Directing Geographically Disparate Clerkship Sites Alan P. Ladd, MD Associate Professor of Surgery Indiana University School of Medicine

Objectives/Disclosure Identify pertinent LCME guidelines in the management of geographically disparate sites Develop a Timeline for the development of new disparate sites of instruction Recognize ongoing assessment aspects for disparate site instruction No Disclosures (wish I had some)

Pertinent LCME Guidelines Link: http://www.lcme.org/standard.htm Handout (crib sheet)

Pertinent LCME Guidelines Educational Program ED-2: Central oversight Clinical Encounters (diagnoses/patients) Level of student responsibility Monitoring

Pertinent LCME Guidelines ED-8: Comparable Experiences (related to ED-2) Identical Educational objectives, administration, assessment, grading. Enhancement of faculty teaching and assessment Orientation of faculty Feedback to sites

Pertinent LCME Guidelines ED-25: Clinical supervision ED-41: Faculty Integration ED-44: Student support services/benefits

Pertinent LCME Guidelines Faculty FA-2: Faculty qualification/time FA-4: Faculty commitment/effectiveness FA-7: Faculty appointment FA-10: Faculty feedback

Pertinent LCME Guidelines Educational Resources ER-7: Facility capability/IT resources ER-9: Affiliation Agreements Learning Environment

Site Establishment Start 12 mon 9 mon 6 mon 3 mon 15-18 mon Faculty Recruitment Initiate Conversation Candidate List Site Adequacy Faculty Development Outine Core content Preceptor Guidelines Schedules Design Schedules Documentation Orientation Design Start 12 mon 9 mon 6 mon 3 mon 15-18 mon Administrative Affiliation Agreements Faculty Appointments Services/Logisics Housing Student Services Clerkship Orientation Assessment Schedule

Site Establishment 18 months 15 months Initial conversation Develop faculty list 15 months Dissemination of clinical instruction requirements Determine site adequacy

Site Establishment 12 months 9 months Affiliation agreements Faculty appointments 9 months Student electronic access—IT Faculty development to core content/objectives Supervision guidelines Student responsibilities

Site Establishment 6 months 3 months Housing Campus facility access Outline daily student schedule Arrange site training Acquire site documentation/training needs

Site Establishment 2 months 1 month Outline local orientation Identify local policies and procedures 1 month Disseminate student schedules Verify student services

Site Establishment During Rotation Global Orientation Verify Instruction Collect Assessments

Site Establishment Following Rotation Gather site-specific and faculty assessments Review student feedback

Site Visits Annual Site Assessments Identify goals for following year Disseminate site and faculty assessments Outline faculty development opportunities and update on intended curricular changes Provide Faculty Development Identify goals for following year

Considerations Grade Distribution/Inflation Apprentice vs. Team-based Model Student perception of Career in Surgery Student Advising Skill Opportunities Scope of Practices Subspecialty Offerings