Phase Two of the Well Beyond Curriculum advances students’ clinical competence through supervised patient care across the core clerkships. During this phase, students apply foundational scientific knowledge in real clinical settings, strengthen their clinical reasoning and documentation skills, and work collaboratively within interprofessional teams. Students also participate in structured coaching, assessment, and reflection activities that support their growth as developing clinicians.
The objectives in this section describe the skills and competencies students are expected to achieve by the end of Phase Two, preparing them for Phase Three’s advanced clinical training and specialty-focused experiences.
Provide patient-centered care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.
1.1 P2 Elicit a complete and accurate patient history from multiple sources, using hypothesis-driven questions appropriate to the clinical context, under supervision.
1.2 P2 Perform a complete physical examination, accurately identifying abnormal findings, while ensuring patient safety, comfort, and dignity, under supervision.
1.3 P2 Generate and prioritize a differential diagnosis for common presentations by linking key history, examination, and initial test findings to each candidate diagnosis, and revise the differential as new data emerge, under supervision.
1.4 P2 Select and justify initial laboratory and imaging studies for common presentations and interpret basic findings with guidance.
1.5 P2 Perform core medical, diagnostic, and technical procedures expected of a clerkship student, maintaining patient safety and comfort, under direct supervision.
1.6 P2 Formulate and propose elements of a patient-centered, safe, effective, and value-based management plan, incorporating clinical findings and patient preferences, with guidance from the health care team.
1.7 P2 Identify and describe the effects of social drivers of health on patient concerns and chronic disease and incorporate these factors into patient evaluation and management under supervision.
1.8 P2 Participate in the development and execution of management plans that support continuity of care and safe transitions between providers or settings, using clear and timely communication under supervision.
1.9 P2 Counsel and educate patients and families about diagnoses, management plans, and preventive health, incorporating patient preferences to support shared decision-making under supervision.
1.10 P2 Recognize patients requiring urgent or emergent care and, under supervision, initiate timely evaluation and contribute to initial management.
1.11 P2 Participate in end-of-life and palliative care discussions with patients and families, demonstrating empathy and respect, under supervision.
1.12 P2 Incorporate health promotion and disease prevention strategies into patient care plans and participate in initiatives that support health maintenance for patients, families, and communities, under supervision.
Demonstrate knowledge of established and evolving biomedical, clinical, epidemiological and social-behavioral sciences, and apply this knowledge to the care of patients and populations.
2.1 P2 Apply a systematic, analytic approach to common clinical problems by generating a problem list, linking key findings to a prioritized differential diagnosis, and justifying an initial assessment and plan; revise reasoning as new data emerge, under supervision.
2.2 P2 Apply established biomedical science principles to preventive care, diagnosis, and management of common medical problems, and relate emerging scientific concepts to patient care, under supervision.
2.3 P2 Apply established clinical science principles to preventive care, diagnosis, and management of common medical problems, and relate emerging clinical concepts to patient care, under supervision.
2.4 P2 Recognize and describe how current and historical factors affecting health equity, including structural inequities in access and quality of care, may influence patient presentations and management decisions, under supervision.
2.5 P2 Apply basic principles of epidemiology, biostatistics, and prevention to identify common health problems, risk factors, and strategies for disease prevention and health promotion in patients and populations encountered during the clerkship, under supervision.
2.6 P2 Apply knowledge of social determinants of health to identify potential barriers to care and incorporate these factors into disease prevention and health promotion strategies for individual patients, under supervision.
2.7 P2 Apply an inquiry-oriented and analytic approach to gather, interpret, and present findings, under guidance.
2.8 P2 Select and appropriately use available technology and decision support tools in common clinical situations, recognizing potential sources of error, bias, and clinical inapplicability, under supervision.
2.9 P2 Recognize situations of ambiguity or uncertainty in patient care and seek timely guidance from supervisors or other appropriate resources to inform decision-making.
Demonstrate the ability to investigate and evaluate one’s care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and life-long learning.
3.1 P2 Elicit feedback on clinical performance and reflect on the input to identify opportunities for improvement, implementing changes under supervision.
3.2 P2 Seek out, appraise, and apply new or updated knowledge, guidelines, products, or services relevant to patient care, with guidance.
3.3 P2 Formulate focused clinical questions, and with guidance, identify and appraise relevant literature to support evidence-based patient care.
Demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals.
4.1 P2 Communicate with patients, families, and members of the health care team using active listening, appropriate nonverbal cues, and empathetic language, under supervision, to build therapeutic relationships, promote inclusion, and ensure understanding.
