Curriculum Inventory Developers’ Workshop Part III: Clerkships, Electives and other Rotations and Tracks Terri Cameron, MA Director, Curriculum Programs AAMC May 9, 2016

Objectives Discuss the types of data that should be entered for Clerkships and Electives Identify sources for gathering Clerkship and Electives data Explain options for entering one iteration of a clerkship Describe how nested sequence blocks might be used in documentation of Clerkships and Electives Discuss documentation of tracks in the Curriculum Inventory Describe options for entering ‘Colleges,’ ‘Academies,’ ‘Bootcamp,’ ‘Sub-Internships,’ Small Groups, and other student/content groupings options

Quick Review Part I  MedBiq CI Specification  AAMC Business Rules Part II  Competencies Part III  Clerkships, Electives, Selectives, Tracks

Quick Review Sequence Block Metadata Title Academic Level Timing: Dates / Duration Expectations Events  Instructional Methods  Assessment Methods  Resources Nested Sequence Blocks Integration Blocks

Quick Review Duration Event Duration – in hours and minutes  PT20H  PT1H30M Sequence Block Duration – in days (Timing_Duration)  P60D  P7D  5 days = 1 week (10-week clerkship = 50 days)  Clerkships must also specify Timing_Dates (Start and End dates) ― Best Practice: Start and End Dates should be for duration of all iterations

Questions?

Documenting clerkships

Clerkship ‘Iteration’ Should represent core activities that majority of students are exposed to  Select one rotation for upload – A specific rotation – First, Last  Create an upload version of a rotation  Upload all iterations – reporting issues May be rotation or integrated Kludge to cross Academic Level  Create Sequence Block in each Academic Level

Clerkships What to Document Clerkship (Sequence Block) name All activities  Didactics  Conferences (M&M, Tumor Board, X-Ray, etc.)  Rounds (Ward, Attending, etc.)  In-patient and Out-patient Activities  Assessment(s) (for each event and/or for Clerkship) How to document  x – Where x = integrated or rotation  What if the clerkship is both integrated and a rotation? – Choose integrated: Sequence Block dates compared to duration shows that clerkship is both integrated and a rotation

Sequence Block Nesting Sequence blocks can be nested No restriction on the number of nest levels Can represent a track or options where only some of the clerkships or courses are required Sequence blocks may be:  Required, Optional, Required In Track  Ordered, Unordered, Parallel  You may require a minimum or maximum # of nested sequence blocks (selectives) A E B F I J 1 2 A E B F I J 1 2 A E B F I J 1 2 A E B F I J 1 2

Knowledge Check You have 9 Phase 2 clerkships; 5 are required. They may occur in any order. How would we represent that?  Required, optional, or required in track?  Ordered, unordered, parallel?  Minimum?  Maximum?

Knowledge Check You have 9 Phase 2 clerkships; 5 are required. 8 must be taken. They may occur in any order. How would we represent that? Clerkships, required = Required, order = unordered, minimum = 8, maximum = 8 Medicine, required = Required Duration – 60 days Medicine, required = Required Duration – 60 days Surgery, required = Required Duration – 40 days Surgery, required = Required Duration – 40 days Pediatrics, required = Required Duration – 30 days Pediatrics, required = Required Duration – 30 days OB/Gyn, required = Required Duration – 30 days OB/Gyn, required = Required Duration – 30 days Neurology, required = Required Duration – 20 days Neurology, required = Required Duration – 20 days Psychiatry, required = Optional Duration – 20 days Psychiatry, required = Optional Duration – 20 days Ambulatory, required = Optional Duration – 20 days Ambulatory, required = Optional Duration – 20 days Anesthesiology, required = Optional Duration – 20 days Anesthesiology, required = Optional Duration – 20 days Emergency medicine, required = Optional Duration – 20 days Emergency medicine, required = Optional Duration – 20 days

Review Curriculum Management Systems Scheduled activities or ‘Upload Version’  Dates / Duration  Instructional methods  Assessment methods  Resources  Objectives (expectations) Add the XML Elements  Academic Level  Calculate duration in days  Clerkship Model

Quick Summary Clerkships are entered as Sequence Blocks. Expectations for Clerkships are referenced at the Sequence Block Level. Single rotation or all rotations? Clerkships are distinguished from other Courses by the use of the Clerkship Model attribute.

