Patient Log
This is basically a log of all the patients that you have
meaningful interactions with and can include simulated patients as
well as procedures. While logs can seem very tedious there is a
rationale for keeping track of the clinical presentations, diagnoses,
and procedures you see and perform. We all learn best by being
actively involved and taking care of patients is one of the best ways
to do this. You are blessed to attend a school that has an extremely
diverse and interesting group of patients. Thus, by periodically
reviewing the cases you have seen, you can look for gaps in your
experience and find opportunities on this clerkship or future
rotations to fill in those gaps.
Because internal medicine patients tend to be complicated, we have
allowed you to enter up to four major diagnoses per patient. This will
also help highlight for you how much you can learn from even one
patient. So, for example, you may admit a patient with a presenting
symptom of shortness of breath and you would enter that as the
presenting complaint. The primary diagnosis may be pneumonia but the
patient may also have diabetes that becomes uncontrolled in the
setting of the infection, be hyponatremic from dehydration, and
develop ischemic chest pain from the stress of the infection and
hypoxia. You will presumably manage all these problems during the
admission and should track them as well by enter pneumonia as the
primary diagnosis, and diabetes, electrolyte disorder, and coronary
artery disease as additional diagnoses.
Evaluation criteria: You are required to
enter a minimum of 15 different patients and at least 10 must have
either a new problem or an acute worsening of an existing problem (as
opposed to scheduled admission). The specific diagnoses you are
required to see and that we are specifically tracking are the
following: acute chest pain ,
acute shortness of breath, altered mental status, fever, anemia, electrolyte disorders, acute renal
failure, common malignancies, uncontrolled diabetes, and hypertension.
These specific problems were highlighted as areas of focus because
they are common, important inpatient internal medicine problems that
have either physical findings or complexity of decision making that is
enhanced by direct patient contact (versus reading about it in a
book).
Failure to meet these requirements may result
in a lowering of your patient care competency, thus if you are having
problems finding patients with these problems, you must contact Dr.
Harrell to arrange an alternate way to meet this requirement.
Link to
Patient Log
