1. If it Ain’t Broke, Don’t Fix it: How does a Junior Faculty Member Know When and How to Update a Clerkship? Katherine P. Land, MPH Marisyl D. de la Cruz, MD Sidney Kimmel Medical College at Thomas Jefferson University

2. Disclosures None

3. Learning Objectives 1.Describe the strategy by which a junior faculty member and coordinator have updated an existing clerkship within an established department 2.Identify successful strategies and potential roadblocks to updating a clerkship 3.Develop an approach to assess and update the clerkship in one’s own institution 4.Demonstrate the value of interprofessional collaboration to enhance a clerkship

4. Overview Jefferson clerkship overview Why make changes? How did we do it? Major clerkship revisions Lessons learned Discussion

5. Jefferson Clerkship Six week clerkship Students rotate at Jefferson and/or affiliate –10 affiliates –Each has its own site director Clerkship is primarily outpatient All locations offer community experiences (e.g., nursing home visits, homeless care, hospice) EBM and OSCE on last Thursday of block Ungraded, but low performing students are reviewed Shelf exam on last Friday of block

6. Why? Rationale for updates Summary of evaluations

9. Positive Significant contact with residents and attendings Diversity of patients Residents and attendings enjoy teaching Negative Fewer assignments (“busy work”) More guidance on the shelf exam EBM project considered redundant (also do on IM) Summary of evaluations

10. Requirements Clinical evaluations EBM Project PELS Patient-Centered Medical Home assignment Preventive Medicine chart review fmCases Medical Letter exercise End of Clerkship OSCE Shelf exam Bedside observation form

11. Process Incorporate students into the update process –Two 3 rd year student liaisons who worked with coordinator and ACD

12. Major revisions to clerkship Clerkship Assignments Evaluation Shelf preparation

13. Examples of changes Clerkship -OSCE cases update -Focus Group -Orientation lecture Assignments -Reviewed for redundancies -Changed format for EBM project Shelf prep -Update list of resources -Interactive prep/study session Evaluation -4 th year feedback on faculty compiled online -Review of 2013-14 3 rd year comments -Feedback training/faculty development Miscellaneous --Blockwide packet

14. One example – EBM Project Before: Only group project Blog/wiki with posting deadlines PPT presentation on 2 nd to last day of clerkship After: Individual/group option Eliminated wiki, blog Eliminated group presentation Written report on articles (4 – individual, 6 – group)

15. Lessons Learned Interdisciplinary process is helpful, particularly with student feedback –Emphasize open (non-punitive) collaboration Share changes with other clerkships Good communication is key Continue periodic evaluation and reassessment

16. Discussion – 15 min What are other examples of improvement in your own clerkship? What are changes you would like to make in the future? What are challenges to implementing changes in your department/institution? How has your school overcome these barriers?

18. Contact info: Marisyl de la Cruz MariaSyl.delaCruz@jefferson.edu

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