Curriculum Inventory Developers’ Workshop

Part III: Clerkships, Electives and other Rotations and Tracks

Terri Cameron, MADirector, Curriculum Programs AAMC Summer 2015

Objectives• Discuss the types of data that should be entered for

Clerkships and Electives• Identify sources for gathering Clerkship and Electives

data• Explain options for entering one iteration of a clerkship• Describe how nested sequence blocks might be used in

documentation of Clerkships and Electives• Discuss documentation of tracks in the Curriculum

Inventory• Describe options for entering ‘Colleges,’ ‘Academies,’

‘Bootcamp,’ ‘Sub-Internships,’ and other student/content groupings options

• Explain how Clerkship and Elective data will be documented in ASSET www.aamc.org/cir

Quick Review• Part I

MedBiq CI Specification AAMC Business Rules

• Part II Competencies

• Part III Clerkships, Electives, Selectives, Tracks

www.aamc.org/cir

Quick Review• Sequence Block Metadata

• Title• Academic Level• Timing: Dates / Duration• Expectations• Events

Instructional Methods Assessment Methods Resources

• Nested Sequence Blocks• Integration Blocks

www.aamc.org/cir

Quick Review• Duration

• Event Duration – in hours and minutes PT20H PT1H30M

• Sequence Block Duration – in days (Timing_Duration) P60D P7D 5 days = 1 week (10-week clerkship = 50 days) Clerkships must also specify Timing_Dates (Start and End

dates)― Best Practice: Start and End Dates should be for

duration of all iterations<Dates> <StartDate>2012-07-01</StartDate> <EndDate>2013-06-30</EndDate> </Dates>

Knowledge CheckMatch the commonly used terms on the left with the appropriate Curriculum Inventory terminology on the right.

1. Course a. Integration Block

2. Learning Objective b. Sequence Block

3. Session c. Expectation

4. Theme d. Event

5. Year e. Academic level

www.aamc.org/medaps

Knowledge CheckMatch the commonly used terms on the left with the appropriate Curriculum Inventory terminology on the right.

1. Course a. Integration Block

2. Learning Objective b. Sequence Block

3. Session c. Expectation

4. Theme d. Event

5. Year e. Academic level

www.aamc.org/medaps

Knowledge CheckWhich of the following statements is true?

a) All events and sequence blocks must document duration in hours.

b) The CI will calculate a week as 7 days.

c) Sequence Blocks must be documented with both duration and dates.

d) Clerkships must be documented with both duration and dates.

www.aamc.org/medaps

Knowledge CheckWhich of the following statements is true?

a) All events and sequence blocks must document duration in hours.

b) The CI will calculate a week as 7 days.

c) Sequence Blocks must be documented with both duration and dates.

d) Clerkships must be documented with both duration and dates.

www.aamc.org/medaps

Questions?

Documenting clerkships

Clerkship ‘Iteration’• Should represent core activities that majority of

students are exposed to Select one rotation for upload

– A specific rotation– First, Last

Create an upload version of a rotation Upload all iterations – reporting issues

• May be rotation or integrated

• May cross Academic Level Create Sequence Block in each

Academic Level

Clerkships• What to Document

• Clerkship (Sequence Block) name• All activities

Didactics Conferences (M&M, Tumor Board, X-Ray, etc.) Rounds (Ward, Attending, etc.) In-patient and Out-patient Activities Assessment(s) (for each event and/or for Clerkship)

• How to document <ClerkshipModel>x</ClerkshipModel>

– Where x = integrated or rotation What if the clerkship is both integrated

and a rotation?– Choose integrated: Sequence Block dates

compared to duration shows that clerkship is both integrated and a rotation

www.aamc.org/cir

Sequence Block Nesting

• Sequence blocks can be nested • No restriction on the number of nest levels• Can represent a track or options where

only some of the clerkships or courses are required

• Sequence blocks may be: Required, Optional, Required In Track Ordered, Unordered, Parallel You may require a minimum or

maximum # of nested sequence blocks (selectives)

A

E

BF

I

J

1 2

A

E

BF

I

J

1 2

A

E

BF

I

J

1 2

A

E

BF

I

J

1 2

Knowledge Check• You have 9 Phase 2 clerkships; 5 are required.

They may occur in any order.

• How would we represent that? Required, optional, or required in track? Ordered, unordered, parallel? Minimum? Maximum?

Knowledge Check• You have 9 Phase 2 clerkships; 5 are required.

8 must be taken. They may occur in any order.

