M4 Interest Group- 2014 Nabil Issa, MD- Director, Surgery Subinternship Northwestern University Feinberg School of Medicine.

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Presentation transcript:

M4 Interest Group Nabil Issa, MD- Director, Surgery Subinternship Northwestern University Feinberg School of Medicine

1.The professional continuum & surgical sub-I 2.The sub-I in literature 3.Position paper- recommendation threads What we’ll talk about

The Professional Continuum & Surgical Subinternship

AAMC: Entrustable Professional Activities (EPA) M1-2 M3 Residents M4

The surgery sub I in literature Still Not Much!

What competencies are deficient among surgical interns in particular? Two studies have explored this topic: I.ACS/APDS/ASE National Preparatory Surgery Curriculum II.Medical student subinternships in surgery: characterization and needs assessment

ACS/APDS/ASE National Preparatory Surgery Curriculum  Needs Assessment- Main findings: 1.Anxiety /deficient technical skills 2.Managing multiple simultaneous demands 3.Managing critical/unstable patients 4.Management of Post-op conditions 5.Difficult communications

Medical student subinternships in surgery: characterization and needs assessment

Findings Subinternship curriculum elements perceived benefit to student education

Literature Synthesis

What students want is more organized educational activities! 1.Formal objectives. 2.Reading list. 3.Review common call problems. 4.Procedures laboratory. 5.Dedicated time with faculty. 6.Direct responsibility. 7.Autonomy.

Position Paper M4- Interest group: Alan Ladd, Steven Goldin, Anne Lidor, Nabil Issa

Conceptual Framework M1-2 M3 Residents M4 AAMC: EPA M3 National Curriculum ACS/APDS/ASE Boot Camp

AAMC: Entrustable Professional Activities (EPA) M1-2 M3 Residents M4

Recommendation Threads 1.Administrative Structure 2.Goals and Objectives 3.Curricular elements 4.Instructional strategies 5.Assessment tools 6.Clerkship evaluation

Administrative Structure M3 ≠ M4

Administrative Structure M3 ≠ M4 M3 Director M4 Director Coordinator

Administrative Structure M3 ≠ M4 M3 Director M4 Director Coordinator

Administrative Structure M3 ≠ M4 M3/M4 Director Coordinator

Role of Sub-I Director 1.Create curriculum: M3 → Residency 2.Explicit goals & objectives 3.Comprehensive orientation 4.Choice of clinical rotations 5.Petition school for resources 6.Protected educational time 7.Career coach

Role of Sub-I Coordinator 1.Coordinating educational activities 2.Administrative link to school and department policies, rules and announcements 3.Documentation: student and rotation activities 4.Weekly follow up s to enforce task completion 5.Administrative timelines

Curricular Elements

Goals and Objectives 1.H&P skills: Concise & pertinent. 2.Clear progress notes. 3.Advanced clinical reasoning. 4.Manage common surgical problems. 5.Perform common bedside procedures. 6.Patient handoffs during transitions of care. 7.Professional communications. 8.Utilize informatics.

Instructional Strategies 1.Direct observations: H&P/DDx/management plans 2.Professor rounds: case-based discussions 3.Mock pages: common problems 4.Web-based modules: SBAR/Handoffs 5.Technical skills lab: common bedside procedures 6.Independent reading: pt. safety/quality controls/ evidence-based medicine 7.End of rotation project or assay.

Assessment Tools Composite Scoring: 1.Appraisals of clinical performance 2.Performance on mock pages 3.Participation in discussion during Prof. rounds 4.Procedural competence 5.Professionalism: timely completion of tasks

Clerkship Evaluation Student feedback Faculty feedback Monitor national trends: AAMC, ASE, ACS, APDS

Position Paper Update First draft completed

Manuscript Revisions M1-2 M3 Residents M4 AAMC: EPA M3 National Curriculum ACS/APDS/ASE BootCamp

QUESTIONS