Student Guide for Chronic Patient Attachment - 2011

Updated: 13.04.2012

Chronic illnesses can be broadly defined as health problems that require ongoing management over a period of years or decades, or more specifically as illnesses that last longer than 3 months and are not self limiting. However one defines them they are characterized in terms of similar demands that they place on patients themselves, on the families of patients, on the health care system and, importantly as well, on the socioeconomic system of a country over time
Further reflections on chronic illness care Couper ID SA Family Practice 2007:49(4)

Objectives: Be able to manage a patient over a prolonged period of time Reflect on acute events in a patients life and their return to the baseline of their chronic illness To discuss the impact of the chronic illness on the patient and their family Process: GEMP3Students select a patient in their clinical partnerships. These attachments need to be confirmed by the 13 May 2011. Students may select a patient from any of the disciplines which they have rotated through or from primary care providers in their area. Students should provide evidence of the patients consent to being part of their learning process. Students should also provide evidence that the patients primary care physician is aware of their consultations with their patient and their agreement to act as local supervisor of the ongoing relationship. If students are unable to locate a patient to follow up for this period, they may approach the CHSE who will direct them to appropriate care givers Attachment will be concluded in August 2011. Students are expected to consult with or visit their patients on at least four occasions over this period. Students should present a record of other visits to the patient using the rubric provided. Students will present portfolios entries (maximum of two pages) for at least four visits which have occurred at least two months apart. The topics which may be included in these portfolios are as follows: o Psychosocial issues relating to their patient, family, work or society o Pathophysiology of the disease process o Pharmacology of the disease process and its management. o Patient lifestyle o Risk stratification complications o Adherence

These portfolios will be due on the following dates: Portfolio 1 20 July 2011 Portfolio 2 26 October 2011 Portfolio 3 30 May 2012 Students may liaise with their selected patients using cellular phones for contact purposes In the event of a patient being unable to continue with the attachment for any reason, the following will apply o If this withdrawal occurs within 6 months of the start of the patient attachment, student will select a second patient or will be reallocated a second patient o If this withdrawal occurs after that time, the process will be reviewed by the CHSE as regards the completion of the requirements for the attachment

Supervision: Students will arrange with the patients primary care giver to act as local supervisor. This person may be the primary care physician, primary health care nurse, physician managing patient at chronic care clinic etc Marking of portfolios will be arranged with departments for each topic.

Content: The outline to their practice is included in article which will be circulated to them: Further reflections on chronic illness care Couper ID SA Family Practice 2007:49(4) Assessment o 2012 GEMP4 Final Integrated Exam Chronic Patient Attachment 20% Four portfolios written over the year Each of these portfolios must attain a mark of 60%. Students will be expected to rewrite these portfolios to attain the expected level. Final Exam Mark 80% A type exams 30 R type exams 30 SACS exam 40

Rubric for each patient encounter Student Name Student Number 1. 1. 2. 2. Patients Name, demographic detail and site of visit:

Subjective

Objective

Biopsychosocial Assessment:

Management Plan Presenting problem Ongoing problems and complications Opportunistic health promotion Planning future health care

All aspects of the consultation should apply the following principles: Continuity Collaboration Comprehension - Change - Clinical guidelines - Capture of information Assess Advise Agree Assist Arrange

Student Names: 1. ..Student Number: 2. ..Student Number:.

Title of Portfolio Entry:

Student Names: 1. ..Student Number: 2. ..Student Number:. Consent Form for participants Patient Information Name Address

Contact Details Primary Health Contact Address

Contact Details

I have been informed by the medical student that they will be visiting me as part of a chronic patient care attachment project. I may, at any stage, without prejudice, withdraw my consent and participation in the attachment.

PARTICIPANT:

Printed Name

Signature / Mark or Thumbprint

Date and time

Student Names: 1. ..Student Number: 2. ..Student Number:.

Consent Form for Primary Care givers Patient Information Name Address

Contact Details Primary Health Contact Address

Contact Details

I have been informed by the medical student that they will be visiting the above patient as part of a chronic patient care attachment project. I agree to being consulted from time to time about the patient and assist the student as far as I can I may, at any stage, without prejudice, withdraw my consent and participation in the attachment.

PARTICIPANT:

Printed Name

Signature

Date and Time

03.01.2011