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8/2/2019 120501 FCHM Rotation Writeup
1/21
YEAR LEVEL 9 CURRICULUM
Family and Community Health Management
Course Description
The Family and Community Health Management rotation of the Internship Program (Year Level 9) is an
integration of the knowledge and skills acquired from Year Levels 5 to 7 and an extension of the core
experience from Year Level 8 with particular focus on the application of the bio-psychosocial patient care
management and public health geared towards achieving sustainable health goals in both hospital and
community-based facility.
The primary training objectives of the program are focused on the development of core competencies
identified as being essential to the practice of family medicine and public health in both hospital and community
settings. Likewise, the rotation will also allow the interns to have an active participation in the strategic
management of the community from which they will be assigned. The integration of the three disciplines:
family and community medicine, public health, and management, is a unique experience crafted to develop a
physician who have a holistic view of an individuals medical condition and its impact to his family and
community using the biopsychosocial approach and applying the demographic profile of combine patient data
to address the concern of the community, not only of health but its association with education, environment and
livelihood towards a sustainable community-managed program.
Course Pre-requisite
The student must have sufficiently fulfilled the course in family medicine and public health at Year
Level 8. Likewise, the student must have passed the requirements for the MBA program and have achieved a
satisfactory rating.
Course Duration
The Family and Community Health Management is a two-month rotation that will be conducted in three
sites (Trese, Molave and Lupang Pangako) in Barangay Payatas in Quezon City. During this period, the student
will be required to undergo clinical rotation either in Payatas B Health Center or Lupang Pangako Health Center
at specified schedule interspersed with group-based intervention activities and strategic management sessions
on flexible schedules. An average of 80 hours will be spent by an intern at the Health Center while an average
of 240 hours combined will be spent for the immersion at his/her respective area of assignment.
ATENEO SCHOOL OF MEDICINE AND
PUBLIC HEALTH
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Grouping
There will be at least 10 interns rotating at any given period. The interns will be divided into three (five
interns) and will be assigned either in Trese, Molave or Lupang Pangako in Barangay Payatas. Each group wil
be further subdivided into two or three interns per subgroup to facilitate the tasking in the health center duty and
the assignment of clusters in the community. While one group is at the clinic, the other group will be assigned
either to a field work (group-based intervention or strategic management) or conduct home visits.
Learning Activities
A. Facility-based Patient Consult
The Facility-based Patient Consult will allow the intern direct patient care, performing a complete
clinical history and focused physical examination, developing a primary working impression and initiating
appropriate and cost-effective diagnostic and therapeutic (pharmacologic and non-pharmacologic) management
Continuity of care is also emphasized as the intern will have enough time to have the patient come for follow-up
consult. There will be two areas to facilitate this activity the local health center (Payata B Health Center or
Lupang Pangako Health Center) and the health hub in their respective areas of assignment.
A1. The Local Health Center
The intern will undergo clinical rotation at a local health unit during the duration of his/her rotation
He/she will attend to clinic consults following the prescribed schedule. The intern will be required to sign in at
7:30 am and sign out at 5:00pm in the Attendance Logbook.
Using the biopsychosocial framework, he/she will conduct clinical interviews and fill up completely the
patient data base (may use the Patient Encounter form in Appendix K). The intern must be able to perform acomplete clinical history and physical examination. Based from the information he/she had obtained, the intern
must be able to arrive at a primary working diagnosis and recommend the appropriate management (diagnostic
and therapeutic, including non-pharmacologic advises and follow-up). The intern will have to affix his/her name
and signature at the end of the chart. The intern will then instruct the patient to stay at the waiting area until
his/her name be called for checking by the medical officer and final disposition.
For patients on follow-up consult, the intern is required to evaluate the patients condition with a
complete clinical history and physical examination, noting new symptoms or improvement of complaints and be
able to interpret laboratory results as needed. The intern is expected to write the patients present working
diagnosis and give recommendation for management.
Table 1. List of symptoms that must be seen by the intern.
