Family Practice Continuum:
Vancouver-Fraser, Island and Northern
Medical Programs
Undergraduate Program
Department of Family Practice
David Strangway Building, Suite 300,
5950 University Boulevard
Vancouver, BC V6T 1Z3
Ph: 604-827-4196/fax: 604-822-6950
FAMILY PRACTICE CONTINUUM (FPC) PARTICULARS
FMPR 401A (SEPT – DEC)
Course Organization
Q.
What is the organization of the FMPR 401A course?
A.
The entire class of 224 medical students (176 Vancouver-Fraser, 24 Island, and 24 Northern) take
part in a series of lectures and seminar sessions throughout most of the semester (Sept – Dec) here in
Vancouver at the UBC Campus.
Students are designated either Tuesday or Thursday (this is their Family Practice day), 112 students
per day, and then grouped into pairs – 56 pairs on Tuesday and 56 pairs on Thursday.
FPC Preceptor offices are being asked to teach 8 afternoons (either Tuesday or Thursday) from late
September to early November in this semester.
Your office can expect a pair of 1st year medical students on these 8 afternoons (see schedule
on GREEN SHEET). Over the first 4 afternoons, you will have 1 pair of students, and then over
the next 4 afternoons, you will have a 2nd pair of students.
While this can appear confusing, we will send you monthly faxes to help you stay on top of
who is coming to your office and when.
Course Requirements
Q.
What assignments do the students have to complete during their time with me?
A.
1. Fill out 2 Patient Encounter Logs (see Appendix for samples).
2. Ensure they are assessed by you on their preliminary office performance (see Appendix for
blank copy of assessment).
Q.
What are these Patient Encounter Logs (PEL’s) and why must the students fill them out?
A.
The Patient Encounter Logs encourage the students to practice different skills while in your office.
Our two-year curriculum focuses at the beginning on having students learn to document patient
encounters using the SOAP format. We have asked them to fill out 2 SOAP logs during their time in
your office.
Family Practice Continuum:
Vancouver-Fraser, Island and Northern
Medical Programs
Undergraduate Program
Department of Family Practice
David Strangway Building, Suite 300,
5950 University Boulevard
Vancouver, BC V6T 1Z3
Ph: 604-827-4196/fax: 604-822-6950
After their time in your office (mid-November), we will ask the students to use the 2 SOAP logs from
your office to complete a log related to informatics and literature searching. The log will be
handed in to a number of librarians who will assess the students’ question formulation and literature
searching skills. We have asked students to fill out these logs to give them practice in actually
carrying out these interviews. We have found that if we ask them to document their encounters with
patients they do a better job than if we do not.
In addition, by having students fill out all of these logs, we are able to ensure that they are interacting
with patients.
Please give the students the opportunity to interview patients and fill out these logs.
Q.
Who is going to mark these 2 SOAP logs?
A.
You will. Since you will be observing the students, we would like you review and initial each of these
logs when they are completed (some students may complete them in the office and some may take
notes and complete them at home—these home-completed logs should still be reviewed by you).
Please give the students feedback. We have included sample Patient Encounter Logs in the
Appendix.
Course Assessment
Q.
Besides reviewing and initialling the 2 SOAP logs, what other assessment will preceptors do?
A.
We want you to assess your students with verbal feedback at the end of each afternoon.
At the end of the 4 weeks/afternoons with your students, we ask that you assess them formally with
the formative assessment you will find at the end of the Appendix.
Q.
What form should we use to assess our students?
A.
We have included a copy of this form at the end of the Appendix.
Q.
How should we assess the students during the course? What criteria should we use?
A.
This formative assessment will identify and reinforce what students do well, suggest areas that they
can work on that are appropriate for their level of training, and provide them with an “educational
prescription” to follow when their commence their intensive Family Practice session in January. The
headings that drive the content of these assessments are very simple: Strongest Feature of this
Student, Area/Skill Requiring Attention for this Student and Any Concerns regarding the student. It is
advisable that the student completes the student section of the assessment (to offer an opportunity for
self-assessment) before the preceptor completes their section.
Family Practice Continuum:
Vancouver-Fraser, Island and Northern
Medical Programs
Undergraduate Program
Department of Family Practice
David Strangway Building, Suite 300,
5950 University Boulevard
Vancouver, BC V6T 1Z3
Ph: 604-827-4196/fax: 604-822-6950
Help & Advice from the FPC Undergraduate Office
Q. Do I have to be concerned that the students’ have had all their immunizations??
A.
It is expected that the students will have completed all of the requirements with respect to
communicable diseases prior to their first visit to clinical offices. You may wish to confirm with
the students that they have met all the necessary requirements (eg, immunization , TB
testing, etc). Should you have any questions or concerns please contact our office at 604827-4196.
Q.
Who can I turn to for help?
A.
Our FPC 401 Undergraduate Office (604) 827-4196.
Q.
What if I am having trouble with a student?
A.
For small problems such as being late once, not having their equipment once, etc., please discuss
with the student.
For more serious problems, please contact the FPC 401 Undergraduate Office. We will be happy to
help.
