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LSI Longitudinal Practice Manual
20122014
The Longitudinal Practice Program Contacts
Ann Dietrich, MD
Longitudinal Practice Program Director
[email protected]
614-562-7807
Diana Bahner
Program Manager
054 Meiling Hall
370 W. 9th Avenue
614-292-2998
614-292-5364 - fax
[email protected]
Dawn Ryan
Program Assistant
B040 Graves Hall
333 W. 10th Avenue
614-292-3119
[email protected]
LSI Longitudinal Practice Manual
LSI Longitudinal Practice Manual
2012-14
The 2012 LeadServeInspire Longitudinal Practice Curriculum ...................................................................... 2
Longitudinal Practice Clinical Experience ................................................................................................................ 3
LP skills Training Program ............................................................................................................................................. 3
Patient Empanelling Process ......................................................................................................................................... 4
Longitudinal Projects ........................................................................................................................................................ 4
Objectives by Curricular Block ...................................................................................................................................... 5
LeadServeInspire Curriculum Overview .................................................................................................................. 7
Features of Part One ..................................................................................................................................................... 7
LeadServeInspire Curriculum Terminology ....................................................................................................... 8
Frequently Used Websites ............................................................................................................................................ 10
Appendices .......................................................................................................................................................................... 11
Sample Patient Empanelling Form ....................................................................................................................... 11
Longitudinal Practice Calendar .............................................................................................................................. 12
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LSI Longitudinal Practice Manual
LSI Longitudinal Practice Manual
2012-14
THE 2012 LEADSERVEINSPIRE LONGITUDINAL PRACTICE CURRICULUM
The Ohio State University College of Medicine has a rich history of curricular innovation. As we
prepare students for post-graduate training opportunities in institutions worldwide, we must
continuously improve our curriculum. The 2012 LeadServeInspire Curriculum will ensure that we
develop physicians who will improve people’s lives through personalized healthcare.
Goals:
Identify the importance of a personal clinician.
Learn about office flow, procedures and facilitating patient care.
Apply knowledge and practice skills they have learned.
Practice the team approach to patient care and identify its importance in achieving
successful health care outcomes.
Key Features:
Basic Procedures/ Skills Based Training
Integrated with Classroom Learning
Timely Communication with Practices
Online Evaluation of Student Performance
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LSI Longitudinal Practice Manual
LSI Longitudinal Practice Manual
2012-14
LONGITUDINAL PRACTICE CLINICAL EXPERIENCE
The new curriculum has at its center a team based clinical experience that will enhance the
student’s integration into clinical practice and teach them to apply foundation science concepts to
patient care. Prior to their first preceptor experience each of the students will receive training in
basic procedural skills to allow for a more active participation in patient care and less disruption to
patient flow at the practice.
Dates:
October 2012-February 2014 - 2 half days/ month for 17 months
23 sessions during Part 1, includes 13 in Year 1 and 10 in Year 2
See Appendix with calendar of dates
LP SKILLS TRAINING PROGRAM
Prior to coming to your practice students will be trained in a variety of procedures/skills. This will
include pediatric scenarios for students assigned to those sites.
Vital signs
ECG lead placement
Visual acuity
Injection technique (ID, SQ, IM)
Finger stick puncture with blood glucose measurement and glucometer technique
Venipuncture/phlebotomy
Cerumen removal (irrigation only)
Sterile technique/universal precautions
Urine collection, dip, and interpretation
Respiratory measurement and treatment (PF measurement, inhaler technique, basic
spirometry)
Oxygen administration/Pulse oximetry
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LSI Longitudinal Practice Manual
LSI Longitudinal Practice Manual
2012-1
PATIENT EMPANELLING PROCESS
As part of the integrated learning process, students will be asked to empanel a patient that has a
diagnosis or behavioral condition consistent with their classroom learning. The following process
should be used when students are empanelling patients in your practice:
1) The student will select patients under the guidance of their preceptor. Under office supervision,
the student will complete a form on each patient they empanel and bring the completed, deidentified form to their weekly small group sessions.
