1. © 2007 Oklahoma State University Enhancing the Clinical Experience for the Student and the Preceptor Abridged Version Vicky Pace, M.Ed. Clinical Training Coordinator, Center for Rural Health Oklahoma State University - College of Osteopathic Medicine AACOM 2007 - Collaboration: The Keystone to Success June 28, 2007 in Baltimore, Maryland

2. © 2007 Oklahoma State University Matching can Enhance Matching the student to the site enhances the experience for both the student and the preceptor. Definition: To make greater, as in value or effectiveness.  Why is it important?  How are we doing now?  Where do we start?  What next?

3. © 2007 Oklahoma State University Why is it Important? Goal: Increase the number of physicians that chose to practice in rural areas. So how are we doing?

4. © 2007 Oklahoma State University

5. Why is it Important? Our Mission The Center for Rural Health supports the mission of the OSU Center for Health Sciences to educate and train osteopathic physicians, research scientists, and other healthcare professionals with an emphasis on serving rural and underserved Oklahomans. The Center for Rural Health uniquely impacts osteopathic physicians from the time they are students through the time they are practicing in rural communities by: Training osteopathic students, providing support services to osteopathic physicians and their rural practices, and strengthening the broader health care delivery systems in rural communities where they practice.

6. © 2007 Oklahoma State University Our Mission - Rural The Center for Rural Health supports the mission of the OSU Center for Health Sciences to educate and train osteopathic physicians, research scientists, and other healthcare professionals with an emphasis on serving rural and underserved Oklahomans. The Center for Rural Health uniquely impacts osteopathic physicians from the time they are students through the time they are practicing in rural communities by: Training osteopathic students, providing support services to osteopathic physicians and their rural practices, and strengthening the broader health care delivery systems in rural communities where they practice.

7. Community Clinic Rotation Sites March 2007

8. Rural Clinic Rotation Sites March 2007

9. © 2007 Oklahoma State University Community Hospital I and II and Emergency Medicine Rotation Sites MAY 2007

10. © 2007 Oklahoma State University Where do we start?  Things are changing  Differences are important  Experiences influence decisions  Learning Happens

11. © 2007 Oklahoma State University Things Change: Cultural Changes 75 million Traditionalist (Veterans) (born before 1945)  10% of the workforce  Large need for healthcare  Retiring (62 and older)

12. © 2007 Oklahoma State University Things Change: Cultural Changes 80 million Baby Boomers (born between 1945 - 1964)  45% of the workforce  Increasing need for healthcare  Nearing retirement (43 to 62)  Community Leaders  Training the future physicians

13. © 2007 Oklahoma State University Things Change: Cultural Changes 46 million Generation Xers (born between 1965 –1980)  30% of the workforce  Our new physicians (age 27 to 42)  Different kind of patient  Different kind of student 10 to 15 years training after high school to become a physician

14. © 2007 Oklahoma State University Things Change: Cultural Changes 76 million Nexters (Generation Y or Millennials) (born after 1980)  15% of the workforce  Recruiting and training now to be our future physicians  Current medical students  What kind of patient?

15. © 2007 Oklahoma State University Things Change: Cultural Changes A large percentage of patients are Traditionalist and Baby Boomers. Traditionalist are retired or retiring. Some Baby Boomers starting to retire. Baby Boomers are training and hiring the new Generation X physicians. Baby Boomers and GenXer’s are teaching the Millenial's to be our future physicians.

16. © 2007 Oklahoma State University Differences are Important GenerationPhysicianPatientStudent Traditionalist Pre-Boomers Veterans “I have had the same career all my life. I followed the rules to move up.” “If I need health information, my physician will tell me. I have gone to him for years.” “That’s the way we were trained.” Baby Boomers Boomers “I live to work. My work is important and says who I am.” “I have already researched my problem and have a list of questions for my doctor so I should be back to work before the meeting.” “If you let us work in a team, we will learn more.” Generation X GenXers “Play is what I choose to do. Work is what I have to do so I can play.” “Just changed jobs so no insurance but I know what the problem is so I made an appointment to see a new specialist.” “Just tell me what I need to know and let me go. I don’t want to waste my time.” Generation Y Nexters Millenials “I will take the job if it is fun, but I want all the instructions in writing.” (What kind of patient will they be?) “We all discussed it and do not feel it is necessary, so why should we do it?”

17. © 2007 Oklahoma State University What are we doing now?  Teaching in the big city (busy hospitals, lots of specialist)  Providing a rural experience (a lottery, kind of like dealing cards)  Attempting to recruit them to rural AFTER they are trained

18. © 2007 Oklahoma State University Remember This?

19. © 2007 Oklahoma State University Experiences influence decisions With the need for Primary Care Physicians in rural areas rising, the student’s experience plays a large role in the decisions made concerning future plans.

20. © 2007 Oklahoma State University Learning Happens! What do we want them to learn?  The very nature of rural medical education lends itself to unpredictable and varied experiences for both the student doctor and the preceptor doctor. What are they really learning? What are we doing? Is it planned?  Limited time on rotations make planned learning critical since it ultimately influences the decisions the student doctor makes regarding future plans.

