CLINICAL MEDICINE COMMITTEE
May 23, 2011
Attending: Drs. Heald, A. Innes, D. Innes, Keeley, Sudhir, Potter, Heald, Ham, Herrington, McGahren, Michaelsen, Mr. Zhao, Chapin, Lieb, Wilson
The meeting was called to order at 5:02 PM.
The LCME “residents as teachers” standard was discussed. Each clerkship should give each resident a copy of the clerkship objectives. While there are excellent web-based resources, it is our understanding that the LCME expects that a “hard copy” be given to each resident and faculty member who will be involved in teaching and evaluating students. There are web-based resources related to “residents as teachers” and faculty development. Each clerkship is encouraged to conduct workshops or similar sessions for their own house staff relative to medical student teaching. Documentation of attendance of the residents is important. It is hoped that some of the existing web resources can be converted to a “Net Learning” module for resident use.
The issue of medical student documentation in the electronic medical record was discussed. Mr. Zhao presented the medical student perspective regarding meaningful participation in the care of patients on clinical clerkships. Several approaches have been used in other institutions and suggested for consideration at UVA. The notion of a “disappearing medical student note” was discussed and was not felt to be desirable. Dr. Keeley mentioned that Drs. Lepsch and Borowitz have worked on guidelines regarding EMR medical documentation by students, and these might be distributed by the clerkship directors to their respective departmental faculty members. Dr. Wilson offered a historical perspective regarding medical student documentation and the notion that this had been left up to individual departments in the past. Some clerkships/departments had used “shadow charts” in the past, while others had students writing in patient charts. One idea that was mentioned was for medical students to produce one “paper-based” patient write-up, possibly using an electronic Word document, that could be submitted, critiqued (using “track changes) and reviewed with the student. This is currently being done on the Pediatrics rotation in Roanoke. Dr. Allison Innes mentioned that the NBME has a “template” which they use as part of the Step 2 Clinical Skills exam, and that this might be useful to our medical students. http://www.usmle.org/Orientation/2011/PatientNote/PNEntry.pdf at http://www.usmle.org/Orientation/2011/PatientNote/PNmain.htm It was felt that the clerkships should strive to keep the medical students meaningfully involved in patient care while on the clinical clerkships. It was also felt that medical students should receive instruction regarding “why” certain orders are written or are a part of a standard order set.
Dr. Donald Innes mentioned the request to estimate definable teaching hours on the various clerkships, which is currently underway. These may be reviewed at an upcoming meeting.
The meeting was adjourned at 5:58 PM.
William G. Wilson, MD
Chair, Clinical Medicine Committee