lsi longitudinal practice manual - ohio state...
TRANSCRIPT
The Longitudinal Practice Program Contacts
Ann Dietrich, MD Longitudinal Practice Program Director [email protected] 614-562-7807
Diana Bahner Program Manager 054 Meiling Hall 370 W. 9th Avenue 614-292-2998 614-292-5364 - fax [email protected]
Dawn Ryan Program Assistant B040 Graves Hall 333 W. 10th Avenue 614-292-3119 [email protected]
2012-2014
LSI Longitudinal Practice Manual
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LSI Longitudinal Practice Manual LSI Longitudinal Practice Manual
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The 2012 LeadServeInspire Longitudinal Practice Curriculum ...................................................................... 2
Longitudinal Practice Clinical Experience ................................................................................................................ 3
LP skills Training Program ............................................................................................................................................. 3
Patient Empanelling Process ......................................................................................................................................... 4
Longitudinal Projects ........................................................................................................................................................ 4
Objectives by Curricular Block ...................................................................................................................................... 5
LeadServeInspire Curriculum Overview .................................................................................................................. 7
Features of Part One ..................................................................................................................................................... 7
LeadServeInspire Curriculum Terminology ....................................................................................................... 8
Frequently Used Websites ............................................................................................................................................ 10
Appendices .......................................................................................................................................................................... 11
Sample Patient Empanelling Form ....................................................................................................................... 11
Longitudinal Practice Calendar .............................................................................................................................. 12
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THE 2012 LEADSERVEINSPIRE LONGITUDINAL PRACTICE CURRICULUM
The Ohio State University College of Medicine has a rich history of curricular innovation. As we prepare students for post-graduate training opportunities in institutions worldwide, we must continuously improve our curriculum. The 2012 LeadServeInspire Curriculum will ensure that we develop physicians who will improve people’s lives through personalized healthcare.
Goals:
Identify the importance of a personal clinician.
Learn about office flow, procedures and facilitating patient care.
Apply knowledge and practice skills they have learned.
Practice the team approach to patient care and identify its importance in achieving successful health care outcomes.
Key Features:
Basic Procedures/ Skills Based Training
Integrated with Classroom Learning
Timely Communication with Practices
Online Evaluation of Student Performance
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LONGITUDINAL PRACTICE CLINICAL EXPERIENCE
The new curriculum has at its center a team based clinical experience that will enhance the student’s integration into clinical practice and teach them to apply foundation science concepts to patient care. Prior to their first preceptor experience each of the students will receive training in basic procedural skills to allow for a more active participation in patient care and less disruption to patient flow at the practice.
Dates:
October 2012-February 2014 - 2 half days/ month for 17 months
23 sessions during Part 1, includes 13 in Year 1 and 10 in Year 2
See Appendix with calendar of dates
LP SKILLS TRAINING PROGRAM
Prior to coming to your practice students will be trained in a variety of procedures/skills. This will include pediatric scenarios for students assigned to those sites.
Vital signs
ECG lead placement
Visual acuity
Injection technique (ID, SQ, IM)
Finger stick puncture with blood glucose measurement and glucometer technique
Venipuncture/phlebotomy
Cerumen removal (irrigation only)
Sterile technique/universal precautions
Urine collection, dip, and interpretation
Respiratory measurement and treatment (PF measurement, inhaler technique, basic spirometry)
Oxygen administration/Pulse oximetry
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PATIENT EMPANELLING PROCESS
As part of the integrated learning process, students will be asked to empanel a patient that has a diagnosis or behavioral condition consistent with their classroom learning. The following process should be used when students are empanelling patients in your practice:
1) The student will select patients under the guidance of their preceptor. Under office supervision, the student will complete a form on each patient they empanel and bring the completed, de-identified form to their weekly small group sessions.
2) The forms are guides for small group discussion; these will not be collected by facilitators and are not graded. See Appendix for sample form.
3) In small group, faculty facilitators will call on one student to present his/her empanelled patient. The facilitator will then ask other students about differences between their empanelled patients and the patient who was presented, i.e. different management plans for similar diagnoses, etc. Discussion is meant to focus on the integration between the basic and behavioral sciences students are studying in the LSI Curriculum Blocks and the clinical assessment/management of patient cases at your sites.
LONGITUDINAL PROJECTS
Every student will maintain a mentored Educational Portfolio throughout the curriculum that will be used to present documentation of readiness for graduation. In addition, three other culminating works will be completed over the course of the three part curriculum. These projects are designed to allow students to achieve competency in certain Core Educational Objectives as relates to self-directed learning, interdisciplinary learning, leadership, understanding health systems, health informatics and scientifically based inquiry.
