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

2. 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)

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

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

5. 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

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

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

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

9. Site Establishment Start 12 mon9 mon6 mon3 mon15-18 mon Faculty Recruitment Initiate Conversation Candidate List Site Adequacy Faculty Development Outine Core content Preceptor Guidelines Schedules Design Schedules Documentation Orientation Design Administrative Affiliation Agreements Faculty Appointments Services/Logisics Housing Student Services Clerkship Orientation Assessment Schedule

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

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

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

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

14. Site Establishment During Rotation – Global Orientation – Verify Instruction – Collect Assessments

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

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

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