BCOE - Best Curriculum On Earth
Results for 2008-2009 Clerkship
Michael Zettler - Class of 2010
Goals and format of the surveys General feedback for all blocks Brief block-specific feedback for mandatory rotations Discussion of results Future goals of BCOE
Online survey http://www.schulich.uwo.ca/survey/Login.as p Personalized e-mail with survey links for rotations just completed sent out every 6 weeks Reminder e-mail with survey links Draw for $50 to Chapter’s three times per year.
Time spent in formal teaching sessions (modalities may include rounds, rotation packages, web-based tutorials etc) to cover major topics in the specialty over the course of the 6-12 weeks. Time spent on informal clinical teaching surrounding patient encounters. 1 = not enough time, 2 = just right, 3 = too much time
Did this rotation adhere to the on-call policy? Were you notified about the rotation placement, schedule and oncall responsibilities at least two weeks in advance. Comments requested if answered ‘no’ to either question.
Nomination of faculty member. Negative feedback on rotation. Positive feedback on rotation.
The supervisors were well aware of the learning objectives and roles appropriate for a clerk within the rotation. As a clerk, I had an appropriate level of independence in seeing/treating patients. The methods of evaluation fairly assessed my knowledge and abilities in this rotation I received constructive feedback well before receiving my final evaluation. The rotation consisted of an excellent variety of patient problems. Teachers in this rotation model exemplary attitude towards gender and diversity issues. Teachers in this rotation model respect for other health professionals Overall, I would recommend this rotation to my friends
OB/Gyn, Family Medicine, Medicine, Pediatrics
7-point Likert scale with anchors from “Strongly Disagree” (1) to “Strongly Agree” (7).
Family Medicine - 4 Paediatrics week, 2 week in London, Windsor, Windsor or London Rural Psychiatry - London, Ob/Gyn - Windsor, Windsor, and Rural London (SJHC, Medicine - CTU VIC), Rural (UH, VIC, ACE, Surgery - General, Windsor), Elder Emergency, Care, Oncology, Optho/ENT, Anaesthesia, Selective (all W & L) Selective (all W & L)
Detailed Results Available!
Presentation will focus on results relevant to all rotations, as well as results specific for mandatory rotations. Please consult distributed document for results for selective rotations. Detailed numerical ratings and respondent comments available to rotation directors upon request. Contact: Michael Zettler email@example.com or via your own student representatives.
Results - Response Rate
Results compiled with 5 of 8 blocks completed. Approximately 90 students finished each mandatory rotation. Response rate for mandatory rotations range from 23% (Emergency Med) to 41% (Psychiatry). Most have approx. 33%. Smaller number of responses and uncertain proportions for selective rotations. Difficulties: “busy clerk” mentality, separate survey system not otherwise used, not mandatory
Results - General Comments
Medical students value a defined and practical role during their rotations Independence in assessing patients and making management plans is commonly cited in positive comments Organization and scheduling known well ahead of time relieves student anxiety. Providing opportunities to learn procedural skills is highly valued on rotations where this is possible. Well planned and carried-out formal teaching is extremely helpful. Consultants and residents who take the time to do informal teaching are wellliked.
Results - General Comments
Medical students do not value being a passive observer at this stage of their training. – Formal teaching must be balanced between different sites, and evaluation methods in-line with the teaching. – Disorganized scheduling on some rotations detracts from the learning experience. – Though rare, having a consultant or resident that does not value teaching medical students makes for a poor experience.
Results - Family Medicine
Many positive comments about individual preceptors and their interaction with medical students. Variety of practice environments, skills performed, and patients seen is highly valued. Independence to assess patients and plan management is a strong positive attribute.
Daytime and on-call scheduling not well communicated on some rural rotations; this is likely preceptor-specific. Clinical cards and on-line cases not reviewed highly as learning tools. A small number of preceptors may not be aware of the role of the medical student and appropriate rotation objectives.
