Drexel University College of Medicine

Individualizing physicians' educational needs
Participants may outline their individual needs in the written application.  The admissions committee reviews this and further explores individual goals during a personal interview.  The director customizes each participant's curricula (daily schedules) to suit the individual goals guided by the overall goals of the course. The Physician Refresher/Re-Entry Course makes every effort to identify a preceptor within the participant's area of interest for ongoing teaching, mentorship, and feedback. The director maintains ongoing contact with the participant and formally meets regularly for curricular discussions, feedback, to monitor progress in meeting the educational goals, to provide assistance with any potential barriers, and to revise the goals or curricula as necessary.

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Patient Care

          Goals:

Objectives:

1. Communicate effectively and demonstrate caring and respectful behaviors when interacting with patients
2. gather essential and accurate information about patients
3. make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment
4. develop patient management plans
5. counsel and educate patients
6. use IT to support patient care decisions and patient education
7. work with health care professionals to provide patient-focused care

Methods:

1. Observing patient rounds with one health care team
2. DxR—a software program that allows participants to completely care for a virtual patient
3. Simulated patient exercises
4. One-on-one teaching with a faculty preceptor
5. Doctoring Curriculum:  This weekly ½ day session run by the director is comparable to the interns’ ambulatory conference series for DUCOM’s internal medicine residency program.  Here, participants have the opportunity to learn and discuss core topics such as acculturation into current US practices, physician well-being, documentation and coding guidelines, feedback skills, quality of care and disclosure of medical errors. 

Assessment:

1. Formative and summative evaluation by faculty preceptor
2. Two sets of simulated patient exercises:
   1. At the beginning of the program, the first exercise will assess the observer’s skills and provide guidance for learning. 
   2. Towards the end of the rotation, a second standardized exercise will evaluate the participant’s progress.

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Medical Knowledge

   

    1.  To demonstrate an investigatory and analytic thinking approach to clinical situations:

         problem identification and application of basic, social, and  clinical sciences for clinical

         reasoning.  

Objectives:

1. demonstrate an investigatory & analytic thinking approach to clinical situations
2. know & apply the basic and clinically supportive sciences

Methods:

1. Participants will have the opportunity to observe a health care team demonstrate complete patient care on working rounds
2. Participants will have opportunities for presentation of various clinical topics brought about by a particular patient on working rounds
3. Knowledge will be reinforced by preceptor discussions
4. Participants will attend a variety of lectures on clinical topics and will have access to a vast collection of recent on-line medical grand rounds and edical library.
5. Participants will have access to DxR—a software program that allows participants to completely care for a virtual patient.
6. In each of the three components of the course, participants will have the opportunity to complete the Step 3 examination on-line.
7. At the end of the preceptorship, all participants may be asked to present a patient centered clinical topic to their group of peers, faculty preceptors, and director. 

Assessment:

1. One-on-one discussion of medical cases with an assigned preceptor.
2. Score from on-line completion of Step 3.  We will include this in the participant’s portfolio of activities.
3. Formal presentation to peers, preceptors, and director.

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Practice-Based Learning and Improvement

1. To investigate, evaluate, and improve patient care practices
2. To appraise and assimilate scientific evidence

Objectives:

1. analyze practice experience
2. locate, appraise, and assimilate evidence from scientific studies related to patient health problems
3. apply knowledge of study designs and statistical methods to the appraisal of clinical studies
4. use information technology to manage information, access on-line medical information, and support own education facilitate learning of other health care professionals

Methods:

1. Participants will complete assignments on topics identified on rounds and discussions based on patient care and trainees’ needs.
2. During the preceptorship, trainees will give a formal presentation on a particular situation raised by patient care which will demonstrate trainees’ ability to access most recent data, present, and teach a group of peers and faculty effectively.  DxR—virtual patient care
3. During weekly discussions with the director, participants will learn feedback skills used in teaching students or peers

Assessment:

1. Through discussions with health care team and preceptor, participants will show evidence that s/he can use information technology to manage information, access on-line medical information; and advance his/her own education.Trainees will receive feedback on these reports.
2. Presentations during rounds, to preceptor, and at end of rotation.
3. DxR

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Interpersonal and Communication Skills

Objectives:

1. use effective listening skills
2. elicit and provide information using effective non-verbal, explanatory, questioning, and writing skills
3. work effectively with others

Methods:

1. Participants will be able to access a website funded by Drexel and American Academy on Communication and Healthcare (doc.com).  This on-line multi-media resource has 40 modules demonstrating core and advanced topics in physician patient communication. 
2. Observing rounds with health care team.
3. Doctoring Curriculum:  This weekly ½ day session run by the director is comparable to the interns’ ambulatory conference series for DUCOM’s internal medicine residency program.  Here, participants have the opportunity to learn and discuss core topics such as acculturation into current US practices, physician well-being, documentation and coding guidelines, feedback skills, quality of care and disclosure of medical errors. 
4. Standardized patient exercises will include cases that address interpersonal and communication skills

Assessment:

1. Verbal feedback from members of the health care team
2. Participant’s interactions with the simulated patient during the OSCE.
3. Participants will be expected to complete one write-up of the standardized patient encounter to assess his/her writing skills and documentation, and will be asked to write up additional patients for whom they have observed intern or resident workups.
4. While reviewing doc.com, participants will complete the multiple choice questions and free text answers in the assessment sections of each assigned doc.com module.
5. Participants will be evaluated by the director during doctoring sessions.
6. Immediate feedbacks from standardized patients, review of the video and feedback with faculty preceptor, and score. 
7. Interactions with faculty preceptor

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Professionalism

          Goals: 

Objectives:

1. demonstrate respect, compassion, and integrity; sensitivity to the needs of patients and society that supercedes self-interest; accountability to patients, society, and the profession; and a commitment to excellence and on-going professional development
2. demonstrate a commitment to ethical principles pertaining to provision or withholding clinical care, confidentiality of patient information, informed onsent, and business practices
3. demonstrate sensitivity and responsiveness to patients’ culture, age, gender, and disabilities.

Methods and Assessment: 

There will be a number of opportunities for evaluation and feedback so that participants can continuously improve their skills.

1. Faculty preceptor
2. Interaction with the medical team
3. Standardized patient exercises
4. meetings with the director
5. doc.com – physician patient communication skills
6. Physician Refresher Course staff

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 Systems-based Practice

Goals: 

1. To bring about an awareness of and responsiveness to the larger context of health systems.
2. To bring about awareness of cost-effective health care and resource allocation, and system resources to provide care that is of optimal quality and value

Objectives:

1. understand how their patient care and other professional practices affect other health care professionals, the health care organization, and the larger society and how these elements of the system affect their own practice
2. know how types of medical practice and delivery systems differ from one another, including methods of controlling health care costs and allocating resources
3. practice cost-effective health care and resource allocation that does not compromise quality of care
4. know how to partner with health care managers and health care providers to assess, coordinate, and improve health care and know how these activities can affect system performance

Methods:

1. Discussions as they arise on rounds and with preceptor
2. Observing complete patient care on rounds
3. attending conferences available to residents and fellows, including quality improvement conferences
4. Weekly group meetings with director to discuss topics such as quality of care and error disclosure
5. Care of the virtual patient on DxR

 
Assessment: 

1. Discussions with feedback from faculty preceptor and director