College of Medicine Undergraduate Education Chipper Griffith, MD Vice Dean for Education Professor of Internal Medicine and Pediatrics

Entrustable Professional Activities Core Principle Phase: 8 activities Obtain a complete history for a patient being admitted to the hospital Appraise a research article for validity, importance and applicability to a patient care question Application Phase: 33 activities Interpret an EKG Provide accurate and complete documentation of a hospital admission Advanced Development Phase: 11 activities Write, dictate, and/or enter safe and appropriate patient orders Obtain informed consent for low-risk procedures

EPA Assessment Cannot perform Requires close supervision Requires minimal supervision Performs independently Cannot complete even with close supervision; restricted to shadowing experiences Requires advance preparation and/or physician guidance to successfully complete Successfully completes with feedback and/or clarification by a supervising physician Competent at an intern level, rarely needs feedback or clarification afterwards Direct Supervision Indirect Supervision (Direct supervision immediately available) (Direct Supervision available) Oversight

Clinical Anatomy & Radiology (9 weeks) August September October November December January February March April May June July Clinical Anatomy & Radiology (9 weeks) Foundations of Infection, Disease & Therapeutics (10 weeks) Winter Break Hematologic & Lymphatic Systems (4 weeks) Neurosciences (8 weeks) Spring Break Behavioral Basis of Medicine (3 weeks) Musculoskeletal & Integumentary Systems (5 weeks) Research & Clinical Elective Experiences Vacation Introduction to Clinical Medicine ICM (con’t) Respiratory System Renal & Urinary Systems Cardiovascular System Gastrointestinal System & Nutrition (6 weeks) Endocrine & Reproductive Systems Assessment Week Multisystem & Integrative Concepts USMLE Step 1 Application Phase Begins Contemporary Practice Advanced Clinical Medicine ACM (con’t)

Clinical Anatomy & Radiology Monday Tuesday Wednesday Thursday Friday 8:00 Podcast Musculoskeletal Development Lecture Hand Case-Based Radiology of the upper limb Small Groups Back & upper extremity prosection lab Back & upper extremity ultrasound cases (SonoSim) Physical exam practice of back & upper extremity 9:00 Superficial Back & Shoulder Demonstration Upper Extremity Physical Exam 10:00 Axilla & Arm Podcast & Quiz Shoulder, Elbow & Hand ultrasonographic anatomy & physiology 11:00 Forearm Independent Study

Introduction to Clinical Medicine Patient Education Week Reading: Literacy and numeracy skills of Americans Video: Health literacy and patient safety Class activity: Discussion and design patient education material Assignment: Describe three approach to overcome literacy difficulties Breaking Bad News Interview Week Reading: Interview tips for breaking bad news and angry patients Video: Example of diabetes diagnosis, pregnancy diagnosis Class activity: simulated patient interviews Breaking Bad News Interview Lab Longitudinal Clinical Experience (LCE): students come to your clinic twice a semester; CONSIDER VOLUNTEERING FOR THIS! These students are capable of interviewing and basic physical exam; contact jfwilson@uky.edu

Advanced Clinical Medicine Lecture: thorax & lung cases Workshop: point-of-care ultrasound Small groups: Interview a patient and complete focused CV/lung exam Focused patient write-up Patient presentation to faculty preceptor Examination of patient with preceptor

M3 Clerkships Students rotate in 12 different rotation groups EPA Week Internal Medicine / Emergency Medicine Surgery Break   Pediatrics Obstetrics & Gynocology Psychiatry Family Medicine Neurology Students rotate in 12 different rotation groups Each has a distinct order of rotations

Transition to Residency Vacation/Interviews/USMLE Step 2 Block 1 Block 2 Block 3 Block 4 Block 5 Block 6 Block 7 Block 8 Block 9 Block 10 Transition to Residency Required Rotations Electives Vacation/Interviews/USMLE Step 2 Primary Acting Internship Secondary Acting Internship Transition to Residency Elective Block Vacation Block

Primary Acting Internship Perform the initial evaluation of patients assigned to the service Write admit and daily orders Develop their own diagnostic and therapeutic plans Write discharge notes Communicate care plans to the patient & family members Coordinate care with consultants & other healthcare professionals Provide cross‐coverage, assist with urgent/emergent medical issues Transition patient care to another healthcare provider

Transition to Residency Monday Tuesday Wednesday Thursday Friday Podcast Goals of care and DNR Reading Obtaining informed consent from patients ACLS protocol Central line placement PALS basics Assessment OSCE Special Topics Workshop Goals of care discussion & Informed consent DNR discussion Simulation Megacode on advanced human simulator Central line placement on task simulator Pediatric respiratory distress on SimBaby Pediatric bradycardia on SimBaby

