Embed Size (px)
Citation preview
Disclosures
• Published evidence provided where possible
• Personal Commentary (*)• Comments do not necessarily reflect the views
of the Indiana University School of Medicine
Disclosures—why me?
• Clerkship Director for 7 years• 340+ students • Central Campus (6 hospitals)• 8 statewide, regional sites• I know JOE
General Surgery at the Academic Health Center
“The Mecca”
General Surgery at AHC • Medical Center or Traditional University Hospital– Specialized and Sub-specialized services
• Typical Services– “Whipple-a-day” service– “Only Breast and Thyroid” service
General Surgery Clerkship
• Training models for MS3 clerks
– Inherent to the Medical Center (traditional)
–Curricular models slow to change
– Lack of opportunities to change
Novel Clerkship Models
• Completely Distributed System–Multiple regional campuses– Student Apprentice Model–Regional oversight for instruction–Central oversight for Curriculum, Resources,
Outcomes
EL Bradley et al. JSR 177 (2012) 14-20TCW Yu et al. JSR 168 (2011) e17-e23
Novel Clerkship Models
• Non-Academic Clerkship Model–Use of Community hospitals–With or without Academic structure of
residency
M Williams, et al. JST 116 (2004) 11-13.
Novel Clerkship Models
• Surgical Subspecialty Model–Use of Subspecialty surgery rotations–High Ambulatory patient population for
instruction
MK Sandquist et al. JSR 153 (2009) 152-5.Poenaru et al. Amer J Surg 175 (1998) 515-517
Novel Clerkship Models
• Common Themes–Centralized Curriculum Oversight– Identical Educational Objectives/Resources– Faculty Development/Instruction–Monitoring of Outcomes
The Solutions toGeneral Surgery at AHC *
• Mindset Change (for CD/Chair/Department)
• Education not about the Emersion
• Universal, Reproducible Surgery Curriculum
• Faculty Development
Clerkship is not Emersion
• Service and/or Hospital becomes Context• Not Team dependent• Team can be redefined
Universal Curriculum
• Identical Objectives• Standard Teaching Material & Resources• Standard Assessments
• Pedagogical Options
Faculty Development
• Shared Educational Goals• Common Understanding of Objectives• Awareness of Resources• Updated Versions
Surgery Core Curriculum
• Successfully Navigating the First year of Surgical Residency: Essentials for Medical Students and PGY-1 Residents
• ( National Curriculum)• Guidebook for Clerkship Directors, 4th Ed
ition
Developing Core INSTRUCTION
• Didactics• Experiential Opportunities• Skill Instruction
• Always remember equivalency (LCME)
The IUSM Example
• Core topic Small Group Discussions• Lectures—Surgical Nutrition, Ventilators• Clinics—Breast Oncology; Colorectal• Calls—Acute Care Surgery/Trauma• Skills—Venipuncture; Suturing; Foley• Patient Assessment—Simulation
General Surgery at AHC
• Curriculum, Objectives, and Instruction that Compile to make a General Surgery experience
General Surgery for the “Non-surgical” Students
“Non-surgical” Students• Who are our learners?• 90+ % of students are not surgeons
• What should be our Educational Mindset?
The Generalist Education
• Clinical Encounters
MJ Curet et al. Am J Surg 178 (1999) 78-84
MJ Curet et al. Am J Surg 178 (1999) 78-84
The Generalist Education
• Clinical Encounters/Diagnoses– Higher interest in topics of subspecialty surgery– Orthopedics– Otolaryngology– Ophthalmology
• Not trauma, vascular problems, CAD, PE
MJ Curet et al. Am J Surg 178 (1999) 78-84
The Generalist Education
• Skill Proficiency
MJ Curet et al. Am J Surg 178 (1999) 78-84
MJ Curet et al. Am J Surg 178 (1999) 78-84
The Generalist Education
• Skill Proficiency– Shared importance of Documentation– Highly rated “office procedures”– Wound Management, Epistaxis, Abscess
MJ Curet et al. Am J Surg 178 (1999) 78-84
The Generalist Surgical Education*
• Not always reflective of AHC healthcare• Higher Subspecialty emphasis• Office-based procedural elements
The IUSM Example
• Core Discipline didactics• Skills—Casting/Splinting; Vascular Exam• TBD
The Generalist Surgical Education*Resources
• WISE-MD• Lawrence Text: Essentials of General Surgery
Headline HereNo More Than 2 Lines
• Body text here. Never center bulleted text.• Line 2• Line 3• Line 4 – no more!
Headline HereNo More Than 2 Lines
• Body text here. Never center bulleted text.• Line 2• Line 3• Line 4 – no more!
• Bullet text here. Never center bulleted text.
• Item 2 might be a single line of text.
• Line 3 might be a bit longer, and could wrap to a second line.
• Line 4 should be the last bullet on your slide!
Major Title SlideLimit to 2 Lines
Major Title SlideWith a subhead
Headline Here• Body text here. Never center bulleted text.• Line 2• Line 3• Line 4 – no more!
