The
Department of Medical Humanities
Southern
Illinois University
School of Medicine
PO
Box 19603
913 N. Rutledge
Springfield IL
62794-9603
TEL:
217.545.4261
FAX: 217-545-7903
Contact:
probertson@siumed.edu
for further information.
Updated
July 30, 2007
DOCTORING: MEDICAL HUMANITIES CLERKSHIP-YEAR 4
SOCIETY, LAW, AND HEALTH CARE: THE PHYSICIAN'S ROLE
INTRODUCTION
The Doctoring: Medical Humanities curriculum is designed to provide students with core knowledge in the humanities, emphasizing application of the content and methodologies of humanities disciplines to the practice of medicine. Substantive areas of teaching emphasis include ethics, health policy, law, medical history, and psychosocial care. During Year 4, the Medical Humanities Clerkship is a two-week learning experience entitled, "Society, Law and Health Care: The Physician's Role."
The first part of the clerkship focuses on the legal aspects of the physician's role in society with emphasis on the judicial process and the administration of justice. During this time, students will expand their knowledge of the interplay between the medical and legal systems through learning about the physician as an expert witness in civil and criminal proceedings, the regulation of medical experts, and the role of forensic medicine. Students also will witness an evidence deposition designed to introduce them to the reality of physician involvement in civil litigation.
During the second part of the clerkship, students will be provided with an overview of the United States health care system. Strengths and inadequacies of the present system will be considered. Students will examine a variety of important policy issues including the following: access to and availability of health care in the United States; the economics, financing and cost of health care; the setting in which health care is delivered; responsibility and accountability of physicians; assuring quality in health care; access to care for the underserved, uninsured, and the vulnerable populations; parity in mental health care services; and other compelling clinical, ethical, legal, and policy issues in health care delivery.
GENERAL LEARNING OBJECTIVES
Students will be able to:
1. Discuss the physician's role in the administration of justice, with emphasis on describing an overview of the judicial process, including physician involvement as an expert witness in civil and criminal litigation.
2. Describe various systems of medical-legal investigation and the manner in which these systems affect public health.
3. Explain the legal and professional structures that regulate the conduct of physicians as expert witnesses.
4. Evaluate how physicians participate in civil litigation through an evidence deposition.
5. Describe the health care system in the United States, discussing its strengths and inadequacies, and comparing it with other health care systems.
6. Describe the economics, financing, and cost of health care in the United States.
7. Discuss policy issues of access to and availability of health care for vulnerable populations in the United States.
8. Explain the concept of parity for mental health care services and describe social and economic barriers to achieving parity.
9. Discuss issues in ensuring quality in medical practice and patient-centered clinical decision-making in the context of the changing health care environment.
10. Compare ethical, legal, and policy issues arising in fee-for-service medicine and in managed care.
FORMAT
Two classroom approaches will be used throughout the learning experience: (1) plenary sessions (e.g. seminars, panel discussions); (2) and tutor groups. During plenary sessions, core material will be presented. The information provided complements required reading assignments. In conjunction with required readings, the content of plenary sessions will constitute the major basis for written examinations.
Tutor group sessions are designed to allow in-depth exploration of the material covered during plenary presentations. Approximately seven students are assigned to each tutor group. These students will meet with the same tutor during all sessions. Each student will be responsible for formally presenting assigned cases in the tutor group setting. Because tutor group participation constitutes an important part of the overall performance evaluation, significant responsibility is given to students in the tutor groups to identify relevant learning issues, present individual cases, and elucidate learning issues that pertain to those cases. All students are expected to interact as informed participants in the discussion of cases presented by other students during each tutor group session. Attendance at all scheduled activities is required.
TUTOR GROUP SESSIONS AND ASSIGNMENTS
Tutor Group Faculty and Student Assignments are listed on page viii and Tutor Group Room Assignments are listed on page ix. Tutors will assist students in identifying and defining pertinent issues for discussion based on the General Learning Objectives. Students will identify and define other issues based upon their own perspectives as individuals newly entering the medical profession.
At each of the Tutor Group Sessions, case presentations should focus on issues drawn from plenary sessions and required readings. Students will be responsible for formally presenting at least two assigned cases. Students will be expected to undertake independent research in support of their case presentations. Active participation in the discussion of all cases is expected.
EVALUATION
Evaluation of performance assumes full participation in and attendance at all scheduled activities. Criteria for evaluation include performance in the context of the following activities: an objective short-answer law examination; tutor group participation; and a final case-based essay examination. In evaluating student performance, faculty will assess student knowledge of course material, critical thinking and problem-solving ability, application of knowledge, oral and written communication skills, self-directed learning, interpersonal relationships, personal/professional maturity, and motivation/dependability/responsibility.
Tutors will evaluate students on the basis of preparation for and participation in tutor group discussions. The objective short-answer law exam will assess student knowledge of information covered in the first four modules. The final written examination will consist of several cases that focus on issues relevant to core material presented during the remaining modules. Students will be asked to respond to certain features of these cases in detailed written essays (3-4 pages). The final written examination will be "open book." However, only class notes, the course document, handouts, and suggested readings may be brought to the examination and used in responding to essay questions. Laptop computers, cellular phones, PDAs, etc., may not be utilized.
Students receive a performance rating for each of the following:
tutor group participation (35%)
objective short-answer law exam (25%)
final case-based essay examination (40%).
The rating scale for student performance is as follows:
5 = Excellent
4 = Commendable
3 = Meets Expectations
2 = Marginal
1 = Unsatisfactory.
Students who receive an overall performance rating of "Excellent" will be awarded honors. Students who receive an unsatisfactory rating for any aspect of the course will be required to make up the deficiency. Minor deficiencies may result in an incomplete ("I") transcript notation until the deficiency has been corrected. A time frame for making up minor deficiencies will be established by the clerkship director in cooperation with Medical Humanities Department faculty. Significant performance deficiencies will be identified by Department faculty and the Student Progress Committee will be informed of specific faculty recommendations for formal remediation.
Students may challenge their final grade for this curricular segment. If a student feels there has been an error in the grading process, he or she should contact the segment director as soon as possible, but not later than six weeks following notification of the grade from the Office of Student Affairs. The segment director will meet with the student to address the concern. Together, they will review the evaluations contained in the student's file. If the student is not satisfied with the outcome of this review, he or she may submit a written document to the clerkship director, outlining the basis for appealing the grade. Further review of the student's evaluations will be undertaken and may involve faculty who participated in direct assessment of student performance as well as faculty who were not involved in such assessment. Following this review, the segment director will make a recommendation to the full-time faculty of the department, who will render a decision regarding whether the final grade should be modified or affirmed. Notification of this decision will be forwarded to the student and to the registrar.