Overview of JABSOM Clinical Skills Program
Longitudinal Clinical Preceptors (LCPs) provide first and second year medical students with some of their first encounters with real patients who complain of real problems. This role is critical and quite formative. Students are paired with an LCP for a 2-year commitment : beginning in September of year 1 and completing in March of year 2. Students will spend 7 days in clinical practice with first years and 5 days during year 2.
Students should practice obtaining histories and performing physical exams on patients with LCP guidance. As the relationships develop, preceptors can weave in clinical reasoning, patient education, oral and written presentations and patient management. JABSOM teaches a Problem-Based Learning (PBL) curriculum with foundational sciences, clinical skills and community health supplementing this process.
The pre-clerkship years begin with PBL tutorials in 1) health and illness, followed by 2) cardiovascular and pulmonary problems, 3) renal and hematologic problems, 4) gastrointestinal and endocrine problems, then 6) locomotor, neurological and behavioral problems and finishing with the specific issues in 7) the complete life cycle. Students also receive formal instruction in clinical skills during their organ-specific blocks or units. Students also participate in simulation scenarios and standardized patient experiences each unit. We hope the LCP sessions partly incorporate what the students are learning at the same time. Faculty are expected to have teaching appointment in their departments and adhere to all JABSOM policies regarding student treatment and professionalism.
A Brief History
The LCP program begain in 2020-2021 and was initally called the Longitudinal Clinical Mentors program. JABSOM moved from a organ system-based teaching faculty structure, which was termed Clinical Skills Preceptors, to a longitudinal and holistic model of instruction with a priority placed on the student-preceptor relationship which is instrumental in physician identity formation. Faculty from the general disciplines and primary care (Pediatrics, Family Medicine, Internal Medicine) are sought to provide students a broader foundation of clinical skills. Some specialists also serve as preceptors in our program.
Where We Are Today
We embark on our fifth year in academic year 2024-2025. We love to have preceptors take one first year and one second year student each academic year. We also welcome preceptors who choose to take one student per year. The committment to the student is for both the first and continued second year of medical school.
All LCPs hold a faculty appointment at JABSOM.
We have approximately 114 preceptors for 156 students. 37% of our LCPs work with both a first year and a second year during the acdemic year.
Leadership
Dr. Dennis Bolger is the Director of Clinical Skills. He moved into this position in April 2022 after previously serving in various teaching and administrative positions in Graduate Medical Education (GME) for Internal Medicine, University of Hwai'i Internal Medicine Residency Program and The Queens Medical Center. He brings his GME experience to Undergraduate Medical Education (UME).
Meet the Team
Clinical Skills collaborates with the Office of Medical Education (OME), especially the Center for Clinical Skills (SPEs) and SimTiki Simulation Center.
I. Lifelong Learning
Graduates will be lifelong learners.
Following PBL tutorial, patient care interactions, or in anticipation of future learning needs, students will be life-long, self-directed learners by:
A) Identifying gaps in knowledge and utilizing learning activities to refine their knowledge base.
B) Addressing learning needs by acquiring, integrating, and evaluating their ability to utilize credible resources.
C) Demonstrating commitment to obtaining new knowledge associated with improving patient/population outcomes.
D) Demonstrating commitment to improving personal performance and acknowledging limits in knowledge.
II. Foundational Knowledge and Discovery
Graduates will understand the foundational knowledge and discovery supporting clinical medicine.
Students will apply foundational knowledge and discovery to the practice of medicine by:
A) Describing the normal structure and function of each organ system and their interaction within the human body as a whole.
B) Explaining the various biological (molecular, cellular, and biochemical) mechanisms and non-biological (social, behavioral, psychological, and environmental) determinants that maintain the body’s homeostasis and maintenance of good health.
C) Explaining the various biological (molecular, cellular, and biochemical) and non-biological (social, behavioral, psychological, and environmental) causes of illness and the way in which they impact the body and mind (pathogenesis).
D) Describing the altered structure and function (pathology and pathophysiology) of the body and its organ systems
and tissues that are seen in various diseases and disorders.
E) Explaining the mechanisms by which various treatment modalities impact the pathogenesis and natural history of
diseases and disorders.
F) Discussing the principles of biomedical research methods, common biostatistical tools, scientific rationale, and
evidence-based medicine in determining the cause of disease and the efficacy of conventional, complementary and/
or alternative therapies, to evaluate the validity and application of research results.
III. Care of Patients
Graduates will provide patient-centered care that is compassionate, appropriate and effective for the
treatment of health problems and promotion of health in the ambulatory and hospital setting.
When seeing a patient presenting with a concern or illness in the ambulatory or hospital setting, students will be able to
care for that patient by:
A) Approaching each patient with an awareness of and sensitivity to the impact the patient’s age, gender, culture,
spiritual beliefs, socioeconomic background, lifestyle, social support, sexuality, and healthcare beliefs may have on
the diagnosis and treatment of their illness.
B) Understanding the components of the informed consent process and being capable of obtaining informed consent
for tests, procedures, and/or other interventions while respecting patient confidentiality and autonomy, and
preserving patient dignity.
C) Applying clinical reasoning and critical thinking to develop functional problem lists and differential diagnoses during
a patient encounter.
D) Performing a complete or complaint-focused history and physical exam following an appropriate exam sequence as
indicated by the context of the encounter and utilizing correct technique in a manner that reflects a clear
understanding of the manifestations of common illnesses.
