Enhancing the Clinical Experience for the Student and the Preceptor Abridged Version

1. Enhancing the Clinical Experience for the Student and the Preceptor Abridged Version Vicky Pace, M.Ed. Clinical Training Coordinator, Center for Rural Health Oklahoma State University - College of Osteopathic Medicine AACOM 2007 - Collaboration: The Keystone to Success June 28, 2007 in Baltimore, Maryland

2. Matching can Enhance Matching the student to the site enhances the experience for both the student and the preceptor. Definition: To make greater, as in value or effectiveness. • Why is it important? • How are we doing now? • Where do we start? • What next?

3. Why is it Important? Goal: Increase the number of physicians that chose to practice in rural areas. So how are we doing?

5. Where do we start? • Things are changing • Differences are important • Experiences influence decisions • Learning Happens

6. Things Change: Cultural Changes 75 million Traditionalist (Veterans) (born before 1945) • 10% of the workforce • Large need for healthcare • Retiring (62 and older)

7. 80 million Baby Boomers (born between 1945 - 1964) 45% of the workforce Increasing need for healthcare Nearing retirement (43 to 62) Community Leaders Training the future physicians Things Change: Cultural Changes

8. Things Change: Cultural Changes 10 to 15 years training after high school to become a physician 46 million Generation Xers (born between 1965 –1980) • 30% of the workforce • Our new physicians (age 27 to 42) • Different kind of patient • Different kind of student

9. Things Change: Cultural Changes 76 million Nexters (Generation Y or Millennials) (born after 1980) • 15% of the workforce • Recruiting and training now to be our future physicians • Current medical students • What kind of patient?

10. Things Change: Cultural Changes A large percentage of patients are Traditionalist and Baby Boomers. Traditionalist are retired or retiring. Some Baby Boomers starting to retire. Baby Boomers are training and hiring the new Generation X physicians. Baby Boomers and GenXer’s are teaching the Millenial's to be our future physicians.

11. What are we doing now? • Teaching in the big city (busy hospitals, lots of specialist) • Providing a rural experience (a lottery, kind of like dealing cards) • Attempting to recruit them to rural AFTER they are trained

12. Remember This?

13. Experiences influence decisions With the need for Primary Care Physicians in rural areas rising, the student’s experience plays a large role in the decisions made concerning future plans.

14. Learning Happens! What do we want them to learn? • The very nature of rural medical education lends itself to unpredictable and varied experiences for both the student doctor and the preceptor doctor. What are they really learning? What are we doing? Is it planned? • Limited time on rotations make planned learning critical since it ultimately influences the decisions the student doctor makes regarding future plans.

15. Right Student Right Preceptor Right Place Right Curriculum Better experience for the student Better experience for the preceptor Better chance of the student returning to the rural community Better experience for the school Matching can Enhance the Experience

16. Addressing the Challenge • Review the process of selecting and placing students in training sites • Review the selection and evaluation process for preceptors and sites • Develop tools that can assist in standardizing the teaching/learning experience • Be aware of how others interact with the process

17. Get to know the students Personal interviews Interest surveys Pre-rotation essays Visit with the student Student Performance Evaluations Recruit from rural areas Return to rural areas as soon as possible and as often as possible Selecting Students

18. Match student to site Personality Cultural differences Specialty interests Personal interests Family needs Academic needs Placing Students

19. Selection Process Preceptor’s CV Site Information Forms Site Visits Evaluation Process Student Site Evaluations Annual visits Training Select and Evaluate Preceptors and Sites

20. Informative Website Site locations and strengths Student accomplishments Competency Checklist Are they getting an equal experience Scheduling/Evaluation Software (EMS) Let them make informed choices Standardizing the Experience

21. Gathering Information Surveys Site visits Evaluations Interviews Setting Guidelines Website Syllabus Checklists Making Changes Feedback Preceptor training Standardizing the Experience

22. Partners in the Process • Telemedicine/ IT Distance Learning support • Area Health Education Centers a friendly face in an unfamiliar place • Physician Manpower Training Commission financial support to help make it happen

23. Spread the Word • Students to Students It’s great! Spread the word. • Site Presentations We have a great location with great people! Let us tell you or show you. • Provide Recognition Great job! Spread the word.

24. Providing Recognition • Positive Feedback • Signs for Public Awareness (sample) • Plaques for Individual Recognition (sample) • Awards (just starting) • Site of the Year • Rural Clinic Award • Student Award “Why we work” wall in Enid, Oklahoma proudly displays family photos of ER staff.

25. Thank you Emails Cards Faxes Phone calls Acknowledgement news releases journal articles website newsletters Positive Communication

26. Personal Visits • Bearing gifts (marketing) • recruitment packets • pens • Member Identification • school lapel pins • signing for office • plaques for the office • shirts with school name

27. Right Student Right Preceptor Right Place Right Curriculum Better experience for the student Better experience for the preceptor Better chance of the student returning to the rural community Better experience for the school Matching Enhances the Experience

28. Now what? Things Change! • Cultural changes continue - what children experience now will affect characteristics of their generation (adapting to their needs) • Rising healthcare needs cause the number of students to increase (recruiting, training, placement) • Increase in number of students and the number retiring preceptors will require adding new training sites and preceptors (selecting and training new preceptors) • Constant evaluation of results (what works?)

29. Questions? Ask the team. William Pettit, D.O. - Associate Dean for Rural Health • Friday Morning’s Brief Presentation on “A Collaborative Model Encouraging Rural and Primary Care Residency Selection and Subsequent Practice” Chad Landgraf, M.S. - Geographic Information Specialist • Friday’s poster session on Telemedicine Machelle Davison, Ed.D. - Educational Development • Friday’s poster session on Cultural Differences Matt Vassar, Ph.D., Warren Finn, Ph.D. and Machelle Davison, Ed.D. • Thursday’s Coping with Growth Challenge Session: An Institutional Model for the Study/Planning of Increased Class Size

30. Thank you! Visit our Oklahoma State University website • Center for Health Sciences http://www.healthsciences.okstate.edu • College of Osteopathic Medicine http://www.healthsciences.okstate.edu/college.edu • Center for Rural Health http://ruralhealth.okstate.edu • Rural Medical Education http://www.healthsciences.okstate.edu/college/clinical/crh.edu • Telemedicine http://www.healthsciences.okstate.edu/telemedicine.edu

31. Information Sources • Understanding Generational Differences • Workshop taught by Michelle Davidson, EdD • Managing a Multigenerational Workforce • Workshop taught by Dr. Mary Jo Major, EdD • The Fragile Generation – Managing New Complexities • Article written by Jane Genova published in The Greentree Gazette Nov 2006 • New Students - New Learning Styles • An article written by Charles C. Schroeder published in Change Sept/Oct 1993 http://www.virtualschool.edu/mon/Academia/KierseyLearningStyles.html • Student Advising Workshop • Myers-Briggs Workshop taught by Paul Tieger based on his best selling books Do What You Are (2000) and The Art of Speed Reading People (1998) • Oklahoma State University Data • Student Performance Evaluations • Site Evaluations • Practice Interest Surveys • Site Information Surveys