Documenting integrated and longitudinal curricula

Integrated / Longitudinal Clerkships The Consortium of Longitudinal Integrated Clerkships (CLIC) states that longitudinal integrated clerkships (LICs) have the following common core elements:  Medical students participate in the comprehensive care of patients over time  Medical students have continuing learning relationships with these patients’ clinicians  Medical students meet, through these experiences, the majority of the year's core clinical competencies across multiple disciplines simultaneously.

Integrated / Longitudinal Clerkships Multiple options for documenting:  Show as single Sequence Block ― Clerkship Model: Integrated  Nested Sequence Block(s) Data Requirements/Sources:  Same as for discipline-specific clerkships Issues:  All / most students participate?  Separate assessments?

Documenting Electives

What data should be entered? Two options – use one or both: ‘Overall’ Elective Program All Elective Courses Both options are Sequence Blocks and should include:  Name  Instructional Method(s)  Assessment Method(s)  Objectives (Expectations)

Electives What to Document Electives Program Requirements  Use Timing_Dates to show entire time period when electives are offered  Use Expectations to describe expectations of the Overall Electives Program Elective Courses  Use Timing_Duration to show number of days for each Elective (5 days = 1 Week)  Use Expectations to describe expectations of the Elective Course Events  Each Elective Course must have at least one event (Instructional Methods, Assessment Methods, Resources, Expectations, etc.)

Electives Options for Uploading Best Practice  Electives Program Requirements as Sequence Block  Elective Courses as Nested Sequence Blocks Other Options  Elective Courses as individual Sequence Blocks  Electives Program Requirements Only ― Use Timing_Dates to show Start and End Dates for entire time period when electives are offered ― Use Expectations to describe expectations of the Electives Program ― Use Description to describe specific requirements (Sub-I, x number of weeks per specialty, etc.)

Electives Data Sources  Curriculum Management Systems – Scheduled activities or ‘Upload Version’  Online Electives Catalogs  Evaluation Systems Entering data  Conversation between curriculum office and vendor / developer to choose best option – Enter as ‘Representative Data’ – Pull one iteration of each scheduled Elective – Other ideas?

Selectives What to Document Selectives Course (Sequence Block) Requirements  Timing_Dates of the Selective Requirement  Expectations of the Selective Requirement Selective Courses (Nested Sequence Blocks)  Timing_Duration to show number of days for Selective Courses (5 Days = 1 Week)  Expectations of the Selective Courses  Is each Nested Sequence Block (Selective Course) required or optional? Events  Each Sequence Block must have at least one event (Instructional Methods, Assessment Methods, Resources)