Results - Psychiatry
On-Call shifts at Victoria ER and in Windsor were valued highly by students; primary reasons cited were undifferentiated problems and teaching by residents. The opportunity to see a variety of patients and pathology was important to many students. Both formal and informal teaching by residents was appreciated by students. A few consultants were nominated for ‘best teacher’ multiple times: Drs. Robinson, Lefcoe, Velehorschi.
Lack of on-call experience in rural rotations Discrepancy in level of independence granted to medical students; more in Windsor and rural rotations, less in London. Child Psychiatry was felt to be inadequate, particularly in places where students only observed interviews. Windsor teaching sessions felt to be less organized and disjointed from London (on which the exam was based?).
Results - Medicine CTU
Medical students enjoyed the experience of working a member of a team. Level of independence to see consultations and care for patients was rated highly. Formal and informal teaching sessions were appreciated by students, with some exceptions (see below). Drs. Larocque, Rehman, and Saad received multiple nominations for ‘best teacher’.
Students felt they did not get enough experience with procedures, either observing or actively involved. Seemingly, there are a small number of consultants who did very little teaching with their team, or had limited involvement generally. While most comments about residents were positive, there were a small number of very concerning complaints.
Results - Paediatrics
Drs. Killorn, McNeill, Awuku received multiple nominations for ‘best teacher’. Paediatric Emergency was the subject of many positive comments, particularly because of the variety of patients. Variety of patients was appreciated at all sites. Formal and informal teaching, especially by residents, was rated highly. Windsor morning teaching sessions were rated highly
CLIPP cases were rated fairly evenly across the spectrum from very helpful to not at all helpful. Students felt there could have been more teaching sessions, especially in light of frequent cancellations. Students in London made several requests for a community paediatric placement. Students in Windsor felt that the videoconferenced teaching from London did not add to their own teaching sessions.
Results - Obs & Gyn
Students spoke highly of the “hands-on” experience available at most sites, but particularly Windsor and rural rotations. Numerous positive comments about physicians at all sites. Variety of Ob/Gyn practice was a positive.
Concerns raised about the St. Joseph’s site: limited clinical experience with general gynaecology, limited “hands-on” experience due to large number of learners, not being involved for deliveries. Students commented that the teaching received did not fit well with the NBME exam evaluation.
Results - General Surgery
Medical students enjoyed the experience of working as member of a team. Level of independence to see consultations and care for patients was rated highly. “Hands-on” experience in the OR is highly valued by many students. Windsor students commented on the flexibility of their experience; able to see a variety of problems with different consultants. Formal teaching sessions were rated highly.
Some students commented on a paucity of informal teaching; this seems to be resident and consultant-dependent. There were discrepancies between the formal teaching received in London and Windsor. Student commented on an expectation to stay well past noon, or for a full day, when post-call. One student said “it was made to seem as though you were disinterested or uncommitted to learning if you didn't stay as long as possible.”
Results - Emergency Medicine
Variety of patient encounters and problems dealt with was a big strength Amount of independence given to students in patient assessment Informal teaching from a number of consultants was highly rated.
Scheduling shifts further in advance would be appreciated by many students There seems to be a small number of preceptors not interested in having students. Students question the validity of being evaluated each shift by a different preceptor.
Results - Oncology
Clinical experiences were valued by students Those able to see a variety of problems appreciated it.
Students felt there was too much time for studying and presentation preparation, at the expense of clinical experience. Students questioned the value of the exam as an evaluation tool.
Discussion of Results
Well-rated rotations provide:
– – – – –
Independence to care for patients Role as a team member where possible Well organized, with schedules known in advance Opportunity for technical skills where possible Enthusiatic and appropriate formal & informal teaching
Discussion of Results
Areas for Improvement
Some rotations do not do a good job at providing an appropriate role for students. – Formal teaching must be coordinated between different sites, and evaluation methods in-line with the teaching. – Disorganized scheduling or lack of communication detracts from the learning experience. – Educate consultants and residents regarding appropriate roles for clerks, how they can improve their experience. – Need to identify rare instances of inappropriate conduct and redress situation.
Future Directions for BCOE
Curriculum evaluation done via Schulich administration. Duplication of some information between Admin. & BCOE Importance of student-run feedback channel. Comments most important? Needs of students and rotation directors?