21. © 2007 Oklahoma State University Matching can Enhance the Experience  Right Student  Right Preceptor  Right Place  Right Curriculum  Better experience for the student  Better experience for the preceptor  Better chance of the student returning to the rural community  Better experience for the school

22. © 2007 Oklahoma State University Addressing the Challenge  Review the process of selecting and placing students in training sites  Review the selection and evaluation process for preceptors and sites  Develop tools that can assist in standardizing the teaching/learning experience  Be aware of how others interact with the process

23. © 2007 Oklahoma State University Selecting Students  Get to know the students  Personal interviews  Interest surveys  Pre-rotation essays  Visit with the student  Student Performance Evaluations  Recruit from rural areas  Return to rural areas as soon as possible and as often as possible

24. © 2007 Oklahoma State University Placing Students  Match student to site  Personality  Cultural differences  Specialty interests  Personal interests  Family needs  Academic needs

25. © 2007 Oklahoma State University Select and Evaluate Preceptors and Sites  Selection Process  Preceptor’s CV  Site Information Forms  Site Visits  Evaluation Process  Student Site Evaluations  Annual visits  Training

26. © 2007 Oklahoma State University Standardizing the Experience  Informative Website  Site locations and strengths  Student accomplishments  Competency Checklist  Are they getting an equal experience  Scheduling/Evaluation Software (EMS)  Let them make informed choices

27. © 2007 Oklahoma State University Standardizing the Experience  Gathering Information  Surveys  Site visits  Evaluations  Interviews  Setting Guidelines  Website  Syllabus  Checklists  Making Changes  Feedback  Preceptor training

28. © 2007 Oklahoma State University Partners in the Process  Telemedicine/ IT Distance Learning support  Area Health Education Centers a friendly face in an unfamiliar place  Physician Manpower Training Commission financial support to help make it happen

29. © 2007 Oklahoma State University Spread the Word  Students to Students It’s great! Spread the word.  Site Presentations We have a great location with great people! Let us tell you or show you.  Provide Recognition Great job! Spread the word.

30. © 2007 Oklahoma State University Providing Recognition  Positive Feedback  Signs for Public Awareness (sample)  Plaques for Individual Recognition (sample)  Awards (just starting)  Site of the Year  Rural Clinic Award  Student Award “Why we work” wall in Enid, Oklahoma proudly displays family photos of ER staff.

31. © 2007 Oklahoma State University Positive Communication  Thank you  Emails  Cards  Faxes  Phone calls  Acknowledgement  news releases  journal articles  website  newsletters

32. © 2007 Oklahoma State University Personal Visits  Bearing gifts (marketing)  recruitment packets  pens  Member Identification  school lapel pins  signing for office  plaques for the office  shirts with school name

33. © 2007 Oklahoma State University Matching Enhances the Experience  Right Student  Right Preceptor  Right Place  Right Curriculum  Better experience for the student  Better experience for the preceptor  Better chance of the student returning to the rural community  Better experience for the school

34. © 2007 Oklahoma State University Now what? Things Change!  Cultural changes continue - what children experience now will affect characteristics of their generation (adapting to their needs)  Rising healthcare needs cause the number of students to increase (recruiting, training, placement)  Increase in number of students and the number retiring preceptors will require adding new training sites and preceptors (selecting and training new preceptors)  Constant evaluation of results (what works?)

35. © 2007 Oklahoma State University Questions? Ask the team. William Pettit, D.O. - Associate Dean for Rural Health  Friday Morning’s Brief Presentation on “A Collaborative Model Encouraging Rural and Primary Care Residency Selection and Subsequent Practice” Chad Landgraf, M.S. - Geographic Information Specialist  Friday’s poster session on Telemedicine Machelle Davison, Ed.D. - Educational Development  Friday’s poster session on Cultural Differences Matt Vassar, Ph.D., Warren Finn, Ph.D. and Machelle Davison, Ed.D.  Thursday’s Coping with Growth Challenge Session: An Institutional Model for the Study/Planning of Increased Class Size

36. © 2007 Oklahoma State University Thank you! Visit our Oklahoma State University website  Center for Health Sciences http://www.healthsciences.okstate.edu  College of Osteopathic Medicine http://www.healthsciences.okstate.edu/college.edu  Center for Rural Health http://ruralhealth.okstate.edu  Rural Medical Education http://www.healthsciences.okstate.edu/college/clinical/crh.edu  Telemedicine http://www.healthsciences.okstate.edu/telemedicine.edu

37. © 2007 Oklahoma State University Information Sources  Understanding Generational Differences  Workshop taught by Michelle Davidson, EdD  Managing a Multigenerational Workforce  Workshop taught by Dr. Mary Jo Major, EdD  The Fragile Generation – Managing New Complexities  Article written by Jane Genova published in The Greentree Gazette Nov 2006  New Students - New Learning Styles  An article written by Charles C. Schroeder published in Change Sept/Oct 1993 http://www.virtualschool.edu/mon/Academia/KierseyLearningStyles.html http://www.virtualschool.edu/mon/Academia/KierseyLearningStyles.html  Student Advising Workshop  Myers-Briggs Workshop taught by Paul Tieger based on his best selling books Do What You Are (2000) and The Art of Speed Reading People (1998)  Oklahoma State University Data  Student Performance Evaluations  Site Evaluations  Practice Interest Surveys  Site Information Surveys