Directing Geographically Directing Geographically Disparate Clerkship SitesDisparate Clerkship Sites

Alan P. Ladd, MDAssociate Professor of Surgery

Indiana University School of Medicine

Objectives/DisclosureObjectives/Disclosure• Identify pertinent LCME guidelines in the

management of geographically disparate sites• Develop a Timeline for the development of new

disparate sites of instruction• Recognize ongoing assessment aspects for

disparate site instruction

• No Disclosures (wish I had some)

Pertinent LCME GuidelinesPertinent LCME Guidelines• Link:• http://www.lcme.org/standard.htm

• Handout (crib sheet)

Pertinent LCME GuidelinesPertinent LCME GuidelinesEducational Program• ED-2:Central oversight– Clinical Encounters (diagnoses/patients)– Level of student responsibility– Monitoring

Pertinent LCME GuidelinesPertinent LCME Guidelines• ED-8:Comparable Experiences– (related to ED-2)– Identical Educational objectives, administration,

assessment, grading.– Enhancement of faculty teaching and assessment– Orientation of faculty– Feedback to sites

Pertinent LCME GuidelinesPertinent LCME Guidelines• ED-25: Clinical supervision• ED-41: Faculty Integration• ED-44: Student support services/benefits

Pertinent LCME GuidelinesPertinent LCME GuidelinesFaculty• FA-2: Faculty qualification/time• FA-4: Faculty commitment/effectiveness• FA-7: Faculty appointment• FA-10: Faculty feedback

Pertinent LCME GuidelinesPertinent LCME GuidelinesEducational Resources• ER-7: Facility capability/IT resources• ER-9: Affiliation Agreements– Learning Environment

Site EstablishmentSite Establishment

Start12 mon 9 mon 6 mon 3 mon15-18 mon

Faculty RecruitmentInitiate ConversationCandidate ListSite Adequacy

Faculty DevelopmentOutine Core contentPreceptor Guidelines

SchedulesDesign SchedulesDocumentationOrientation Design

AdministrativeAffiliation AgreementsFaculty Appointments

Services/LogisicsHousingStudent Services

ClerkshipOrientationAssessment Schedule

Site EstablishmentSite Establishment• 18 months– Initial conversation– Develop faculty list

• 15 months– Dissemination of clinical instruction requirements– Determine site adequacy

Site EstablishmentSite Establishment• 12 months– Affiliation agreements– Faculty appointments

• 9 months– Student electronic access—IT– Faculty development to core content/objectives– Supervision guidelines– Student responsibilities

Site EstablishmentSite Establishment• 6 months– Housing– Campus facility access

• 3 months– Outline daily student schedule– Arrange site training– Acquire site documentation/training needs

Site EstablishmentSite Establishment• 2 months– Outline local orientation– Identify local policies and procedures

• 1 month– Disseminate student schedules– Verify student services

Site EstablishmentSite Establishment• During Rotation– Global Orientation– Verify Instruction– Collect Assessments

Site EstablishmentSite Establishment• Following Rotation– Gather site-specific and faculty assessments– Review student feedback

Site VisitsSite Visits• Annual Site Assessments– Disseminate site and faculty assessments– Outline faculty development opportunities and

update on intended curricular changes– Provide Faculty Development

• Identify goals for following year

ConsiderationsConsiderations• Grade Distribution/Inflation• Apprentice vs. Team-based Model• Student perception of Career in Surgery• Student Advising• Skill Opportunities• Scope of Practices• Subspecialty Offerings