Please note any problems on their formative assessment so that the student has time to remedy any
deficiencies and we have documentation thereof.
Q.
How do I get in touch with the undergraduate office?
A.
Primary contact: Mrs. Marika Dauberman, (604) 827-4196, Fax: (604) 822-6950.
Name
Mrs. Marika
Dauberman
Dr. Gurdeep Parhar
Dr. Lys Fonger
Dr. Catherine Textor
Position
Year 1 FPC Program Assistant
Phone
E-mail
(604) 827-4196 fpc.401@familymed.ubc.ca
Vancouver-Fraser Course Director (604) 827-4196
Island Course Director
(604) 827-4196
Northern Course Director
(604) 827-4196
Family Practice Continuum:
Vancouver-Fraser, Island and Northern
Medical Programs
Undergraduate Program
Department of Family Practice
David Strangway Building, Suite 300,
5950 University Boulevard
Vancouver, BC V6T 1Z3
Ph: 604-827-4196/fax: 604-822-6950
Appendix: sample Patient Encounter Logs
In these examples, a single patient is used to demonstrate all of the patient encounter logs. However,
students will be expected to do each of their logs with a different patient.
SOAP
S
38 year old woman comes in with a report of feeling “dizzy” and “unsteady on her feet”
Dizziness started 10 days ago
Episodes last 1-3 minutes
Occur 2-3 times a day, not getting more frequent
Can occur at any time and nothing seems to help except sitting down
Room does not seem to spin, but on one episode she felt faint “like I am going to pass out”
Sometimes feels heart pounding in chest during these episodes
O

No chest pain, no history panic attacks, not “stressed out”

Drinks one cup of coffee a day

Does not drink alcohol and does not currently smoke
BP 120/60, HR 78 regular
Normal heart sounds
No carotid bruits
Normal thyroid to palpation
A
Possible panic attacks but unlikely
Given faint feeling that is relieved by sitting down and heart pounding in chest during these episodes
must consider a dysrhythmia
P
Will arrange a Holter monitor (a 24 hour monitor of the patients heart rhythm) for tomorrow.
Will do some blood work today (TSH, CBC, lytes)
Will have the patient follow up if things get worse (more frequent, more severe, any chest pain)
Will have the patient follow up in the office after the Holter
Family Practice Continuum:
Vancouver-Fraser, Island and Northern
Medical Programs
Undergraduate Program
Department of Family Practice
David Strangway Building, Suite 300,
5950 University Boulevard
Vancouver, BC V6T 1Z3
Ph: 604-827-4196/fax: 604-822-6950
Appendix: sample Patient Encounter Logs
SOAP, Learning Issues, PICO Question
S
O
A
P
As previously
As previously
As previously
As previously
Learning Issues (please derive at least 3 from this encounter)
Is this an appropriate indication for a Holter monitor?
How good are Holter monitors at picking up dysrythmias?
What are some causes of dizziness or passing out in this age group?
Should this patient have a mammogram?
What is the difference between dizziness and passing out?
Should a 38-year-old woman be taking oral contraceptives?
When I don’t know the diagnosis and it could be serious should I tell the patient this?
What are the appropriate investigations (if any) for this problem of near passing out?
Could she die from this if it is a dysrythmia?
Should this possible dysrhythmia be investigated more urgently?
Could this “dizziness” be small strokes?
If these are small strokes could the oral contraceptive pill be causing this?
Clinical Question
PICO (population—intervention—comparison—outcome)
In a 38-year-old woman without a family history of breast cancer (population) does screening mammography
(intervention) compared to not performing screening mammography (comparison) prevent premature death
(outcome)?
Family Practice Continuum:
Vancouver-Fraser, Island and Northern
Medical Programs
Undergraduate Program
Department of Family Practice
David Strangway Building, Suite 300,
5950 University Boulevard
Vancouver, BC V6T 1Z3
Ph: 604-827-4196/fax: 604-822-6950
SOAP, PICO Question & Answer
S
O
A
P
As previously
As previously
As previously
As previously
Clinical Question
PICO (population—intervention—comparison—outcome)
In a 38-year-old woman without a family history of breast cancer (population) does screening mammography
(intervention) compared to not performing screening mammography (comparison) prevent premature death
(outcome)?
Answer
Source
Glasziou PP. Woodward AJ. Mahon CM. “Mammographic screening trials for women aged under 50. A quality
assessment and meta-analysis.” Medical Journal of Australia. 162(12): 625-9, 1995
Abstract:
Objective: To carry out a systematic quality review and meta-analysis of all randomised trials of
mammographic screening that included women aged less than 50 years.
Data Sources: Reports of randomised trials of mammographic screening were identified via MEDLINE and
checks of the bibliographies of retrieved articles and reviews.
Data Synthesis: Identified trials were assessed for: (i) method of randomisation; (ii) documented
comparability of baseline data; (iii) standardised criteria for breast cancer death; (iv) blinded review of
cause of death; (v) completeness of follow-up; and (vi) use of an "intention-to-treat analysis". Seven
randomised trials including almost 160,000 women aged under 50 were studied. The combined estimate of
relative risk was 0.95 (95% confidence interval, 0.77-1.18), a statistically non-significant reduction of 5%.
