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Present (underlined) were: Reid Adams, Eve Bargmann,
Robert Bloodgood, Anita Clayton, Gene
Corbett, Donald Innes (Chair), Howard Kutchai,
Marcus Martin, Chris Peterson, Jerry Short,
Linda Watson, Bill Wilson, Brian Wispelwey,
Nnaemeka Anyadike, Michael Richardson, Michael Rein
(guest), Debra Reed (secretary)
- Clinical Skills Educator: The Teaching Attending.
Eugene Corbett and Michael Rein presented a proposal to establish and
fund clinical skills educator positions in the Medicine
Clerkship.
Basic clinical skills education is an essential element of
undergraduate medical education. In an effort to improve students’
skills education during the clinical clerkship year, a “Clinical Skills
Educator” faculty position is herein proposed to be piloted in the
Internal Medicine clerkship. The task of this designated faculty member
will be to meet with medical students weekly while they are rotating
through the inpatient portion of clerkship, giving particular emphasis
to the development of their basic clinical skills. Faculty will be
selected for their interest and expertise in medical
student clinical education.
Faculty responsibilities will include:
Session management (8 or 16 session
hours per week)
Clinical skills teaching
Student performance evaluation and
feedback
Student records review and
feedback
Submission of summary student evaluation
document
Maintain session case log
The basic clinical skill areas should include patient interviewing and
history-taking, physical examination, case presentations, clinical
record keeping, and interpretation of clinical tests and radiological
imaging. It is expected that related skill issues such as
professionalism, medical ethics, and medical economics will also be
addressed as the opportunity arises. The teaching and practice of basic
clinical procedures (e.g., arterial or iv draw, obtain an ecg or peak
flow, NG tube insertion) will continue to remain primarily the
responsibility of the ward residents and attending physician.
Students will be expected to bring cases from their ongoing ward
experience to each session. Whenever possible, teaching should center
upon case-based clinical skill learning, and include both classroom and
bedside activities.
Each student will be required to select at least one patient from their
service for each session. Activities should include brief case
presentations, bedside history and physical examination, case
debriefings/discussion, radiological/test review , and review of
student clinical notes (usually in the succeeding session after faculty
review). The time allotted to each activity should be at the discretion
of the faculty with the goal of repeatedly addressing all of these
areas over the month. Time should also be budgeted in each subsequent
session for a brief discussion of pertinent evidence-based case
material which the student may be assigned to research independently
between sessions.
The following represents weekly core curricular
elements for this experience:
Observed student history-taking
Observed and practiced physical examination, e.g.,
Head and neck examination
Pulmonary examination
Cardiovascular examination
Abdominal examination
Time-specified case presentations
Review and feedback of student notes
Initial Hx and PE
F/u chart notes
Selected test and image interpretation, e.g.,
Fluid/electrolytes
Acid-base
Organ-system chemistry
Arterial blood gas
Chest xray
Electrocardiogram
Observed patient communication and professionalism skills
Studentswill participate in pairs- 4 hours per student pair per week (2
sessions, 2 hours each)
Each student will have 16 hours per month.
Faculty (1 or 2) will be assigned to a 4 week block with 1 or
2 scheduled sessions daily (1-3 and 3-5pm ).
For purposes of evaluating the content of the clinical skill sessions,
a final evaluation form will be provided for both student and faculty
completion.
Funding for faculty will be the standard equivalent clinical FTE
reimbursement based upon 16 hours of session (8) and
preparation/reviewing time (8) per week.
Curriculum Committee Discussion:
Program, if approved, would be piloted in the Medicine Clerkship Spring
(March/April), 05, with full implementation in Medicine by Fall,
05.
The same curriculum can be used at the Roanoke and Salem sites. Bedside
interaction is a key feature of this program.
It was suggested that faculty be recruited and trained by Drs. Rein and
Corbett.
Compensation issues are on the table in budget negotiations and should
be in place soon.
Whether this program or other individualized programs of a similar
nature would be
implemented for the rest of the clerkships was discussed.
- Geriatric Subspecialty in Medicine. Mike Rein
announced the addition of a new Geriatrics subspecialty training area
in Medicine. Of the first six available slots, five have been
filled. Students in this subspecialty will act as junior
housestaff and will be able to follow their patients when they leave
the hospital.
- Dr. Michael Rein was congratulated for receiving the 2005
Robley Dunglison Award. Michael is an exceptional teacher and an
inspiration for students in all areas of medicine.
The next meeting of the Curriculum Committee will be Thursday,
January 6, 2005 , at 4:00 in the Surgery Conference Room.
Agenda: 1) Dr. Claudette Dalton will discuss the second year
Preceptorship Program 2) Begin review of Practice of Medicine
program.
Donald Innes/dmr
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