Flexible Clinical Experiences (FCE) AY1415: Review Samir Malkani MD Colleen Burnham MBA December 14, 2015

Four, one-week electives, embedded in the third year Core Clinical Experiences curriculum Provides opportunity for individual exploration in a broad range of specialties related to healthcare Aims to provide exposure to areas not covered by the core curriculum. Student driven, to allow for career exploration and to discover one’s interests FCE Program Description

1.Career exploration and development 2.Exposure to evolving and cutting-edge branches of medicine not covered in the core curriculum 3.Provide opportunity to work with recognized experts in medicine and allied sciences 4.Exposure to novel concepts and systems of care Specific Program Objectives

Student Evaluation Data What worked particularly well... Implementation of recommendations made in AY1314 for program improvement – Data where applicable Proposed changes Concerns for committee consideration Outline

Student Evaluation Data

The wide variety of faculty designed offerings spanning all departments in the medical school Increase in number and variety of student designed experiences All students have completed the experiences successfully and been granted credit What worked particularly well…

Question 1: Broad Range of Specialties and Offerings Hosting DepartmentAY1213AY1314AY1415AY1516* Medicine Family Medicine & Community Health Pediatrics Surgery Radiology Anesthesiology Obstetrics & Gynecology Pathology Orthopedics & Physical Rehabilitation Psychiatry Neurology Emergency Medicine Radiation Oncology Ophthalmology Urology21198 Program in Molecular Medicine0403 Quantitative Health Sciences0031 Biochemistry & Molecular Pharmacology0000 Cancer Biology1000 Cell Biology0400 Microbiology & Physiology Systems0000 Neurobiology0000 Otolaryngology0200 TBD (student design)

Wide variety of pre-designed experiences across all disciplines of medicine  AY1213: 84 pre-designed & 84 student designed across 15 departments*  AY1314: 89 pre-designed & 116 student designed across 18 departments*  AY1415: 82 pre-designed & 135 student designed across 22 departments*  AY1516: 90 pre-designed & 104 student designed (so far) across 22 departments! Careers in fields not traditionally related to medicine – Office of General Counsel (legal needs of the Umass Medical Center) – Health Insurance Policy – AGILE information technology management – Global Health Policy *the EPC identifies 22 formal departments; Urology added AY1415 Question 1: Wide variety of course offerings Question 1: wide variety of course offerings

Student Design FCEs since program implementation *6 FE terms into the 10 term academic year Question 1: Increase in student designed experiences

How improvement suggestions were implemented Proposed change #1Outcome EVOS: student preference and scheduling Goal was to increase automation of the enrollment process  PSCS (student) schedule change management  Program management: enrollment & grades Enrollment process partially improved; however, PSCS not conducive environment for all hoped for changes (ie, schedule changes continue to be processed by hand)  Reduced redundancy in enrollment & grading processes  IREA direct access to enrollment data (SharePoint)  Reduced OSA involvement  Bulk/batch upload enrollment (FCE program)  Reduced registrar office work  Program access to input grades to PSCS

How improvement suggestions were implemented Proposed change #2Outcomes Faculty and Student Focus Groups. Obtain student feedback on how well course meets its objectives Faculty feedback re: results & rewards  Poor attendance at Student Focus group in Spring 2015  Pursuing scheduling focus group on interstitial day o We have been in touch with Julie Jonassen and Mary Philbin  Faculty Focus group in Retreat format scheduled for January 8, 2016 o Good response (26) faculty members are scheduled to attend and share their feedback  Implemented program evaluation in addition to course and faculty evaluations to get student feedback regarding four program objectives. o 113 students have provided feedback- results are very encouraging o Curriculum Development Summer student administered surveys to pre-clinical students to analyze program expectations (K. Li) o A fourth year student analyzed the impact of the FCE in preparing students for a career in surgical specialties (D. Perry)

How improvement suggestions were implemented Proposed change #3Outcomes Increase Faculty Recruitment to increase the number of offered courses (experiences) We were able to increase faculty offered experiences  Direct mailing to faculty  one on one communication  FMCH retreat attendance  Student design faculty staying with the program Data for Faculty Recruitment shown previously in “what worked well…”

To formally assess how well the FCE meets this objective we… Surveyed classes of Compared FCEs completed with residency match Developed End of Year Program Evaluation (specifically for this objective) Summer Curriculum Development Student to continue work Assessment of how the FCE Program meets the objective: Career Exploration and Development Proposed Change #2: Student feedback on course objectives

Survey #1: Classes of (Perry, 2015) How important were the following experiences in deciding to pursue the field you are in or going in to? Perry, 2015 Proposed Change # 2: student feedback on course objectives

Perry, 2015 Proposed Change # 2: student feedback on course objectives

Survey #2: Pre-FCE on career expectations Classes 2018, 2019 (n = 135) Proposed Change # 2: student feedback on course objectives Li, 2015

Survey #3 Post-FCE assessment of Career Exploration: Agree End of Year Program Evaluation AY1415 Proposed Change # 2: student feedback on course objectives

End of Year Program Evaluation AY1415 Objective 2: Exposure to evolving and cutting-edge branches of medicine not covered in the core curriculum Proposed Change # 2: student feedback on course objectives

End of Year Program Evaluation AY1415 Objective 3: Provide opportunity to work with recognized experts in medicine and allied sciences Proposed Change # 2: student feedback on course objectives

End of Year Program Evaluation AY1415 Objective 4: Exposure to novel concepts and systems of care Proposed Change # 2: student feedback on course objectives

Proposed changeRationale Clarify requirements for using self- designed FCEs for the benefit of Capstone Projects to Capstone faculty and to rising MS3s  Faculty have communicated they are not clear about the expectation of a Capstone-specific FCE  Students seem to use the two FCE terms to continue work on their capstone project without a clearly defined objective specific to the FCE week  Capstone FCEs frequently designed around self- study in the library Make changes based on the feedback obtained from the planned faculty and student sessions We need to respond to feedback from students and faculty on how well the program is working for all involved. Investigate a more streamline process (ie, application) for record keeping for a program with so many moving parts. Current system is prone to breakdown. Over 500 experiences each year from over 1000 slots are manually managed, by a single person, after initial EVOS process. Enrollment records maintained in SharePoint. (PSCS) Current enrollment flexibility allows for high number of last minute student change requests Changes for AY , Question 3: proposed future changes

Problem and concerns for committee consideration Technology- ideas for technology solutions or software for record keeping, enrollment and grading Ideas for experiences with recognized experts and cutting-edge and novel areas of health sciences including information technology, public health policy, global health Increase faculty and student awareness of appropriate use of FCE time

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