E) Selecting and interpreting appropriate diagnostic tests with careful consideration of the test characteristics, risks,
potential complications, discomfort to patients, cost, and patients’ overall therapeutic goals.
F) Performing routine procedural skills under appropriate supervision that are considered essential for a particular area
of medical practice.
G) Developing and implementing an appropriate treatment plan, including the practice of order and prescription entry,
that takes into account efficacy, adverse effects, socioeconomic, safety, and compliance issues in the context of the
patient’s values and overall goals for treatment.
H) Recognizing and initiating therapy for acute life-threatening conditions.
I) Understanding the complex decision making that is intertwined with palliative and end-of-life care for patients.
J) Incorporating principles of inter professional, high quality, team-based patient care.
K) Learning to apply the principles of quality improvement and systems-based practice to the care of patients.
IV. Communication and Interpersonal Skills
Graduates will be able to communicate effectively with patients, families and other providers in the
interdisciplinary healthcare team.
When in a classroom, clinical, or other healthcare setting, students will communicate effectively with others by:
A) Communicating and effectively educating patients, families, members of the interprofessional team across a broad
range of backgrounds and identities, demonstrating collaboration, sensitivity, cultural modesty, and respect for
individual perspectives.
B) Demonstrating emotional awareness needed to develop and manage interpersonal interactions. This may include
how one’s own biases, identities, and lived experiences may influence one’s perspectives, interactions and clinical
decisions.
C) Effectively conveying clinical information and reasoning, with appropriate assertiveness, in all types of formal and
informal oral and written presentations.
D) Effectively documenting clinical care in medical records.
E) Delivering and receiving feedback effectively from peers, faculty, administration, staff and patients.
V. Population and Community Health
Graduates will understand, advocate, and apply principles and strategies of population and
community health that will result in equitable care of diverse patients and communities.
When in a classroom, clinical, or community setting, students will provide equitable care of diverse patients and
communities by:
A) Demonstrating an understanding of Native Hawaiian and other Indigenous peoples’ views of health and illness, the
impact of social and cultural determinants on their health status, and applying effective strategies for providing
culturally safe, appropriate, and competent care to improve their overall health and wellbeing.
B) Demonstrating meaningful participation in collaborative community health activities that optimize the health and
quality of life of all persons who live and/or work in a defined community or communities.
C) Evaluating the influence of social determinants of health, including economic, psychological, behavioral,
environmental, political, and cultural factors, as well as the effects of racism, that contribute to the maintenance of
health and the care of patients, their families, and communities.
D) Demonstrating knowledge of the physician’s role in global health issues such as climate change, emerging infections
and pandemics, bioterrorism, war, and environmental disasters.
E) Utilizing data from medical records, insurance claims, or other datasets to identify important public health or
population health management strategies (including telehealth) that support the health of communities.
F) Applying the epidemiology of common illnesses within diverse populations to integrate systematic approaches in
reducing the incidence and prevalence of such illnesses.
G) Caring for all patients, regardless of ability to pay, and advocating for equitable access to health care for
underserved and vulnerable populations.
H) Integrating important legal considerations in the practice of medicine by understanding the relationship between
public health practice and national and state laws.
I) Effectively tailoring healthcare strategies to constantly changing conditions faced by populations and their
communities.
VI. Professionalism
Graduates will be professional and ethical and demonstrate an enthusiasm for medicine while
delivering compassionate care to their patients.
When practicing medicine or representing JABSOM both inside and outside the classroom or clinical setting, students
will exhibit the highest standards of professional and ethical behavior by:
A) Applying the theories and principles that govern ethical decision-making including those related to the major
dilemmas in medicine.
B) Adhering to JABSOM policies regarding academic integrity, completing school and professional requirements in a
timely manner, cheating, plagiarism, fabrication, and falsification and to JABSOM and UHM policies regarding
student conduct.
C) Showing respect, honesty, altruism, accountability, honor, excellence, integrity, and humility.
D) Presenting a professional attire and demeanor.
E) Respecting patient confidentiality and preserving patient dignity.
F) Recognizing potential conflicts of interest inherent in various financial and organizational arrangements in the
practice of medicine.
G) Dealing with professional mistakes openly and honestly in ways that promote patient and clinical team trust and self-
learning.
H) Acknowledging personal limitations, ability to reflect and self-assess, and the need for lifelong learning.
I) Contributing to a safe and positive environment by active participation in JABSOM learning opportunities,
willingness to teach and support others, and demonstrating respect for diversity.
J) Incorporating principles of interdisciplinary collaboration, especially in the areas of communication and patient
safety.
K) Developing professional identity formation to embody the JABSOM Professionalism Philosophy.
VII. Wellness and Resiliency
Graduates will have the skills and strategies to maintain wellness and resiliency.
Students will maintain their wellness and resiliency by:
A) Describing strategies to maintain personal physical and mental health while fostering positive connections with
others.
B) Stating healthy habits to manage stress and exam anxiety.
C) Stating strategies to maintain personal safety and the safety of others in both academic and clinical environments.
D) Debriefing critical clinical incidents, such as unexpected outcomes and mistakes, with colleagues to reflect on
lessons learned.
E) Identifying resources available for treating physical and mental illness, including substance use disorder, and other
forms of physician impairment.
F) Stating the key elements of the student mistreatment policy, including the definition of mistreatment and how to
report it.
G) Recognizing and reflecting upon the importance of wellness and its impact on one’s personal and professional life.