• How would we represent that?

Clerkships, required = Required, order = unordered, minimum = 8, maximum = 8

Medicine, required = RequiredDuration – 60 days

Surgery, required = RequiredDuration – 40 days

Pediatrics, required = RequiredDuration – 30 days

OB/Gyn, required = RequiredDuration – 30 days

Neurology, required = Required

Duration – 20 days

Psychiatry, required = OptionalDuration – 20 days

Ambulatory, required = OptionalDuration – 20 days

Anesthesiology, required = OptionalDuration – 20 days

Emergency medicine,

required = OptionalDuration – 20 days

Review• Curriculum Management Systems

• Scheduled activities or ‘Upload Version’ Dates / Duration Instructional methods Assessment methods Resources Objectives (expectations)

• Add the XML Elements Academic Level Calculate duration in days Clerkship Model

Knowledge CheckWhich of the following statements is NOT true?

a) Clerkships are entered as Sequence Blocks.

b) Expectations for Clerkships are referenced at the Sequence Block Level.

c) All rotations of each clerkship should be uploaded.

d) Clerkships are distinguished from other Courses by the use of the Clerkship Model attribute.

www.aamc.org/medaps

Knowledge CheckWhich of the following statements is NOT true?

a) Clerkships are entered as Sequence Blocks.

b) Expectations for Clerkships are referenced at the Sequence Block Level.

c) All rotations of each clerkship should be uploaded.

d) Clerkships are distinguished from other Courses by the use of the Clerkship Model attribute.

www.aamc.org/medaps

Documenting integrated and

longitudinal curricula

Integrated / Longitudinal Clerkships• The Consortium of Longitudinal Integrated

Clerkships (CLIC) states that longitudinal integrated clerkships (LICs) have the following common core elements:

Medical students participate in the comprehensive care of patients over time

Medical students have continuing learning relationships with these patients’ clinicians

Medical students meet, through these experiences, the majority of the year's core clinical competencies across multiple disciplines simultaneously.

Integrated / Longitudinal Clerkships• Multiple options for documenting:

Show as single Sequence Block― Clerkship Model: Integrated

Nested Sequence Block(s)

• Data Requirements/Sources: Same as for discipline-specific clerkships

• Issues: All / most students participate? Separate assessments?

Documenting Electives

What data should be entered?• Best case scenario:

Elective Course (Sequence Block) documentation should include:• All Elective Courses:

Name Instructional Method(s) Assessment Method(s) Objectives (Expectations)

Electives• What to Document

• Electives Program Requirements Use Timing_Dates to show entire time period when electives

are offered Use Expectations to describe expectations of the Overall

Electives Program

• Elective Courses Use Timing_Duration to show number of days for each Elective

(5 days = 1 Week) Use Expectations to describe expectations of the Elective

Course

• Events Each Elective Course must have at least one event

(Instructional Methods, Assessment Methods, Resources, Expectations, etc.)

www.aamc.org/cir

Electives• Options for Uploading

• Best Practice Electives Program Requirements as Sequence Block Elective Courses as Nested Sequence Blocks

• Other Options Elective Courses as individual Sequence Blocks Electives Program Requirements Only

― Use Timing_Dates to show Start and End Dates for entire time period when electives are offered

― Use Expectations to describe expectations of the Electives Program

― Use Description to describe specific requirements (Sub-I, x number of weeks per specialty, etc.)

www.aamc.org/cir

Electives• Data Sources

Curriculum Management Systems– Scheduled activities or ‘Upload Version’

Online Electives Catalogs Evaluation Systems

• Entering data Conversation between curriculum office and vendor /

developer to choose best option– Enter as ‘Representative Data’– Pull one iteration of each scheduled Elective– Other ideas?

www.aamc.org/cir

Selectives• What to Document

• Selectives Course (Sequence Block) Requirements Timing_Dates of the Selective Requirement Expectations of the Selective Requirement

• Selective Courses (Nested Sequence Blocks) Timing_Duration to show number of days for

Selective Courses (5 Days = 1 Week) Expectations of the Selective Courses

• Events Each Sequence Block must have at least one

event (Instructional Methods, Assessment Methods, Resources)

www.aamc.org/cir

Selectives• Options for Uploading (Best Practice)

Selectives Course Requirements as Sequence Block– Use Timing_Dates to show entire time period when

Selective Requirement occurs– Use Expectations to describe expectations of the overall

Selectives Course

Selective Courses as Nested Sequence Blocks– Use Timing_Duration to show number of days for each

Selective Course (5 days = 1 week)– Use Expectations to describe expectations of the specific

Selective Course

Events– Each Sequence Block must have at least one Event

(Instructional Methods, Assessment Methods, Resources)

www.aamc.org/cir

Knowledge Check• You have 8 fourth year sub internships;

1 is required.

