VCOM College Catalog and Student Handbook

• Level of Supervision: Direct or Indirect Supervision as appropriate based on: o The level of training of the student. o The clinical abilities of the student. o The acuity of the patient and the level of risk to the patient. o The complexity of the clinical case/procedure. M : Manager • Focus at this state: Emphasis is predominantly on the Plan of the SOAP note.

Managers are able to develop and defend a holistic and osteopathic diagnostic and a therapeutic plan for each of their patients’ central problem(s). Managers are able to utilize their growing clinical judgment to decide when action needs to be taken. Managers can analyze the risk/benefit balance of specific diagnostic and therapeutic measures based on an individual patient’s circumstances. • Emphasis: The P (Plan) part of SOAP. • Learner: Predominantly fourth year medical students. While some students will acquire sufficient knowledge, skills, and confidence to function as Managers for some of their patients earlier in the OMS 4 year, not all will make this transition until the latter part of the OMS 4 year. The transition from Interpreter to Manager is essential during the course of the OMS 4 year. • Level of Supervision: Direct or Indirect Supervision as appropriate based on: E : Educator • Focus at this stage: Educators have mastered the fundamental skills described above. Educators have the insight to define important questions to research in more depth, the drive to seek out the evidence behind clinical practice, and the skills to scrutinize the quality of this evidence. Educators take a share in educating the rest of the team. An educator’s responsibility is to assess the individual’s skills within the RIME framework and provide feedback to allow the learner to make progress within this framework. • Learner: The transition from Manager to Educator is usually completed during Internship and Residency. Expectations of Supervising Faculty Physicians/Clinical Faculty a. Provide opportunities for students to demonstrate responsibility and ownership of patient care duties. These opportunities include but are not limited to taking patient histories, performing complete and/or focused physical examinations, and reporting and entering findings in the patient’s medical record with the d. Students should have their health care related education take priority over routine menial tasks. e. Examine all patients seen by the student doctor; review and independently verify all student findings, assessments, and treatment/management plans; and document this review, including countersigning progress notes. f. Approve and sign off on notes within the Electronic Medical Record entered by students for educational purposes, if cleared by the rotation site and supervising physician. At no time do student notes serve as the attending physician’s notes. Billing must be directly related to the attending physician’s notes. Some sites have separate pages in charts set aside for "Student Progress Notes.” These should also be reviewed and co signed by the attending physician. g. It is the supervising faculty physician’s role to ensure that any non-physicians and/or residents who are engaged in clinical teaching of medical students are acting within their scope of practice and skill level. o The level of training of the student. o The clinical abilities of the student. o The acuity of the patient and the level of risk to the patient. o The complexity of the clinical case/procedure explicit approval of the patient’s supervising attending physician. b. Treat all students with respect as health care professionals. c. Students should be a participant in patient care decisions whenever possible.

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