1. KENIA MANSILLA-RIVERA, MD UNIVERSITY OF CONNECTICUT STFM MSE JANUARY 2016 You have a message in your box! Using email to evaluate and train different skills

2. Objectives Describe how to use and develop an assignment or activity for their curriculum with an email account. Identify different core competencies and skills that can be evaluated with an email assignment. Identify the benefits and challenges using email as a tool for a course.

3. Email as a Tool Easy to set up and use. It can deliver easily an assignment with instructions of any kind to all students at the same time. Assessment of response can be done anytime anywhere. Assessment of other competencies in addition to medical knowledge outside of the preceptor evaluation.

4. Core Competencies that have been assessed with this assignment Communications skills with patient and/or any other health professionals. Medical Knowledge. Practice Based Learning System Based Practices

5. Challenges of Email as a Tool Time from Faculty assessing. It requires individualized feedback. You count on students’ honor code, not “sharing” in between rotations.

6. Email Assignments: Example 1 Results of lipid profile on a patient are sent to you from your medical assistant in the office with a note to call the patient for results. She tells you she is upset because recently a family member had a heart attack. Medication list and all other history is provided for the student to calculate risk. Patient is also asking about garlic tablets. Students are instructed to explain the results, the meaning with calculating the CV risk, and answer patient question.

7. Example 2 Patient calls with symptoms of dysuria. Patient is the same patient they saw virtually on didactics, and she is allergic to sulfa. She was already tested on didactics for STD. Students are asked to treat her for presumptive UTI and patient following on next didactics.

8. Example 3 Patient recently discharged from hospital, VNA contacting the doctor to reconcile medications, since they are some discrepancies. Patient on 12 medicines, one of them warfarin.

9. Example 4 Diabetic patient they know from didactics has some bleeding on gums and calls to see if she should cancel dentist appointment or if she should be on antibiotics.

10. “Please rate your current level of knowledge/understanding of e-mail communication and patient care” Pre Clerkship N = 117 Post Clerkship N = 124 Post Clerkship N = 68 Post Clerkship N = 60 AY 2013-2014 AY 2012-2013

11. N = 40 AY 2015-2016 (July-December) “Please rate how valuable the e-mail assignment was to your learning”

12. Some comments…. I am not sure how useful was the email assignment was. I agree that this in the future will be the way of communication with patients, but it felt like busy work, and there was so much else to do for this rotation, it took time away from my studies for the exam. The email assignment is a great idea, I wish it would not count for the grade. The email assignment took me a long time, and I did not learn anything. The extra assignments were too much. Because of all the assignments, the rotation was a bit hectic.

13. They don’t like it but… do they need it? Students would calculate correctly the CV risk for patient, but would not counsel to quit smoking. Students would use words like atherosclerotic disease, statistical significance, endocarditis. They talk about statins, LDL and HDL without explaining what those are. Brother of the patient has a heart attack, they don’t say anything about that. They send a message to nurse without saying thank you or being courteous. They say to stop taking natural remedies without searching or explaining.

14. Thank You!!