MSCHE/ACOE Self Study

Given the large number of clinical instructors, it is not surprising that consistency in grading of intern clinical performance is a challenge. A Faculty Calibration Meeting, at which grading data, grading criteria and case examples will be reviewed, has been scheduled for May 2011. To provide stronger linkage to the didactic curriculum, course syllabi were reviewed and a list of clinical conditions and procedures taught in each semester was formulated (Appendix B-30) . This material was then correlated with the levels of clinical development and integrated into the Table of Intern Clinical Competencies where it is most apparent in the Assessment and Plan columns. A student who is having difficulty meeting clinical performance expectations meets with his/her educational facilitator to develop an individualized education plan (IEP). These plans are designed by the facilitator to remediate particular weaknesses as reported by clinic supervisors (see Appendix B-31 for an example of an IEP). Progress in meeting the objectives of this plan is monitored by the educational facilitator, who may meet with the department chair and Committee on Course and Standing as necessary. Routine collection of data relevant to student learning led to a major reconfiguration of the third-year clinic that was launched in fall 2010. Surveys indicated that third-year students were being supervised by many different instructors early in their clinical training rather than being consistently supervised by a small number of instructors. These data led to concern that student learning may be limited by the lack of consistent instruction during the time that students were first applying newly learned techniques and clinical reasoning to a clinical population. To further investigate this concern, the dean appointed an ad-hoc committee to review the third-year clinical experience. In its report (Appendix B-32), the committee recommended the creation of clinical teams (now called pods) consisting of 2 faculty members and a group of third-year students who would work together over a period of 8 or 16 weeks. Consistency of instruction and evaluation of student performance would be addressed by having the same two instructors work with the same students for an entire day over an extended period of time (8 weeks). Based on its observations, the committee proposed that the integrative seminar, which provides students with an opportunity to discuss cases, be built into the one-day clinical experience. A trial of the new structure was piloted in winter 2010 and results discussed at the March 2010 faculty retreat. The presentation at the retreat made by the faculty members who participated in the pilot is given in Appendix B-33. Based on the positive pilot results, the pod system was instituted for the fall semester of 2010. Its implementation will be monitored through course/instructor surveys, regular meetings of the dean with students, Meditrek (the student-patient encounter tracking system) and performance on the third-year, case-driven integration

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