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Waiting List
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No
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Course Type
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Required
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Location
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Mile Bluff Clinic, LLP
1040 Division St.
Mauston, WI 53948
http://www.milebluff.com/
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Instructors
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Ann Hoffmann, MD (lead preceptor) will coordinate experience, which includes working with several of 18 family physicians, 3 general surgeons, and 3 OB/GYN MDs.
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Availability
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1 student
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Initial Registration
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Ann Hoffmann, M.D.
EMail: ahoffmann@milebluff.com
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To Add
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Place request with Louisa Zelm at the Medical School
Email: zelm@wisc.edu
Phone: (608) 265-9081
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To Drop
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Place request with Louisa Zelm at the Medical School
Email: zelm@wisc.edu
Phone: (608) 265-9081
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Report To
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Contact the lead preceptor or contact person one month prior to your preceptorship starting date. The first day of your rotation (Monday) is for traveling to your preceptorship site to get settled with housing, taking part in any site orientation and at 6 p.m. taking part in a phone orientation in which you will need computer access. You will be informed of the remaining two phone orientations from Dr. Paul Hunter, Course Director. In most cases you will begin clinical work on the second day (Tuesday) of the rotation, however, please check with your site as some students may be on call the first night of your preceptorship. If you have questions about your preceptorship, contact Louisa Zelm at the Medical School by phone: 608-265-9081, or via Email: zelm@wisc.edu. Your background check information and immunization records can be found in OASIS under Academic History/My Med School. It is your responsibility to copy that information and send it to your site coordinator or preceptor via email before your preceptorship starts. On the first day of your rotation, you are to go first to the lower floor at Mile Bluff Clinic,,( address: 1040 Division St, Mauston, WI. 53948) and meet up with Carol Fronk, our clinic administrator and myself at 8:00 a.m. You will receive a tour of the facilities and background information and Carol Fronk will help you get set up with beepers, keys, computer access, housing etc, etc. After all the needed logistics are carried out, you will then go join up with your preceptor in her clinic.
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Housing
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Housing: Currently students are provided free housing at the home of a very friendly retired clinic nurse, PA's
or physician's houses, very close to the hospital and clinic. Housing at a local motel may be provided during certain blocks. When in ER/ on-call / awaiting an OB with your preceptor you will have a separate bedroom in the on-call / ER suite, which has TV, high speed internet and shower facilities. The clinic and hospital have wireless guest internet accessible 24/7 for students with wireless devices, and multiple accessible computers for those without.
Food at the hospital and clinic: Free lunches are usually available at the clinic, and all meals are provided by the hospital when you are "on call" or staying at the hospital for an OB delivery.
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Parking
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Free parking. Student will need a car for transportation between housing and hospital/clinic. Community located 70 miles from Madison, Marshfield and La Crosse via Interstate Hwy. (one hour drive). RECREATION: Biking, XC Skiing, canoeing, boating, fishing, hiking and wildlife opportunities abound. Site is close to Castle Rock Lake, the Elroy-Sparta bike trail, various county parks, and Wisconsin Dells. (However, most students miss these opportunities because the patient care experiences are so interesting.)
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Objectives
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GOALS AND OBJECTIVES -
Overarching Goals -
Upon completion of the 4th Year Preceptorship, students will:
1. Understand the complexities of a multidisciplinary health care system
2. Develop proficiency in providing patient care in a community setting
3. Apply principles of preventive medicine to clinical care
4. Recognize the impact of health care and reimbursement systems on the delivery of health care
5. Expand upon their personal and professional growth and development
6. Recognize the effect of quality measurement and improvement on clinical decision-making, cost of care, and patient satisfaction
Educational Objectives -
Patient Care (Problem solving and Clinical Skills)
Students are expected to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.
1. Conduct an efficient & effective clinical medicine interview
2. Describe the impact of continuity of care on health care delivery
3. Develop independent assessments and differential diagnoses
4. Negotiate management plans with patients & preceptors
5. Describe the impact of local culture on health care, wellness, the work environment, and the community
6. Provide continuous care and assure effective care transitions for patients as they move through multiple health care settings
7. Describe challenges of chronic disease management in the US healthcare system
Medical Knowledge -
Students are expected to demonstrate knowledge of established and evolving biomedical, clinical and social sciences.
1. Describe the impact of nutrition, physical activity, and weight on physical and mental health
2. Locate ACIP recommendations for immunizations and describe strategies for improving community immunization rates for both children and adults
3. Describe the impact of USPSTF and other professional groups screening recommendations on the clinical practice of your preceptor
Practice Based Learning and Improvement -
Students are expected to investigate and evaluate their patient care practices by appraisal and assimilation of scientific evidence.