4.2 P2 Communicate with dignity, respect, and professionalism in interactions with other learners, physicians, health professionals, and health-related agencies, under supervision as appropriate.
4.3 P2 Work collaboratively and respectfully with others as a contributing member of the health care team, seeking guidance when appropriate.
4.4 P2 Accurately and promptly document patient encounters in the medical record, following site-specific procedures, maintaining privacy, and adhering to legal and ethical standards, under supervision.
4.5 P2 Deliver organized and accurate oral presentations that are appropriate to the purpose, context, and audience, under supervision.
4.6 P2 Assist in, and when appropriate, participate in, discussions with patients and families involving sensitive or difficult topics (e.g., breaking bad news, error disclosure, or end-of-life care) under direct supervision of the health care team.
4.7 P2 Recognize and reflect on one’s own emotional responses and those of others, and respond professionally in emotionally charged situations, seeking guidance as needed.
4.8 P2 Share relevant medical knowledge with peers, patients, families, and other health care professionals during educational and patient care activities, under supervision, ensuring accuracy and appropriateness.
4.9 P2 Identify common barriers to communication and, with guidance from preceptors, use strategies to address them to support effective patient care.
Demonstrate a commitment to carrying out professional responsibilities and an adherence to moral and ethical principles.
5.1 P2 Demonstrate compassion, integrity, accountability, and respect in interactions with patients and members of the health care team.
5.2 P2 Prioritize the needs of patients while maintaining awareness of one’s limits, seeking supervision as appropriate and recognizing the balance between autonomy and oversight.
5.3 P2 Demonstrate respect for patient privacy, autonomy, and vulnerability, and acknowledge inherent power differentials in health care relationships while maintaining professional boundaries.
5.4 P2 Participate in behaviors that promote allyship and support equitable health care, under guidance.
5.5 P2 With preceptor guidance, participate in navigating ethical dilemmas in patient care, including informed consent, confidentiality, provision or withholding of care, conflicts of interest, and competing priorities, maintaining the primacy of patient interests.
5.6 P2 Abide by relevant laws, policies, and regulations.
5.7 P2 Demonstrate trustworthy behavior that fosters confidence among patients, colleagues, and the health care team by following through on responsibilities, maintaining confidentiality, and accepting accountability.
Demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care.
6.1 P2 Work effectively within different clinical settings and delivery systems by adapting to local workflows, policies, and team roles, and by using available resources to support patient care, under supervision.
6.2 P2 Participate in coordination of care and safe transitions between providers or settings by performing structured handoffs (e.g., I-PASS) and clarifying follow-up responsibilities, under supervision.
6.3 P2 Incorporate basic cost and risk–benefit considerations into diagnostic and treatment recommendations for individual patients and discuss options with the team (and patients as appropriate), under supervision.
6.4 P2 As a member of a quality-improvement effort, identify an opportunity for improved care or safety, apply a simple method (e.g., PDSA), and propose feasible solutions, with guidance.
6.5 P2 Demonstrate emerging leadership behaviors that enhance team functioning and the learning environment (e.g., setting shared goals, inviting input, closing the loop on tasks), under supervision.
Demonstrate the ability to engage in an interprofessional team in a manner that optimizes safe, effective patient- and population-centered care.
7.1 P2 Work with other health professionals in clinical settings to contribute to a climate of mutual respect, dignity, diversity, ethical integrity, and trust.
7.2 P2 Describe the roles and responsibilities of all members of the health care team, including the physician, and actively apply this understanding to collaborate in addressing patients’ health needs, under supervision.
7.3 P2 Communicate with other health professionals in a timely, respectful, and clear manner to support collaborative, patient-centered care, under supervision.
7.4 P2 Participate as an active team member to contribute to interprofessional team function and patient care, seeking guidance to ensure safe, efficient, effective, and equitable outcomes.
Demonstrate the qualities required to sustain lifelong personal and professional growth.
8.1 P2 With input from supervisors and peers, recognize personal limitations and engage in appropriate help-seeking behaviors.
8.2 P2 Demonstrate organizational and time management skills that support patient care responsibilities and personal well-being.
8.3 P2 Actively solicit feedback and incorporate guidance into practice. Engage in critical reflection to support lifelong learning and improvement.
8.4 P2 Identify personal strengths and limitations in knowledge, skills, and attitudes, and engage in targeted learning activities with some guidance to address gaps.
8.5 P2 Set and monitor specific, measurable learning and improvement goals, with input from supervisors, to address deficiencies in knowledge, skills, attitudes, and abilities.
8.6 P2 Under supervision, provide education to peers, students, and other health care professionals in the clinical setting.