Learning Objectives for Essential Knowledge Base Components for

Clinical Competency

Elements of the Clinical Encounter

http://ebp.uga.edu/courses/Chapter%201%20-%20Diagnostic%20process/3%20-%20The%20healthcare
%20encounter.html

List and describe the basic steps in each patient-physician encounter

Establish the chief complaint(s)

Develop a differential diagnosis
Perform a history and physical examination
Obtain office-based diagnostic test(s)
Order laboratory or imaging studies
Establish a provisional diagnosis(es)
Negotiate a management plan with the patient
o
It is important to understand each of these steps as a _framework__ for
understanding the environment of healthcare.
How does the field of Epidemiology tie into this unit of study?
-it makes each step in the proves more rational, more efficient, and more consistent
with the best research evidence

My take away from this is: Epidemiology is NOT just the study of infectious dz.
Understand all that this field encompasses.

What is a clinical skill?

http://www.ncbi.nlm.nih.gov/pubmed/22530719

List and describe the 3 domains of clinical skills

learning how to perform certain movements (procedural knowledge), why one

should do so (underlying basic science knowledge), and what the findings might
mean (clinical reasoning).

Didactic Method
http://en.wikipedia.org/wiki/Didactic-method

The _didactic_ method is a teaching_ method that follows a consistent

scientific_ approach or educational style to _engage_ the students
mind.
The theory of didactic learning methods focuses of:
o
o and seeks to _____________.
The teacher or educator functions in this role as an ______ figure, but
also as both a guide and a ______ for the students.
Compare this to Self-Directed Learning.
Who facilitates this type of learning?

History or Present Illness

http://en.wikipedia.org/wiki/History_of_the_present_illness

List the flow of the events with this patient encounter

o CC

_____

This is a detailed interview prompted by the ______.

Americans Will Experience at Least One Medical Diagnosis Error in Their

Lifetime.
http://www://medscape.com/viewarticle/853328

Understand the Importance of the HPI

Define Adverse Event

Define Diagnostic Error

Deliberate Practice and Narrative Medicine

http://www.medscape.com/viewarticle/857224

What is Deliberate Practice?

What is it intended for?

What is Narrative Medicine?

List the steps of Narrative Practice

How does Deliberate Practice relate to Medical Errors?

Differential Diagnosis
http://en.wikipedia.org/wiki/Differential_diagnosis

Define DDX

List and describe the 4 steps

Problem-based learning in medicine: an introduction

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2398141/

Define PBLs in Medicine

List the content that is emphasized

CMU Academics-Problem Based Learning

http://www.cmumed.org/academics/pbl.htm

Define
o ______ is a systematic approach to learning which integrates basic _____
principles with sound _____ practices to solve patient _____.

List the benefits

o
o
o

Describe a PBL session under the Clinical Approach

o During a PBL session students generate a list of possible patient
_______ based on ______.
o A DDX is generated. Then list the sequence of events.

Evidence-Based Practice: Understanding the Process

www.medscape.com/viewarticle/567786

Define EBP

State the 2 outcomes of utilizing EPBs

State the time it takes for the research to be incorporated into practice?

NPs should understand the concepts of ____ and ways to _____ ______ ______
into the ______.

EPB is the use of _____ _____ _____ combined with _____ ______ and _______ to
formulate sound _____.

The EBP movement was founded by _______ - state his specialty. It identified
a gap between _____ ____ and _____ _____ _____.

The Cochran Review was developed to:

o Evaluate _____
o Synthesize the ____ _____.
o Thus, facilitating ________ based on _______.

List the 3 variables when making an Evidence-based clinical decision.

o
o
o

A key element of _____ is the ________ of the evidence to fit the patient
circumstances.

The nursing model of care and EPB process conceptual frameworks that
promote integration of _______ and _____ ______ in practice ______.

The Iowa Model of EPB uses ______ to _____ practice decisions.

List and describe the 4 steps that the NP must make when utilizing the Iowa
Model for EBP.

Clinical expertise in the era of evidence-based medicine and patient choice

http://ebm.bmj.com/content/7/2/36.full

Traditionally, clinicians have been credited with ____ _____ according to their
skills in _____ _____ and prescribing or administering treatment.
The application of current _____ _____ from research is now an expected _____
to _____ _____.
Based on this model, clinicians mush apply their _____ to assess the patients
problem and must also incorporate the _____ _____ and the _____ _____ or
values before making a management recommendation.

Definition of Continuity of Care

It is concerned with the quality of care over time.
It reduces fragmentation of care and this improves patient safety and quality of
care.
Continuity of Care- AAFP Policies (1983) (2015 COD)
www.aafp.org/about/policies/all/defintions-care

What is Continuity of Care

www.ncbi.nlm.nih.gov/pubmed/17018200

Continuity of Care is concerned with _____ of care over _____.

It is _____ _____ through _____, _____ and sharing of information between _____
____.
From a provider perspective, the focus is on new models of service delivery
and improved _____ _____.
Both should come together to enhance the _____-_____ of care.

More Pressure of PCPs to Reduce Hospital Readmissions

www.medscape.com/viewarticle/838053

Describe the Federal Government Readmission Reduction Program.

Define the CMS

What did this program propose to do to hospitals?

The CMS imposed heavy penalties on hospitals for what it considers

avoidable readmissions on what 3 DX?
o
o
o

The Guidelines There and Home Again, Safely list several

recommendations.
o
o

True of False

These guidelines can help reduce needless admissions.

The rate of readmission is highest at what point after discharge?

Name the biggest cause of readmission.

List the factors that are involve with this cause.

o
o
o