Cough Low back pain Loose bowel movement
Colds Joint pains Sleeping difficulty
Elevated blood pressure Difficulty of breathing Blurring of vision
Abdominal pain Dysuria Hemoptysis
Headache Weight loss Ear discharge
Dizziness Vomiting Fever
Chest pain Skin rashes Seizure
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It is suggested that filing of the patient data base forms follow the heads of the family. The student will
be required to fill up the daily census and file accordingly.
Interns are also encouraged to perform clinical procedures as needed, initially to be assisted by the nurse
or midwife. This will enhance their clinical skills that are essential in the primary health care.
Table 2. List of clinical procedures that may be performed by an intern at the health center.
Taking blood pressure Prostate examination Cerumen extractionFundoscopy Skin testing Simple ear irrigation
Visual acuity testing Vaccination Circumcision
Otoscopy Blood extraction Incision and drainage
Tuning fork test Foley catheter reinsertion Wound dressing
Breast examination Nasogastric tube reinsertion Cyst excision
Internal examination Torniquet test Suturing
Digital rectal examination Pap smear Suture removal
The interns assigned in the clinic may be assigned to (1) attend to the regular patient consult, (2) attend
to outreach activities of the clinic (immunization at satellite clinics, etc.), (3) facilitate public health lectures or
(4) partner with a barangay health worker as assigned by the MHO and conduct field visits.
All interns report to the municipal health officer of the local health unit and endorse all patients seen for
final disposition. The intern will also be responsible in providing and filling of the laboratory request forms and
prescriptions that will be given to the patient with proper instructions. The interns may be requested to conduct
emergency cases as accompanying medical personnel to the referral hospitals and endorse properly to the
receiving physician. The interns can also assist in the preparation of monthly health reports.
The interns are expected to maximize their learning opportunities through discussions with the MHO
and the HC staff. Interns are expected to learn and understand the processes involved in the management of a
barangay health unit, the administrative and operational issues of concern and the relationship of allstakeholders in relation to health care delivery and its referral system.
A2. The Health Hub
A health hub is a facility provided in each of the areas in the community. The intern will be required to
sign in at 8am and sign out at 4:00pm in the Attendance Logbook.
He/she will attend to clinic consults following the prescribed schedule (recommended is 9am-12noon)
Using the biopsychosocial framework, he/she will conduct clinical interviews and fill up completely the patient
data base (may use the Patient Encounter form in Appendix K). The intern must be able to perform a complete
clinical history and physical examination. Based from the information he/she had obtained, the intern must be
able to arrive at a primary working diagnosis and recommend the appropriate management (diagnostic and
therapeutic, including non-pharmacologic advises and follow-up). All prescriptions and laboratory requests
should be properly filled-up and signed. The intern will have to affix his/her name and signature at the end of
the chart. If a faculty is present, he/she may be required to present the case prior to discharge.
For patients on follow-up consult, the intern is required to evaluate the patients condition with a
complete clinical history and physical examination, noting new symptoms or improvement of complaints and be
able to interpret laboratory results as needed. The intern is expected to write the patients present working
diagnosis and give recommendation for management.
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B. Home Visit
The home visit will be conducted either at the GK-Trese, GK-Molave, or GK-Cox, depending to where
the intern will be assigned. Both areas are established GK-Ateneo villages. Each intern are required to have
three families all thru out his/her rotation. The home visit will be conducted on a once a week basis per family,
unless where a more regular schedule is needed.
The following is a suggested template of activities in relation to the conduct of home visits:
Weeks 1-2: Family profile (biomedical)Weeks 3-4: Family assessment toolsgenogram, SCREEM, etc
Weeks 5-6: Family wellness plan
Weeks 7-8: Endorsements
The intern will fill up the family profile charts and update it every follow up visit.
Table 3. Template of schedule of home visits.
