Clinical Rounds

The DAOM Clinical Rounds at EC is designed to provide a core clinical experience under the direct supervision of faculty members, performing the role of Clinical Supervision in the DAOM clinic.  The fellows are expected to build advanced clinical skills and understandings in Oriental medicine and within the specialty of the program’s two specializations –physical medicine and internal medicine.  Fellows are expected to:

  • utilize assessment, diagnosis, intervention and treatment modalities of AOM with advanced and deepened competence
  • to integrate Western medical diagnostic techniques during care
  • to be able to make Evidence-Based-Medical decisions in AOM

Fellows are provided feedback on their clinical performance by supervisors, the Dean of Clinics, the DAOM program director, and by their peers.  In the EC clinic, supervisor evaluation forms are completed at the end of each quarter.  Patient treatment cases performed in the clinic under supervision may also be written up using the Integrative Medical Case Review template (one per quarter) and presented for review and discussion during Grand Rounds, with feedback from the Clinical Adviser.

➤ Forms
➤ Integrative Medical Case Report
➤ Useful Links and Resources

Purpose

The purpose for this rotation is to provide opportunities for DAOM fellows to practice advanced patient assessment and diagnosis and conduct advanced clinical intervention and treatment for pain conditions under the direct supervision of highly experienced AOM practitioners and other healthcare providers.

Objectives

After successful completion of this rotation, fellows shall able to:

  • Demonstrate the ability to conduct detailed history and collect health information in the form of patient history and clinical assessment, with respect to pain conditions and/or chief complaints, and to be able to develop an advanced AOM diagnosis and treatment plan.
  • Demonstrate the ability to conduct both effective and accurate comprehensive and focused physical examinations including, but not limited to, neurological tests and orthopedic evaluations.
  • Demonstrate knowledge and skills regarding the use of laboratory and radiological findings to inform patient care, to relate to AOM diagnosis, and to know when to refer out.
  • Demonstrate the appropriate acupuncture technique, herbal formula prescription skills, and other treatment modalities for the program’s two specializations — orthopedics/sports medicine and internal medicine.
  • Demonstrate professionalism in relation to staff, faculty, peers, and patients.
Educational Program and Formats

There are academic and clinical activities involved in this rotation, with a goal of achieving advanced clinical assessment, conceptualization, and an increased repertoire of treatment options, skills, and critical thinking.

  1. Patient care:  When in the clinic working with patients, fellows are going to be in the role of either an observer (who collaborates on the possible diagnosis with the other fellows) or as the one who will be treating a particular patient as the treating practitioner.  These roles of observer versus treating practitioner will alternate amongst the fellows from one patient to the next. So fellows will work as a team member under the direct supervision of the clinical supervisor, a senior practitioner. fellows are expected to bring the possible diagnosis and treatment plan that they propose to the clinical advisor for approval and possible modifications before treating the patient. The team approach allows fellows to learn from their peers in a consultative manner.  fellows will be in teams of 2 or more. The Dean of Clinical Education will monitor the clinical experiences the fellows are getting while using this approach. The team is expected to collaborate on case conceptualization, assessment, and treatment planning. Only 1 person should do the needling and the person who needles should also be the person who is responsible for the patient care and documents the patient treatments.
  2. Didactic Activities and Independent Study:  There are formal discussions on a variety of subjects that are part of the educational program of the internship residency program.  All fellows are expected to actively prepare and participate in the discussion. The clinic format for DAOM fellows includes time for two treatments (2 clients) per evening shift and one case presentation time period (~ 1 hour at the end of the clinic day).  
  3. Academic Portion:  fellows are expected to do a quarterly written Integrated Case Review based on a patient seen in the clinic, preferably one who has been seen for multiple visits and is a challenging case appropriate to advance the learning of the DAOM group in case review.  
Schedules

DAOM Clinic is held on Thursday and Friday evenings (4:45 pm – 9:00 pm).  All DAOM Clinicians are expected to arrive no later than 4:45 pm for their assigned shift for check in and set.  fellows sign up for their internship clinical rotations on a quarterly basis.

Prerequisites and Corequisites
Requirements
  • Orientation Meeting: fellows may start the orientation portion of the internship residency program of the DAOM Clinic in their first week of enrollment in the DAOM program.  The Clinical orientation meeting will be conducted and combined with the new fellows’ orientation. An introductory orientation package (including Clinic Manual, Exposure Control Plan, HIPAA manual, faculty phone numbers, and a list of recommended educational material) will be provided with sufficient time to the fellows prior to the start of the program. The fellow is expected to review all the material prior to the first day of the program. In order to actually treat patients, fellows will need to have a current California acupuncture license in good standing, a current CPR and First Aid card from either the American Heart Association (AHA) or American Red Cross (ARC), current malpractice insurance, Hepatitis B vaccination declination, and an official (not photocopied) duplicate wall license issued from the CAB. Details of the above-listed, required certifications and papers will be covered during the orientation sessions.
  • Professional Attire: The fellows shall dress in appropriate professional attire and white lab coat. EC ID must be worn at all times.
  • Hours: All fellows are required to complete a minimum of 100 hours of internship residency training in the EC Clinical Rounds (this includes Orientation sessions during the first quarter of the program).  At EC clinic, fellows use their current DAOM fellow ID card to clock in and out.
  • Daily Clinical Logs: There is no required minimum number of treatments; however, fellows must keep daily clinical logs. The daily clinical logs should include as much information as possible: age, gender, chief complaint(s) and date of the treatment. The daily clinical logs are turned in monthly to the DAOM program office on a Thursday or Friday while the fellows are onsite for course work.  The daily clinical logs may be turned in to the DAOM program office more often during clinic hours, but not less than once monthly.
Evaluation and Assessment

There are two types of evaluation during the onsite internship ‘residency’ rotation; one is Grand Rounds and the other is clinical performance evaluation.  At the end of each quarter (three months), the DAOM Clinic Advisor will conduct clinical performance evaluations for each fellow.  The focus of the clinical evaluation completed by the supervisor is on advanced DAOM level clinical competencies (please see the evaluation form).

Some other tools or methods may also be used for the evaluation and assessment of the fellows’ clinical performances.  Fellows’ clinical logs are also reviewed to assess the type, depth, and amount of clinical experiences they are getting.  This information is used to remediate the training plan, program plan, and to develop relationships with outside practitioners who may refer patient case types to our clinic.

Readings and Texts

Required Readings

College Manuals

Textbooks

 

Recommended Readings