The Community Health Education project requires students to research the needs of a population and develop a program to address these needs. Students will work with their Longitudinal Preceptors to identify a patient population within their assigned practice that would benefit from this project. Students will provide updates and their final report to their preceptors and present their findings during a longitudinal group session.
The Health Coaching project requires students to work with a specific patient to develop a health improvement plan focusing on behavior change. Students will need to recruit a patient from their Longitudinal Practice and may ask for assistance from their preceptor with this task. Students will provide updates to their preceptor regarding the referred patient’s status over time.
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OBJECTIVES BY CURRICULAR BLOCK
Year 1
Medical Practice and Patient Care-October: 2 sessions
Meet members of the office, introduce self and understand roles of different providers
Respectfully communicate with patients, staff, and other team members.
Review office policy and procedures with office manager
Shadow the MA or designee, understand their role
Independently perform MA functions (Intake, Vital Signs)
Practice interviewing patients and obtain HPI, Past medical history, including medications and Family history
Perform vital signs and obtain and document chief complaint observed by MA or designee
Bone and Muscle Disorders-November-December: 2/3 sessions
Respectfully communicate with patients, staff, and other team members.
Perform one supervised procedure (ECG, visual screen, ear irrigation, phlebotomy)
Have 1 direct observation of obtaining chief complaint and history of present illness, WITH feedback
Practice developing a differential diagnosis with real patients and discuss with preceptor
Independently use the CODIER technique with one patient
Practice documenting a patient encounter
Practice back/spine PE
Practice knee or shoulder PE Items in Italics must be logged by students. Items in Bold require direct observation.
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Neurologic Disorders-January-March: 4/5 sessions
Respectfully communicate with patients, staff, and other team members.
Independently interview patients and formulate an illness script for each patient
Practice collecting information on behavioral and mental issues for patients
Practice neurologic PE
Have 1 direct observation of obtaining past medical history including medication and allergies, WITH feedback
Practice oral presentation with preceptor
Practice STAGE framework for oral presentations with preceptor
Independently use the musculoskeletal, neurologic focused ROS as appropriate for chief complaint
Cardiopulmonary Disorders – April-May: 4 sessions
Respectfully communicate with patients, staff, and other team members.
Be aware of the cultural diversity in the practice; learn about the practice interpreter resources
Have 1 direct observation of obtaining family history and social history, WITH feedback
Practice cardiopulmonary focused ROS as appropriate for chief complaint
Practice cardiac PE
Practice pulmonary PE
Practice focused history and ROS as related to a cardiac chief complaint
Practice focused history and ROS as related to a pulmonary chief complaint
Direct observation of focused history and focused exam on a patient whose chief complaint is related to a cardiopulmonary or neurologic condition
Practice collecting information on the self-management needs of patients with chronic illness
Practice supporting patients health behavioral change
Year 2-Objectives for Year 2 will be sent prior to students return to the office in August 2013.
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LEADSERVEINSPIRE CURRICULUM OVERVIEW
The LeadServeInspire Curriculum provides an opportunity to develop instruction that integrates foundational sciences, clinical sciences, and behavioral sciences to provide more contextual relevance for students.
Instruction is integrated to provide greater contextual relevance for students.
Increased emphasis on multiple teaching methods is designed to promote active learning.
Foundational science content will be reinforced in Parts 2 and 3.
Anatomy is taught concurrently with and integrated into individual blocks.
Student projects throughout are designed to emphasize core educational objectives and teach lifelong learning skills.
Students will get early clinical exposure to real patients in clinical practices.
FEATURES OF PART ONE
Part 1 will be divided into 7 blocks covering the major foundational sciences topics and is approximately two months shorter than the current Med 1 and 2 years. All essential basic and behavioral science components will be covered with these concepts being revisited later in Parts 2&3. Anatomy will be taught longitudinally, with anatomical concepts being tightly integrated with histology, physiology, pathology and clinical applications covered during each block.
EARLY CLINICAL EXPERIENCE
Students will get early clinical exposure which will reinforce foundational science concepts
Students will be in longitudinal practice one half-day every other week for 17 months.
FIGURE 1: TIMELINE FOR PART 1
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Students will participate in a half-day longitudinal group session 3 hours every week on either a Monday or Wednesday
Students receive skills based training in Medical History Taking, Physical Examination and a Basic Procedures Training Program
EVALUATION AND ASSESSMENT
All students will achieve competency in all Core Educational Objectives (CEOs). Each aspect of each CEO will be measured at some point in the curriculum. The measures will be based on learning objectives and independent from learning methods. The Educational Portfolio will be used to foster self-directed learning and individualization of educational plans.