Office of Medical Education Contacts Senior Associate Dean for UME Christopher A. Feddock, MD Chris.Feddock@uky.edu Curriculum Research and Leadership Development Director Helen Garces, MSEd (859) 218-0013 helen.garces@uky.edu Administrative Coordinator Dorcas D. Beatty (859) 257-5286 dorcas.beatty1@uky.edu Evaluations Coordinator Miriam Lightfoot, MSEd (859) 323-4643 miriam.lightfoot@uky.edu Assistant Dean for Clinical Education John Ragsdale, MD, MS john.ragsdale@uky.edu Clerkship Development and Administration Amy Murphy-Spencer, EdS (859) 323-1196 amspenc@uky.edu M1-M2 Course Support Staff Ben Lawson (859) 323-5779 joseph.lawson@uky.edu Katie Finch (859) 257-1609 katiefinch@uky.edu Porsha Thomas (859) 257-1572 porsha.thomas@uky.edu

M1 & M2 Course Directors MD 810 Foundations of Infection, Disease, and Therapeutics Paul Murphy, MD Pathology and Laboratory Medicine pmurphy@uky.edu   MD 820 Contemporary Practice Christopher Feddock, MD Internal Medicine Chris.Feddock@uky.edu MD 811 Introduction to Clinical Medicine John Wilson, PhD Behavioral Sciences jfwilson@uky.edu MD 821 Advanced Clinical Medicine Scott Morehead, MD Internal Medicine/Pulmonary smore2@uky.edu  MD 813 Behavioral Basis of Medicine Raven Piercey, PhD Behavioral Science Raven.piercey@uky.edu MD 824 Endocrine & Reproductive Systems Michael Kilgore, PhD Pharmacology & Nutritional Sciences mwkilg0@uky.edu   MD 814 Clinical Anatomy & Radiology Wayne Cass, PhD Anatomy and Neurobiology Wacass1@uky.edu  MD 825 Renal and Urinary Systems Brian Jackson, PhD Physiology Brian.jackson@uky.edu MD 816 Hematologic & Lymphatic Systems pmurphy@uky.edu  MD 826 Cardiovascular System Mike Piascik, PhD Pharmacology and Nutritional Sciences mtp@email.uky.edu  MD 817 Neurosciences Sam Franklin, PhD Anatomy & Neurobiology sfranklin@uky.edu  MD 827 Respiratory System Pulmonary MD 818 Musculoskeletal & Integumentary Systems Brian Higgins, PhD Microbiology & Immunology bphi223@g.uky.edu MD 828 Gastrointestinal System & Nutrition Dexter Speck, PhD dfspeck@uky.edu  MD 829 Multisystem & Integrative Concepts Chipper Griffith, MD cgriff00@uky.edu

M3 & M4 Course Directors MD 830 Pediatrics Allen Hall, MD Allen.hall@uky.edu MD 838 Obstetrics & Gynecology Mark Hoffman, MD Obstetrics and Gynecology Mark.hoffman@uky.edu MD 831 Emergency Medicine Jonathan Bronner, MD j.bronner@uky.edu  MD 840 Transition to Residency Tom McLarney, MD Anesthesiology jmcla00@uky.edu MD 832 Neurology Amy Hessler, DO aehe222@uky.edu SUR 862 Acting Internship: Surgery Jitesh Patel, MD Surgery Jitesh.patel@uky.edu MD 833 Psychiatry James Hawthrone, MD James.hawthorne@uky.edu PED 859 Acting Internship: Pediatrics Berry Seelbach, MD berry.seelbach@uky.edu MD 834 Family and Community Medicine Ginny Gottschalk, MD Family & Community Medicine glgott2@uky.edu  MED 870 Acting Internship: Internal Medicine Adam Gray, MD Internal Medicine ajgray2@uky.edu MD 835 MED 872 Acting Internship: Med-Peds Anthony Lile, MD aglile@uky.edu MD 837 Joseph Iocono, MD Pediatric Surgery Jioco2@uky.edu  FM 850 Acting Internship in Family & Community Medicine Archana Kudrimoti, MD Archana.Kudrimoti@uky.edu

Academy of Medical Educators Clinical Teaching Classroom Teaching Resident Teaching Master Educator Awards Program Abraham Flexner Teaching Awards for achievements in Educational Leadership and Administration, Outstanding Teaching Contribution and Mentorship, Educational Innovation and Curriculum Development, Educational Evaluation and Research, Faculty Development in Education https://meded.med.uky.edu/medical-education-academy-medical-educators

Source: Kentucky Health News, 2014.

Rationale: KY has a shortage of physicians. UK COM has a deep applicant pool. UK COM is at its enrollment capacity on the Lexington campus. These University partnerships provide the educational space (Western KY University, Morehead State University, Northern Kentucky University).  These clinical partnerships provide sites for clinical education (Medical Center at Bowling Green; St. Claire Regional Medical Center; St. Elizabeth’s Healthcare System) The goal is to provide the same high quality education at the regional sites as in Lexington, “first class medical education close to home” UK COM-Bowling Green to open July 2018 Morehead already has a 2 year clinical campus, the Rural Physician Leadership Program; 4 year campus in Morehead/ Northern KY possibly in 2019