1. Describe a local quality improvement initiative at your preceptorship site
Systems Based Practice -
Students are expected to demonstrate an awareness of the larger context and system of health care and effectively call on system resources to provide optimal care.
1. Use and refer patients to appropriate community-based healthcare resources
2. Participate in community health activities
3. Describe your preceptor's relationship to the healthcare system in which (s)he practices
4. Describe the roles of federal, state and private programs that pay for health care within the US healthcare system
5. Describe the relationships between health care financing and health care delivery
6. Identify contemporary healthcare issues and discuss their impact on the practice of medicine
Interpersonal and Communication Skills -
Students are expected to effectively communicate and collaborate with patients, their families and health professionals.
1. Work and communicate with doctors, nurses, therapists, physician assistants, medical assistants, chaplains and other healthcare personnel in a manner that fosters mutual respect and excellence in patient care
Professionalism -
Students are expected to demonstrate a commitment to carrying out professional responsibilities, and to be responsive and compassionate.
1. Conduct yourself in a professional manner
2. Obtain formative feedback and improve communication, history & physical exam skills
3. Identify areas of tension between professional, family, and personal aspects of your life
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Content
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ELECTIVES: General surgery, OB/GYN, ER, radiology, podiatry, orthopedics, ENT, ophthalmology, urology, GI, neurology, oncology available on periodic basis. OVERVIEW: This site has raised cooperation in rural health care to a fine art. The schedule is prearranged with student's input up to 4 weeks in advance of rotation. Although the experience is usually family practice oriented, students may request a rural surgical emphasis or other enhanced experiences in advance, including working with visiting physician specialists, meeting with the Public Health Department, Hospice, a chaplain or spiritual leader, dietitian, quality improvement staff, CEO of hospital etc.
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Prerequisites
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Site offers excellent learning opportunities, but personal initiative and motivation are required by student.
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Methods
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CLINICS/HOSPITALS: Clinic and hospital are connected with a skilled nursing home and assisted living facility on the same campus. HOSPITALS: Mile Bluff Medical Center is a 40 bed independent progressive rural hospital offering typical inpatient medical, surgical, peds, OB, ortho and rehab services. It is not a critical access hospital, so patients are typically not transported or referred elsewhere unless they require tertiary care. On site diagnostics include MRI, spiral CT, ultrasound, nuclear med and nuclear cardiology. Cardiologists and radiologists are on site 5 days/week and orthopedics 2 days/week plus as needed for ORIF of fractures. Hospital inpatients typically have challenging and multiple problems, which enables students to gain skills in complex primary management rather than poly physician subspecialty care. CLINICS: The Mile Bluff Clinic physician group includes 18 FP's, 3 general surgeons, 3 GYNs, 2 podiatrists, 2 nurse practitioners and 15 PAs (2 surgery, 13 family practice) who practice in the main clinic in Mauston and in 4 satellite clinics in neighboring towns 7 - 20 miles away. The hospital and all clinics are electronically linked to the same scheduling and patient information systems, with full EHR conversion in late 2008/2009. Outreach physicians to many specialties from Madison, Marshfield and LaCrosse see patients in clinic 2 days/week to 2 days/month depending on need. Cooperative opportunities include the Public Health Dept., Home Health, Hospice and 2 correctional facilities.
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Materials Provided
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Computers with high speed InterNet access are available to students at all clinics and the hospital, including access to Up-To-Date and InfoRetriever. Wireless high speed access using student's personal laptop throughout facility may be possible. Home access to Internet via dial-up for personal laptop may be arranged.
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Expectations
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EMERGENCY ROOM/ON CALL: Students are on call with the assigned MD 1 - 2 nights/week and 1 - 2 weekend days/month, but may choose additional ER time, since students typically enjoy this experience very much. ER is covered for inpatients, so it is interesting and busy. FP PA's staff the adjacent Urgent Care during non clinic hours - the combination is typically 30 - 50 patients per day. Students' ER experience emphasizes learning local primary management of cardiac problems, trauma and orthopedics, and includes following 3 - 5 admissions with the attending.
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Evaluating
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A mid-rotation and cumulative evaluation will be completed by the preceptor based on all attendings input involved in the clinical and academic experiences.
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Recommended Texts
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Reference books are available in ER and MDs' offices in addition to online resources.
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Meets Patient Care Requirement
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