Electives You have 20 Electives that must be taken in a 40-week period; 2 are required. 10 must be taken. They may occur in any order. How would we represent that? Electives, required = Required, order = unordered, minimum = 10, maximum = 12 Sub-Internship, required = Required Duration – 20 days Sub-Internship, required = Required Duration – 20 days Basic Sciences Critical to Clinical Practice, required = Required Duration – 20 days Basic Sciences Critical to Clinical Practice, required = Required Duration – 20 days Family Med Elective, required = Optional Duration – 20 days Family Med Elective, required = Optional Duration – 20 days OB/Gyn Elective, required = Optional Duration – 20 days OB/Gyn Elective, required = Optional Duration – 20 days Neurology Elective, required = Required Duration – 20 days Neurology Elective, required = Required Duration – 20 days Psychiatry Elective, required = Optional Duration – 20 days Psychiatry Elective, required = Optional Duration – 20 days Medicine Elective, required = Optional Duration – 20 days Medicine Elective, required = Optional Duration – 20 days Anesthesiology Elec., required = Optional Duration – 20 days Anesthesiology Elec., required = Optional Duration – 20 days ER Elective, required = Optional Duration – 20 days ER Elective, required = Optional Duration – 20 days Surgery Elective, required = Optional Duration – 20 days Surgery Elective, required = Optional Duration – 20 days Pediatrics Elective, required = Required Duration – 20 days Pediatrics Elective, required = Required Duration – 20 days Critical Care Elective, required = Optional Duration – 20 days Critical Care Elective, required = Optional Duration – 20 days Ambulatory Elective, required = Optional Duration – 20 days Ambulatory Elective, required = Optional Duration – 20 days History of Med Elec., required = Optional Duration – 10 days History of Med Elec., required = Optional Duration – 10 days Bus of Med Elec, required = Optional Duration – 10 days Bus of Med Elec, required = Optional Duration – 10 days Cost of Care Elec, required = Required Duration – 10 days Cost of Care Elec, required = Required Duration – 10 days Physician & Society El, required = Optional Duration – 10 days Physician & Society El, required = Optional Duration – 10 days ENT Elective, required = Optional Duration – 20 days ENT Elective, required = Optional Duration – 20 days Orthopaedics Elec., required = Optional Duration – 20 days Orthopaedics Elec., required = Optional Duration – 20 days Thoracic Elective, required = Optional Duration – 20 days Thoracic Elective, required = Optional Duration – 20 days

Selectives Options for Uploading (Best Practice)  Selectives Course Requirements as Sequence Block – Use Timing_Dates to show entire time period when Selective Requirement occurs – Use Expectations to describe expectations of the overall Selectives Course  Selective Courses as Nested Sequence Blocks – Use Timing_Duration to show number of days for each Selective Course (5 days = 1 week) – Use Expectations to describe expectations of the specific Selective Course  Events – Each Sequence Block must have at least one Event (Instructional Methods, Assessment Methods, Resources)

Knowledge Check You have 8 fourth year sub internships; 1 is required. How would we represent that?  Required, optional, or required in track?  Ordered, unordered, parallel?  Minimum?  Maximum?

Knowledge Check You have 8 fourth year sub internships; 1 is required. How would we represent that? Sub Internships, required = Required, order = parallel, minimum = 1, maximum = 1 Medicine Sub-I, required = Optional Duration – 20 days Medicine Sub-I, required = Optional Duration – 20 days Surgery Sub-I, required = Optional Duration – 20 days Surgery Sub-I, required = Optional Duration – 20 days Pediatrics Sub-I, required = Optional Duration – 20 days Pediatrics Sub-I, required = Optional Duration – 20 days OB/Gyn Sub-I, required = Optional Duration – 20 days OB/Gyn Sub-I, required = Optional Duration – 20 days Emergency Medicine Sub-I, required = Optional Duration – 20 days Emergency Medicine Sub-I, required = Optional Duration – 20 days Family Medicine Sub-I, required = Optional Duration – 20 days Family Medicine Sub-I, required = Optional Duration – 20 days Psychiatry Sub-I, required = Optional Duration – 20 days Psychiatry Sub-I, required = Optional Duration – 20 days Anesthesiology Sub-I, required = Optional Duration – 20 days Anesthesiology Sub-I, required = Optional Duration – 20 days

Colleges,’ ‘Academies,’ ‘Bootcamps’ What to document Sequence Block for Requirement  Timing_Dates (Entire time period)  Expectations Nested Sequence Blocks for each Option  Timing_Duration (5 Days = 1 Week)  Expectations? Nested Sequence Block for each ‘Course’ in the Option  Expectations  Events o Instructional Methods o Assessment Methods o Resources o Expectations

