1. Te4Q Educational Project Review Learning “systems skills” in medical school: What all clerkship directors need to know Arpi Bezmekian, Chris Hess, Rachael Lucatorto, Lindsay Mazotti, Jeff Tice, Sandrijn van Schaik

2. Goal/Aim To create a curriculum for clerkship directors and other educational leaders that familiarizes them with the relevant milestones and allows them to identify and create opportunities within their clerkship for students to gain experiences towards these milestones.

3. Learning Objectives After clerkship directors have completed the curriculum, they will be able to 1. Describe the UCSF SOM QI and patient safety milestones; 2. Identify existing opportunities within your clerkship for students to gain experiences that help them to achieve these milestones; 3. Use the stimulus from others’ examples to provide new opportunities for students by: a.creating new opportunities in existing activities, or b.by developing new activities.

4. Educational Design and Strategies Needs assessment: Identify final milestones Explore current efforts for clerkships to include QI/PS activities Get feedback on initial ideas (objectives/educational design) from core clerkship directors Create inventory of currently existing activities to inform examples

5. Educational Design and Strategies On-line curriculum that Informs clerkship directors about student curriculum in QI/PS and prior experiences Walks clerkship directors through the process of identifying/creating experiences, using a stepwise approach with map of examples based on existing experiences Helps clerkship directors complete a grid to map experiences to milestones

6. Educational Design and Strategies The curriculum includes references to UCSF modules/workshops and other resources to gain content expertise re. QI/PS and tips about making connections to departmental QI/PS champions Embedded in a broader effort of faculty development around Teaching for Quality

7. Example

8. Learner Assessment Clerkship Directors’ confidence in knowledge/skills about the content and ability to apply to learning experiences Successful completion of checklist/map

9. Program Evaluation Short term: Clerkship directors are able to articulate milestones relevant to QI/PS (survey) Clerkships directors are able to map experiences in the clerkships to milestones (annual review of clerkship experiences) Medium term: Students report explicit learning about QI/PS in the clerkships (evaluations) Students report increased faculty involvement in QI/PS (evaluations) SOM can catalogue clerkship activities in which students gain experience towards milestones for Practice-based learning and improvement and Systems-based practice (annual review of clerkship experiences)

10. Program Evaluation Long-term: Increased number of scholarship projects by students around QI/PS from clerkships Improved Graduation Questionnaire in relevant areas

11. Summary of progress to date Completed initial needs assessment of core clerkship directors Identified main EPA and draft competencies related to QI/PS Submitted proposal to health professions education pathway to engage learner in project

12. Needs Assessment Core clerkship directors welcome this project Few core clerkship have relevant didactic component.

13. Needs Assessment Students participation in QI/PS activities is variable among clerkships Survey data will inform further investigation into successful practices that can inform “best practices” (interviews with select directors) YesNo Students attend M&M77 Students attend RCA27 Students attend quality/safety meetings 36 Students participate in QI projects72

14. Barriers/challenges Faculty too busy “Module fatigue” Needs to link to overall structure o Assessment o Student expectations Need FAQ/contact for person to approach if there are difficulties

15. Next steps/timeline When will the curriculum be implemented? Pilot winter 2015/16 Confidence in ability to complete by January 16 Pilot should be completed, but will likely need adjustments before finalizing

16. Dissemination Plan and Additional Activities What is the plan for dissemination? (Publication, presentation, etc) MedEdPortal AAMC Annual Medical Education Meeting Are there other educational activities aside from this project that you will implement? This project is closely linked to the overall Te4Q program and other faculty development initiatives for the new UCSF SOM curriculum, in particular those around EPA’s and milestones and the CMC