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MEC Review

MEC Review. Psychiatry Dec 17,2013. Recommendations. Update Objectives - done Update Essential skills/conditions language – done Essential skills/conditions – delirium. Learning Tools Learning Environment/Activities Residents as Teachers. Delirium. New Hampshire Hospital :

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MEC Review

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  1. MEC Review Psychiatry Dec 17,2013

  2. Recommendations • Update Objectives - done • Update Essential skills/conditions language – done • Essential skills/conditions – delirium. • Learning Tools • Learning Environment/Activities • Residents as Teachers

  3. Delirium • New Hampshire Hospital: • The admissions process actively screens out patients with delirium. • NHH assigned students (max of 32 per year) do call at DHMC and may see this condition in this setting. • However, that is not reliable enough to have this as an essential condition. • Therefore, we would petition the MEC to reassign delirium to an alternative clinical service (eg medicine or surgery).

  4. Learning Assessment Tools • Recommendation • Consider Mini-CEX • Considering: • Oral Board model - • Last week of clerkship • 30 min interview • 5 min student prep • 10 min presentation • 10 min feedback • 4 trained evaluators • To standardize evaluation and feedback • Formative and Summative feedback (12.5 points) • Reporter skills (5 pts) • Interpreter (2.5 pts ) • Manager • Early (2.5 pts) • Proficient (2.5 pts)

  5. Learning Environment/Activities • Recommendation: • Outpatient: “enhance experience across sites.” • Current schedule: • DHMC – ½ day in the same clinic across 5 weeks. • NHH – ½ day at Heater Rd Primary Care. • VA – 1 full day at WCBH Claremont. • CPMC – ½ to 1 full day in child clinic. • Working toward: • DHMC – working with attendings and residents on more active student role. • NHH – adding an additional ½ day in another DHMC based integrated clinic (GIM or OB/GYN) • VA – re-new student involvement in PMHC walk-in clinic – which has received the 2005 American Psychiatric Association Gold Achievement Award and the 2007 VA Advance Clinical Access National Champion Award. • CPMC – actively working with Dr. Chung to expand this experience. • Site visit planned for March 2014

  6. Learning Environment/Activities • Recommendation: • Didactics: “more interactive” • Current schedule: • DHMC/NHH/VA – ½ day all together each Friday 1 -4pm. • Case centered discussion based is the goal. • But drifts back to power point format • CPMC – 2 students with Dr. Chung, very case based (no need to change) • Considering: • DHMC – 3 sessions will change to SBM-like live patient interview and discussion. • (students interview) • Mood disorders - Dr. Holtzheimer • Psychotic disorders - Dr. Noordsy • Substance use - Dr. Nordstrom • NBME review session • (as we are starting to see a downward trend in average test scores)

  7. Learning Environment/Activities • Recommendation: • Assignments: “checklist”

  8. Learning Environment/Activities • Recommendation: • Call hours: “more equitable .” • Current schedule: • Call is 5pm to MN • DHMC – 3 nights • NHH – 2 nights at DHMC • 2-3 admission nights at NHH – end before MN • VA – 2 nights at DHMC and phone call for VA • CPMC – 4 nights. • Changes already made: • NHH and VA – used to have a 12 - 24 hour weekend call. • Now is an 8 hour shift more on par with evening call.

  9. Resident as Teachers • Recommendation: • “Assure distribution of policies and objectives” • Consider Survey Monkey to track and document. • Changes: • Chris Bolka is working with pediatrics coordinator to implement the same system.

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