Senior Elective

SENIOR ELECTIVE COURSE SYLLABUS
UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES COLLEGE OF MEDICINE

Course Number: LPEDI
Course Title: ICM I Preceptorship
Duration: August 2002 - April 2003

Course Director:

C. James Graham, MD
Course Director, ICM I
Associate Prof., Ped. Emergency Medicine
Associate Dir., Ped. Emergency Department
Office at Arkansas Children’s Hospital
E-mail GrahamJames@uams.edu
Telephone 320-1051
Pager 891-4285

COURSE DESCRIPTION

The word "doctor" is derived from the Latin, docco, which means "to teach." This elective provides an opportunity for the senior student to develop leadership and teaching skills by precepting first-year medical students in the Introduction to Clinical Medicine I course.

Each senior student will be paired with a clinical faculty member to facilitate a group of 8 to 10 freshman students. The group sessions focus on basic history taking and physical examination skills. Preparation time will be required for critiquing student write-ups, responding to e-mail journals, reading course materials, and planning sessions with the co-preceptor.

Students will spend approximately 148 hours to earn 4 credit hours, including:

• 32 hours attending 16 faculty and small group meetings
• 4 hours/session for preparation, critiquing student write-ups
• 1 hour per week responding to e-mail journals and reviewing assigned readings
• 4 hours for faculty development (including orientation to the preceptor role).

COURSE OBJECTIVES

Through participation in this elective, the senior student will:

1. Expand communication and leadership skills by active participation in small group sessions.

2. Develop teaching skills by observing and coaching students with medical interviewing and physical examination skills practice sessions.

3. Facilitate student learning through the use of effective feedback.

4. Demonstrate professional attributes by serving as a role-model for the student group.

5. Improve teaching skills by participating in faculty development activities.

6. Enhance medical history and physical examination skills by preparing for and participating in small group sessions.

GRADING

Evaluation will be on a "pass"/"fail" basis. There will be no written or oral exams. The purposes of this elective will be achieved through preparation for and completion of the assigned activities.

While attendance and active participation are required, we understand that seniors are sometimes out of town for "away" rotations or residency interviews and therefore may miss an occasional small group meeting. To pass the elective, students must attend faculty orientation (late July or early August) and at least 12 of the 16 small group sessions. Students who can not meet the attendance requirement but who are interested in serving in this role are encouraged to talk to the course directors about serving as a “volunteer” preceptor.

While attendance and active participation are required, we understand that seniors are sometimes out of town for "away" rotations or residency interviews and therefore may miss an occasional small group meeting.

RESPONSIBILITIES

Peer teaching has been recognized as an important part of the medical education experience. It helps the "teacher" to learn the educator role that is an important element of clinical practice, and it facilitates deep learning and reflection by the "learners." As a co-facilitator/small group leader and former student of ICM, you play a vital role in the professional development of our students, serving as a mentor/role model. You have a unique opportunity to positively impact the course by confirming and reinforcing clinical situations described by the clinical faculty, and we value your input. While formalized teaching and mentoring may be new experiences for you, the ICM small groups will be a nice arena for you to try teaching strategies or techniques.

To facilitate your role as a small group leader, a teaching guide will be provided with your course syllabus. You are strongly encouraged to introduce new articles, material, and experiences which you feel will enhance the topics or course. (Introduction of new material should be reviewed with your co-preceptor ahead of time.) If successful, please share ideas with the ICM course directors.

Please consider the following roles and expectations:

1. Attend orientation and faculty development sessions.

2. Contact the attending in your rotation ahead of time, arrange to make up any necessary work. (A letter can be sent from the course directors anytime it would be helpful.)

3. Contact your co-preceptor to arrange for a substitute when you are unavailable to teach a scheduled session and let the ICM office know you will not be present.

4. Prepare for each small group meeting by reviewing the syllabus, assigned readings, and preceptor guide. Meet with your co-preceptor before each session and decide how to share leadership responsibilities for each session.

5. Be well groomed, dress professionally, and wear your white coat to every small group session.

6. Attend the faculty briefings from 2:15-2:30. You must sign in at each of the preceptor sessions so that we will have a record of your attendance.

