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 MCW_CentralWIDiscovery Curriculum Teaching Toolbox

CENTRAL WISCONSIN Foundations of Clinical Medicine Sign-Up Form

Thank you for your interest in participating as a small group facilitator in the M-1 Foundations of Clinical Medicine (FCM). Participating as a small group facilitator in the M1 Foundations of Clinical Medicine (FCM) at the Medical College of Wisconsin in Central Wisconsin. Please complete this form to add your name to our database for future student assignments. Any questions about the program, contact Lisa Dodson, Dean, 870-0919.

Physician Information

First Name  
Last Name  

Contact Information

Physician Email  
Physician Phone  
Physician Pager  
Assistant Name  
Assistant Email  
Assistant Phone  

Facilitators have the opportunity to participate in up to 3 different sessions per week over a period of five weeks.  Pick and choose sessions based on your level of interest and/or comfort.  The Foundations of Clinical Medicine course runs for five weeks, from early July through early August.  Sessions are tentatively scheduled on three different half days per week (Monday and Wednesday afternoons and Thursday mornings).  Actual assignment of sessions and schedules will be finalized at a later date.  The sessions are listed below.  .

Check which sessions you would be interested in. Check all that apply.

Intro to FCM

Professionalism, Feedback, Ethics

Gathering the patient history/Patient Education Gathering the patient history/Patient Education

Chronic disease history/Social History

Chronic disease: Motivational Interviewing, glucometer testing, POC A1c

Sexual History/Social History

Vital signs/medication reconciliation

Sore throat: ENT examination Rapid Strep test

Pediatric History:  Developmental milestones, anticipatory guidance

Chest pain/shortness of breath:  basic lung exam/peak flow, pulse oximetry, nebulizer

Palpitations: basic heart exam

Abdominal Pain: basic abdominal exam, urinalysis, urine pregnancy test

Low back pain: basic back exam and DTRs

Upper extremity pain: exam of shoulder and arm

Head-to-toe exam practice

Let us know if you have any questions.  


Page Updated 02/25/2016