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Transitions AND the Advanced Clinical Experience. Hofstra North Shore-LIJ School of Medicine Curriculum Committee Presentation October 22, 2012. Transitions. Time Frame. Spring Break: 3/25 – 4/1/13 Comprehensive Basic Science Test: 4/2 – 4/5 Step 1 Study Time: 4/6– 5/31/13 - PowerPoint PPT Presentation
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Transitions AND the Advanced Clinical Experience
Hofstra North Shore-LIJ School of MedicineCurriculum Committee Presentation
October 22, 2012
Transitions
Spring Break: 3/25 – 4/1/13 Comprehensive Basic Science Test: 4/2 – 4/5 Step 1 Study Time: 4/6– 5/31/13 Deadline to Take Step 1: Friday May 31st
To the best of our knowledge i.e. subject to change Transitions: 6/1 – 6/30/13 3rd Year ACE: 7/8 – 6/29/14
◦ Includes 3 weeks vacation and 9 weeks selective 4th Year ACE: Starts 6/30
Time Frame
Recertify in BLS Acclimate to hospital settings Navigate hospital systems and EMR Refresh basic skills- CXRs, EKGs,
phlebotomy, IV placement, suturing, knot tying
Learn new skills- new procedures, inpatient and outpatient notes, the 1min/3min/15min presentation
Experience new horizons- e.g. anesthesia Pick up some longitudinal patients
Transitions
Preliminary Schedule
The Advanced Clinical Experience
Lack of meaningful responsibility or an authentic role
Insufficient development of clinical reasoning skills
Conflicting interests between learning and getting a good grade
Inadequate information to make an informed career decision
Inadequate assessment data
Unintended Consequences of the Traditional Clerkship Experience
What we can do to improve the Third Year Experience
Give students authentic responsibility for patients and place them where the thinking occurs
Cultivate “whole illness” relationships with patients and develop longitudinal coaching relationships with faculty
Assess students in a way that drives learning and integrates science into clinical education
Give students better insight into careers in medicine and facilitate “differentiation” through self-directed learning time and electives
We CAN
to be feasible as tracks in leading medical schools (a decade of experience)
to improve long term retention and capacity for learning
to provide students with a superior clinical experience in terms of depth and volume of core diseases (by orders of magnitude)
to create patient-centered doctors
Longitudinal Integrated Clerkships…PROVEN
Feasibility for our class size Considerable multi-tasking for students
Challenges
The Best of Both Worlds
“Hybrid” Model for 3rd YearKeeps the discipline-specific focus of traditional clerkships while
Integrating cumulative and longitudinal features of a Longitudinal Integrated Clerkship
Discipline-specific focus6-week cycles focused on one discipline
Discipline-specific morning “ACE” rounds
Discipline-specific class time, one full half day per week
Shelf exams (national multiple choice exam-one for each specialty) every 6 weeks
Cumulative and Longitudinal Features Self-directed time for follow-up of patients Ongoing, cumulative experiences in
Internal Medicine and Surgery Longitudinal continuity clinic experiences
in Internal Medicine Highly select group of longitudinal patients
to follow Week-long “Reflection, Integration, and
Assessment” (RIA) weeks at the end of each trimester
New Model
Sample Schedule: Neurology
ACE Manager – combo course manager and student affairs – at both campuses
ACE Directors – at least one for each discipline – paid to dedicate half of their time to you
Me – office on campus with candy
Infrastructure and Support
Grades will be given for each discipline◦ Honors, High Pass, Pass, Fail◦ Assigned at the end of the year (though will have
tentative grades at the end of each trimester)◦ Will reflect achievement of real milestones
Dean’s letters will not only look familiar but will include more robust data
We will have AOA and Gold Humanism chapters
Our students will be highly sought after!!
And to top it all off….
Fourth Year
Discussion