2) The forms are guides for small group discussion; these will not be collected by facilitators and
are not graded. See Appendix for sample form.
3) In small group, faculty facilitators will call on one student to present his/her empanelled patient.
The facilitator will then ask other students about differences between their empanelled patients
and the patient who was presented, i.e. different management plans for similar diagnoses, etc.
Discussion is meant to focus on the integration between the basic and behavioral sciences students
are studying in the LSI Curriculum Blocks and the clinical assessment/management of patient cases
at your sites.
LONGITUDINAL PROJECTS
Every student will maintain a mentored Educational Portfolio throughout the curriculum that will
be used to present documentation of readiness for graduation. In addition, three other culminating
works will be completed over the course of the three part curriculum. These projects are designed
to allow students to achieve competency in certain Core Educational Objectives as relates to selfdirected learning, interdisciplinary learning, leadership, understanding health systems, health
informatics and scientifically based inquiry.
The Community Health Education project requires students to research the needs of a population
and develop a program to address these needs. Students will work with their Longitudinal
Preceptors to identify a patient population within their assigned practice that would benefit from
this project. Students will provide updates and their final report to their preceptors and present
their findings during a longitudinal group session.
The Health Coaching project requires students to work with a specific patient to develop a health
improvement plan focusing on behavior change. Students will need to recruit a patient from their
Longitudinal Practice and may ask for assistance from their preceptor with this task. Students will
provide updates to their preceptor regarding the referred patient’s status over time.
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LSI Longitudinal Practice Manual
LSI Longitudinal Practice Manual
2012-1
OBJECTIVES BY CURRICULAR BLOCK
Year 1
Medical Practice and Patient Care-October: 2 sessions
Meet members of the office, introduce self and understand roles of different providers
Respectfully communicate with patients, staff, and other team members.
Review office policy and procedures with office manager
Shadow the MA or designee, understand their role
Independently perform MA functions (Intake, Vital Signs)
Practice interviewing patients and obtain HPI, Past medical history, including medications and
Family history
Perform vital signs and obtain and document chief complaint observed by MA or
designee
Bone and Muscle Disorders-November-December: 2/3 sessions
Respectfully communicate with patients, staff, and other team members.
Perform one supervised procedure (ECG, visual screen, ear irrigation, phlebotomy)
Have 1 direct observation of obtaining chief complaint and history of present illness,
WITH feedback
Practice developing a differential diagnosis with real patients and discuss with preceptor
Independently use the CODIER technique with one patient
Practice documenting a patient encounter
Practice back/spine PE
Practice knee or shoulder PE
Items in Italics must be logged by students.
Items in Bold require direct observation.
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LSI Longitudinal Practice Manual
LSI Longitudinal Practice Manual
2012-1
Neurologic Disorders-January-March: 4/5 sessions
Respectfully communicate with patients, staff, and other team members.
Independently interview patients and formulate an illness script for each patient
Practice collecting information on behavioral and mental issues for patients
Practice neurologic PE
Have 1 direct observation of obtaining past medical history including medication
and allergies, WITH feedback
Practice oral presentation with preceptor
Practice STAGE framework for oral presentations with preceptor
Independently use the musculoskeletal, neurologic focused ROS as appropriate for chief
complaint
Cardiopulmonary Disorders – April-May: 4 sessions
Respectfully communicate with patients, staff, and other team members.
Be aware of the cultural diversity in the practice; learn about the practice interpreter
resources
Have 1 direct observation of obtaining family history and social history, WITH
feedback
Practice cardiopulmonary focused ROS as appropriate for chief complaint
Practice cardiac PE
Practice pulmonary PE
Practice focused history and ROS as related to a cardiac chief complaint
Practice focused history and ROS as related to a pulmonary chief complaint
Direct observation of focused history and focused exam on a patient whose chief
complaint is related to a cardiopulmonary or neurologic condition
Practice collecting information on the self-management needs of patients with chronic
illness
Practice supporting patients health behavioral change
Year 2-Objectives for Year 2 will be sent prior to students return to the office in August 2013.
