Professional Documents
Culture Documents
University of Miami
Miller School of Medicine
Class of 2017
Gordon Center for Research in Medical Education Director, Clinical Skills Program
305-243-6491 305-243-6499
of of Medicine Week
Comprehensive Competency Assessment Week
Second-Year MD Student Manual
Purpose
The focus of all the exercises is on the process involved in how you use
knowledge, skills, and attitudes acquired during the second year. Ultimately, it will be
a reflection on how well you have learned to self-direct your learning. It is a
requirement that all students participate successfully in all components of the CCAW
at the end of the first two years. Advancement to the next year in the curriculum is
dependent on having done so. Passing all components of both years will be
necessary in order to begin third-year clerkships. Therefore, for the very few students
who have a truly emergent situation that interferes with completion of all tasks,
make-up sessions must be completed by the Friday before the beginning of the
next year; these must be coordinated through the Deans' Offices.
The complexity of the schedule throughout the week necessitates that you arrive
ahead of time, whenever and wherever you are scheduled. Regrettably, there will be
no opportunity to alter an individual's schedule or reschedule a missed session
once the week has begun. Therefore, it is imperative that you become familiar with
your individual schedule and all of the information in this manual.
The exercises throughout the week are valuable learning opportunities. Adhering to
the utmost professional behavior is critical to making this a productive experience for
everyone involved.
Overview
Orientation to CCAW activities overall will take place April 14, 2015.
Orientation to the Careers in Medicine website, PULSE surveys, and devising the
Personal-Professional Development Plan will take place April 21, 2015.
Deadline
*Please complete your evaluation of the entire week after your individual faculty
advising session. For the majority of the class, this will be on May 1, so please
complete the evaluation immediately afterward, while events of the week are fresh
in your mind. For those who meet their advisor another time and for others who
haven't yet completed the evaluation, the form will remain open online until 5:00 PM
on May 8, 2015.
Because the whole week has been designated an "exam week", there are certain
expectations regarding student behavior:
3. Dress requirements
For all exercises involving “patients” (including standardized patients and other
simulations) – namely, the History-taking and Physical Examination exercises and
Patient Safety activities – it is expected that you will adhere to the Clinical Dress
Code:
• Dress should be professional. You should appear appropriately attired,
clean, and well-groomed, as when you see patients in the hospital,
clinic, or office setting.
• Acceptable clothing includes:
For women: dresses or blouses and skirts or slacks.
For men: shirts, slacks, ties encouraged.
(No one is to wear jeans, shorts, sneakers, or sandals.)
• If your dress is not considered appropriate, you will be given feedback,
to include a possible filing with the Professionalism Incident Reporting
System (PIRS).
For other activities (e.g., computer exams, video review and faculty advisor
sessions, etc.), you may follow usual UMMSM dress code standards.
Components
The student will be given various clinical scenarios and asked to perform
relevant components of the physical examination. The physical examination
exercise will be video-recorded for future review.
The student will elicit a history from the SP and then document the
encounter with a patient note. The SP encounter will also be video-recorded
for later review and feedback in small groups.
One facilitator and 6-8 students will review and provide feedback on SP
encounters, from which each student will select a 5-minute segment of the
video-recording for self-reflection and group discussion. Facilitators will assess
each student.
Components to be completed by the student during the first three or four days
of the week:
PULSE Surveys
N.B.: Students will NOT complete PULSE (Physician Universal
Leadership Skills Education) self and peer surveys during the CCAW
this year. Rather, these will be completed after students take USMLE
Step 1 and return to campus for the Interprofessional Patient Safety
Week prior to beginning third-year clerkships.
Through a series of simulated clinical cases, you will be asked to perform the most
appropriate components of the physical exam on a standardized patient over a 28-
minute period. A faculty member will be present to observe your technique and complete
a form indicating whether or not you performed each aspect of the exam correctly. The
faculty member will provide feedback to you at the end of each clinical case.
In preparation for this exercise, you should utilize information derived from the
Doctoring course clinical skills lectures, small group discussions, and Academic
Society training sessions.
SP History-taking Exercise
These exercises will take place in the morning on Monday, April 27 or Tuesday, April
28 from 8:00AM to 12:00 PM and will last up to 30 minutes (although students
typically take about 20 minutes). During this time the student will follow the guidelines
for patient contact and elicit a history of the patient's problems.
Assessment of the encounter by the SP will be based on the process of the interview
with associated student behavior and communication/interpersonal skills.
The patient note will take place immediately after the SP encounter and will consist of
documenting the patient's history. The patient note must be turned in before leaving the
test site. This note will be evaluated by faculty who will provide written feedback.
Examples of the forms you will use for this part of the exercise and the scoring rubric
that will be followed to evaluate these write-ups are shown in Appendix Ill. Sample
patient notes and a listing of abbreviations you may utilize in these write-ups are
provided in Appendix IV.
