Important Facts for You to Know
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Clinical rotations for third year medical students begin in March. This means third year students in March will be very new to the clinical environment. It is very important that you take this into account while teaching.
Fourth year elective rotations also begin in March. Advanced Clinical Electives (ACE) have higher expectations of medical students, and are sometimes referred to as acting internships.
Regarding medical students’ use of EPIC:
Medical students can take and enter verbal orders (with the EXCEPTION of medication orders).
Medical students can enter Protocol Orders* in the inpatient and outpatient setting but they must be “pended”.
Medical students may enter Order Sets** but they must be “pended”.
In the outpatient setting, medical students may NOT transmit a verbal prescriptions
* Protocol Order ? An order that contains a specific, established set of actions. Protocol orders are not actionable until signed by an LIP.
** Order Set ? A group or collection of orders. An order set may be used to improve clinician efficiency or to operationalize a clinical pathway, guideline, or protocol. Order sets are not actionable until signed by an LIP.
Please refer to Medical Center Policy No. 0109.
Allowable medical student documentation includes
Documentation of procedures ONLY if the teaching physician is present for the entire procedure. As a supervisor, you must document the procedure and your presence for the entire procedure. You may refer to the medical student’s documentation for further details, e.g. “Present and supervised the entire (procedure name). See medical student’s note for details. (Teaching physician name)”.
However, the medical student’s documentation should be thoroughly reviewed prior to signing.
- Review of systems
- Past family history
- Social history component of evaluation/management
Teaching physicians may use medical student documentation if the documentation is reviewed and either signed by or referred to in the teaching physician’s documentation.
- Non-allowable documentation: Medical students may conduct the following, although their documentation of these is not allowable for billing purposes:
History of present illness
Medical decision-making components of evaluation/management
Please refer to Medical Center Policy No. 0094.
Medical Students use a "note type" in EPIC entitled "student note" that clearly indicates the note was created by a student and its primary function is teaching. The inpatient note is in APSO format, to emphasize assessment and plan. No data are automatically imported into the student note template to emphasize the importance of abstraction, summarization and synthesis.
Medical students are given EPIC training on how to create appropriate student notes. As part of that training students are shown how to route completed notes to their supervising attending physician for review and comments.
First and foremost, focus on the basics with medical students. As students demonstrate their knowledge and ability, proceed to more complex concepts.
Copies of the medical student goals and objectives for each of the medical student clerkships can be found on each clerkship’s web site:
Your department will be offering sessions to teach residents to teach, although the session topics ?will vary from one department to the next. These may be offered as part of a retreat, workshops, conference sessions, or you may be sent to programming developed by your professional organization. Check with your Residency Director or your Residency Coordinator for specific information pertaining to your department.
A variety of programming is also available through the institution, including:
GME Core Lecture Series: This series is offered on a monthly basis and content is focused towards graduate trainees at the University of Virginia. The series addresses a wide range of topics, including both ACGME required topics and other topics of current interest. The lecture series is available to all graduate trainees at the University of Virginia and is regularly attended by residents across many departments. In 2012/2013, two of the sessions specifically addressed "teaching" topics.
UVA Teaching Resource Center (TRC): The TRC offers a number of services and resource materials designed to enhance the teaching abilities and professional development of faculty and teaching assistants at the University of Virginia. See the attached link for a listing of programs that are available throughout the year: http://trc.virginia.edu/
UVA Residents as Teachers This website offers a variety of learning modules, as well as resources and other important reference information.
UVA School of Medicine Excellence in Medical Education Series:The Excellence in Medical Education Series is an optional certificate program offered in collaboration with the Office of Faculty Development, the Office of Medical Education, and the Academy of Distinguished Educators at the University of Virginia School of Medicine. The series topics are wide ranging and address inter-professional education; medical simulation; setting expectations for learners; clinical teaching “on the fly”; effective mentoring relationships; maximizing small group teaching; the struggling learner; among others. Participants who attend 10 workshops over a two-year period will receive a Certificate of Commitment to Faculty Development in Medical Education. This series is also available to graduate trainees.
At minimum, your teaching may be evaluated the following ways:
Personalized evaluation by students you teach through the clerkship evaluation form ? your teaching may be evaluated by the following questions:
- Generalized evaluation of resident teaching for your service through the annual Mulholland Report
- Your teaching may also be evaluated by your Program Director or other faculty in your department
This document provides guidelines for the teacher-learner relationship. It includes basic guiding principles and outlines responsibilities of teachers and learners.
The formal SOM Policy on Student Mistreatment and Other Unacceptable Behaviors is posted in several locations, including the SOM Policy page;
the electronic Student Handbook;
and the webpage of the Medical Student Advocacy Committee (MSAC).
There is also a statement on Personal Relationships between Faculty and Students posted in the (Policies section of the MSAC website), which includes a link to the Provost’s page linking to the UVA Policy on this matter.
Students are introduced to the SOM policies and MSAC procedures during Orientation and again in the Transitions to Clerkship Course.
Every medical school in the U.S. must comply with specific standards in order to receive accreditation. The following (ED-24) is the standard related to residents as teachers:
ED-24 ? At an institution offering a medical education program, residents who supervise or teach medical students and graduate students and postdoctoral fellows in the biomedical sciences who serve as teachers or teaching assistants must be familiar with the educational objectives of the course or clerkship rotation and be prepared for their roles in teaching and assessment.
The minimum expectations for achieving compliance with this standard are that:
- residents and other instructors who do not hold faculty ranks (e.g. graduate students and postdoctoral fellows) receive a copy of the course or clerkship rotation objectives and clear guidance from the course or clerkship rotation director about their roles in teaching and assessing medical students and,
- the institution and/or its relevant departments provide resources (e.g. workshops, resource materials) to enhance the teaching and assessment skills of residents and other non-faculty instructors.
There should be central monitoring of the level of residents’ and other instructors’ participation in activities to enhance their teaching and assessment skills.
There should be formal evaluation of the teaching and assessment skills of residents and other non-faculty instructors, with opportunities provided for remediation if their performance is inadequate. Evaluation methods could include direct observation by faculty, feedback from medical students through course and clerkship rotation evaluations or focus groups, or any other suitable method.