1. Join the conversation! Our Twitter hashtag is MSE12 Experience with fmCASES at University of Oklahoma Rachel Franklin, M.D.

2. Background Public University 2 campuses: Oklahoma City and Tulsa, OK Campuses linked but separately administered (Ed-8 challenge) 160 medical students/year (total) Family Medicine: 4 week required rotation (MS-3)

3. Weekly longitudinal Patient-Based Learning session (PBL) Twice-Weekly PBL sessions on acute/chronic care Online quiz bank of hot topics Dermatology lecture Musculoskeletal lectures (3) and skills session Mid-clerkship feedback Objective Clinical Skills Examination (OSCE) Criterion-referenced in-house written examination Prior Curricular Structure

4. OKC: student feedback Tulsa: faculty shortage Pilot program participant and case author (fmCASES 18: Headache) Proposed structure: – Once-weekly sessions (OKC, Tulsa) – Add Note Writing session (OKC) – Add EKG analysis session (Tulsa) – Keep longitudinal patient case (OKC) Another component needed to ensure Ed-2 (recorded via MedHub) Curricular Challenges

5. First: curricular review: – Can we replace PBL with fmCASES? – Can we maintain faculty feedback/teaching opportunities? 22 cases required – Week 1: Preventive Care and Musculoskeletal Pain (cases 1,2,4,10,11) – Week 2: Chronic Disease and Complications (cases 6,7,8,9,13,18) – Week 3: Assessing Undifferentiated Complaints (cases 3,19,20,21,23,24,26) – Week 4: Reproductive Health and Dermatologic Lesions (cases 14,16,17,27) Integrating fmCASES

6. Weekly longitudinal Patient-Based Learning session (PBL) Weekly fmCASES Quiz and Faculty-led feedback session Dermatology lecture Musculoskeletal lectures (3) and skills session Weekly Progress Note presentation and feedback session Mid-clerkship feedback Objective Clinical Skills Examination (OSCE) Current Structure

7. Weekly quiz review – 10 questions, multiple choice – Worth 2% of final grade each week – Faculty-led feedback session Final exam – 100 questions – fmCASES exam, 4-5 questions per case – Worth 40% of final grade fmCASES-Supported Curriculum

8. Standardized curricular component – Guaranteed remediation of Ed-2 – How we track in MedHub – OB/STD most often not seen in “real” patients Fewer classroom sessions – OKC students happy not to have 2X/week – Tulsa faculty able to cover feedback Improved efficiency of classroom sessions – Added EKG analysis PBL to longitudinal patient – Added Progress Note assignment and feedback sessions Benefits

9. LCME Ed-2 – caution advised! Cases no longer being used as intended – Too much available in PDF files? – Time per case year 1: 20-120 minutes – 5 minute minimum rule for OU – Campus print shop Drawbacks