Sequence block, required=Required, order=Parallel, minimum=1, maximum=1 College 1 Required= Optional College 1 Required= Optional College 2 Required= Optional College 2 Required= Optional College 3 Required= Optional College 3 Required= Optional College 4 Required= Optional College 4 Required= Optional Colleges,’ ‘Academies,’ ‘Bootcamps’

PBL / TBL / Small Groups What to Document One iteration of each specific session (e.g., by case or content) as Event Duration of the specific event for the case or content (in hours)  PT20H  PT1H30M Metadata:  Instructional Methods  Assessment Methods  Resources  Expectations

PBL / TBL / Small Groups Options for Uploading  Upload one set of events (one student group) for upload  Create an upload version of a set of events Issues  “Each student group has different learning issues” – Same concept as for all teaching sessions – enter faculty objectives for cases/small group discussion

Multiple Sites What to Document  One curriculum per institution ‒ LCME: “Show sum of lectures, conferences, and teaching rounds; range of hours if there is significant variation across sites” ‒ *Include the number of sites used for inpatient teaching and the number of sites used for outpatient teaching in the clerkship in the following format: # inpatient / # outpatient **Sum of lectures, conferences, and teaching rounds; show the range of hours if there is significant variation across sites Clerkship Total wks % Amb. # Sites used* Typical hrs/wk formal instruct** Clinical encounter criteria† (Y/N) Patient log (Y/N)

Multiple Sites Options for Uploading  One iteration of each Sequence Block  Representative curriculum that most students experience  Upload all iterations and CI Reports will create summary data for your institution or exclude your institution from certain reports Issues? 

Tracks What to Document  One curriculum per institution Options for Uploading  Nested Sequence Blocks  Sequence Block for each Academic Level – Parallel Nested Sequence Blocks for each Track – Additional Nested Sequence Blocks to enter individual courses for each Track  Representative curriculum that most students experience Issues? 

Regional Campuses What to Document  One curriculum per institution Options for Uploading  Number of campuses is an institutional decision  One campus means one EIS code  Representative curriculum that most students experience Issues 

Questions?

Pearls A Sequence Block Week is 5 Days Clerkships are Sequence Blocks with Clerkship Model (Rotation or Longitudinal) rotation Check date / duration formats PT2H PT90M PT1H30M P13D P12M

Pearls Events must have Instructional Method OR Assessment Method(s) OR Both Use Instructional Method and Assessment Method UIDs!!!! IM013 AM012 Can have multiple Instructional Methods but one must be Primary Can have multiple Assessment Methods – no Primary Must have Duration Formative / Summative Assessment Events No Instructional Methods

Pearls Country Code: 3-character code (USA, CAN) USA

Pearls Program Code: 2-character code (MD, DO, PA) M.D Parallel Tracks Denote same cohort of students in separate tracks (should not be used to designate concurrent Academic Levels for multiple cohorts of students)

12345 NoSuch University School of Medicine Main Street Baltimore MD US M.D NoSuch School of Medicine Curriculum en-us The NoSuch curriculum reframes the context of health and illness to encourage students to explore a larger, integrated system.

Questions? Please use Q & A option to submit questions.

Schedule Staging available now School Portal Opens: August 1 School Portal Closes: September 30 Status sent to CI Primary Admin, Curriculum Dean, and School Dean: September 30 Data clean-up/reporting starts: November 1

Resources Curriculum Inventory Implementers’ Listserv: Competency Framework Specs and Schemas: AAMC Curriculum Inventory Developer Resources: Physician Competency Reference Set URIs: ve/resource/793 ve/resource/793 MedBiquitous: Curriculum Inventory Working Group: Competencies Working Group: ‘For Developers’ Section of  Sample XML file and Verification Report from UCSF  CI XML Template from UVA  Slides/Recordings from Past Training Webinars  Registration for Upcoming Webinars

Questions? List of upcoming Curriculum Inventory Webinars and materials from today’s session: