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Whole Campus Implementation of 3-Year Curriculum Medical College of Wisconsin Lisa Grill Dodson, MD, Matthew Hunsaker, MD, FAAFP, Regional Campus Team Program Overview The Medical College of regional campuses employ the following medical education innovations: Whole campus implementation of three- year curriculum Community-engaged admissions process Integrated science and clinical learning Scholarly projects addressing local needs Longitudinal clinical experiences (MCW- Central Wisconsin) Employing a community-engaged model, the regional campuses will prepare future physicians to work in primary care, general surgery, and psychiatry. This initiative aims to secure healthcare for patients and families and address a forecasted shortage by preparing a physician workforce with an intimate understanding of regional needs. MCW regional campuses employ a three- year, immersive curriculum that utilizes local physicians as faculty. By removing vacation months and subspecialty elective time, MCW’s accelerated medical education program affords the opportunity for talented and motivated students to complete the same required coursework as their Milwaukee campus counterparts in 134 weeks instead of 154. Should their career interest require it, the regional campuses offer the opportunity for students to extend their curriculum to accommodate desired elective rotations. Advice for Other Institutions Explain program in number of weeks comparison (134 weeks vs. 152 weeks) rather than three years vs. four years. Anticipate misunderstanding and resistance, and expect to need to do a lot of faculty development regarding accelerated curricula. FAQ’s and 1-2 page White Papers work well for busy faculty. Prepare students to expect and be able to handle naysayers. Longitudinal integrated clerkships are labor intensive, but well-suited to an accelerated model. Program Curriculum: Two Campuses, Two Different Clinical Learning Models Program Contacts: Founding Campus Deans MCW-Central Wisconsin: Lisa Grill Dodson, MD, [email protected] http://www.mcw.edu/Medical-School/Central-Wisconsin-Campus.htm MCW-Green Bay: Matthew Hunsaker, MD, [email protected] http://www.mcw.edu/Medical-School/Home/Admissions/Green-Bay-Campus.htm Program Status & Accomplishments (as of July 2017) First whole campus implementation of three-year curriculum in the U.S. MCW-Green Bay is fully enrolled with three classes. (80 medical students total) MCW-Central Wisconsin has matriculated the first two classes (50 students total) and will achieve full enrollment in July 2018. First students will graduate with MD in June 2018 (MCW-Green Bay) and June 2019 (MCW-Central Wisconsin). 100% of rising M3s at MCW-Green Bay passed the USMLE Step 1 in 2017 on the first attempt. $10.6 million in philanthropic gifts to regional campuses for launch and scholarships. Over 85% of regional campus medical students are from the state of Wisconsin. 250+ regional physicians are teaching or have expressed interest in teaching medical students. Basic Science Foundations MCW regional campus medical students complete basic science coursework together with their four-year counterparts at MCW-Milwaukee, including all the same assessments on the same timeline. In addition, regional campus students have basic science concepts reinforced by real world patient care in early clinical experiences during the M1 and M2 years. Early Clinical Experience The blending of basic science with clinical learning is a hallmark of MCW’s three-year program. Medical students begin their education by completing Foundations of Clinical Medicine, a course teaching basic history taking and physical examination skills. Completion of this course prepares students to participate in a half-day per week clinical apprenticeship throughout the M1 year. This apprenticeship, as well as the clinically-oriented Continuous Professional Development (CPD) course, assures readiness for clerkship rotations. Community Scholarly Projects During the Scholarly Pathways course, MCW-Green Bay medical students complete Community- Oriented Primary Care (COPC) projects in conjunction with local organizations and non-profits. This process promotes public health while linking students’ medical education with both the resources of our clinical partners and the needs of local communities. Regional Campus Photos Community Engagement Integrated Clerkships

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Page 1: Medical College of Wisconsin - NYU Langone Health · Early Clinical Experience The blending of basic science with clinical learning is a hallmark of MCW’s three-year program. Medical

WholeCampusImplementationof3-YearCurriculumMedicalCollegeofWisconsinLisaGrillDodson,MD,MatthewHunsaker,MD,FAAFP,RegionalCampusTeam