Monday Tuesday Wednesday Thursday Friday
Week 1 Subgroup B Subgroup C Subgroup D Subgroup A Subgroup B
Week 2 Subgroup C Subgroup D Subgroup A Subgroup B Subgroup C
Week 3 Subgroup D Subgroup A --- Subgroup C Subgroup D
Week 4 Subgroup A Subgroup B --- Subgroup D Subgroup A
Week 5 Subgroup B Subgroup C Subgroup D Subgroup A Subgroup B
Week 6 Subgroup C Subgroup D Subgroup A Subgroup B Subgroup C
Week 7 Subgroup D Subgroup A Subgroup B Subgroup C Subgroup D
Week 8 Subgroup A Subgroup B Subgroup C --- ---
The intern may also perform clinical procedures as needed and facilitate referral to the health center if
the case requires.
Table 4. List of clinical procedures that may be performed by an intern during a home visit.
Taking blood pressure Breast examination Vaccination
Fundoscopy Internal examination Nasogastric tube reinsertion
Visual acuity testing Digital rectal examination Torniquet test
Otoscopy Blood extraction Wound dressing
Tuning fork test Foley catheter reinsertion
C. Teaching-Learning Conferences
All Wednesday afternoon (230-5pm, except the first Wednesday 1-5pm) of the rotation are reserved for
the teaching-learning conference. This provides an opportunity for the faculty preceptors to discuss with the
rotating interns their experiences during the rotation. The topics for discussion are categorized into two: the
biopsychosocial rounds and thepublic health and management rounds.
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The suggested template of the topics as per week is as follows:
Week 1 Skills session (CEA, facilitating skills, active listening skills,etc)
Week 2 Mentoring/Coaching
Week 3 Project cycle management and Impact monitoring/impact chains
Week 4 Mentoring/Coaching
Week 5 Clinical case discussion (cases seen at the health center and home visits)
Week 6 Mentoring/Coaching
Week 7 Family case presentationsWeek 8 Endorsements
Interns are also expected to attend the staff conference facilitated by the municipal health officer every
second and fourth Mondays of the month. They are also encouraged to provide feedback on the health programs
and health status in their assigned communities.
D. Community Field Visits
The interns will be assigned either in GK-Trese, GK-Molave or GK-Cox.
Table 5. Template of schedule of community field visits.
Monday Tuesday Wednesday Thursday Friday Saturday
Week 1 Subgroups C/D Subgroups A/D Subgroups A/B Subgroups B/C Subgroups C/D Subgroups
A/B/C/DWeek 2 Subgroups A/D Subgroups A/B Subgroup B Subgroup C Subgroup D
Week 3 Subgroups A/B Subgroups B/C Subgroups C/D Subgroup D Subgroup A/B
Week 4 Subgroups B/D Subgroups C/D Subgroups A/D Subgroup A Subgroups B/C
Week 5 Subgroups C/D Subgroups A/D Subgroups A/B Subgroups B/C Subgroups C/D
Week 6 Subgroups A/D Subgroups A/B Subgroup C Subgroup C Subgroup D
Week 7 Subgroups A/B Subgroups B/C Subgroup D Subgroup A Subgroups A/B
Week 8 Subgroups B/C Subgroups C/D Subgroup D Subgroups A/B Subgroups A/B/C
Activities for community field visits will be guided by the strategic plan or health agenda that will be
developed with the partner community. Hence, they may observe and assist in the conduct consultative
meetings with stake holders (i.e. Gawad Kapitbahayan of each community, Gawad Kalinga-Ateneo, local
government units especially the barangay council, etc). The interns are encouraged to contribute their thoughts
in community development such as in the design and implementation of group-based and skills-based education
intervention. The interns are also expected to mobilize the community to participate in these interventions.
The interns are also to review data source, gather and analyze information regarding the prevailing
health status of the community. This will be interspersed with the information they obtain from the home visits
that they conduct. They are expected to generate recommendations that will be consistent with the strategic
plans of the community and the organization.
E. Public Health Awareness Lectures
Interns are encouraged to facilitate and conduct public health awareness lectures either in the Payatas B
Health Center or in the respective areas where they are assigned (Purok Molave or Purok Trese). Topics for the
lectures should be based on the community needs and information they have obtained during their community
field visits. Interns should also be able to involve the community health workers in facilitating the lectures.