Adjustment for the cluster randomisation of two trials, and for degree of compliance, did not substantially
change this result.
Conclusions: These analyses suggest little, if any, benefit for women under 50 years of age. The results are
not explained by the quality of the trials or the radiology. We recommend that women in this age group
intending to be screened should be fully informed of these results.
The Canadian Task Force on Preventive Health Care [http://www.ctfphc.org/]
Current evidence regarding the effectiveness of screening mammography does not suggest the inclusion of
the manoeuvre in, or its exclusion from, the periodic health examination of women aged 40–49 years at
average risk of breast cancer (grade C recommendation). Upon reaching the age of 40, Canadian women
should be informed of the potential benefits and risks of screening mammography and assisted in deciding at
what age they wish to initiate the maneuver.
Given the above information, I would discuss the evidence with this patient around mammographic screening of
women under the age of 50.
Undergraduate Program
Family Practice Continuum:
Vancouver-Fraser, Island and Northern
Medical Programs
Department of Family Practice
David Strangway Building, Suite 300,
5950 University Boulevard
Vancouver, BC V6T 1Z3
Ph: 604-827-4196/fax: 604-822-6950
FMPR 401A Assessment of Student
Student:
Preceptor:
DATE:
LOGS COMPLETED:
Student has completed and shown you: SOAP Log # 1
SOAP Log #2
This is a preliminary assessment of student – designed to aid students in identifying areas of strength and
general areas for improvement. Both the preceptor and the student need to highlight specific areas of
strengths and general areas for improvement for the student as they continue with their Family Practice
experience (p. 1). Preceptors are asked to complete (p. 2) to provide the Course Director(s) with an
assessment of the student’s development over the semester.
Preceptors, please note if there are any concerns about the student. Please check off the completed
logs 1 & 2 above. Please review this assessment with the student and return it to the student whom will return
it to the FPC 401 office (or it can be faxed to the office at 604-225-2557).
Strongest Feature of this Student:
Preceptor comments:
Student comments:
General Area/Skill Requiring Attention for this Student:
Preceptor comments:
Student comments:
(…cont’d)
Family Practice Continuum:
Vancouver-Fraser, Island and Northern
Medical Programs
Undergraduate Program
Department of Family Practice
David Strangway Building, Suite 300,
5950 University Boulevard
Vancouver, BC V6T 1Z3
Ph: 604-827-4196/fax: 604-822-6950
(…p.2)
Does not meet
requirements
Requires
Improvement
Meets requirements
Exceeds Requirements
□ More often than not
has difficulty obtaining
information in an
efficient and organized
way.
□ Does not accept
criticism well; presents
various excuses to
explain shortcomings;
rarely revises
judgments despite
evidence.
□ Sometimes has
difficulty obtaining
information in an
efficient and
organized way.
□ Does not accept
criticism well, but
can be convinced
to change
judgments when
evidence shows
error.
□ Obtains
information in an
organized
fashion.
3. Patient
Relations:
□ Is unable and unwilling
to deal with emotional
and personal needs of
patients and their
families and has
difficulty gaining
cooperation. Patients
often feel
uncomfortable with the
student.
□ Has difficulty in
grasping and
dealing with
emotional and
personal needs of
patients and their
families and
usually has
difficulty gaining
cooperation from
the patient.
□ Able to
understand and
deal with
emotional and
personal needs
of patients and
families and can
enlist their
cooperation.
4. Reliability:
□ Makes commitments
with respect to patient
care but often (more
than twice) does not
keep them.
□ Makes
commitments with
respect to patient
care but
occasionally (once
or twice) does not
keep them.
5. Professionalism:
□ Cynical, arrogant, and
aloof with patients.
Can be disrespectful
to patients,
occasionally berating
and chiding them.
Keeps own interests
ahead of the patient.
Complaints from
patients
□ Somewhat
arrogant, and aloof
with patient. Often
uses jargon to
maintain emotional
detachment Often
fails to
demonstrate
empathy towards
the patient. No
patient complaints.
□ Is dependable
regarding
commitments
made with
respect to
patient care
except in
occasional and
justifiable
circumstances.
□ Is respectful of
patients and for
the most part
behaves in a
professional and
caring manner.
□ Conducts an
exemplary and
efficient interview
conveying clear
messages.
□ Accepts criticism
easily and seeks
out evaluative
advice from
colleagues; willingly
changes judgments
if evidence shows
errors.
□ Unusually sensitive
and skilful in
eliciting and dealing
with emotional and
personal problems
of patients and
families.
Establishes rapport,
and wins
confidence and
cooperation of
patients.
□ Always dependable
regarding
commitments made
regarding patient
care. Goes out of
the way to meet
commitments even
m extraordinary
circumstances.
1. Communication:
2. Selfassessment:
□ Accepts criticism.
Can be
convinced to
change
judgments when
evidence shows
error.
□ Words and actions
demonstrate a
respect for the
values of the
medical profession;
always puts
patients first, and
demonstrates great
concern and caring
for the patient.
Any Concerns: _____________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________