T1 #meded It’s extremely hard to do direct observation with the students in clinic, in particular. There may be marginally more time in hospital settings
T1 we depend a lot on our residents for this. It’s how I was trained so I never thought much about it. I am not sure there would be time for this. It also takes a lot of time to review their notes and give feedback. #MedEd
I think there needs to be scholarly work to figure out what kinds of patient load strikes the best balance with educational activities. It can’t be only about patient care in an academic medical center. #meded
No. But I think people offload some of this to OSCEs and SPs RT @GLBDallaghan: @02amor T1 #meded That’s definitely true, but can you say that a #medstudent is completely competent if never before observed in a clinical setting?
T1: I think an integrative approach is most feasible. The reality is it’s hard to guarantee a formal teaching session espesically on acute care services. Inviting and involving patients in the learning if the situation is right is ideal! #meded#patientengagement
T1 #meded My argument is we can't because it is a testing environment. #medstudents can bring it for an exam. It's not the same as patient care settings?
It’s helpful, but probably overly relied upon RT @Alliance4ClinEd@GLBDallaghan T1 #meded Can we say that a simulated experience truly represents an authentic patient encounter as a means of determining competence?
T1 #meded This gets back to @myheroistrane suggestion of better metrics for educational productivity that are comparable to clinical productivity....especially for our academic health sci centers
In reply to
@MedEdChat, @jamee_walters, @myheroistrane
Topic 2: The 12 Tips article suggests getting curriculum leaders to support entrustment decisions. If clinical leaders do not, what alternatives can be employed? #mededhttps://t.co/yroyqyGII7
Thought: why not capture video in real clin environments, and do the observation asynchronously? Would need a secure system to be HIPAA compliant, but that should be doable. #meded
Topic 2: The 12 Tips article suggests getting curriculum leaders to support entrustment decisions. If clinical leaders do not, what alternatives can be employed? #mededhttps://t.co/yroyqyGII7
Thought: why not capture video in real clin environments, and do the observation asynchronously? Would need a secure system to be HIPAA compliant, but that should be doable. #meded
T2 #meded And this is something a community preceptor recently told me was the reason she quit teaching students. Add entrustment to that mix and it would be even worse! @COMSEPediatrics
In reply to
@jamee_walters, @Alliance4ClinEd, @MedEdChat, @myheroistrane, @COMSEPediatrics
T2 #meded How do we resolve this issue as well....that program directors may not fully support #medstudents can be entrusted on some of these EPAs https://t.co/0cHITWXQB7
And require a robust system for patient consent - with clear rules and principles for whether and how videos are stored. We need more patient voice in this process.
T2 #meded Is it possible to leverage larger organizations to support this so clinical leaders & compliance offices aren't so nervous about #medstudents being more responsible in clinical care?
The @CFMSFEMC will continue to stand beside and advocate for each and every unmatched CMG student in Canada until this crisis is over. #BetterTogether#MedEd
I think that there would be all kinds of pushback, AND....
Communications researchers have been recording clinical encounters for decades. It can be done, when there is a trusting relationship between stakeholders.
#meded
Thought: why not capture video in real clin environments, and do the observation asynchronously? Would need a secure system to be HIPAA compliant, but that should be doable. #meded
Topic 3: 12 Tips suggests using case discussions as alternatives to actual patient encounters. What concerns do you have about entrustment decisions using a case discussion option? #meded
Topic 3: 12 Tips suggests using case discussions as alternatives to actual patient encounters. What concerns do you have about entrustment decisions using a case discussion option? #meded
T3- this is all about context as entrustment requires situational awareness, emotional intelligence, AND clinical acumen for both the learner and supervisor #meded
T3 #meded I thin this pulls us right back to the earlier discussion about entrustment in one setting being equivalent to another or use of simulation as a proxy?
This year, for the first time, more women than men entered medical school. Yet the number of women in C-suite positions and other high-level posts remains low. Can sponsorship help? #meded#GMEhttps://t.co/hGUIXhLO0S
A relative beginner can pass a driving test, but that doesn’t mean I will be comfortable in the passenger’s seat. There is no substitute for actual practice - you gotta log the hours. #meded
T3 - I think simulation can supplement workplace-based observation & assessment- maybe in a portfolio. But real patient care has to be the bulk of this. #meded
T3 #meded True. Simulation is a great training ground, but some literature I've seen indicates it is insufficient as a means of determining entrustment decisions.
I agree; I just went through this with my son - told him I wouldn’t let him test until I no longer felt afraid in the passenger seat. Took a lot of driving to get there, but when he finally took the test, he sailed right through. #meded
In reply to
@abhaydandekar, @GLBDallaghan, @Alliance4ClinEd
#meded Final thought.....attempting to assess EPAs still feels a lot like pornography to me....you know it when you see it. Begs the question of how the medical school can honestly evaluate them.
#meded what should those metrics be & how should they look in order to easily track data for entrustment decisions? The article says to utilize tech but maybe we should better define what we need from that tech to make observations more efficient & produce useful data. Thoughts?
In reply to
@Alliance4ClinEd, @MedEdChat, @jamee_walters, @myheroistrane
Personally don’t feel these EPAs are unrealistic at all. Just need dedicated effort to identify opportunities to teach/assess these. Maybe (gasp) we don’t all assess oral pres/notes. Some rotations concentrate on these? #Meded
T3 #meded But can we honestly say that the sum of parts equates to a competent physician? I think most agree these are reasonable, but can we truthfully say #medstudents can do them unsupervised?