ProgramOverviewTheMedicalCollegeofregionalcampusesemploythefollowingmedicaleducationinnovations:

• Wholecampusimplementationofthree-yearcurriculum

• Community-engagedadmissionsprocess• Integratedscienceandclinicallearning• Scholarlyprojectsaddressinglocalneeds• Longitudinalclinicalexperiences(MCW-

CentralWisconsin)

Employingacommunity-engagedmodel,theregionalcampuseswillpreparefuturephysicianstoworkinprimarycare,generalsurgery,andpsychiatry.Thisinitiativeaimstosecurehealthcareforpatientsandfamiliesandaddressaforecastedshortagebypreparingaphysicianworkforcewithanintimateunderstandingofregionalneeds.

MCWregionalcampusesemployathree-year,immersivecurriculumthatutilizeslocalphysiciansasfaculty.Byremovingvacationmonthsandsubspecialtyelectivetime,MCW’sacceleratedmedicaleducationprogramaffordstheopportunityfortalentedandmotivatedstudentstocompletethesamerequiredcourseworkastheirMilwaukeecampuscounterpartsin134weeksinsteadof154.Shouldtheircareerinterestrequireit,theregionalcampusesoffertheopportunityforstudentstoextendtheircurriculumtoaccommodatedesiredelectiverotations.

AdviceforOtherInstitutions• Explainprograminnumberofweekscomparison(134weeksvs.152weeks)ratherthan

threeyearsvs.fouryears.• Anticipatemisunderstandingandresistance,andexpecttoneedtodoalotoffaculty

developmentregardingacceleratedcurricula. FAQ’sand1-2pageWhitePapersworkwellforbusyfaculty.

• Preparestudentstoexpectandbeabletohandlenaysayers.• Longitudinalintegratedclerkshipsarelaborintensive,butwell-suitedtoanaccelerated

model.

ProgramCurriculum:TwoCampuses,TwoDifferentClinicalLearningModels

ProgramContacts:FoundingCampusDeansMCW-CentralWisconsin:LisaGrillDodson,MD,[email protected]://www.mcw.edu/Medical-School/Central-Wisconsin-Campus.htmMCW-GreenBay:MatthewHunsaker,MD,[email protected]://www.mcw.edu/Medical-School/Home/Admissions/Green-Bay-Campus.htm

ProgramStatus&Accomplishments(asofJuly2017)• Firstwholecampusimplementationofthree-yearcurriculumintheU.S.• MCW-GreenBayisfullyenrolledwiththreeclasses.(80medicalstudentstotal)• MCW-CentralWisconsinhasmatriculatedthefirsttwoclasses(50studentstotal)and

willachievefullenrollmentinJuly2018.• FirststudentswillgraduatewithMDinJune2018(MCW-GreenBay)andJune2019

(MCW-CentralWisconsin).• 100%ofrisingM3satMCW-GreenBaypassedtheUSMLEStep1in2017onthefirst

attempt.• $10.6millioninphilanthropicgiftstoregionalcampusesforlaunchandscholarships.• Over85%ofregionalcampusmedicalstudentsarefromthestateofWisconsin.• 250+regionalphysiciansareteachingorhaveexpressedinterestinteachingmedical

students.

BasicScienceFoundationsMCWregionalcampusmedicalstudentscompletebasicsciencecourseworktogetherwiththeirfour-yearcounterpartsatMCW-Milwaukee,includingallthesameassessmentsonthesametimeline.Inaddition,regionalcampusstudentshavebasicscienceconceptsreinforcedbyrealworldpatientcareinearlyclinicalexperiencesduringtheM1andM2years.

EarlyClinicalExperienceTheblendingofbasicsciencewithclinicallearningisahallmarkofMCW’sthree-yearprogram.MedicalstudentsbegintheireducationbycompletingFoundationsofClinicalMedicine,acourseteachingbasichistorytakingandphysicalexaminationskills.Completionofthiscoursepreparesstudentstoparticipateinahalf-dayperweekclinicalapprenticeshipthroughouttheM1year.Thisapprenticeship,aswellastheclinically-orientedContinuousProfessionalDevelopment(CPD)course,assuresreadinessforclerkshiprotations.

CommunityScholarlyProjectsDuringtheScholarlyPathwayscourse,MCW-GreenBaymedicalstudentscompleteCommunity-OrientedPrimaryCare(COPC)projectsinconjunctionwithlocalorganizationsandnon-profits.Thisprocesspromotespublichealthwhilelinkingstudents’medicaleducationwithboththeresourcesofourclinicalpartnersandtheneedsoflocalcommunities.

RegionalCampusPhotos

CommunityEngagement

IntegratedClerkships

Page 2: Medical College of Wisconsin - NYU Langone Health · Early Clinical Experience The blending of basic science with clinical learning is a hallmark of MCW’s three-year program. Medical

MCW-CentralWisconsinCurriculumLongitudinalIntegratedClerkships

MCW-GreenBayCurriculumModifiedBlockClerkships

IntegratedClerkships

Page 3: Medical College of Wisconsin - NYU Langone Health · Early Clinical Experience The blending of basic science with clinical learning is a hallmark of MCW’s three-year program. Medical

HealthProfessional&PsychiatryShortagesinWisconsin

By2030,ashortfallof2,000doctorswillseverelylimithealthcareaccessthroughoutthestate,particularlyinruralareasandunderservedpopulations.

TheMCWregionalcampuseswillemphasizepreparingstudentsinterestedinprimarycare&generalsurgery.

(2011,WisconsinHospitalAssociation)

TheMCWregionalcampuseswillemphasizepreparingmedicalstudentsinterestedinpsychiatry.

Newpsychiatryresidencyprogramshavebeencreatedineachregioninordertoattractandretainthestudentsintheregionforgraduatemedicaleducation.

PsychiatryShortagePhysicianShortage

Page 4: Medical College of Wisconsin - NYU Langone Health · Early Clinical Experience The blending of basic science with clinical learning is a hallmark of MCW’s three-year program. Medical

PhysiciansintheCommunityPathwayScholarlyProjectsMCWregionalcampusmedicalstudentsarerequiredtocompletepublichealthscholarlyprojectsinconjunctionwithlocalorganizationsandnon-profits.

Thefocusisoncommunityhealthcareprojectsthatwilladdresslocalhealthconcerns.Localmentorsfromtheparticipatingorganizationsareguidingourstudents,whowillusethesevitallessonsupongraduationwhentheybegintheirpracticeascommunityphysicians.

TheprojectswilllinkeducationwithcommunityneedsandpromotehealthincentralandnorthernWisconsin.

MedicalStudentProjectTitles(MCW-GreenBay,Classof2018)Usingasmartphoneapplication(Fooducate)toimprovenutritionknowledgeanddietarybehaviorsofpediatricpatientsandtheirprimarycaregivers.EffectsofanInterventionTargetingCoreStrengthandGrossMotorSkillsonGrossandFineMotorSkills,PersonalSocialInteractionsandSocial-EmotionalBehaviorPreventativeEducationwithCommunityPartnersMethodsforpreventingburnoutanddevelopingresiliencyinmedicalstudents

ProcessImprovementofPost-PartumDepressionResourcesPatientknowledge:theCorrelationBetweenHypertension,Diabetes,andDentalHygienePrimaryCareInterventioninNortheastWisconsin:ArsenicinWellWaterIncreasingCardiacRehabilitationparticipationforCongestiveHeartFailurePatientsinNortheastWisconsinAdvanceDirectivesinNortheasternWisconsinEffectsofEducationonHypertensionKnowledgeMCW-GreenBaycardiovascularemergencyawarenessandrecognitionproject

IncreasingfollowupdentalcareinlowincomeBrownCountypregnantfemalesAnAssessmentoftheAfterVisitSummary:IsItAnAffectiveMethodofCommunicationBetweenProviderandPatient?BarrierstoHealthyEatingandWellnessinLow-IncomePopulationsandtheImpactoftheWICProgram'sFarmer'sMarketNutritionProgramAnalysisofEmergencyRoomusagebypatientswithnon-emergentfeversinGreenBayIdealformandfunction:AneducationalapproachtonutritionandweightmanagementforhighschoolwrestlersAttitudesandPerceptionsofDomesticViolenceamongyoungHmongadultsofWisconsin

Page 5: Medical College of Wisconsin - NYU Langone Health · Early Clinical Experience The blending of basic science with clinical learning is a hallmark of MCW’s three-year program. Medical

CommunityEngagementatMCWRegionalCampuses

Theregionalcampusesareacollaborativeeffortengagingareacivic,academic,healthcare,andcommunitypartners.Fromadmissionstoclinicallearning,communitymembersworkcloselywithourstudents,staffandfacultytoaligntheregionalcampusmissiontolocalopportunitiesandneeds.

Asshowninthestart-upfundingchartbelow,philanthropicsupportfromthelocalcommunitiesiscriticaltoregionalcampussuccess.

• CommunityAdvisoryBoards:Drawnfromeachcommunity,theBoardincludesourhealthcareandeducationpartners,MCWalumni,localcivicandlocalgovernmentleaders,andcommunityrepresentatives.

• RegionalApplicantAdvisoryCommittee:CommunitymembersaretrainedbytheMCWAdmissionsCommittee.ThesededicatedvolunteersscreenandinterviewapplicantsandproviderecommendationsofsuitabilityforthecampustotheAdmissionscommittee.TheMCWAdmissionsCommitteereviewsallapplicantsandextendsalloffers.

• Faculty:Collaborationwithphysiciansandseniorsciencefacultyfromeducationalpartnersisacriticalcomponenttothesuccessofthiscollaborativemodel.MCWhasdevelopedfacultyfromexistingmedicalpracticesintheregion.

• PhysiciansintheCommunityPathwaysPartners:Studentspartnerwithcommunityhealthorhealthcareorganizationstocompletearesearchprojectinthecommunity.

• StandardizedPatients:Adiversecadreofcommunitymembersaretrainedtoroleplayduringstudentclinicallearningandexamssothatstudentscanlearnexcellentpatientinteractionskills.Standardizedtrainingensuresacomparableexperienceforeachstudentandminimizesvariabilitybetweenpatients.

• Pipelineefforts:Significanteffortisbeingmadetohelplocalhighschoolandbaccalaureatestudentstoconsidermedicineasacareerchoiceandtoimprovetheirpreparationforfuturemedicalschoolattendance.Earlyoutcomesshowaregion-wideincreaseinapplicationandmatriculationtomedicalschoolsinadditiontotheregionalcampuscohorts.

• Philanthropy:PhilanthropicsupportiscriticaltoMCWsuccessoflaunchingtheregionalcampuses.Thecampaigngoalistoraise$15milliontosupportlaunch.TheGreenBayPackersFoundationmatchedscholarshipgiftsforMCW-GreenBaymedicalstudents,whichledto$800,000+designatedforthecampusin18months.

• MarquetteMedicalSchool/MCWAlumni:Alumniareengagingsignificantlywiththeregionalcampusestoteach,volunteer,andcontributephilanthropically.

MCWRegionalCampuses

CommunityAdvisoryBoards Regional

ApplicantAdvisory

Committee

LocalPhysicianFaculty

ScholarlyPartners

CommunityCollaborators

Philanthropy

StandardizedPatients

Alumni

Page 6: Medical College of Wisconsin - NYU Langone Health · Early Clinical Experience The blending of basic science with clinical learning is a hallmark of MCW’s three-year program. Medical

WhatisaLongitudinalIntegratedClerkship?Longitudinalintegratedclerkships(LICs)havethefollowingcommoncoreelements:

•Medicalstudentsparticipateinthecomprehensivecareofpatientsovertime•Medicalstudentshavecontinuinglearningrelationshipswiththesepatient'sclinicians•Medicalstudentsmeet,throughtheseexperiences,themajorityoftheyear'scoreclinicalcompetenciesacrossmultipledisciplinessimultaneously

CommunityFaculty

Expectations

PatientPanelCohortsRequirements

WhyisMCW-CentralWisconsindevelopingCWIC?•AnewcampusprovidesopportunitytodifferentiateMCW'scurriculum•ALongitudinalIntegratedClerkshipmeetsneedsofMCW-CentralWisconsineducationalpartners,andcreatesanadditionaloptionforMCW,andstudents•ALongitudinalIntegratedClerkshipincreaseslearningflexibility•LongitudinalIntegratedCurriculautilizeadditionaladultlearningandworkplacelearningmodels•ThelargegeographicareacoveredbytheMCW-CentralWisconsincampusislessamenabletomovingstudentsaroundonblockrotationsthanplacingtheminlongitudinalexperiences

IntegratedClerkships(CWIC)

Page 7: Medical College of Wisconsin - NYU Langone Health · Early Clinical Experience The blending of basic science with clinical learning is a hallmark of MCW’s three-year program. Medical

IntegratedClerkshipSession1Requirements

Administrative:SitecoordinatorLeadfacultypreceptorforsiteOneormorefacultywithMCWappointmentsin:

FamilymedicineMedicineSurgeryPediatricsOB/GYNAnesthesia

Academicschedule:CWIC1beginsnoearlierthan Tuesday,May30,2017CWIC1beginsnolaterthanMonday,June5,2017CWIC1endsonTuesday,August8,2017FinalevaluationsduenolaterthanFriday,September1Amaximumofoneweekvacationtime(includingbothweekends)maybetakenduringtheclerkshipClinicalreleasedates:

Wednesdayafternoons(1-5pm)fordidacticsMonday,May29(MemorialDay)Friday,June23(Exam),studentsshouldnotbeoncallthenightofJune22.Tuesday,July4(IndependenceDayholiday)Friday,July14(ExamandWhiteCoatCeremony),studentsshouldnotbeoncallthenightofJuly13.Thursday,July27– SaturdayJuly29(AAFPResidentandStudentConference)—forapprovedstudents

OtherlogisticsCallroomavailabilityforovernightcall(where/whenapplicable)Localhousingoptions(where/whenapplicable)

AcademicRequirementsProvideformativewrittenfeedbackonstudentperformancemonthlyProvidesummativefeedbackincludingnarrativecommentsatendofrotationPromptlynotifyCWICcoordinatoranddirectorofanystudentconcerns(academic,professional,other)

ClinicalrequirementsFM1dayperweekStudentsexpectedtoroundon1-2patientseachmorningwithpreceptorsupervisionPediatrics ½ -1dayperweekSurgery(generalpreferred,butspecialtyok)½-1dayperweek,withexposuretoanesthesiaInternalmedicine(generalpreferred,butspecialtyok) ½- 1dayperweekOB/GYN ½-1dayperweekWewilleventuallyrequiresomeexperienceswithneurologyandpsychiatry,butnotnecessarilythissummer.½daydidactic(Wednesdayafternoons)2halfdaysofclinicalcare“flextime”weekly.Thisistimeforstudentstofollowcontinuitypatients(e.g.homevisit,nursinghomecare,patientfollowupfortests/studies/labs/procedures,oroperatingroomtime.Studentsmayalsopursueotherclinicalexperiences,e.g.lab,pharmacy.ThistimeshouldNOTbeusedforindependentstudy,boardsprep,orothernon-clinicornon-patientcareexperiences.

IntegratedClerkships

Page 8: Medical College of Wisconsin - NYU Langone Health · Early Clinical Experience The blending of basic science with clinical learning is a hallmark of MCW’s three-year program. Medical

Benefits.CentralWisconsinIntegratedClerkship(CWIC)curriculumemphasizescontinuityrelationshipswithpatients,faculty,andcommunities.Thiscanhaveanumberofbenefitsforallparties.Studentsdevelopimprovedskillsandrelationshipbuildingwithpatientsstudentsbecomemoreawareof,andabletomanage,electronichealthrecords,referralnetworksandothersystemcomponentsstudentsbecomeanongoingcomponentofaninter-professionalteamstudentsprovide“valueadded”servicetobothpatientsandpracticesrelatedtoadditionalservicesprovided(suchasacomfortingpatientonconsultationvisits,patienteducation,reduceddegradationofempathyandpatientcenterednessduringmedicaltrainingimprovedpatientsatisfactionandsenseofwell-beingdeeperknowledgeofpatient’sillnessandpsychosocialsituationstudentsneedonlybeorientedonceratherthanrepeatedlythroughouttheyear

DevelopingapatientcohortTheCWICoffersnumerousopportunitiesfordevelopinglongitudinalrelationshipswithpatients.Thiscanbestructuredbypre-assignmentwithpatientsselectedbythepreceptorsorstaff,studentselectionofpatientsmetinvariousclinicalsettings,andpatientrequest.Thereisalsoinformalcontinuitythatoccursbynatureofbeinginthesameclinicalsettingoveranextendedperiodoftime.patientcanbefollowedduringscheduledclinicaltime,duringafter-hoursvisits(EDorurgentcare)oratalternativesettingssuchaslong-termcare,homevisitsandaccompanyingpatientstoconsultationvisits.Atient panelsorcohortsallowstudentstofollowpatientsovertimeandthroughmultipleepisodesofcareinthevarioussettingsinwhichtheyoccur.Continuityofpatientcarecanbeplanned,orsometimesevolvesmorespontaneouslyduetofrequentvisits.

SizeofCohortCohortsizeswillvarydependingonmanyvariables,butatypicallyrangesfrom20to40patientsoverthecourseoftheyear.Patientsmaybeselectedbasedontheirdiagnosis,theircomplexityofillness,needforcoordinationofcare,studentinterest,patientwillingness,orotherfactors.Patientsmayberecommendedbyphysiciansortheirstaffiftheyattendclinicfrequently,iftheymightbenefitfromextraservicesortime,oriftheyprovideaparticularlyusefullearningopportunity.

ResponsibilitytoCohortPatientsWhilestudentsareexpectedtotakeanappropriatelevelofresponsibilityforallpatientstheyarecaringfor,theymaytakeonadditionalresponsibilitiesforcohortorcontinuitypanelpatients.Studentsshouldattempttobeavailableforpatientencountersacrossthevarioussettingsinwhichapatientmightbeseen.Thiscouldincludeprimarycareclinic,specialtyconsultationvisits,surgicalcare,homevisits,emergencydepartmentorotherafter-hourscare,anddiagnosticvisits.Whileastudentmaynotbeavailableforeveryencounter,itishopedthatthestudentwillbeinvolvedwithpatientscareacrossmultiplesettingsovertime.

ChallengestoPatientContinuityWhilecontinuityisencouraged,patientsandstudentsshouldbegiventheopportunitytooptoutofacontinuityrelationshipsduringtheyear.Forformalcontinuityrelationships,asignedconsentformisadvisable.Schedulingappointmentscanbechallenging,butattemptsshouldbemadetoinvolvethestudentinasmanyaspectsofthepatientscareaspossible.Studentscanutilizeflextimeormakespecificarrangementswithpreceptorstoallowinvolvementacrossdifferentsettings.Patientscanbeencouragedtonotifystudentswhentheyhaveencounterswiththesystem,bothscheduledandunscheduled.Whereverpossibletechnologycanbeusedtonotifyautomaticallynotifystudentswhentheircohortpatientspresentforcare.StudentscanalsoutilizeEHRtocommunicatewithpatientsfornon-face-to-facecontinuity.Studentsshouldbeinencouragedandinstructedinmaintainingprofessionalboundarieswithpatients.AttentionshouldalsobepaidtoclosureoftherelationshipatthecompletionofCWIC

Whotocontact:IfyouhaveanyquestionsregardingCWIC,studentinvolvementwithpatientcareorneedotherinformation,pleasecontact:

JacobPrunuske,[email protected] [email protected] 715870-LisaGrillDodson,[email protected] 715-870-0919

IntegratedClerkships

IntegratedClerkshipPatientCohortPanels

Page 9: Medical College of Wisconsin - NYU Langone Health · Early Clinical Experience The blending of basic science with clinical learning is a hallmark of MCW’s three-year program. Medical

TheCommunityFacultyPreceptorplaysavitalroleintheeducationofMCW-CentralWisconsinstudents.Thepreceptoractsasaclinicalresourcewhilestudentsapplythemedicalknowledgeobtainedduringthedidactictraining.Theleadpreceptormustbeaphysicianandisresponsiblefortheon-sitesupervision,training,assessmentandevaluationofthestudent.Sincestudentsarepreparingtointeractwiththeentirehealthcaresystem,dailyteachingdutiescanbesharedwithotherhealthprofessionals,staff,residents,physicianassistantsornursepractitioners,underthedirectorofthephysicianpreceptor.

StudentScheduleandworkhourrestrictionsStudentsareexpectedtoadheretothePreceptor’sworkschedule.Studentsareexpectedtoworkatthesiteatleast40hoursperweekbutthiscanvarydependingonthesite.Studentsareexpectedtoworknights,weekends,andbeon-callasrequiredandavailableatthesite.Studentsshouldadheretonationalresidentworkhourrestrictions:nomorethan80hoursperweek,andnomorethan30hoursconsecutively,inadditiontootherrestrictions(seeCWIChandbookforadditionaldetails).

DidacticeducationApproximatelyonehalfdayperweekwillbedevotedtodidacticeducationaltime.Routinepatientcareactivitiesshouldnotbescheduledduringthishalfdayblock.Extraordinaryclinicalexperiencesmaybeabletobeaccommodated,butstudentsshouldnotifyMCW-CWfacultyforapprovaltomissscheduleddidactics.

ClinicalExperienceStudentsshouldspendthemajorityoftheirtimeinvolvedinsupervisedhands-onpatientcareactivities.Seeingthebroadestdiversityofpatientsthatispossibleatthesiteenhancesthelearningexperience,andallstudentsshouldobtainexposuretopatientsacrosstheentirelifespanandscopeofeachspecialty.

ObjectivesStudentsaregivenMCWlearningobjectivesandrequirementstoguidetheirlearningandtofocustheirstudyeffortsforperiodicmedicalknowledgeexams.Studentsarerequiredtodocumentpatientencountersthroughouttheclinicalyear.Weaskthatthepreceptorreviewthelearningobjectivesandrequirements.ThesewillbeprovidedintheCWIChandbook.

SupervisionThepreceptorisresponsiblefortheoverallsupervisionofthestudent’seducationalexperienceattheclinicalsite.Anassignedqualifiedpractitioner(attendingphysician,residentphysician,PA,NP)mustbeonthepremisesandavailableatalltimeswhilethestudentisperformingpatientcaretasks.Studentwillbesupervisedinallhis/heractivitiescommensuratewiththecomplexityofcarebeinggiven,thestudent’sownabilitiesandwithprinciplesofgoodmedicalpractice.

DocumentationStudentdocumentationdoesnotstandalone,andcannotbesimplycountersigned(ie “Ihavereadandagreewithabovenote”isnotallowed).Preceptorsmustprovidetheirowndocumentationandchartingtothelevelrequiredforthebillingcodeselected.StudentsshouldhaveaccesstotheElectronicHealthRecordsystemasallowedbyhealthsystempolicy,butataminimummusthave“readonly”accesstopatientrecords.Ifhealthsystempolicydoesnotallowstudent“write”accesstotheEHR,thepreceptortoshouldassign(andsubsequentlyevaluate)writtennotes,ordersandprescriptionstothestudent.StudentswillalsosubmitsampledocumentationtoMCW-CWcorefacultyforperiodicreview.