Materials for the lectures will be on the discretion of the interns.
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F. Strategic Management Activities
As such that the strategic management activities is anchored in the strategic plan of the community and
the organization, the interns are expected to participate in the on-going strategic assessment and planning and
programs. The interns are expected to apply principles of change management and leadership in the
implementation of community based programs. They are also encouraged to utilize basic management
functions, such as planning, organizing and leading, in implementing these programs.
The interns may conduct community focused group discussions (FGDs), join meetings with leaders andkey stakeholders as well as interview key informants. They may also facilitate communication and marketing
activities as necessary but still anchored in the strategic plan.
The interns will be required to write a journal of learning and reflections regarding their experiences on
the activities that they are involved in. The interns are required to accomplish the Report of Activity forms and
submit it at the end of their rotation.
Course RequirementsAt the beginning of the rotation, all interns are required to fill up two (2) copies of the Personal Data
Sheet and attach two (2) pieces of their recent 2x2 ID pictures. One copy will be submitted to the Medica
Health Officer during the clinic orientation while the other copy will be submitted to their respective facultypreceptors.
A. Case Presentations
The interns will be required to present two case presentations during their rotation: case discussion andfamily case.
For the case discussion, each subgroup will present a case that they have seen during their health centerduty and/or home visits. They will discuss the assessment and management of the case using the
biopsychosocial approach. Each group will be given 20 minutes for the oral presentation and a 10-minutediscussion will follow. The group will be required to submit a written report at the end of the session.
For the family case, each group (Trese, Molave and Cox) will present one family using thebiopsychosocial approach. The group must highlight the family profile, the family assessment tools used and
the family wellness plan. Each group will be given 30 minutes for the oral presentation and a 10-minutediscussion will follow. The group will be required to submit a written report at the end of their rotation
incorporating the comments and feedback during the open forum.
B. Patient Census LogAll patients seen during the health center duty, health hub, outreach clinics and home visits should be
logged. The patients name, age, sex, address, chief complaint, present working impression and summary ofmanagement should be logged following the format provided. It will be submitted as a course requirement at the
end of their rotation.
Table 6. Patient Census Log.Date seen Name Age/Sex Address Chief Complaint Present Working
Impression
Summary of
Management
Signature
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C. Family Profile ChartsEach intern will be assigned five families under their care for the two-month rotation. The intern is
required to accomplish the Family Profile Chart (Appendix __) and update necessary information during hishome visits. The Family Profile Charts will be arranged based on the head of the family. Each intern will make
recommendations and provide a Family Wellness Plan for each of the family he/she is assigned. The charts willbe collated in a filing cabinet provided at the Payatas B Health Center.
D. Journal/Report of ActivityEach intern will accomplish a Journal and Report of Activity form that will detail their learning and
experiences in the activities they have been involved during their rotation. This will be used as part of theprocessing during the teaching-learning conferences as well as a feedback form that will be collated as
accomplishment report to be submitted at the Quezon City Health Office and the Payatas B Health Center.
E. End-of-Rotation ExaminationAt the end of the rotation, the interns will have a 100-points written Objective Structured Clinical
Examination. Topics covered will be based on common diseases seen during clinic consults and home visits
(including clinical practice guidelines, EPI, NTP, IMCI, etc), family and community medicine concepts, public
health principles and management concepts. MPL for the examination is 70.
Course Evaluation
Interns will be evaluated based on their performance at the health center; involvement in the strategic
planning and program planning and implementation; oral presentations and written reports requirements; theend-of-rotation examination; behaviour and attitude evaluation; and attendance.
Performance evaluation (MHO, faculty preceptor, CO) 30%Participation and involvement in the strategic planning and implementation 25%Case report requirements 15%
End-of-rotation examination 15%Behaviour and attitude evaluation 10%Attendance 5%
Suggested Readings1. Expanded Program for Immunization2. National Tuberculosis Program 20103. Integrated Management of Childhood Illnesses4. National Compendium 2011
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PERSONAL DATA SHEET
Group Number: ______
Date of Rotation: ___________________
Name: ________________________________________
Attach latest 2x2/passportsize photo here.
