1. Developing a Formalized Application Process For Pre-medical Student Shadowing Hobart Lee, M.D. Academic Fellow Clinical Lecturer Department of Family Medicine University of Michigan Kent J. Sheets, Ph.D. Professor of Family Medicine Professor of Medical Education University of Michigan

2. Introduction Problem Background Visiting Observer Checklist Collaboration Application Debriefing & Feedback

3. The Problem Family Physicians feel the moral obligation to give back and encourage the next generation of physicians We are great physicians for undergraduates to shadow U of Michigan Family Medicine: 60+ physicians over 5 clinic sites who receive individual requests (e.g. your neighbor’s daughter who is interested in medicine) Triage and create a standard process

4. Background First year medical students benefited from observing third year medical students, including “the practice of medicine, the process of becoming a doctor, providers of health care, the nature of real patients, and the procedures of medicine” –Alford CL et al. Introducing first-year medical students to clinical practice by having them “shadow” third-year clerks. Teach Learn Med 2004 Summer; 16(3):260-3 Direct relationship between the number of “shadowing” events and overall rating of their experiences –Black MG et al. Providing Clinical Experience to First-year Students. Academic Medicine 1993; 68(8):613-4

5. Visiting Observer Checklist Written approval of the hosting department or Chief of Staff Visiting Observer ID badge Immunizations –MMR, Varicella, Hep B, TB Code of Conduct Statement and Certification HIPAA

6. Code of Conduct Statement and Certification Knowledge, understanding, and compliance with the policies and procedures Avoid fraud, waste, and abuse Protecting the confidentiality and security of information Disclosing actual and potential conflicts of interest or commitment and complying with any plans imposed to manage those conflicts Agree to treat all hospital personnel with respect, courtesy, and dignity Understand that noncompliance is subject to immediate disciplinary or corrective action Immediately report suspected noncompliance

7. HIPAA University of Michigan Health System HIPAA basic training –Includes FAQ section –Printable PDF certificate

8. Collaboration University of Michigan Health System Volunteer Services Pre-medical associations/clubs (3+) –Alpha Epsilon Delta Pre-Health Honor Society –Pre-medical Club Medical School

9. The Application Demographic, contact information, and available dates Involvement in pre-medical student association or hospital volunteer? Why are you interested in becoming a physician? What do you hope to gain from shadowing a physician?

10. Where to shadow? Outpatient clinic Inpatient medicine/pediatrics/obstetrics Nursing home/Home visits Sports Medicine game coverage Other ideas ???

11. Who to work with? Residents vs. Attendings Residents are used to having people shadow them (medical students) Undergraduates students learn from the precepting/rounds model No issues with attending educational reimbursement

12. Remember they are undergrads … Proper Dress Transportation Issues Showing up on time Cancellation policy

13. Debriefing & Feedback Undergraduates Average Rating: 6.67 (Likert scale 1-7) “Participating in the Family Medicine Pilot Program has sparked my interest in primary care.” “I was personally very impressed with how the senior resident, first-year resident, medical student, and attending openly communicated about each patient … I realize that this communication system between on- call physicians is quite common in many hospital systems, but it was inspiring to see the action behind the scenes for the first time … observing “rounds” was a highlight from the shadowing experience.” Residents/Attendings Average Rating: 5 (Likert scale 1-7) “The student seemed very interested and I enjoyed providing the opportunity to be exposed to family medicine and our love for the work we do.” “I was contacted by multiple concerned staff that were unaware of the student coming. HIPPA forms, clinic policies, etc seemed to have been a problem. The student felt uncomfortable about this.”

14. Questions?