• How would we represent that? Required, optional, or required in track? Ordered, unordered, parallel? Minimum? Maximum?

Knowledge Check• You have 8 fourth year sub internships; 1 is

required.

• How would we represent that?

Sub Internships, required = Required, order = parallel, minimum = 1, maximum = 1

Medicine Sub-I, required = OptionalDuration – 20 days

Surgery Sub-I, required = OptionalDuration – 20 days

Pediatrics Sub-I, required = OptionalDuration – 20 days

OB/Gyn Sub-I, required = OptionalDuration – 20 days

Emergency Medicine Sub-I,

required = OptionalDuration – 20 days

Family Medicine Sub-I, required = OptionalDuration – 20 days

Psychiatry Sub-I, required = OptionalDuration – 20 days

Anesthesiology Sub-I, required = OptionalDuration – 20 days

Colleges,’ ‘Academies,’ ‘Bootcamps’

• What to document• Sequence Block for Requirement

Timing_Dates (Entire time period) Expectations

• Nested Sequence Blocks for each Option Timing_Duration (5 Days = 1 Week) Expectations?

• Nested Sequence Block for each ‘Course’ in the Option Expectations Events

o Instructional Methodso Assessment Methodso Resourceso Expectations www.aamc.org/cir

Sequence block, required=Required, order=Parallel, minimum=1, maximum=1

College 1Required=Optional

College 2Required=Optional

College 3Required=Optional

College 4Required=Optional

Colleges,’ ‘Academies,’ ‘Bootcamps’

PBL / TBL / Small Groups• What to Document

• One iteration of each specific session (e.g., by case or content) as Event

• Duration of the specific event for the case or content (in hours) PT20H PT1H30M

• Metadata: Instructional Methods Assessment Methods Resources Expectations

www.aamc.org/cir

PBL / TBL / Small Groups• Options for Uploading

Upload one set of events (one student group) for upload

Create an upload version of a set of events• Issues

“Each student group has different learning issues”

– Same concept as for all teaching sessions – enter faculty objectives for cases/small group discussion

www.aamc.org/cir

Multiple Sites• What to Document

One curriculum per institution‒ LCME: “Show sum of lectures, conferences, and

teaching rounds; range of hours if there is significant variation across sites”

‒ *Include the number of sites used for inpatient teaching and the number of sites used for outpatient teaching in the clerkship in the following format: # inpatient / # outpatient**Sum of lectures, conferences, and teaching rounds; show the range of hours if there is significant variation across sites

www.aamc.org/cir

 Clerkship

 Total wks

 %

Amb.

 # Sites used*

 Typical hrs/wk

formal instruct**

Clinical encountercriteria†

(Y/N)

Patient log

(Y/N)

                                                                                           

Multiple Sites• Options for Uploading

One iteration of each Sequence Block Representative curriculum that most students

experience• Issues?

www.aamc.org/cir

Tracks• What to Document

One curriculum per institution• Options for Uploading

Nested Sequence Blocks Sequence Block for each Academic Level

– Parallel Nested Sequence Blocks for each Track

– Additional Nested Sequence Blocks to enter individual courses for each Track

Representative curriculum that most students experience

• Issues?

www.aamc.org/cir

Regional Campuses• What to Document

One curriculum per institution• Options for Uploading

One campus Representative curriculum that most students

experience• Issues

www.aamc.org/cir

Questions?

Top 10 Questions from CI Implementers Listserv(Find answers in the Listserv Archives)

1. What code should be used for ProgramID?

2. Do schools have to use a Curriculum Management System Vendor to participate in the Curriculum Inventory?

3. Will an error be generated if <CompenencyObjectReference> is in an Event tag when that reference refers to a <CompetencyObject> that has a program-level Category?

4. How many levels are required in a CI data file?

5. Is there a defined set of keywords that must be used in the CI?

Top 10 Questions from CI Implementers Listserv6. How can PBL, TBL, and other small-group, case-based

curricula be entered in a Curriculum Management System so it makes sense in the CI?

7. What is the correct format for event duration and sequence block duration?

8. Is there a rule that states that all competency objects must be referenced by at least one event OR sequence block? That is, is it possible to have competency objects that don't have a competencyobjectreference anywhere?