Nickname: __________________________
Age : ___________ Birthday: _________
Contact information:
CP number: ___________________________________
Email: ___________________________________
Address: __________________________________________________________________
__________________________________________________________________
Educational background:
High school: _______________________________________________________
College/Course: _______________________________________________________
Hobbies/Skills/Special interests: _________________________________________________
Person to notify in case of emergency
Name: _______________________________________________
Contact number: _______________________________________________
Specimen signature: 1. ___________________________________________
2. ___________________________________________
ATENEO SCHOOL OF MEDICINE AND
PUBLIC HEALTH
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PATIENT CENSUS LOG
Name of Intern: ____________________________ Group No.: _____ Date of Rotation: ____________________
Date seen Name Age/Sex Address Chief Complaint Present Working
Impression
Summary of
Management
Checked by
ATENEO SCHOOL OF MEDICINE AND
PUBLIC HEALTH
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FAMILY CHART FORM
Name of Intern: _________________________ Group No.: _____ Date of Rotation: ___________
Name of Family : _____________________________________
Address: ______________________________________ Contact No. : __________________
Family Profile
Name of Family Member Age/Sex Occupation
Genogram
Family Structure:____________________________________________________
Family Life Cycle Stage:_______________________________________________
Issues to be anticipated:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
ATENEO SCHOOL OF MEDICINE AND
PUBLIC HEALTH
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Family Map
Indicate the following: Index Patient, Primary Breadwinner, Primary CaregiverFamily APGAR
Family
Member 1
Family
Member 2
Family
Member 3
ADAPTATION I am satisfied that I can turn to my family for help whensomething is troubling me.Akoy nasisiyahan dahil sa nakakaasa ako ng tulong sa
aking pamilya.
PARTNERSHIP I am satisfied with the way my family talks over thingswith me and shares problems with me.
Akoy nasisiyahan sa paraaang nakikipagtalakayan sa
akin ang aking pamilya tungkol sa aking problema.
GROWTH I am satisfied that my family accepts and supports mywishes to take on new activities or directions.
Akoy nasisiyahan at ang aking pamilya ay tinatanggap
at sinusuportahan ang aking mga nais gawin patungo
sa mga bagong landas para sa aking ikauunlad.
AFFECTION I am satisfied with the way my family expresses
affection and responds to my emotions, such as anger,sorrow or love.
Akoy nasisiyahan sa paraang ipinadadama ng aking
pamilya ang kanilang pagmamahal at nauunawaan ang
aking damdamin katulad ng galit, lungkot at pag-ibig.
RESOLVE I am satisfied with the way my family and I share timetogether.
Akoy nasisiyahan na ang aking pamilya at ako ay
nagkakaroon ng panahon sa isat isa.
OVERALL ASSESSMENT
Score: 0 hardly ever (halos hindi) 1 some of the time (minsan) 2 almost always (palagi)
Interpretation: 0-3: severely dysfunctional 4-6: moderately dysfunctional 7-10: highly functional
SCREEM
PARAMETER RESOURCE PATHOLOGY
Social
Cultural
Religious
Economic
Educational
Medical
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FAMILY HEALTH CARE PLAN
Family Member Screening TestsImmunizations/
Chemoprophylaxis
Lifestyle
ModificationCounseling Needs
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EPISODIC CONSULT SHEET
Name of Family: _______________________________________
Date of visit Name Chief complaint Course of Illness/PE Assessment Management
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FAMILY AND COMMUNITY HEALTH MANAGEMENT
Performance Evaluation (Health Center Duty)
Name of Intern: ____________________________________________
Date of Rotation: __________________________________________
Health Center (encircle one): Payatas B Lupang Pangako
Rate according to the frequency with which the competency is manifested by the
intern as observed by the evaluator
5 = 90% of the time (Outstanding)4 = 75% of the time (Very Satisfactory)
3 = 50% of the time (Satisfactory)
2 = 25% of the time (Fair)
1 = very rarely seen, (Unsatisfactory)
NO = not observed (No opportunity for observation)
COMPETENCIES
AS A DOCTOR
1. Got a pertinent clinical history. _____
2. Performed a thorough physical examination. _____
3. Gave a complete biopsychosocial diagnosis and differential . _ ____
4. Utilized a cost effective laboratory procedures. _____
5. Prescribed the most cost effective treatment intervention. _____
6. Gave medical advice and other non pharmacologic
intervention to patients.