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LSI Longitudinal Practice Manual
LSI Longitudinal Practice Manual
2012-1
LEADSERVEINSPIRE CURRICULUM OVERVIEW
The LeadServeInspire Curriculum provides an opportunity to develop instruction that integrates
foundational sciences, clinical sciences, and behavioral sciences to provide more contextual
relevance for students.
Instruction is integrated to provide greater contextual relevance for students.
Increased emphasis on multiple teaching methods is designed to promote active learning.
Foundational science content will be reinforced in Parts 2 and 3.
Anatomy is taught concurrently with and integrated into individual blocks.
Student projects throughout are designed to emphasize core educational objectives and
teach lifelong learning skills.
Students will get early clinical exposure to real patients in clinical practices.
FIGURE 1: TIMELINE FOR PART 1
FEATURES OF PART ONE
Part 1 will be divided into 7 blocks covering the major foundational sciences topics and is
approximately two months shorter than the current Med 1 and 2 years. All essential basic and
behavioral science components will be covered with these concepts being revisited later in Parts
2&3. Anatomy will be taught longitudinally, with anatomical concepts being tightly integrated with
histology, physiology, pathology and clinical applications covered during each block.
EARLY CLINICAL EXPERIENCE
Students will get early clinical exposure which will reinforce foundational science concepts
Students will be in longitudinal practice one half-day every other week for 17 months.
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LSI Longitudinal Practice Manual
LSI Longitudinal Practice Manual
2012-1
Students will participate in a half-day longitudinal group session 3 hours every week on
either a Monday or Wednesday
Students receive skills based training in Medical History Taking, Physical Examination and a
Basic Procedures Training Program
EVALUATION AND ASSESSMENT
All students will achieve competency in all Core Educational Objectives (CEOs). Each aspect of each
CEO will be measured at some point in the curriculum. The measures will be based on learning
objectives and independent from learning methods. The Educational Portfolio will be used to foster
self-directed learning and individualization of educational plans.
ASSESSMENT WEEKS
At the end of each block a week of assessments will include computer based Multiple Choice
Question (MCQ) exams and Objective Structured Clinical Exams (OSCE). Note: Students will
not be in your practice during assessment weeks.
Longer blocks (Medical Practice and Patient Care, Neurological Disorders, Cardio
Pulmonary Disorders, and Host Defense) will also have a mid block assessment.
LEADSERVEINSPIRE CURRICULUM TERMINOLOGY
Term
Definition
Academic Program
Parts of the curriculum e.g. Part One Foundational Sciences
Curricular Block
A multiple week section of a program e.g. Medical Practice and Patient Care,
Cardiopulmonary Disorders
Longitudinal Group
Focused developmental tasks students work on in weekly groups throughout
the curriculum relating basic and behavioral sciences to the practice of
medicine
Longitudinal Practice
Students are scheduled for ½ a day every other week to a practice site to
apply basic science and clinical skills development.
Longitudinal Projects
Focused developmental tasks students work on throughout the curriculum
e.g. Health Coaching
OSCE
Objective Structured Clinical Examination - will measure whether students
have become proficient at professional behaviors, communication &
patient care skills across cases and contexts
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LSI Longitudinal Practice Manual
LSI Longitudinal Practice Manual
2012-1
ASSESSMENTS IN LONGITUDINAL PRACTICE
Each preceptor will be asked to evaluate the students online in medStar at the end of each block.
The assessment questions directly reflect the objectives of the block and are meant to assess the
student’s attendance, performance and successful completion of target objectives. The evaluations
by the preceptors are integrated into the overall block assessment grades.
Several types of Assessments will be used to monitor achievement of learning outcomes of the
Longitudinal Practice component of LSI, including Attendance, Preceptor Assessments, Direct
Observation of Competence, and Student Logs.
o
o
o
o
o
Attendance will be reported for each Longitudinal Practice session
Preceptor Assessments will allow LP preceptors to report summary observations
of important student behaviors in the practice.
Direct Observation of Competence will be used in the practice to assess student
performance of key clinical skills with a real patient. Some of these may be
completed by other members of your staff.