AssignmentofActivitiesStudentsshallbedirectlyinvolvedintheevaluationandmanagementofpatientsbasedontheclinicalpreceptor’spreference andtheindividualstudent’sskillandknowledgelevel.Patientencountervolumesvarydependingonthespecialty,locationandpractice;however,astudentwilltypicallyseebetween3-10patientsperdayastheprimaryproviderfortheencounterforearlyrotationsand8-15patientsperdaybytheendoftheclinicalyear.Studentsshouldnotbeusedtosubstituteforregularclinicaloradministrativestaff.Thepreceptorshouldassignthestudentstoappropriateclinicalorientedactivities.Thismayincludebutisnotlimitedto:historyandphysicalexamination;admissionanddischargefromhospitalordayfacilities;assistingwithprocedures/surgeries;clinicalorientedpaperwork(reviewingdiagnostictestresultsandconsultationreports,pharmacyrefillrequests,treatmentpriorauthorizations,insurance/specialistreferrals);diagnosisandtreatmentresearch;homeoralternativecaresitevisits;afterhourscall

PresentationPreceptorsshouldhavethestudentpresentpatientsonaregularbasis.

TeachingThePreceptorshouldallowtimeforteachingactivities.Thiscanbeaccomplishedinavarietyofwayssuchasstructuredteachingrounds,chartreviewperiods,readingassignments,hallwayorinformalconsultationsbetweenpatientencountersand/orrecommendingspecificconferences.Itisexpectedthatthepreceptorwillmodel,exposestudentstoandteachinaccordancewithcurrentpracticeguidelinesandtheacceptedstandardsofcare.

StudentEvaluationThepreceptormustobserveandassessthestudentperformingclinicalfunctions,includingphysicalexaminationanddocumentation,onaregularbasisandprovideconstructiveverbalfeedbacktothestudentperiodicallyoverthecourseoftherotation.Thepreceptormayalsobeaskedtogivefeedbackonstudentperformancetofacultymembersduringsitevisits.ThepreceptorwillbeaskedtocompletinganelectronicevaluationofstudentcompetenceandperformanceatintervalsthroughouttheCWICrotationandagain attheendoftherotationusingtheMCW-CWform.Receivinghonestcritiqueandconstructivefeedbackiscriticaltotheacademicandprofessionalprogressionofastudent.

FacultyEvaluationStudentswillprovideperiodicevaluationoftheCommunityFacultyPreceptors,andthatwillbemadeavailableviagroupeddata,untilthereisasufficientnumberofevaluationstoprotectstudentanonymity,andthenindividualdatawillbeprovidedtopreceptors.

IntegratedClerkships

IntegratedClerkshipCommunityFacultyPreceptorResponsibilities

Page 10: Medical College of Wisconsin - NYU Langone Health · Early Clinical Experience The blending of basic science with clinical learning is a hallmark of MCW’s three-year program. Medical

RegionalCampusLeadershipTeams

MCW-GreenBay§ MatthewHunsaker,MD, FAAFP – FoundingCampusDean§ CraigHanke,PhD – AssistantDean,Basic Science§ MichaelMedich,MD– AssistantDean,ClinicalLearning§ SunnyDebelak– CampusAdministrator

CollaboratingPartnersBellinCollegeBellinHealthHospitalSistersHealthSystem– EasternWisconsinDivisionPreveaHealthMiloC.Huemphner VAOutpatientClinicNortheastWisconsinTechnicalCollegeSt.NorbertCollegeUniversityofWisconsin-GreenBay

MCW-Central Wisconsin§ LisaGrillDodson,MD – FoundingCampusDean§ RoyLong,PhD– AssistantDean,Basic Science§ JacobPrunuske,MD– AssistantDean,ClinicalLearning§ TheresaGutsch– CampusAdministrator

CollaboratingPartnersAscensionHealthcareAspirus,Inc.NorthcentralTechnicalCollegeUniversityofWisconsin-MarathonCountyUniversityofWisconsin-Marshfield/WoodCountyUniversityofWisconsin-StevensPoint

Page 11: Medical College of Wisconsin - NYU Langone Health · Early Clinical Experience The blending of basic science with clinical learning is a hallmark of MCW’s three-year program. Medical

RegionalCampusPhotos:CommunityEngagement,Technology,andEarly

ClinicalLearning