The self-assessment of the video recording must be completed prior to the small
group meeting on Wednesday, April 29 or Thursday, April 30. As part of the self-
assessment, students should Identify a discussion-worthy 5-minute segment of the
interview and cue the recording to start there.
The small group consisting of one facilitator and 6-8 students will meet to review
each student's self-identified video segment and offer feedback.
The student self-assessment form is to be completed and brought to the small group
meeting. This form will then be turned in by the faculty facilitator to be added to each
student’s Learning Portfolio after completion of the small group session.
The faculty facilitator will assess students’ ability to provide and receive constructive
feedback during these small group sessions.
This computer-based test will consist of actual National Board exam items chosen
according to the Miller School of Medicine curricular blueprint for the organ-based
modules you have completed during the past two years. Student performance on this
exam allows us to evaluate effectiveness of our pre-clinical curriculum as it compares
across the two different degree tracks (MD and MD/MPH) and against national
standards. Students will be scheduled for a 3-hour block, which includes 2.5 hours
for the 100-item exam per se, plus time for administrative functions and an optional
tutorial.
Expectations for the one-on-one session are that the student and advisor will review
• results of the CCAW exercises
• other contents of the Learning Portfolio
• student's grades
• notices of deficiencies
• student's Individual Learning Plans and CV from last year and the first iteration of
the Personal-Professional Development Plan, which will be brought to the
Faculty Advisor Session along with an updated CV. (See Appendices I and II for
more information.) These documents will then be re-visited during advisory
Deans' meetings in the third and fourth years.
The Faculty Advisor will also make an assessment of the student's interaction during
the session.
APPENDICES
In order to create your PPDP, you will be utilizing the Careers in Medicine program:
http://www.aamc.org/cim. Many of you have already accessed the site.
IF YOU HAVE NEVER accessed Careers in Medicine, please take a moment to at least
ensure your ability to log on PRIOR to the start of Competency Week. This will allow you
more time to devote to the activity, if you need some assistance retrieving old
information. For those who have not logged on, please follow the detailed instructions
below:
NOTE: If this will be your first time logging on to Careers in Medicine, PLEASE
log on the week PRIOR to competency week, even if you complete the exercise
later. This will allow you time to ensure that you can troubleshoot any difficulty
you may encounter getting onto the site!
How do I decide which assessment is best for me? While we hope that you will revisit
the Careers in Medicine site several times between now and when you graduate, at this
point in time you are all in different stages of self-awareness and indecision. Review the
attached descriptions of the two inventories and decide which you think will be most
useful to you.
By the end of the Comprehensive Competency Assessment Week, you will have created
your individual PPDP that your Faculty Advisor will review with you. This PPDP will serve
to initiate career discussions with your future advisors and Deans.
I. List
*what needs to be developed
*why it needs to be developed
List at least three and up to ten goals (Personal and Professional). They should be
specific, focused, measurable and relevant to your development as a physician.
II. Resources/Strategies
*how is your goal going to be developed?
*what will be done to learn and develop?
*what resources will be used?
The methods for each goal should be practical and directly related to achieving
the goal.
IV. Verification
*how will a record be kept of progress and outcomes?
V. Development process
*how formulation of this plan will link to past and future development
Use this checklist to specifically assess your development goals (personal and
professional):
Are they:
* clearly stated?
* realistic and achievable?
* appropriate for your experience and stage of development?
*worthwhile?
* recognized as starting points and modifiable?
ii. Faculty Advisor Review of the PPDP should answer the following questions:
Has the student created a profile on Careers in Medicine site?
Has the student completed one of the CiM inventories?
Have the personal and professional objectives been stated?
Is there evidence of reflection and original thought?
Is there evidence of realistic goal-setting?
See the attached sample of how you might devise a PPDP and how, using the questions
posed above, you can review this yourself and with your faculty advisor to set concrete,
achievable goals and begin your process of self-reflection about career and personal
choices for the future.
