The Longitudinal Practice Program Contacts Ann Dietrich, MD Diana Bahner
Transcription
The Longitudinal Practice Program Contacts Ann Dietrich, MD Diana Bahner
LSI Longitudinal Practice Manual 20122014 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] 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 1 LSI Longitudinal Practice Manual LSI Longitudinal Practice Manual 2012-14 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 2 LSI Longitudinal Practice Manual LSI Longitudinal Practice Manual 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 3 LSI Longitudinal Practice Manual LSI Longitudinal Practice Manual 2012-1 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, deidentified 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 selfdirected 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. 4 LSI Longitudinal Practice Manual LSI Longitudinal Practice Manual 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 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. 5 LSI Longitudinal Practice Manual LSI Longitudinal Practice Manual 2012-1 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. 6 LSI Longitudinal Practice Manual LSI Longitudinal Practice Manual 2012-1 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. FIGURE 1: TIMELINE FOR PART 1 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. 7 LSI Longitudinal Practice Manual LSI Longitudinal Practice Manual 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 8 LSI Longitudinal Practice Manual LSI Longitudinal Practice Manual 2012-1 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 o o o o Attendance will be reported for each Longitudinal Practice session Preceptor Assessments will allow LP preceptors to report summary observations of important student behaviors in the practice. 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. Student Logs will be used to track the types of patient encounters students experience and the skills they perform during each block. 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. 9 LSI Longitudinal Practice Manual LSI Longitudinal Practice Manual 2012-1 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/ 10 LSI Longitudinal Practice Manual LSI Longitudinal Practice Manual 2012-1 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: 11 2012-1 LSI Longitudinal Practice Manual LSI Longitudinal Practice Manual LSI Longitudinal Practice October 2012-February 2014 This outlines weeks students in the practices Preceptor practices for LP. Thiscalendar calendar outlines thethe weeks whenwhen students will be inwill the be Preceptor for LP. Students willbebeassigned assigned to or LP1 orgroup, LP2 group, asawell as half a specific half day. Students will to LP1 LP2 as well as specific day. Students are in the practice for ½ day during their assigned weeks. Students are in the practice for ½ day during their assigned weeks. The shaded areas are whenare students NOT beWILL in theNOT offices. The shaded areas whenWILL students be in the offices. LONGITUDINAL PRACTICE CALENDAR October 2012 Sun Mon Tue Wed Thu Fri Sat 1 2 3 4 5 6 November 2012 December 2012 Sun Mon Tue Wed Thu Fri Sat 1 2 3 Sun Mon Tue Wed Thu Fri Sat 2 3 4 5 6 7 8 4 9 LP1 7 8 LP2 9 10 11 12 13 LP2 14 15 22 16 17 18 19 20 11 29 7 8 9 10 12 23 24 25 26 27 18 30 31 Assessment week 25 10 11 12 13 14 15 18 19 20 21 22 27 28 29 LP1 13 14 15 16 17 16 Holiday LP2 LP2 28 6 LP1 LP1 21 5 19 20 LP2 Holiday 26 27 17 Assess ment 21 22 23 24 23 24 Week 25 26 Winter Break 28 29 30 1- Dec LP1 30 31 Winter Break January 2013 February 2013 March 2013 Sun Mon Tue Wed Thu Fri Sat 1 2 3 4 5 Sun Mon Tue Wed Thu Fri Sat 1 2 Sun Mon Tue Wed Thu Fri Sat 1 2 6 3 3 LP2 7 8 9 10 11 12 LP2 13 14 15 16 17 18 19 22 23 24 25 26 29 30 31 LP1 20 21 Holiday 27 28 4 5 6 7 8 9 LP1 10 11 18 12 13 14 15 16 10 24 25 19 20 21 22 23 17 Mar LP1 7 8 9 10 11 12 13 LP2 14 15 16 17 18 19 20 LP1 21 22 23 24 LP2 28 29 LP1 30 25 11 18 26 27 28 24 25 26 27 13 14 15 16 19 20 21 22 23 28 29 30 Week 26 27 Assess ment 7 8 9 10 11 9 10 Week 11 12 Explora tion LP2 12 12 13 Sun Mon Tue Wed Thu Fri Sat 2 3 4 5 6 7 8 LP1 6 9 June 2013 Sun Mon Tue Wed Thu Fri Sat 1 2 3 4 5 8 Spring Break May 2013 Sun Mon Tue Wed Thu Fri Sat 31- 1 2 3 4 5 6 7 Assess ment LP2 April 2013 6 LP2 LP1 LP2 5 LP1 LP2 17 4 13 14 15 Week 14 15 16 17 18 16 17 18 19 20 21 22 21 22 23 24 25 23 24 25 26 27 28 29 28 29 30 31 1Jun 30 Summer Break 12 LP1 19 20 LP2 26 27 Holiday LSI October 2012-February 2014 This calendar outlines the weeks when students will be in the Preceptor practices for LP. Longitudinal Practice Students will be assigned toManual LP1 or LP2 group, as well as a specific half day. 2012-1 Students are in the practice for ½ day during their assigned weeks. LSI Longitudinal Practice Manual The shaded areas are when students WILL NOT be in the offices. July 2013 August 2013 September 2013 Sun Mon Tue Wed Thu Fri Sat 1 2 3 4 5 6 Sun Mon Tue Wed Thu Fri Sat 1 2 3 Sun Mon Tue Wed Thu Fri Sat 1 2 3 4 5 6 7 Holiday 7 8 9 10 11 12 13 4 5 6 7 8 9 10 8 9 10 11 12 13 14 17 18 19 20 21 24 25 26 27 28 LP2 14 15 16 17 18 19 20 11 12 13 14 15 16 17 15 LP1 21 22 23 24 25 26 27 18 19 LP1 20 21 22 23 24 22 LP2 28 29 30 31 Summer Break 25 26 16 23 Assess ment Week 27 28 29 30 31 29 LP1 30 LP2 October 2013 November 2013 December 2013 Sun Mon Tue Wed Thu Fri Sat 1 2 3 4 5 Sun Mon Tue Wed Thu Fri Sat 1 2 Sun Mon Tue Wed Thu Fri Sat 1 2 3 4 5 6 7 3 8 LP1 LP2 6 7 8 9 10 11 12 14 15 16 17 18 19 10 21 22 23 24 25 26 17 28 7 8 9 11 18 29 30 24 31 25 9 10 11 12 13 14 17 18 19 20 21 24 25 26 27 28 LP2 12 13 14 15 16 15 16 LP1 19 20 Explora tion LP1 27 6 Holiday LP2 20 5 LP1 LP1 13 4 21 22 23 22 Week 26 27 23 Winter Break 28 29 30 29 30 31 Winter Break LP2 LP2 January 2014 February 2014 Sun Mon Tue Wed Thu Fri Sat 1 2 3 4 Sun Mon Tue Wed Thu Fri Sat 2 3 4 5 6 7 8 LP1 5 6 7 8 9 10 11 LP2 12 13 14 15 16 17 18 21 22 23 24 25 28 29 30 31 1- LP1 19 20 Holiday 26 27 LP2 9 10 11 12 13 14 15 18 19 20 21 22 LP2 16 17 Assess ment Week 23 24 25 26 27 28 Feb 13