Become familiar with POCUS for cardiopulmonary exams

11. Begin to synthesize medical information (history, PE, ABG, CXR, EKG) to suggest assessment and plan

MD 3 - Renal and Hematologic Health Problems

1. Define and articulate common urinary symptoms and signs (dysuria, hematuria, pyuria, frequency, incontinence)

2. Interpret basic components of urinalysis

3. Classify acute kidney risk, injury, failure, loss and end-stage renal disease (RIFLE) and Kidney disease international improving global outcomes (KDIGO) by stages

4. Obtain and interpret orthostatics vital signs

5. Assess volume status

6. Percuss costophrenic angles

7. Understand physical exam techniques used to palpate bladder and kidneys

8. Examine patients for edema in the following areas: periorbital, abdominal wall, lower extremities, sacrum

9. Determine if pallor is present and discuss its’ significance

10. Elaborate the pertinent review of systems questions for the hematological system

11. Describe the physical exam technique for assessing hepatosplenomegaly

12. Explain and interpret the elements of complete blood count

13. Perform examination of the shoulder and knee with denotation of surface anatomy landmarks

14. Identify common signs of anemia

15. Obtain and interpret an electrolyte panel

16. Recognize the limitation of the eGFR based on creatinine

17. List the ddx for fatigue with particular attention to the heme and renal causes

MD 4 - Endocrine and Gastrointestinal Health Problems

1. Describe the anterior and posterior approach to examination of the thyroid gland

2. Appreciate the importance of the eye, skin, foot, sensory neurological exam and reflexes exam in the diabetic patient

3. Discuss modalities to measure peripheral sensory nerves

4. Considers a differential diagnosis of common endocrine diseases after reviewed a patient scenario/case

5. Generates a hypothesis-generated history and physical exam after presented with a brief patient complaint (endocrine issue)

6. Conducts the gastrointestinal exam in the organized sequence (BPES)

7. Assesses a patient’s liver size by physical exam palpation, percussion and auscultation

8. Examines abdomen for evidence of ascites (shifting dullness, fluid wave, bulging flanks)

9. Describes advanced steps of the GI exam (Mc Burney point, Murphy’s sign)

10. Positions the patient properly for the abdominal exam

11. Auscultates the abdomen for bowel sounds and bruits

MD 5 Summer session and Selective experiences

MD 6- Locomotor, Neurological and Behavioral Health Problems

1. Describe components of both the basic and extended examination of the joints

2. Review elements of the history important for rheumatologic diseases

3. Articulate the proper nomenclature for descriptions of  joint movement,  positions and surface anatomy

4. Characterize the elements of the screening sports exam 

5. Describe spinal vertebral levels, nerve roots, myotomes and dermatomes and how they relate

6. Delineate the nerve roots responsible for the basic reflexes  

7. Grade muscle strength

8. Define the sub-disciplines of ophthalmology

9. Demonstrate the basic functions of direct ophthalmoscopy

10. Point out the anatomical components of the eye

11. Explain the 7 elements of the screening neurological exam

12. Appreciate when to expand the neurological exam

13. Define the sub-disciplines of neurology

14. Describe exam techniques to test the 12 cranial nerves

15. Discuss the Glasgow Coma Scale

16. Explain the components of the mental status exam

17. Describe the biopsychosocial model

MD 7- The Life Cycle

1. Examines newborn in proper sequence (follows checklist)

2. Understands the principle concept of teams

3. Know the team leader’s (manager’s) role

4. Know standard formats for communication in medical teams

5. Employ depression screening tools for adolescents and children (i.e.PHQ-A, MFQ)

6. Compare risk factors for suicide between adolescents and adults

7. List resources for suicide prevention

8. Define HEEADSSS acronym used in adolescent and young adult medicine

9. Describe ADLs and iADLs

10. Highlight prominent pediatric developmental disabilities

11. Calculate a child’s age and when to compensate for prematurity

12. Interpret child’s age and development on growth chart

13. Describe the components of the female pelvic examination sequence and technique

14. Articulate how you examine the breasts 

15. Compare/contrast different types of oral presentation based on setting: new pt to hospital H&P, outpt visit SOAP note, follow-up inpt SOAP 2.0, ICU pt by organ system

16. Differentiate the elements of the written note and oral patient presentation

17. Detail the proper positioning of a male patient for the genitorectal exam