lsi longitudinal practice manual - ohio state...

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

mailto:[email protected]



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LSI Longitudinal Practice Manual LSI Longitudinal Practice Manual

2012-14

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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2012-14

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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2012-1

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


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


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


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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2012-1

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/

http://fd4me.osu.edu/modules/8



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


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


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


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


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


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


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


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


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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2012-1

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


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


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


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


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


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


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


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


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

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