Directing Geographically Disparate Clerkship Sites

1. Directing Geographically Disparate Clerkship Sites Alan P. Ladd, MD Associate Professor of Surgery Indiana University School of Medicine

2. Objectives/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)

3. Pertinent LCME Guidelines • Link: • http://www.lcme.org/standard.htm • Handout (crib sheet)

4. Pertinent LCME Guidelines Educational Program • ED-2: Central oversight • Clinical Encounters (diagnoses/patients) • Level of student responsibility • Monitoring

5. Pertinent 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

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

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

8. Pertinent LCME Guidelines Educational Resources • ER-7: Facility capability/IT resources • ER-9: Affiliation Agreements • Learning Environment

9. Site Establishment Schedules Design Schedules Documentation Orientation Design Faculty Recruitment Initiate Conversation Candidate List Site Adequacy Faculty Development Outine Core content Preceptor Guidelines Start 15-18 mon 12 mon 9 mon 6 mon 3 mon Administrative Affiliation Agreements Faculty Appointments Clerkship Orientation Assessment Schedule Services/Logisics Housing Student Services

10. Site Establishment • 18 months • Initial conversation • Develop faculty list • 15 months • Dissemination of clinical instruction requirements • Determine site adequacy

11. Site Establishment • 12 months • Affiliation agreements • Faculty appointments • 9 months • Student electronic access—IT • Faculty development to core content/objectives • Supervision guidelines • Student responsibilities

12. Site Establishment • 6 months • Housing • Campus facility access • 3 months • Outline daily student schedule • Arrange site training • Acquire site documentation/training needs

13. Site Establishment • 2 months • Outline local orientation • Identify local policies and procedures • 1 month • Disseminate student schedules • Verify student services

14. Site Establishment • During Rotation • Global Orientation • Verify Instruction • Collect Assessments

15. Site Establishment • Following Rotation • Gather site-specific and faculty assessments • Review student feedback

16. Site 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

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