Psychiatry Clerkship Review

Student Evaluation ResultsJessie Bay11/1/13

Overall Evaluation of Clerkship Experience: General

CPMC 4.62

DHMC 4.42

NHH 4.48

VAMC 4.36

Strengths: Teamwork• Students loved working with the multidisciplinary team and felt

like valued team members.– “I enjoyed the team-based approach to health care delivery at New

Hampshire Hospital. It was great to work together with social workers, nursing staff, mental health workers, and physicians to coordinate care for our patients and get a better understanding of their respective circumstances and responsiveness to treatment.”

– “I really enjoyed the large, inter-disciplinary team on the inpatient unit at CPMC; everyone worked well together, was very respectful, and the outcome was truly synergistic.”

– “Medical students were able to play an integral role in the treatment and care of the patients.”

– “The attendings and residents treated me as if I were a very important part of the treatment team”

– “I felt that I was a valued member of the team that could make contributions to patient care.”

Strengths: Learning Environment

• Students felt the learning sites created a supportive safe learning environment– “Learning environment was conducive to both self-

motivated and structured formats”– “The learning environment was very

comfortable/open.”– “I loved that everyone involved in this clerkship

were shining examples of what good doctoring is all about. Every attending and every resident was great to work with and learn from.”

Strengths: Teaching

• “I liked how all the attendings were very dedicated to our learning. They would take the time to give a short lecture on a topic whenever we asked.”

• “Attendings and especially the residents were amazing at teaching new topics and for taking an interest in my education of the field”

Quality of TeachingSITE Attendings Residents

CPMC 4.69 4.25

DHMC 4.48 4.30

NHH 4.61 4.29

VAMC 4.21 3.93

Strengths: Variety of Experiences

• “The design of this clerkship provided me a good idea of the breadth of psychiatry. That is, I got to experience psych in an emergent inpatient setting, a regular inpatient setting, outpatient, consult liaison, and procedural (ECT).”

• “Thought the exposure to a wide variety of aspects of psychiatry was really helpful--it was very helpful to get to go to the IOP meeting, an afternoon in the suboxone clinic, the outpatient clinic at the hospital, the consult service, and the inpatient service.”

Strengths: Clerkship Leadership and Design

• Students felt that clerkship leadership was available and responsive. – “In terms of administration, they were by far the best in terms

of managing students, answering questions, etc. Dr. Duncan is great at responding and helping out students, and the clerkship coordinator, Chris Bolka, is EXCELLENT.”

• Students felt the assignments were appropriate and there was minimal busywork.– “They give us tasks and assignments so we can learn our

material at the inpatient wards, in the clinic, and in our teaching/didactics. They do an excellent job of minimizing the busy work.”

• Objectives and expectations were clearly presented.

Clarity of Expectations/ObjectivesSITE Expectations Objectives

CPMC 4.50 4.62

DHMC 4.39 4.43

NHH 4.57 4.61

VAMC 4.29 4.57

Strengths: Site specific highlights

• CPMC: Patient diversity and seeing a good mix of conditions

• DHMC: Lots of time to spend with patients, variety of experiences.

• NHH: Exposure to the medico-legal aspects of the field and working directly with attendings

• VAMC: Teamwork, interesting patient stories

Areas for Improvement: CPMC

• Some students would be interested in more outpatient experience.

• Some felt that 1 week of consult/liaison experience would be sufficient.– “Possibly decrease consult from two weeks to one

week to allow for more continuity on inpatient unit”

Areas for Improvement: DHMC• Ways to get students more actively involved in

outpatient clinic?• More feedback on notes and patient interviews– “Feedback on notes and interviewing would be helpful so

students can incorporate changes into their clinical practice. Students would also benefit from getting their H&P feedback (which was very informative and helpful) returned to them sooner.”

• Some wanted more variety (time split between 2E/W) and others wanted more consistency.

• Some loved the consult week while others felt it was a less useful learning experience.

Areas for Improvement: NHH

• Some students were interested in more exposure to outpatient, consult and psychotherapy, and substance abuse treatment.

• Parity of call hours between sites—NHH students felt they had more call overall.– “Students at NHH have to also do call at DHMC on a full Saturday

and a Friday night. It would be better to make the call on Thursday night (when we would already need to be in Hanover the following day for either ECT or outpatient clinic) and then also keep the Friday night. The full day on Saturday wasn't as useful for learning -- a couple of us just rounded on the DHMC patients but then saw no admissions/ER -- and I don't feel that it was entirely comparable to the students at other sites for their clerkship given that we also had call at NHH.”

• Mid-day didactics at NHH took away from patient time and some students felt that they were too long.

Areas for Improvement: VAMC

• Clarify student role/increase active participation of students– “I would work to clarify expectations at the away sites (VA,

Concord) in terms of the amount of participation expected.”– “Give students more opportunities to lead the discussion

during morning report.”• More consult experience if possible• Better organized orientation to the VA on the first day

– “Need better coordination in terms of orientation and administrative issues at the VA Hospital. It was confusing in terms of how to obtain my ID and EMR training.”

Areas for Improvement: Overall

• Didactics: mixed reviews, student learning hampered by presenter absences in some blocks, students would like more interactive presentations and fewer powerpoint lectures.

• Make a checklist of all assignments and their due dates

• Some students at each site indicated they would have appreciate more opportunities for exposure to child psych

Quality of Educational ExperiencesSITE Consult/

LiaisonCritical Thinking

Didactics

CPMC 3.94 4.47 4.44

DHMC 3.90 3.77 3.93

NHH 4.00 4.09 3.78

VAMC 4.00 4.00 3.93

Summary• Strengths:

– Clerkship is extremely well rated by students across sites.– Great leadership and coordination– Supportive learning environment and teaching– Opportunity to work with and learn from a multi-

disciplinary team– Students feel like valued team members– Exposure to a wide variety of experiences

• Areas for Improvement:– Students at some sites indicate desire for increased

exposure to consult, outpatient, and child psych– Room for improvement in didactics by making them more

interactive