ASSESSMENT WEEKS
At the end of each block a week of assessments will include computer based Multiple Choice Question (MCQ) exams and Objective Structured Clinical Exams (OSCE). Note: Students will not be in your practice during assessment weeks.
Longer blocks (Medical Practice and Patient Care, Neurological Disorders, Cardio Pulmonary Disorders, and Host Defense) will also have a mid block assessment.
LEADSERVEINSPIRE CURRICULUM TERMINOLOGY
Term Definition
Academic Program Parts of the curriculum e.g. Part One Foundational Sciences
Curricular Block A multiple week section of a program e.g. Medical Practice and Patient Care,
Cardiopulmonary Disorders
Longitudinal Group Focused developmental tasks students work on in weekly groups throughout
the curriculum relating basic and behavioral sciences to the practice of
medicine
Longitudinal Practice Students are scheduled for ½ a day every other week to a practice site to
apply basic science and clinical skills development.
Longitudinal Projects Focused developmental tasks students work on throughout the curriculum
e.g. Health Coaching
OSCE Objective Structured Clinical Examination - will measure whether students
have become proficient at professional behaviors, communication &
patient care skills across cases and contexts
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ASSESSMENTS IN LONGITUDINAL PRACTICE
Each preceptor will be asked to evaluate the students online in medStar at the end of each block. The assessment questions directly reflect the objectives of the block and are meant to assess the student’s attendance, performance and successful completion of target objectives. The evaluations by the preceptors are integrated into the overall block assessment grades.
Several types of Assessments will be used to monitor achievement of learning outcomes of the
Longitudinal Practice component of LSI, including Attendance, Preceptor Assessments, Direct
Observation of Competence, and Student Logs.
o Attendance will be reported for each Longitudinal Practice session
o Preceptor Assessments will allow LP preceptors to report summary observations
of important student behaviors in the practice.
o Direct Observation of Competence will be used in the practice to assess student
performance of key clinical skills with a real patient. Some of these may be
completed by other members of your staff.
o Student Logs will be used to track the types of patient encounters students
experience and the skills they perform during each block.
o Each Curricular Block will end with an Assessment Week OSCE that will measure
whether students have become proficient at professional behaviors, communication
& patient care skills across cases and contexts. Students will be practicing these
skills at the LP sites, while the OSCE is the mechanism for testing their
competency.
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FREQUENTLY USED WEBSITES
CARMEN AND MEDSTAR
medSTAR is the College of Medicine’s Student Information System. Longitudinal Preceptors have instructor accounts in this system in order to evaluate student performance. At designated points in times you will receive an email notification from the medSTAR system with a link to an evaluation of the student(s). The link will take you directly to the evaluation form and you will not need to log-in.
If you have any issues accessing the evaluation forms you should contact Diana Bahner.
FACULTY DEVELOPMENT FOR MEDICAL EDUCATORS (FD4ME)
Faculty Development for Medical Educators is a series of interactive, e-learning modules devoted to improving the knowledge, attitudes and skills of medical and allied health faculty in the important domain of teaching.
Modules of interest to Longitudinal Practices:
Teaching Students in the Ambulatory Setting I: Getting Started Cynthia Ledford, M.D.
Teaching Students in the Ambulatory Setting II: Patient Care Skills Cynthia Ledford, M.D.
Teaching Students in the Ambulatory Setting III: Evaluation and Feedback Cynthia Ledford, M.D.
Direct Feedback and Coaching in Medical Education Sorabh Khandelwal, M.D.
Most modules are linked to longer video presentations and/or power point presentations.
Earn CME credit
Visit the site at: http://fd4me.osu.edu/
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APPENDICES
SAMPLE PATIENT EMPANELLING FORM
NEVER PRESENT INFORMATION THAT MAY IDENTIFY THE PATIENT IN ANY MANNER.
Date:
CC:
HPI:
ROS:
Meds: Allergies:
PMHx:
FHx:
SHx: Surgeries/Hospitalizations:
Physical Exam:
Lab Results:
Assessment:
Plan:
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LONGITUDINAL PRACTICE CALENDAR
This calendar outlines the weeks when students will be in the Preceptor practices for LP. Students will be assigned to LP1 or LP2 group, as well as a specific half day. Students are in the practice for ½ day during their assigned weeks. The shaded areas are when students WILL NOT be in the offices.
LSI Longitudinal Practice October 2012-February 2014
This calendar outlines the weeks when students will be in the Preceptor practices for LP. Students will be assigned to LP1 or LP2 group, as well as a specific half day.
Students are in the practice for ½ day during their assigned weeks. The shaded areas are when students WILL NOT be in the offices.
