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Community Medicine Rotation
Syllabus & Course Objectives

1. COURSE TITLE: COMMUNITY MEDICINE

2. COURSE/PREFIX NUMBER: PHA 417
3. CREDIT HOURS: 3

4. CONTACT HOURS: 172 clinical hours and community outreach hours

5. COURSE PREREQUISITES/COREQUISITES: Successful completion of Year I of the PA Program and Leader Training for the Chronic Disease Self-Management Program by Stanford University Patient Education Research Center.

6. COURSE DESCRIPTION:

   This is a required one-month rotation that takes place in a rural community setting. The purpose of this rotation is to educate the physician assistant student about public health efforts to enhance health through community-based health promotion and disease prevention services.  

• Student will spend 1-2 days a week working on community medicine project tasks and assignments to facilitate an understanding of the health problems of a community, specifically community populations that suffer from chronic diseases, and management of these diseases, so that culturally appropriate resources can be developed and established to assist community members with self-management of their diseases.
• Student will spend 1-2 days a week providing service, support, and education assistance to health initiatives already established within a variety of communities in the area.
• Student will spend an additional 1-2 days a week in a clinical setting to maintain clinical skills and to apply the Stanford Model Self-Management skills to the clinical setting.

7. COURSE OBJECTIVES: 

   By the end of the rotation, the student will be able to:

   1. Recognize the function of a community health assessment for program development and health initiatives.
   2. Recognize the impact sociocultural factors have as determinants of disease, health status, patient self-mangement behaviors, and readiness for therapeutic lifestyle change.
   3. Use a patient-centered, cross-cultural care approach to develop treatment partnership with all patients.
   4. Assess clinical status, risk factors, and patient-community members' knowledge, beliefs, concerns, and daily behaviors related to the chronic condition and its treatment.
   5. Provide support for patient self management during clinic visits and community programming via action plans, problem solving, teaching of self-management skills and techniques, reinforcement of what patient needs to know to self manage, and linking patients to community-based resources and support for disease management.
   6. Demonstrate collaborative work and communication with other healthcare providers, clinicians, professions, and community agencies for effective chronic disease management.
   7. Participate in the planning, marketing, implementation, and/or evaluation of community programs and interventions.
   8. Use health education materials, health assessment tools and methods, and program evaluation tools and methods that are culturally and literacy appropriate.
   9. Demonstrate professional demeanor by adherence to dress code, attendance expectations, general behavior guidelines, and response to constructive criticism.
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8. LECTURE/LAB/CLINICAL SCHEDULE: Rotations individually assigned.
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9. COURSE GUIDELINES AND EXPECTATIONS:  
   Policies will be consistent with those published in the Clinical Year Manual and the College Student Handbook. The 7-point grading scale in the College Student Handbook will be used.
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10. METHOD OF EVALUATION:

    Community Medicine Preceptor Evaluation	25%
    Community Medicine Faculty Evaluation	25%
    Summary Report	20%
    Written Exam	20%
    EOR quiz	10%

11. TEXTS/REFERENCE MATERIALS – In addition to books required for all rotations:

    Required Books: 

    • Feldman, Christensen (1999). Behavioral Medicine in Primary Care: A Practical Guide. Stamford, Conn.: Appleton & Lange.

    • Lorig, Gonzalez & Laurent (1999). The Chronic Disease Self-Management workshop: Master Trainer's Guide and Leaders Manual, Stanford Patient Education Research Center.

    • Lorig, Gonzalez, et al. (2000). Living a Healthy Life with Chronic Conditions: Self-Management of Heart Disease, Arthritis, Diabetes, Asthma, Bronchitis, Emphysema and others. 2nd ed. James Bull.

    • McKenzie, Smeltzer (2000). Planning, Implementing, and Evaluating Health Promotion Programs: A Primer. 3rd ed. Boston: Allyn and Bacon.

    Required Articles: 

    • Bodenheimer, Wagner & Grumbach. "Improving Primary Care for Patients with Chronic Illness," JAMA, October 2002, Vol. 288, No. 15.

    • Hardee. "An Overview of Empathy," The Permanente Journal, Fall 2003, Vol. 7, No. 4.

    • Rothman, Wagner. "Chronic Illness Management: What Is the Role of Primary Care?," Annals of Internal Medicine. Feb. 4, 2003. Vol. 138, No. 3.

    Other suggested texts, pocket books, and supplemental readings:

    • Billings and Stoeckle (1999). The Clinical Encounter: A Guide to the  Medical Interview and Case Presentation. Mosby. Chapters 10 and 14.

    • Community Health Manual, Aspen Publications. 1999. Provided by Program and kept in site offices.

    • Trafton & Gordon (2004). Best Practices in the Behavioral Management of Chronic Disease, Vol. 1 & 2. Institute for Disease Management. Provided by Program and kept in site offices.

  XII.    DATE OF SYLLABUS APPROVAL/REVIEW/REVISION:  March 6, 2006