University of Virginia School of
Clerkship/Post Clerkship Committee
Clerkship Leadership Present: Bray, Cheng, Herrington, Sudhir, Shah,
Others: D. Innes, McDaniel
Guest: L. Thomas
Discussion: there was extensive discussion regarding technical standards on the clerkships. The learning objectives are currently written to reflect subject knowledge during the core clerkships and surgical selectives. There are no learning objectives specific to technical standards. Each clerkship does require that the students have ability to perform the following:
Obtain history from patients
Perform physical examinations
Communicate in written and oral formats
Perform tasks which require fine and gross motor skills including but not limited to standing on rounds and in procedures, assisting in surgery and procedures, phlebotomy
Issues related to a student with hearing disability on the clerkship would be related to above. The level of hearing loss and level to which hearing aids and sound augmentation would matter to the student’s education.
It was agreed that there would be no safety issues for the patient if communication was adequate. An ASL translator would need to be present at all times. It is possible that situational awareness that comes from sounds (alarms, agitated patient, commotion) might be impaired. Communication in the operating room or trauma room could be impaired as masks will prevent lip reading. There may be technologic solutions to these concerns.
It was stressed that adequate lead/preparation time would be critical so that clerkship faculty would be prepared for adaptation to the student’s need.
It was agreed that more information as to the nature and depth of the hearing loss and to what degree hearing aids can mitigate the impairment would be important.
Next Meeting 4/22/13 5 PM Pediatric Conference Room.
Agenda: Please discuss and plan respond to the
following items from the Curriculum Committee:
The Committee discussed the Mulholland report focusing on the highlighted concerns where follow-up is needed. Each Clerkship and Surgical Specialty must achieve the following:
Clarity in scheduling and expectations especially on multi-site rotations is necessary.
Review of the orientation/written expectations for the clerkships and specialty rotations shows OBGYN clerkship and the Urology and Plastic Surgery to be models. Request the clerkships and specialty rotations to use the OBGYN clerkship and the Urology and Plastic Surgery specialties as models. This can be done with post-clerkship students on the Medical Education elective with faculty assistance writing and approving the expectations. Good communication between the clerkship director and the teaching faculty at all sites is essential.
- Ensure formal mid-rotation feedback to the
- Ensure all clerkships at UVA are allowing/requiring
students to write notes in Epic as approved at the Curriculum
Committee meeting 2/21/13.
- Clerkships with varying patient populations (seasonal disorders,
pediatric population as at Veterans Hospital) must address the
lack of patient diversity, e.g. with UVA developed case
studies, SIMPLE (medicine) or CLIPP (pediatric) cases.
Define EPAs (entrustable professional activities) for medical competent students in each clerkship. Consider the following examples:
1. Obtain social and family histories; review of systems 2. Obtain vital signs 3. Improve the quality and patient safety 4. Work within inter-professional health care teams 5. Demonstrate personal habits of lifelong learning 6. Demonstrate professional behavior
Examples of EPAs for residents can be found at http://www.im.org/AcademicAffairs/milestones/Pages/EndofTrainingEPAs.aspx
Ensure that all students are aware of procedures for reporting unprofessional behavior during clerkship orientation. This is done in the Transition but must be reinforced during each clerkship orientation.
Arrange for UVA lectures and Internal Medicine morning report available by Webcam or Podcast to students at all clerkship sites whenever possible.
Work with your departments and residency directors to strive for more medical student continuity with attending physicians when possible. Consider assigning teaching physicians to work with students in an on-going manner.