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Troubleshooting Your Clerkship 104: Teaching Challenges Alan P
Troubleshooting Your Clerkship 104: Teaching Challenges Alan P. Ladd, MD
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Disclosures Published evidence provided where possible
Personal Commentary (*) Comments do not necessarily reflect the views of the Indiana University School of Medicine
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Disclosures—why me? Clerkship Director for 7 years 340+ students
Central Campus (6 hospitals) 8 statewide, regional sites I know JOE
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General Surgery at the Academic Health Center
“The Mecca”
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General Surgery at AHC Medical Center or Traditional University Hospital Specialized and Sub-specialized services Typical Services “Whipple-a-day” service “Only Breast and Thyroid” service
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General Surgery Clerkship
Training models for MS3 clerks Inherent to the Medical Center (traditional) Curricular models slow to change Lack of opportunities to change
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Novel Clerkship Models
Completely Distributed System Multiple regional campuses Student Apprentice Model Regional oversight for instruction Central oversight for Curriculum, Resources, Outcomes EL Bradley et al. JSR 177 (2012) 14-20 TCW Yu et al. JSR 168 (2011) e17-e23
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Novel Clerkship Models
Non-Academic Clerkship Model Use of Community hospitals With or without Academic structure of residency M Williams, et al. JST 116 (2004)
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Novel Clerkship Models
Surgical Subspecialty Model Use of Subspecialty surgery rotations High Ambulatory patient population for instruction MK Sandquist et al. JSR 153 (2009) Poenaru et al. Amer J Surg 175 (1998)
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Novel Clerkship Models
Common Themes Centralized Curriculum Oversight Identical Educational Objectives/Resources Faculty Development/Instruction Monitoring of Outcomes
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The Solutions to General Surgery at AHC *
Mindset Change (for CD/Chair/Department) Education not about the Emersion Universal, Reproducible Surgery Curriculum Faculty Development
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Clerkship is not Emersion
Service and/or Hospital becomes Context Not Team dependent Team can be redefined
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Universal Curriculum Identical Objectives
Standard Teaching Material & Resources Standard Assessments Pedagogical Options
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Faculty Development Shared Educational Goals
Common Understanding of Objectives Awareness of Resources Updated Versions
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Surgery Core Curriculum
Successfully Navigating the First year of Surgical Residency: Essentials for Medical Students and PGY-1 Residents ( National Curriculum) Guidebook for Clerkship Directors, 4th Edition
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Developing Core INSTRUCTION
Didactics Experiential Opportunities Skill Instruction Always remember equivalency (LCME)
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The IUSM Example Core topic Small Group Discussions
Lectures—Surgical Nutrition, Ventilators Clinics—Breast Oncology; Colorectal Calls—Acute Care Surgery/Trauma Skills—Venipuncture; Suturing; Foley Patient Assessment—Simulation
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General Surgery at AHC Curriculum, Objectives, and Instruction that Compile to make a General Surgery experience
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General Surgery for the “Non-surgical” Students
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“Non-surgical” Students
Who are our learners? 90+ % of students are not surgeons What should be our Educational Mindset?
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The Generalist Education
Clinical Encounters MJ Curet et al. Am J Surg 178 (1999) 78-84
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MJ Curet et al. Am J Surg 178 (1999) 78-84
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The Generalist Education
Clinical Encounters/Diagnoses Higher interest in topics of subspecialty surgery Orthopedics Otolaryngology Ophthalmology Not trauma, vascular problems, CAD, PE MJ Curet et al. Am J Surg 178 (1999) 78-84
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The Generalist Education
Skill Proficiency MJ Curet et al. Am J Surg 178 (1999) 78-84
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MJ Curet et al. Am J Surg 178 (1999) 78-84
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The Generalist Education
Skill Proficiency Shared importance of Documentation Highly rated “office procedures” Wound Management, Epistaxis, Abscess MJ Curet et al. Am J Surg 178 (1999) 78-84
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The Generalist Surgical Education*
Not always reflective of AHC healthcare Higher Subspecialty emphasis Office-based procedural elements
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The IUSM Example Core Discipline didactics
Skills—Casting/Splinting; Vascular Exam TBD
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The Generalist Surgical Education* Resources
WISE-MD Lawrence Text: Essentials of General Surgery
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Headline Here No More Than 2 Lines
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