_____
7. Referred appropriately when necessary. _____
8. Gave particular importance to preventive care and health
promotion e.g., lifestyle modification and screening
_____
9. Provided specific follow-up date. _____
AS A RESEARCHER
Utilized the most current and best research on
diagnosis and treatment.
_____
AS COUNSELOR
Showed empathy to patients who are physically and/or
emotionally in pain.
_____
AS EDUCATOR / LEARNER
1. Educated patients on the nature of their illness, its
causation, management and prognosis.
_____
2. Taught barangay health workers. _____
3. Actively participated in case discussions of cases. _____
AS MANAGER AND PUBLIC HEALTH ADVOCATE
1. Managed time and resources wisely. _____
2. Worked harmoniously with a team. _____
3. Maintained pertinent and updated patient records. _____
4. Recorded the most common causes of mortality and
morbidity of the clinic.
_____
5. Screened for diseases that can pose a threat to the family
and community.
_____
6. Reported notifiable diseases to proper authorities.
7. Recommended appropriate family or community
intervention in relation to the diseases encountered.
_____
REMARKS:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
__________________________________________________________________________________________________________________________
_____________________________________________________________
_____________________________________________________________
___________________________ Name and Signature of Evaluator
Date : ________________
ATENEO SCHOOL OF MEDICINE
AND PUBLIC HEALTH
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YL9 SKILLS RATING SCALE FORM
Date: ______ Rotation: ___________________
Name of Intern: _____________________________________
Lowest Highest
Made sure that the correct procedure
was being done to the correct patient at
the correct site.
N/A 0.25 0.5 0.75 1.0 1.25 1.5 1.75 2.0
Maintained good rapport with thepatient, including making an effort to
put the patient at ease and to minimize
discomfort and pain.
N/A 0.25 0.5 0.75 1.0 1.25 1.5 1.75 2.0
Paid meticulous attention to basicasepsis and antisepsis techniques.
N/A 0.25 0.5 0.75 1.0 1.25 1.5 1.75 2.0
Paid strict and meticulous attention to
basic techniques throughout theprocedure.
N/A 0.25 0.5 0.75 1.0 1.25 1.5 1.75 2.0
Correctly used the proper instruments
during the entire procedure.
N/A 0.25 0.5 0.75 1.0 1.25 1.5 1.75 2.0
FINAL SCORE
Evaluated by: ________________________________________
Name and Signature of Evaluator
Date: _______________
ATENEO SCHOOL OF MEDICINE AND
PUBLIC HEALTH
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YL9 RATING SCALE FOR PROFESSIONALISM
Date: _______________________ Name of Intern: _________________________________
Rotation: ____________________ Hospital: _______________________________________
Lowest Highest
Has good working relationship with other team
members, enhances the value of the team0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0
Shows proper respect for patients, peers, faculty, and
allied health personnel
0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0
Shows sensitivity and compassion to patients culture,
age, gender, and disabilities
0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0
Maintains honesty and integrity at all times 0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0
Demonstrates a commitment to ethical principles
(confidentiality of patient information, informed
consent, provision or withholding of clinical care, and
business practices)
0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0
Demonstrates initiative and a desire for excellence 0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0
Accepts limitations and failings, open to feedback and
criticism, shows desire for self-improvement
0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0
Maintains a professional demeanor in manner, dress and
action, and excludes self-confidence
0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0
Demonstrates organizational ability, responsibility,
dependability
0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0
Punctual and complete attendance 0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0
FINAL SCORE
Evaluators Signature ________________________________
Evaluators Name ________________________________
Evaluators Position Consultant
Resident
Faculty
ATENEO SCHOOL OF MEDICINE AND
PUBLIC HEALTH
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PEER EVALUATION FORM
Group Number: ______ Date of Rotation: ___________________
INSTRUCTIONS: Rate your co-interns under each criterion according to the following rating scale:
5 = 90% of the time (Outstanding)
4 = 75% of the time (Very Satisfactory)
3 = 50% of the time (Satisfactory)2 = 25% of the time (Fair)
1 = very rarely seen, (Unsatisfactory)
Name of Co-interns A B C D E F G H I J
Evaluated by: ________________________________________
Name and Signature of Evaluator
Date: _______________
CRITERIA DESCRIPTION OF PERFORMANCE
5 4 3 2 1
A. ABILITY TO
APPLY
KNOWLEDGE IN
CLINICAL
SITUATIONS
Has an unusual fund of knowledge
which is applied effectively and
promptly in clinical problems.