Student Logs will be used to track the types of patient encounters students
experience and the skills they perform during each block.
Each Curricular Block will end with an Assessment Week OSCE that will measure
whether students have become proficient at professional behaviors, communication
& patient care skills across cases and contexts. Students will be practicing these
skills at the LP sites, while the OSCE is the mechanism for testing their
competency.
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LSI Longitudinal Practice Manual
LSI Longitudinal Practice Manual
2012-1
FREQUENTLY USED WEBSITES
CARMEN AND MEDSTAR
medSTAR is the College of Medicine’s Student Information System. Longitudinal Preceptors have
instructor accounts in this system in order to evaluate student performance. At designated points
in times you will receive an email notification from the medSTAR system with a link to an
evaluation of the student(s). The link will take you directly to the evaluation form and you will not
need to log-in.
If you have any issues accessing the evaluation forms you should contact Diana Bahner.
FACULTY DEVELOPMENT FOR MEDICAL EDUCATORS (FD4ME)
Faculty Development for Medical Educators is a series of interactive, e-learning modules devoted to
improving the knowledge, attitudes and skills of medical and allied health faculty in the important
domain of teaching.
Modules of interest to Longitudinal Practices:
Teaching Students in the Ambulatory Setting I: Getting Started
Cynthia Ledford, M.D.
Teaching Students in the Ambulatory Setting II: Patient Care Skills
Cynthia Ledford, M.D.
Teaching Students in the Ambulatory Setting III: Evaluation and Feedback
Cynthia Ledford, M.D.
Direct Feedback and Coaching in Medical Education
Sorabh Khandelwal, M.D.
Most modules are linked to longer video presentations and/or power point presentations.
Earn CME credit
Visit the site at: http://fd4me.osu.edu/
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LSI Longitudinal Practice Manual
LSI Longitudinal Practice Manual
2012-1
APPENDICES
SAMPLE PATIENT EMPANELLING FORM
NEVER PRESENT INFORMATION THAT MAY IDENTIFY THE PATIENT IN ANY MANNER.
Date:
CC:
HPI:
ROS:
Meds:
Allergies:
PMHx:
FHx:
SHx:
Surgeries/Hospitalizations:
Physical Exam:
Lab Results:
Assessment:
Plan:
11
2012-1
LSI Longitudinal Practice Manual
LSI Longitudinal Practice Manual
LSI Longitudinal Practice
October 2012-February 2014
This
outlines
weeks
students
in the practices
Preceptor
practices for LP.
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calendar outlines
thethe
weeks
whenwhen
students
will be inwill
the be
Preceptor
for LP.
Students
willbebeassigned
assigned
to or
LP1
orgroup,
LP2 group,
asawell
as half
a specific
half day.
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to LP1
LP2
as well as
specific
day.
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are
in
the
practice
for
½
day
during
their
assigned
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The shaded
areas are
whenare
students
NOT beWILL
in theNOT
offices.
The shaded
areas
whenWILL
students
be in the offices.
