Level IV: Clinical Consultation

Overview

Level IV training includes patient-specific clinical consultation provided to health care professionals. Characteristics of this level of training are: 1) interaction between two clinicians, 2) training initiated by trainee/topic selected by trainee and based on a patient-specific clinical question, 3) discussion of state of the art clinical care, 4) communication via telephone, electronic media, or in person on-site at trainee location, 5) no direct contact between patient and trainer, 6) interaction supported financially or administratively by AETC funds. These training activities may include clinical consultation, case based discussion with cases supplied by trainee, or clinical consultation on-site at trainee's clinical setting.

Training Objective

	Change in clinical problem-solving
	Change in clinical decision-making for better or more appropriate care
	Impart state of art knowledge on specific HIV care

Methods

	Interaction between clinical consultant and clinical consultee (1-to-1 or multiple consultees)
	Patient-specific questions and problem-solving via phone, Internet, fax or on-site
	Telemedicine

Role of Learner

	Provider-driven

Resources

National HIV/AIDS Clinicians' Consultation Center

The National HIV/AIDS Clinicians' Consultation Center (NCCC) provides health care providers with a national resource to obtain timely and appropriate responses to clinical questions related to treatment of persons with HIV infection and/or possible health care worker exposure to HIV and other blood-borne pathogens.

National HIV Telephone Consultation Service (Warmline): 800-933-3413

Monday-Friday, 8am-8pm EST. For questions about HIV/AIDS, including antiretroviral therapy, HIV clinical manifestations, laboratory evaluation, etc.

National Clinicians' Post-Exposure Prophylaxis Hotline (PEPline): 888-HIV-4911 (888-448-4911)

24 hours a day, 7 days a week. For questions about occupational exposures (eg, needle sticks, splashes) to HIV and other bloodborne pathogens.

National Perinatal HIV Consultation and Referral Services (Perinatal Hotline): 888-HIV-8765 (888-448-8765)

24 hours a day, 7 days a week. For questions about the care of HIV-infected pregnant women as well as indications and interpretations of rapid and standard HIV tests.

Some AETC regional offices coordinate local and regional clinical consultation resources. See your region for details.

Examples and Case Studies

	Support for AETC Training on HIV Testing Date: 05/2006 Source: National HIV/AIDS Clinicians' Consultation Center
	Training Mental Health and Substance Abuse Providers: Maximizing the Impact of Ryan White Care Act Funding Date: 01/2006 Source: Southeast AETC
	Pediatric HIV Consultations Teleconference Date: 05/2005 Source: Midwest AETC
	Level IV Clinical Consultation Nuggets Date: 05/2005 Source: National HIV/AIDS Clinicians' Consultation Center
	New York/New Jersey AETC: Implementation of a Multidisciplinary Longitudinal Training Model Date: 01/2005 Source: New York/New Jersey AETC
	Southeast AETC Builds Capacity through Consultation Groups Date: 01/2005 Source: Southeast AETC
	Florida/Caribbean AETC Perinatal Rapid Testing Initiative Date: 08/2004 Source: Florida/Caribbean AETC
	Warmline and PEPline Assist Clinicians Date: 02/2004 Source: National HIV/AIDS Clinicians' Consultation Center
	Chart Review for Targeted Training Date: 06/16/2003 Source: Florida/Caribbean AETC
	Four Levels of Training in a Day! Date: 03/01/2003 Source: Southeast AETC

Bibliography

	5 Models of Successful Clinical Consultation Date: 01/2005 Source: Pacific AETC, East Bay AETC Author:  Cynthia Carmichael, MD From The 4th Level, the Pacific AETC newsletter for clinical consultants.
	Literature Review: The One-minute Preceptor Date: 04/2004 Source: Pacific AETC, East Bay AETC Author:  Cynthia Carmichael, MD From The 4th Level, the Pacific AETC newsletter for clinical consultants.
	Literature Review: Curbside Consultations Date: 09/2003 Source: Pacific AETC, East Bay AETC Author:  Cynthia Carmichael, MD From The 4th Level, the Pacific AETC newsletter for clinical consultants.
	Effective Consultation via Case-Conferencing [PPT 378 KB] Date: 08/2003 Authors:  John Roberts, MSN, RNCS and Donna Gallagher, MS, RNC, ANP, FAAN Source: New England AETC Slide presentation prepared for the 2003 National AETC Faculty Development Workshop. 20 slides.
	What Makes a Good Clinical Consultant? Date: 03/2003 Source: Pacific AETC, East Bay AETC Author:  Cynthia Carmichael, MD From The 4th Level, the Pacific AETC newsletter for clinical consultants.
	Strategies to Translate One's Expertise into an Effective Consultation Date: 04/05/2002 Source: National Clinicians' Consultation Center Tips for clinician consultants. See also the NCCC's online consultation library.

Links

Links here