October 2012
Sun Mon Tue Wed Thu Fri Sat
1 LP1
2
3
4
5
6
7
8 LP2
9
10
11
12
13
14
15 LP1
16
17
18
19
20
21
22 LP2
23
24
25
26
27
28
29
30
31
Assessment week
January 2013
Sun Mon Tue Wed Thu Fri Sat
1
2
3
4
5
6
7 LP2
8
9
10
11
12
13
14 LP1
15
16
17
18
19
20
21 Holiday
22
23
24
25
26
27
28 LP2
29
30
31
April 2013
Sun Mon Tue Wed Thu Fri Sat
31-Mar
1 LP1
2
3
4
5
6
7
8 LP2
9
10
11
12
13
14
15 LP1
16
17
18
19
20
21
22 LP2
23
24
25
26
27
28
29 LP1
30
November 2012
Sun Mon Tue Wed Thu Fri Sat
1
2
3
4
5 LP1
6
7
8
9
10
11
12 Holiday
13 LP2
14
15
16
17
18
19 LP2
20 Holiday
21
22
23
24
25
26 LP1
27
28
29
30
1-Dec
February 2013
Sun Mon Tue Wed Thu Fri Sat
1
2
3
4 LP1
5
6
7
8
9
10
11 LP2
12
13
14
15
16
17
18 LP1
19
20
21
22
23
24
25 LP2
26
27
28
May 2013
Sun Mon Tue Wed Thu Fri Sat
1 LP1
2
3
4
5
6 LP2
7
8
9
10
11
12
13 LP1
14
15
16
17
18
19
20 LP2
21
22
23
24
25
26
27 Holiday
28
29
30
31
1-Jun
December 2012
Sun Mon Tue Wed Thu Fri Sat
2
3 LP2
4
5
6
7
8
9
10 LP1
11
12
13
14
15
16
17 Assess
18 ment
19 Week
20
21
22
23
24 Winter
25 Break
26
27
28
29
30
31
Winter Break
March 2013
Sun Mon Tue Wed Thu Fri Sat
1 LP2
2
3
4 LP1
5
6
7
8
9
10
11 LP2
12
13
14
15
16
17
18 Assess
19 ment
20 Week
21
22
23
24
25 Spring
26 Break
27
28
29
30
June 2013
Sun Mon Tue Wed Thu Fri Sat
2
3 Assess
4 ment
5 Week
6
7
8
9
10 Explora
11 tion
12 Week
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Summer Break
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LSI Longitudinal Practice October 2012-February 2014
This calendar outlines the weeks when students will be in the Preceptor practices for LP. Students will be assigned to LP1 or LP2 group, as well as a specific half day.
Students are in the practice for ½ day during their assigned weeks. The shaded areas are when students WILL NOT be in the offices.
July 2013
Sun Mon Tue Wed Thu Fri Sat
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Summer Break
October 2013
Sun Mon Tue Wed Thu Fri Sat
1 LP2
2
3
4
5
6
7 LP1
8
9
10
11
12
13
14 LP2
15
16
17
18
19
20
21 LP1
22
23
24
25
26
27
28 LP2
29
30
31
January 2014
Sun Mon Tue Wed Thu Fri Sat
1
2
3
4
5
6 LP2
7
8
9
10
11
12
13 LP1
14
15
16
17
18
19
20 Holiday
21
22
23
24
25
26
27 LP2
28
29
30
31
1-Feb
August 2013
Sun Mon Tue Wed Thu Fri Sat
1
2
3
4
5
6
7
8
9
10
11
12 LP1
13
14
15
16
17
18
19 LP2
20
21
22
23
24
25
26 LP1
27
28
29
30
31
November 2013
Sun Mon Tue Wed Thu Fri Sat
1
2
3
4 LP1
5
6
7
8
9
10
11 Holiday
12
13
14
15
16
17
18 Explora
19 tion
20 Week
21
22
23
24
25 LP2
26
27
28
29
30
February 2014
Sun Mon Tue Wed Thu Fri Sat
2
3 LP1
4
5
6
7
8
9
10 LP2
11
12
13
14
15
16
17 Assess
18 ment
19 Week
20
21
22
23
24
25
26
27
28
September 2013
Sun Mon Tue Wed Thu Fri Sat
1
2 Holiday
3
4
5
6
7
8
9 LP2
10
11
12
13
14
15
16 LP1
17
18
19
20
21
22
23 Assess
24 ment
25 Week
26
27
28
29
30 LP2
December 2013
Sun Mon Tue Wed Thu Fri Sat
1
2 LP1
3
4
5
6
7
8
9 LP2
10
11
12
13
14
15
16 LP1
17
18
19
20
21
22
23 Winter
24 Break
25
26
27
28
29
30
31
Winter Break