Development Goal Method of Achieving Goal Date of Review ® & Means of Comments and
Personal/Professional Date of Completion Verification Concerns
Create a Careers in Log onto www.aamc.org/cim Logon week of Have web access to
Medicine Profile Follow loq on instructions 4/27/15 site
Complete CiM Complete one of the two self- During week of Print out personal
Inventory assessment inventories on the 4/27/15 profile page
CiM website Complete by 5/1/15
Improve my Spanish Utilize Spanish vocabulary book Ongoing Personal review May not learn
proficiency Utilize Rosetta Stone if quickly enough
available
Join an Interest Log onto Student Government Fall semester 2015 Personal Review
Group in my specialty website and inquire about which
interest of choice specialty qroups are active
Focus on improving Reflect on what holds me back Continuous Personal Review
my ability to from answering questions in a Clerkship evals
participate assertively group setting. Be willing to Discuss w/advisor
on a team improve my confidence
Plan to engage in Seek out faculty in my area of Meet with faculty by Personal Review Not sure of my
clinical research interest (by meeting with faculty 9/2015 Review by Advising specialty interest
project in OPDCG & with Mrs. Dean
Biederman, or advisors)
Maintain my personal Continue daily exercise (or Continuous I worry that I won't
health several times a week) while I have time for "me"
beqin mv clinical rotations while on the wards
Attain leadership Get more involved in groups Summer 2015 Personal Review Hoping to be able
opportunities with leadership options to "teach"
underclassmen
The Curriculum Vitae (CV) provides a concise summary of your personal and
professional development. It documents formal education, employment, research and
publications, involvement in activities, etc. This will be an important tool in your
professional life going forward, often required as part of applications for employment,
research opportunities, residency positions and the like. Although you may feel that your
CV is "skimpy" at this early stage in your career, you should realize that it is an evolving
document to which you will add as your personal and professional experiences broaden
and deepen. We thought it a useful exercise to begin developing your CV at the end of
first year, and now we require that you update your CV as part of the CCAW exercises
this year.
We hope that updating your CV will be a reflective exercise as well, because it requires
that you look back at your personal history, training, and accomplishments to date; in the
process, you may discover that goals set earlier (e.g., in the ILP from last year?) may
remain as yet unrealized. Such revelations, in turn, may form the basis for new goals
that you enumerate in your Personal-Professional Development Plan. For this reason,
these two activities are purposely linked: you will work on both documents during the
week and bring these to your individual advising session to be reviewed and discussed
with your faculty advisor and included in your learning portfolio.
***We request that you also e-mail an electronic version of your CV to Ms. Sharon Goni in
the Office of Professional Development and Career Guidance: sgoni@med.miami.edu.***
As part of the CV writing assignment, you should visit the webpage for the Office of
Professional Development and Career Guidance:
http://www.mededu.miami.edu/MedEd/opdcg/index.htm
Examples of CVs are shown under "Document Samples" at the upper right of the page.
Consider watching the workshop on "Writing a CV and Personal Statement" by Dr. Hilit
Mechaber and Mrs. Joyce Biederman (link is at lower left under "Professional
Development").
0 – NOT DONE
1 – NEEDS IMPROVEMENT – a performance I would prefer to see improve
before student becomes a doctor
2 – ACCEPTABLE – I feel comfortable with this student’s performance
(most students will perform at this level.
3 – OUTSTANDING – definitely performed better than most other students
Is appropriately attired 0 1 2 3
Introduces self 0 1 2 3
HISTORY: Document the history you obtained from the patient. Include identifying patient data,
chief complaint, history of present illness with pertinent positives and negatives, past medical history,
social history and family history, medications, allergies, review of system(s). You may use the back side
if needed.
2.
2. Diff Diagnosis –
3. Supporting data –
4.
3. Diff Diagnosis –
5. Supporting data –
Standardized Patient Encounter
Patient Note Scoring Rubric
Student Name:
TOTAL SCORE:
Evaluator: __________________________________
Problem List Problem list is inconsistent Problem list is generally Problem list correctly reflects
with findings or some consistent with findings, but the history in the case
information is lacking some information may be
lacking
Differential Diagnoses Differential diagnoses are Differential diagnoses generally Differential diagnoses are
inconsistent with the history or consistent with the history, but complete and reasonable,
important diagnoses were some are not consistent or supported by the history
not listed some important diagnoses are
not listed
Supporting Key supporting data is not Supporting data appropriately All the reported supporting data
Data listed, or supporting data does supports diagnosis, but some of is listed and appropriately
not support the diagnosis the reported supported data is supports the diagnosis
not included
Student Name: «Last», «First»
_____
_____
What was positive about the interaction and what determined this? ___________
_____
_____
_____
What was negative about this interaction and what determined this? ___________
_____
_____
_____
Do you believe that you elicited the information you needed? YES NO
_____
_____
_____
_____
_____
-OVER-
Please rate the following statements on this scale:
I began the interaction with open ended questions YES ____ NO____
For what reasons have you’ve chosen the particular “troublesome” segment?
_____
_____
_____
What kind of specific help/feedback are you seeking from the group review?
_____
_____
_____
Re: Feedback
Requested appropriate feedback 0 1 2
Response to feedback 0 1 2
Re: Observation
Attentive watcher 0 1 2
Attentive listener 0 1 2
Made appropriate observations 0 1 2
Re: Feedback
Provided feedback about specific behavior
[not global feedback] 0 1 2
Was concerned about how it was received 0 1 2
Did the student inhibit or hamper the group process? Yes___ No___
**Please use the space below on this form for comments, noting the student’s strengths
or areas in need of improvement
Student’s Name: «Last», «First»
general attitude 1 2 3 4 5
maturity 1 2 3 4 5
ability to communicate 1 2 3 4 5
of of Medicine Week
IV. Supplemental Materials for Standardized Patient History