LONGITUDINAL PRACTICE CALENDAR
October 2012
Sun Mon Tue Wed Thu Fri Sat
1
2
3
4
5 6
November 2012
December 2012
Sun Mon Tue Wed Thu Fri Sat
1
2 3
Sun Mon Tue Wed Thu Fri Sat
2
3
4
5
6
7 8
4
9
LP1
7
8
LP2
9
10
11
12 13
LP2
14
15
22
16 17
18
19 20
11
29
7
8
9
10
12
23 24
25
26 27
18
30 31
Assessment
week
25
10
11 12
13
14 15
18 19
20
21 22
27
28 29
LP1
13
14
15
16 17
16
Holiday LP2
LP2
28
6
LP1
LP1
21
5
19
20
LP2
Holiday
26
27
17
Assess ment
21
22
23 24
23
24
Week
25 26
Winter Break
28
29
30 1-
Dec
LP1
30
31
Winter Break
January 2013
February 2013
March 2013
Sun Mon Tue Wed Thu Fri Sat
1
2
3
4 5
Sun Mon Tue Wed Thu Fri Sat
1 2
Sun Mon Tue Wed Thu Fri Sat
1 2
6
3
3
LP2
7
8
9
10
11 12
LP2
13
14
15 16
17
18 19
22 23
24
25 26
29 30
31
LP1
20
21
Holiday
27
28
4
5
6
7
8
9
LP1
10
11
18
12 13
14
15 16
10
24
25
19 20
21
22 23
17
Mar LP1
7
8
9
10
11
12 13
LP2
14
15
16 17
18
19 20
LP1
21
22
23 24
LP2
28
29
LP1
30
25
11
18
26 27
28
24
25
26 27
13
14
15 16
19 20
21
22 23
28
29 30
Week
26 27
Assess ment
7
8
9
10 11
9
10
Week
11 12
Explora tion
LP2
12
12 13
Sun Mon Tue Wed Thu Fri Sat
2
3
4
5
6
7 8
LP1
6
9
June 2013
Sun Mon Tue Wed Thu Fri Sat
1
2
3 4
5
8
Spring Break
May 2013
Sun Mon Tue Wed Thu Fri Sat
31- 1
2
3
4
5 6
7
Assess ment
LP2
April 2013
6
LP2
LP1
LP2
5
LP1
LP2
17
4
13
14 15
Week
14 15
16
17 18
16
17
18 19
20
21 22
21 22
23
24 25
23
24
25 26
27
28 29
28 29
30
31
1Jun
30
Summer Break
12
LP1
19
20
LP2
26
27
Holiday
LSI
October 2012-February 2014
This calendar outlines the weeks when students will be in the Preceptor practices for LP.
Longitudinal
Practice
Students will be
assigned toManual
LP1 or LP2 group, as well as a specific half day.
2012-1
Students are in the practice for ½ day during their assigned weeks.
LSI
Longitudinal Practice Manual
The shaded areas are when students WILL NOT be in the offices.
July 2013
August 2013
September 2013
Sun Mon Tue Wed Thu Fri Sat
1
2 3
4
5 6
Sun Mon Tue Wed Thu Fri Sat
1
2 3
Sun Mon Tue Wed Thu Fri Sat
1
2
3 4
5
6 7
Holiday
7
8
9
10
11 12 13
4
5
6
7
8
9 10
8
9
10 11
12 13 14
17 18
19 20 21
24 25
26 27 28
LP2
14
15
16 17
18 19 20
11
12
13 14
15 16 17
15
LP1
21
22
23 24
25 26 27
18
19
LP1
20 21
22 23 24
22
LP2
28
29
30 31
Summer
Break
25
26
16
23
Assess ment Week
27 28
29 30 31
29
LP1
30
LP2
October 2013
November 2013
December 2013
Sun Mon Tue Wed Thu Fri Sat
1 2
3
4 5
Sun Mon Tue Wed Thu Fri Sat
1 2
Sun Mon Tue Wed Thu Fri Sat
1
2
3 4
5
6 7
3
8
LP1
LP2
6
7
8
9
10 11 12
14
15 16
17 18 19
10
21
22 23
24 25 26
17
28
7
8 9
11
18
29 30
24
31
25
9
10 11
12 13 14
17 18
19 20 21
24 25
26 27 28
LP2
12 13
14 15 16
15
16
LP1
19 20
Explora tion
LP1
27
6
Holiday
LP2
20
5
LP1
LP1
13
4
21 22 23
22
Week
26 27
23
Winter Break
28 29 30
29
30
31 Winter Break
LP2
LP2
January 2014
February 2014
Sun Mon Tue Wed Thu Fri Sat
1
2
3 4
Sun Mon Tue Wed Thu Fri Sat
2
3
4 5
6
7 8
LP1
5
6
7
8
9
10 11
LP2
12
13
14 15
16 17 18
21 22
23 24 25
28 29
30 31 1-
LP1
19
20
Holiday
26
27
LP2
9
10
11 12
13 14 15
18 19
20 21 22
LP2
16
17
Assess ment Week
23
24
25 26
27 28
Feb
13