7. Attend small group sessions from 2:30-4:00 on the following dates:

9. Participate in the Vital Signs Lab/Clinical Skills Center orientation on September 4, 2002 .

10. Critique written assignments and return them to students on a timely basis.

11. Dialogue with students through their weekly e-mail journals.

12. Act as a liaison between students, faculty preceptors, and the ICM staff.

13. Evaluate each medical student in your group via formative (i.e., brief, timely feedback) and summative (i.e., semester evaluations).

14. Help find patients on wards for interviews and physical examinations. (This role is especially helpful to non-physician faculty.)

The seniors in this elective are encouraged to document and disseminate their innovations through presentations at educational meetings and/or submission of manuscripts to medical education journals.

Participants will be asked to complete a faculty evaluation of the ICM I course at the end of the academic year. Students will evaluate their preceptors and individual data will be provided to participants as evidence of their teaching effort. Students are also encouraged to provide timely, ongoing feedback about the elective and the ICM course to the course directors.

RESOURCES

The ICM Office, open from 8:00 a.m. until 4:30 p.m. Monday through Friday, is equipped with the following for your use: a small library of materials (including those recommended in this syllabus), a copy machine, a fax machine (501-686-7564) and telephone (501-686-5800). Clerical assistance (typing, data entry, photocopying, mailing) may be provided with permission of the course director.

Required text for M-1 students:

Swartz MH. (2002). Textbook of physical diagnosis: History & examination (4th ed.). Philadelphia: W. B. Saunders Company.

Required readings (provided by the course directors):

Armstrong JL & Yarbrough SL. (1996). Learning in groups: Exploring fundamental principles, new uses, and emerging opportunities. New directions for adult and continuing education, 71, 33-9.

Barrows HS. (1988). The Tutorial Process (revised edition). Springfield, Illinois: Southern Illinois University School of Medicine, pgs. 21-25.

Sachdeva AK. (1996). Preceptorship, mentorship, and the adult learner in medical and health sciences education. Journal of Cancer Education, 11, 3, 131-6.

Sachdeva AK. (1996). Use of effective feedback to facilitate adult learning. Journal of Cancer Education, 11(2): 106-118.

Pinsky LE, Monson D & Irby DM. (1998) How excellent teachers are made: Reflecting on success to improve teaching. Advances in Health Sciences Education, 3, 207-215.

Steinert Y. (1996). Twelve tips for effective small-group teaching in the health professions. Journals Oxford Ltd., 203-207.

Recommended references (available from the course directors):

Barrows HS. (1987). Simulated (standardized) patients and other human simulations: A comprehensive guide to their training and use in teaching and evaluation. Chapel Hill, NC: Health Sciences Consortium.

Barrows HS. (1988). The Tutorial Process (revised edition). Springfield, Illinois: Southern Illinois University School of Medicine.

Bickley LS. (1999). Bates’ guide to physical examination and history taking. (7^th ed.) Philadelphia: Lippincott.

Billings JA & Stoeckle JD. (1989). The clinical encounter: A guide to the medical interview and case presentation. Chicago: Year Book Medical Publishers, Inc.

Bonner TN. (1995). Becoming a physician: Medical education in Britain, France, Germany, and the United States, 1750-1945. Baltimore: The Johns Hopkins University Press.

Christensen CR, Garvin DA, Sweet A. (1991). Education for judgment: The artistry of discussion leadership. Boston: Harvard Business School Press.

Cole SA & Bird J. (2000). The medical interview: The three-function approach (2^nd ed.). St. Louis: Mosby.

Coulehan JL & Block MR. (2001). The medical interview: Mastering skills for clinical practice (4^th ed.). Philadelphia: F. A. Davis Company.

Davis BG. (1993). Tools for Teaching. San Francisco: Jossey-Bass.

Ficklin FL, Browne VL, Powell RC & Carter JE. (1988). Faculty and house staff members as role models. Journal of Medical Education, 63, 392-6.

Frank D et al. (1996). An integrated curriculum for teaching preparatory clinical skills at a traditional medical school. Teaching and Learning in Medicine, 8, 1, 4-9.

Haist SA, Wilson JF, Brigham NL, Fosson SE & Blue AV. (1998). Comparing fourth-year medical students with faculty in the teaching of physical examination skills to first-year students. Academic Medicine, 73, 198-200.

Haist SA, Wilson JF, Fosson SE & Brigham, N. L. (1997). Are fourth-year medical students effective teachers of the physical examination to first-year medical students? Journal of General Internal Medicine, 12, 177-181.