Average knowledge which is
usually applied appropriately
without gross effort.
Lacks/minimal
fund of
knowledge.
Unable to apply
knowledge in
clinical
situations.
B. ABILITY TO
OBTAINHISTORY
Exceptional case histories.
Complete clinical history.Asks the right diagnostic questions.
Clearly and logically records data
on chart.
Careful history with most
significant issues covered.Reasonable clarity and
organization in recording in
chart.
Incomplete
histories.Disorganized
recording.
C. ABILITY TO
PERFORM
ACCURATE
PHYSICAL
EXAMINATION
Asks permission to the patient.
Excellent, careful thorough
physical examination.
Detects most pathological findings
and assesses their importance
accurately.
Treats patient with utmost respect
Careful physical examination.
Most pathologies detected and
significance usually
understood.
Superficial or
incomplete
physical
examination.
Misses
pathological
findings or fails
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PUBLIC HEALTH
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and explains procedures. to understand
their
significance.
D. QUALITY OF
DIAGNOSTIC
AND
THERAPEUTIC
MANAGEMENT
Appropriate diagnostic and
therapeutic management guided by
evidence and treatment guidelines.
Cost-effective.
Considered patients capacity to
conform with the recommendedmanagement.
Suggested management is
acceptable.
Recommended
management is
variable.
E. COMMUNITY
ORIENTATION
Highly community-oriented,
showing excellent analysis of the
social conditions and deep
understanding of root causes of
community problems.
Sees self as part of the community
he/she is working with.
Compassionate towards the
community.
Sees self separate from the
community and its effort at
improving its lifestyle.
Fair analysis of the situation.
Does activities assigned to
him/her.
Apathetic.
Underinterested
in working for
or with the
community.
F. LEADERSHIP Able to elicit active participation
from the people in the community
and together initiate appropriate
solutions to identified problems.
Adequate performance
expected of the student.
Needs prodding
and constant
urging to do
assigned tasks.
G. CHOICE OF
TOPIC FOR
DISCUSSION
DURING
LECTURES
Chooses the most important topics
needed by the community.
Uses simple language.
Excellent ability to integrate with
topics previously discussed.
Performs adequately.
Sometimes include topics
which are unclear or irrelevant
to the audience.
Poor
performance.
Talks about
topic without
regard for the
participants or
the community
context.
H. USE OF VISUAL
AIDS INLECTURES
Uses appropriate and clear visual
aids, more for the lay audiencerather than as visual cues for
himself.
Well-prepared and creative.
Adequate visual aids with
occasional lapses in language.
None or
haphazardlydone visual
aids.
I. ABILITY TO
ELICIT AUDIENCE
PARTICIPATION
Audience lively and highly
participative.
High enthusiasm among the
participants.
Moderate participation from
the audience.
Audience
silent, lacks
enthusiasm.
J. RELATIONSHIP
WITH
PRECEPTORS
Exceptionally cooperative.
