Clinical Medicine Committee
August 26, 2013
Megan Bray, Yvonne Newberry, Huai Cheng, Laurie
Archibald-Pannone, Peter Ham, Catherine Casey, Wanda Hudson,
Pamila Herrington, Nassima Ait-Daoud Tiouririne,
Meg Keeley, Gene McGahren, Anneke Schroen,
Amita Sudhir, Chris Ghaemmaghamii, Guillermo
Solorzano, Binit Shah, Ashley Shilling, Stephen Collins,
Brian Wispelwey, Evan Heald, William Wilson, Robert
Boyle, Anne Chapin, Allison Innes, Darci Lieb,
Nancy McDaniel, Thomas Jenkins, J, Donald Innes, Karen
Knight, Sylvie Moore, Matt Dickerson, Carolyn
Engelhard, Derrick Thiel, Mary Grace Baker (SMD 2014)
Members Present: Bold
- Patient Safety Curriculum in the Clerkships
From July meeting: Email Peggy Plews-Ogan with the patient safety concepts that your clerkship will cover each rotation (AIM, Heald only director that responded).
Key concepts not covered will be assigned to a clerkship and director will be notified.
Patient Safety Concepts that need to be covered in the clerkships
Team function/communication in patient safety
Handoff of care
Culture of safety
Disclosure and Peer support:
Patient/family role in patient safety
Infection control (hand-washing, central line infections, c. diff.)
Escalation of care and topic of appropriate supervision
Transitions in care
How we use data to improve safety in each specialty
Patient safety tools that can be used to support and teach the concepts
Central line checklist
Surgical checklist Surgery Clerkship is doing this item
Handoff of care tool
Sepsis best practice alert
SBAR or other communication tool
Root Cause Analysis
M&M Medicine Clerkship is doing this item, required for students
Disclosure tool (Ask/tell/ask) and resources
EMR safety tools
- Alerts (drug drug interactions, allergies, drug monitoring alerts)
- reminders (health maintenance, best practice)
- decision support ( example=sepsis)/
The curriculum and learning objectives for patient safety are posted on the Curriculum web page of the SOM. All clerkships should link to it from their web page.
Additional resources for education:
Especially the resources for M1-3s from University of Illinois
- Discussion of Graduation Questionnaire item
All Clerkship directors, co-directors and directors of surgical selectives were asked if they were ever made aware of a student being pressured for sexual favors in return for a grade. All responded and none had any knowledge that this had ever happened on their clerkship.
- LCME preparation: ED2 lists and sign off
· All clerkships have a list of patients/conditions that students are to see. This is the ED2 list required by the LCME. · The requirement is that each student will have exposure to all patients on the list. There is an expectation that there will be an alternative if the student did not see a certain kind of patient/condition. Survey of the clerkships indicates that alternative means are used less than 1% of the time. · Documentation related to completion of the clerkship requirements was discussed at length.
o Electronic method is viewed by students as an item to complete in order to be able to take the examination and complete the clerkship. o Many students wait until the end of the clerkship and “batch” the entries. This is problematic in that the opportunity for immediate feedback is lost. The details of the student’s performance may be too remote to be useful. Delay results in a lot of work by the Clerkship Coordinators in sending reminders to the students to complete the items. o Some faculty are not signing off on items in a timely manner resulting in work for the Clerkship Coordinators. o The smart phone application has not been widely adopted. This is in part due to the perception that internet connection at the time of sign-off is needed. This is also in part due to faculty reluctance to use/remember PIN number. o The paper passports were discussed and the advantages were: no PIN or smart phone required, portability, real time feedback, opportunity for faculty to look over passport to see areas that needed to be completed. The disadvantage of paper passports was lack of data collection. It was noted that some students did ask for signatures after the interaction but this was less than is currently happening with the electronic version. o The paper passports were discussed and the advantages were: no PIN or smart phone required, portability, real time feedback, opportunity for faculty to look over passport to see areas that needed to be completed. The disadvantage of paper passports was lack of data collection. It was noted that some students did ask for signatures after the interaction but this was less than is currently happening with the electronic version. o A small workgroup will be formed to make recommendations to this group about potential solutions to this issue.
- Clerkship Reviews will be conducted early Fall. The directors will
conduct a self-study and members of the Curriculum Committee will be
assigned clerkships to review. Findings will be presented to the
- Other business
a. Critical Review of Medical Literature: It has been observed by faculty and Clerkship directors that the current clerkship students appear less prepared to do critical review of literature than previous classes. This appears to be related to the change in curriculum which will be addressed via the Curriculum Committee. The skills can be broken down into components which include how to choose and article, how to critique an article and practice of those skills. It was recognized that faculty development will be needed. It was recognized that even expert clinicians have variable skills in this arena and that students need to also learn about and utilize resources that perform the critical review of a topic.
· Population medicine is introduced early in the curriculum. It is difficult for a beginning student to critically read an article that is beyond their medical knowledge. This skill needs to be learned and practiced across the curriculum with items in Foundations, CPD, Transition and Clerkships.
· A new Thread Leader has been identified for Epidemiology
· There are opportunities for learning and practice of these skills in Medicine, Neurology and Emergency Medicine.
b. Weekend Rounding for current second year students. Pediatrics, Psychiatry and Medicine Clerkships were recognized for providing this opportunity. Dr. Wispelwey remarked that this is known to be a valuable experience and it should not be voluntary. Currently this activity would not be covered in the required activities for the students in the pre clerkship phase of their studies.
c. Matt Dickerson was introduced as a new member of the committee. He is the interim Director for IT support for Medical Education.
d. Discussion of process and rules for absences
· Excused Absences must be approved by the College Deans.
· Students may still approach the Clerkship Director with a schedule request. If there is flexibility in the clerkship schedule and duties then it is up to the Clerkship Director as to whether or not the request can be honored. If there is no flexibility and the student is expected for clinical duty then the request is declined.
· From the Student Handbook:
Students may miss required academic activities for health related reasons (see Absences due to Illness), compelling personal or family issues (e.g., death in immediate family, participant in wedding), professional meetings (e.g., participant in meeting – poster, presenter, panel), or public service (e.g., jury duty). They must notify the course, system or clerkship director as well as the immediate faculty instructor by e-mail or in person. If a student misses more than 2 contiguous days, she/he must also notify their Student Affairs Dean and the Office for Student Affairs (firstname.lastname@example.org). The course, system or clerkship director will determine how and when the student can make up the time and activities that have been missed. (8/2000; 8/2010; 1/2011)
Nancy McDaniel, Co-Chair, recording of minutes
Patient Safety concepts not covered will be assigned to a clerkship and director will be notified.
Work group to discuss Clerkship Requirements will be formed and report back to next meeting
Joint Clerkship Meeting October 23, 2013. Jordan Hall. Please put on your calendars and plan to attend.
Next Meeting: September 23th meeting: please forward any agenda items.