How Students Can Add Value to Your Office
Students will come to your clinic with a variety of skills and experience. Talk to the Clerkship Director and your student about which of these tasks the student may be able to take on.
Before a patient visit, students can:
- Help with pre-visit planning, put in orders for preventive services where appropriate, pend orders for medication refills, determine what labs are needed, and call patients in advance of visits to discuss any pertinent issues
- Meet patients in the hospital prior to discharge (then see the patients during their outpatient visits post discharge)
- Conduct concurrent visits with the preceptor (preceptor can complete one or more visits while student conducts basic components of another visit)
- Participate in goal setting in advance of patient visits (i.e., what will we ask and how?, and what is the anticipated outcome of the visit?)
- Review social histories and participate in huddles in order to understand patients. The student will not only be more effective in the office but will also become a better doctor!
During the visit, students can:
- Room patients (empower nursing staff to help educate students)
- Help patients and families complete developmental screening questionnaires, school physical forms, etc.
- Help document care in EHRs:
- Update problem lists and medication lists
- Write and pend orders and prescriptions
- Complete after-visit summaries and review them with patients
- Write encounter notes (limitations apply to patients with Medicare where only ROS, PMH, FH, SH can be referred to in billing)
- Perform medication reconciliation:
- Discuss medication side effects with patients
- Assess for medication interactions
- Give immunizations
- Draw blood
- Find and review quality patient education materials with patients
- Create collaborative care plans with patients
- Perform scribe functions (especially students in early training)
- Give common patient education talks (URI, constipation etc)
After the visit, students can:
- Students can fully document in the patient record. The teaching physician may verify the student's work, rather than re-document it.
- With supervision, answer patient questions in the EHR/patient portal “in basket” and communicate lab results to patients.
- Call patients several days after visits. This provides an opportunity for students to ensure patients understand and are adhering to their treatment plans.
- Provide care coordination by accompanying patients to specialty care visits, the hospital, the pharmacy, and/or their homes (This is especially good for complex patients.). Students can bring information back to the practice.
- Make calls to coordinate specialty visits, social work assessments, and/or referrals to other resources
Students can work with team members to help manage the care of populations by:
- Following a panel of patients during the rotation (and possibly transitioning the population to the next student)
- Working with front desk staff, lab techs, nurses, social workers, care managers etc. Students do not need to be with physician preceptors throughout the day; others on the team have a lot to teach.
- Setting aside time to perform pre-visit and after-visit care. It’s important that students recognize this is part of taking care of patients (and not a bureaucratic function).
- Proactively reaching out to patients who need care (patients who have gaps in care, such as high A1c’s and those who haven’t received flu shots)
- Helping teams meet quality metrics by working with patients and understanding how to document care in EHRs
Students can contribute to the team and enhance clinical skills by:
- Creating patient handouts that list reliable patient education websites
- Bookmarking quality patient education sites on office computers or within the EHR
- Using sophisticated computer knowledge to help clinicians work more effectively with EHRs
- Answering clinical questions that arise during patient care and sharing the answers with the preceptor
- Sharing information about high quality medical apps with preceptors and the practice team1
Source:
Society of Teachers of Family Medicine. Strategies to Ensure that Students Add Value in Outpatient Offices. https://stfm.org/media/1348/studentsasaddedvalue2018.pdf. Accessed April 09, 2019.