1. Contributions of Community-Based Preceptors to the Clerkship Curriculum David Wright, MD dwright@seaton.com Blackstock Family Health Center, Austin, TX Radheshyam Miryala, MD ramiryal@utmb.edu University of Texas Medical Branch, Galveston, TX Robert J. Bulik, PhD rjbulik@utmb.edu University of Texas Medical Branch, Galveston, TX 35 th Annual Predoctoral Education Conference Savannah, GA: January, 2009

2. Summarize the main elements of the case authoring template utilized by community preceptors to author web-based clinical cases. Describe the value of the contributions that community preceptors can make to the overall clerkship curriculum. Outline the process that this one clerkship utilizes to involve community preceptors in authorship of web- based clinical cases. Describe the process of peer review utilized by the clerkship for maintaining quality of web-based materials and for ensuring credit for authorship of enduring educational materials. Summarize the main elements of the case authoring template utilized by community preceptors to author web-based clinical cases. Describe the value of the contributions that community preceptors can make to the overall clerkship curriculum. Outline the process that this one clerkship utilizes to involve community preceptors in authorship of web- based clinical cases. Describe the process of peer review utilized by the clerkship for maintaining quality of web-based materials and for ensuring credit for authorship of enduring educational materials. Session Objectives

3. Design-A-Case Template Design-A-Case © Template Template has two unique components:  authoring template for faculty  library of interactive web based cases on common Family Medicine topics Template has two unique components:  authoring template for faculty  library of interactive web based cases on common Family Medicine topics Shokar,GS, Burns, DS, Bulik, RJ. Design-A-Case Template (Computer Software). Copyright: 2003, revised – 2007; Board of Regents UT System. Shokar,GS, Burns, DS, Bulik, RJ. Design-A-Case Template (Computer Software). Copyright: 2003, revised – 2007; Board of Regents UT System.

5. Developed in a linear format   helps students in their information gathering skills by giving them a structure similar to what they use in the clinical setting   same format as final Family Medicine clinical exam (OSCE) Learning objectives positioned at the end of the case   progressive disclosure style cases   avoid influencing student decision making skills through the case Developed in a linear format   helps students in their information gathering skills by giving them a structure similar to what they use in the clinical setting   same format as final Family Medicine clinical exam (OSCE) Learning objectives positioned at the end of the case   progressive disclosure style cases   avoid influencing student decision making skills through the case The Web-Based Cases

6. Each module has two screens (or modules):   Screen one: Contains the text, question(s) to students, and text box for student answers.   Screen two: Has faculty responses (answers) to the question(s) posed in screen one, and a designated section for clinical pearls and links to citations or other web resources. Each module has two screens (or modules):   Screen one: Contains the text, question(s) to students, and text box for student answers.   Screen two: Has faculty responses (answers) to the question(s) posed in screen one, and a designated section for clinical pearls and links to citations or other web resources. The Web-Based Cases

7. DAC DAC - Student

8. DAC DAC - Faculty

10. DAC DAC - Student

14. www.designacase.org

24. Precepting Clinic vs. Online

25. Precepting - Clinic  The Good  Dynamic evaluation of patient  Hands On - REAL  Able to evaluate history and physical exam  Direct interaction with students  Ability to tailor discussion around student’s strengths and weaknesses.

26. Precepting - Clinic  The Bad  TIME CRUNCH!!!

27. Precepting - Clinic  PITFALLS  Taking over the case  Not allowing sufficient “wait time”  Giving inappropriate lectures  Asking questions with “preprogrammed answers”  Pushing the learner past his or her ability

28. Precepting - Online   The Bad   Static   Not a real patient encounter

29. Precepting - Online   The Good   TIME!!!   Complexity can be tailored to demand   Cases can be rich and deal with a broad range of issues for a certain problem – cost, pharmacology, basic science, etc   Students learn to be independent learners

30. Design-A-Case (DAC) The rest of the story…………

36. Major Funding Support HRSA (7/2000–6/2003): WEB-Reach Texas: Integrating Technology and Enhanced Clinical Cases into Predoctoral Education   DAC – 20 cases   Web-based clinical cases for the Family Medicine Clerkship HRSA (7/2003–6/2006): The Focus on Community and Virtual Families (FOCUS)   DAC – 20 cases   Web-based clinical cases based on a family (genetics/family history) HRSA (2007-2010): Longitudinal Exposure to Complex Medical/ Societal Problems in Family Medicine   DAC - cases   Cases for 1 st and 2 nd year POM courses The University of Texas System (11/2008-10/2011): Innovations in Medical Education Project Grant:   Developing Interactive Web-based Clinical Cases Across all the UT Medical Schools   Additional 100 web cases across Internal Medicine, Pediatrics, Psychiatry, OB/GYN & Surgery

39. Bulik RJ, Burdine RL, Shokar GS. Seamless integration of self- and other directed learning. International Journal of Self-Directed Learning. 2007;4(1):1-15. Bulik RJ, Burdine RL, Shokar GS. Seamless integration of self- and other directed learning. International Journal of Self-Directed Learning. 2007;4(1):1-15. Shokar GS, Burdine RL, Calloway M, Bulik RJ. Relating student performance on a family medicine clerkship with completion of web cases. Family Medicine Journal. 2005;37(9):620-622. Teaching and Learning in Medicine. 2005;17(1):74-79. Shokar GS, Bulik RJ, Baldwin CD. Student perspectives on the integration of interactive web-based cases into a Family Medicine Clerkship. Teaching. Teaching and Learning in Medicine. 2005;17(1):74-79. DAC – Studies

40. DAC – Recognition National: 2006 Society of Teachers of Family Medicine (STFM) Innovative Program Award – April, 2006 Board of Directors of the Society of Teachers of Family Medicine: Spring Conference – San Francisco, CA. State: Innovation in Medical Education Award – October, 2005. The University of Texas System – Innovations in Medical Education Conference, Austin, TX. University: Presidential Curriculum Innovation Award for 2004-2005. Academic Executive Council University of Texas Medical Branch, Galveston, TX

41. Contributions of Community- Based Preceptors to the Clerkship Curriculum David Wright, MD dwright@seaton.com Blackstock Family Health Center, Austin, TX Radheshyam Miryala, MD ramiryal@utmb.edu University of Texas Medical Branch, Galveston, TX Robert J. Bulik, PhD rjbulik@utmb.edu University of Texas Medical Branch, Galveston, TX