9. Are instructional methods and assessments methods optional for an event?

10. Is Category under CompetenceObject required, and, if so, are there prescribed categories?

Pearls• A Sequence Block Week is 5 Days

• Clerkships are Sequence Blocks with Clerkship Model (Rotation or Longitudinal)<ClerkshipModel>rotation</ClerkshipModel>

• Check date / duration formats<ReportDate>2011-07-01</ReportDate> <ReportingStartDate>2010-07-01</ReportingStartDate> <ReportingEndDate>2011-06-30</ReportingEndDate>

<EventDuration>PT2H</EventDuration><EventDuration>PT90M</EventDuration><EventDuration>PT1H30M</EventDuration><Duration>P13D</Duration><Duration>P12M</Duration>

Pearls

• Events must have Instructional Method OR Assessment Method(s) OR Both

• Use Instructional Method and Assessment Method UIDs!!!!• <InstructionalMethod primary="true">IM013</InstructionalMethod>• <AssessmentMethod purpose="Summative">AM012</AssessmentMethod>

• Can have multiple Instructional Methods but one must be Primary

• Can have multiple Assessment Methods – no Primary • Must have Duration• Formative / Summative• Assessment Events

• No Instructional Methods

Pearls• Country Code:

• 3-character code (USA, CAN)<a:Country> <a:CountryCode>USA</a:CountryCode> </a:Country>

Pearls• Program Code:

• 2-character code (MD, DO, PA)</Institution> <Program> <ProgramName>M.D.</ProgramName> <ProgramID domain="idd:aamc.org:cip">5678</ProgramID>

• Parallel Tracks• Denote same cohort of students in separate tracks

(should not be used to designate concurrent Academic Levels for multiple cohorts of students)

<ReportID domain="idd:nosuch.edu:cip">12345</ReportID>

<Institution>

<m:InstitutionName>NoSuch University School of Medicine</m:InstitutionName>

<m:InstitutionID domain="idd:aamc.org:institution">987</m:InstitutionID>

<m:Address>

<a:StreetAddressLine>720 Main Street</a:StreetAddressLine>

<a:City>Baltimore</a:City>

<a:StateOrProvince>MD</a:StateOrProvince>

<a:PostalCode>21205</a:PostalCode>

<a:Country>

<a:CountryCode>US</a:CountryCode>

</a:Country>

</m:Address>

</Institution>

<Program>

<ProgramName>M.D.</ProgramName>

<ProgramID domain="idd:aamc.org:program">5678</ProgramID>

</Program>

<Title>NoSuch School of Medicine Curriculum 2010-2011</Title>

<ReportDate>2011-07-01</ReportDate>

<ReportingStartDate>2010-07-01</ReportingStartDate>

<ReportingEndDate>2011-06-30</ReportingEndDate>

<Language>en-us</Language>

<Description>The NoSuch curriculum reframes the context of health and illness to encourage students to explore a larger, integrated system.</Description>

<SupportingLink>http://www.nosuchmedicine.org/crc/</SupportingLink>

Questions?Please use Q & A option to submit questions.

2014-2015 Schedule• Staging available now• School Portal Opens: August 1• School Portal Closes: September 30• Status e-mail sent to CI Primary Admin,

Curriculum Dean, and School Dean: September 30

• Data clean-up/reporting starts: November 1

Resources• Curriculum Inventory Implementers’ Listserv:

http://medbiq.org/mailman/listinfo/ciimplementer_medbiq.org

• Competency Framework Specs and Schemas: http://www.medbiq.org/working_groups/competencies/index.html

• AAMC Curriculum Inventory Developer Resources:https://www.aamc.org/initiatives/cir/about/349624/fordevelopers.html

• Physician Competency Reference Set URIs: https://www.aamc.org/external/348732?url=https://www.mededportal.org/icollaborative/resource/793

• MedBiquitous: www.medbiq.org • Curriculum Inventory Working Group:

http://www.medbiq.org/curriculum_inventory

• Competencies Working Group:http://www.medbiq.org/working_groups/competencies/index.html

• ‘For Developers’ Section of www.aamc.org/cir Sample XML file and Verification Report from UCSF CI XML Template from UVA Slides/Recordings from Past Training Webinars Registration for Parts II and III of 2015 Developer Webinars

www.aamc.org/cir

Questions?List of upcoming Curriculum Inventory Webinars and materials

from today’s session:

www.aamc.org/cir