Open to teaching efforts.
Accepts constructive criticism
well.
Good attitude.
Average receptiveness to
teaching efforts.
Displays little
interest in the
subject.
Defensive.
Resistant or
passive-
aggressive.
8/2/2019 120501 FCHM Rotation Writeup
19/21
YL9 RATING SCALE FOR PERFORMANCE
(Small Group Discussion/Case Presentation)
Date: ______ Rotation: ___________________
Name of Intern: ____________________________ Group: __________
Lowest Highest
Did the intern carry out a rationaldiagnostic approach?
Obtained pertinent data and also sought
to exclude other possible diagnosis.
Obtained accurate and complete historyin a logical manner.
Performed a complete and systematic
physical exam.
5 6 7 8 9 10 11 12
Did the intern describe the patients
clinical manifestations clearly, concisely
and accurately?
5 6 7 8 9 10 11 12
Did the intern arrive at a good clinicalimpression?
Was the intern able to recognize salient
features and correlate data to make adiagnosis?
8 9 10 11 12 13 14 15 16
Did the intern rule in/out pertinent and
plausible differential diagnosis?
Did the intern recommend/requestappropriate tests?
Was the intern able to rationalize the
use of such test?
5 6 7 8 9 10 11 12
Was the intern able to explain theunderlying pathophysiology of the
patients illness?
1 2 3 4 5 6
Was the intern able to discuss/suggest/carry out a rational and appropriate
treatment plan for the patients?
8 9 10 11 12 13 14 15 16
Was the intern able to analyze the
patients clinical course/response totreatment?
5 6 7 8 9 10 11 12
Was the intern able to explain appropriate
preventive health care measures that maybe recommended to the patient andfamily?
5 6 7 8 9 10 11 12
Was the intern able to make a concise yet
fairly complete contextual analysis of thepatients over-all biologic, physiologic,
socioeconomic and spiritual status?
1 2 3 4 5 6
FINAL SCORE
Evaluated by: ________________________________________
Name and Signature of Evaluator
ATENEO SCHOOL OF MEDICINE AND
PUBLIC HEALTH
8/2/2019 120501 FCHM Rotation Writeup
20/21
YL9 Rating Scale for Family Case Presentation
Date: _________ Rotation: _________________Name of Interns: ____________________________ Group: __________
5 = Fulfills task beyond expectation
4 = Fulfills tasks; no deficiency
3 = Fulfills with minimal deficiency
2 = Needs improvement
1 = Unable to fulfil task
CONTENT
Presented the patient and profile of his/her family. 1 2 3 4 5
Provided a rationale why it was chosen for presentation. 1 2 3 4 5
Analyzed appropriately the family dynamics of the patient as it relates to the
biopsychosocial concern identified.
1 2 3 4 5
Analyzed the impact of illness in the family. 1 2 3 4 5
Utilized appropriately family interventions in the biopsychosocial problems of
the family.
1 2 3 4 5
Evaluated the effects of the family interventions done. 1 2 3 4 5
PROCESS
Organized the content and presented it systematically. 1 2 3 4 5
Held attention of audience by making voice loud and clear. 1 2 3 4 5
Used relevant and properly proportioned audiovisual aids. 1 2 3 4 5
Adequately answered questions asked during the open forum. 1 2 3 4 5
Evaluated by: ________________________________________
Name and Signature of Evaluator
ATENEO SCHOOL OF MEDICINE AND
PUBLIC HEALTH
8/2/2019 120501 FCHM Rotation Writeup
21/21
Family and Community Health Management
Activity Report: _______________________________
Name of Intern: _________________________________
Site Assignment: ________________________________
Name of Activity:______________________________________________________________
Date and Venue: _______________________________________________________________
Activity Objectives:
Sponsoring and Partner Agencies: _____________________
Task as Intern:
Program of the Activity:
Key Issues Identified:
Comments on the Activity:
Personal Learning:
Next steps/recommendations:
ATENEO SCHOOL OF MEDICINE AND
PUBLIC HEALTH