Clinical Clerkship Educational Guidelines
rev: 5-24-06
Clinical Clerkship Programs at MSUCOM Base Hospitals
Management Of The Training Program
The Clinical Clerkship Program is the culminating phase of the MSU/COM program. As such, it must be designed and administered so as to be consistent with the goals of the College. It is essential that the collective faculty of the College, those on campus and those in the community, have a common understanding of the total curriculum and the role the Clinical Clerkship Program plays in developing the professional competence of MSU/COM students. Coordination and communication are critical elements of successful management of the educational program.
A. Program Administration
The Clinical Clerkship Program is administered by the clinical departments and the Associate Dean for Academic Programs. Coordination of the program is delegated to the Clinical Clerkship Office and the training center Director of Medical Education.
B. Training Center Coordination
The hospital based portion of the Clinical Clerkship Program is cooperatively designed and managed by the College and the training center. The on-site manager/coordinator of the total educational program is the Director of Medical Education (DME). The DME establishes guidelines for maintaining quality assurance of service training programs, coordinates students' schedules, maintains student training records, manages hospital educational programs, and serves as training center liaison to College administrators in the matters of program development and management and student evaluation and remediation.The on-site clinical clerk training within the major services (Medicine, Obstetrics/Gynecology, Surgery, Anesthesiology, Emergency Medicine, and Primary Care Ambulatory Clerkship) is coordinated by staff physicians designated by the DME. These training coordinators manage the clinical clerkship training plan, make student/supervisor assignments, monitor the students' professional development, and work together with their teaching faculty and on-campus counterparts to evaluate and revise the training plan.
C. Individual Service Training Programs
Each clinical clerkship rotation is intended to enhance the student's professional competence. Each service's clinical clerk training plan must include teaching/learning activities specifically directed toward developing four aspects of the student's clinical competence: basic medical knowledge, fundamental procedures/skills, medical problem solving (diagnosis and patient management), and professional attitudes and behavior. Assigned readings, student presentations, morning report or grand rounds, staff review of students' history and physical examinations and progress notes, student presentations of consults, and attendance at hospital-sponsored lectures/seminars are considered essential elements of a quality clinical clerkship training program.
The specific objectives, as delineated by the respective clinical department faculty and described in the service protocols, should be reviewed by the student together with the clinical supervisor/s. Student responsibilities with regard to patient care, lecture attendance, presentations, readings, examinations, etc., and the specific criteria by which the student's performance will be assessed must be fully understood by the student at the beginning of the clerkship rotation.Continuous assessment of the student's performance and timely feedback to the student are essential elements of an effective training plan. Minimally, the evaluation plan should include:
- The student's routine performance of clinical tasks (patient work-ups, consults, presentations, etc.) should be continuously evaluated and immediate oral feedback be given by clinical supervisors, i.e., staff physicians, residents, interns, and other health professionals.
- The student's overall performance vis-a-vis the stated objectives must be formally evaluated, using evaluation forms provided by the College, discussed with the student, and forwarded to the College.
Training Center Educational Programs And Facilities
The Clinical Clerkship Program is viewed as an integral part of the training center's overall clinical education and continuing medical education programs. Therefore, it is presumed that clinical clerks will participate in existing training programs, including lecture series, special conferences and seminars, service journal clubs, grand rounds, morning report, etc. In fact, it is presumed that the clinical clerks' participation in these programs will be a part of the training plan for each service and their participation will be properly monitored and evaluated.
To ensure a quality Clinical Clerkship Program, the College requests that the training center:
- Prepare a weekly or monthly list of all educational programs (lectures, conferences, seminars, television tapes, movies, etc.) being conducted at the hospital.
- Provide regularly scheduled morning report, grand rounds, conferences, seminars and/or lectures in all major medical disciplines and require clinical clerks' participation in these programs.
- With the on-campus faculty, cooperatively develop and present specific classes and conferences for clinical clerks and/or trainers.
- Encourage clinical clerks to keep up with the agreed upon set of directed readings for each rotation through questioning and/or review of the material in the context of patient care.
- Ensure that clinical clerks have access to library facilities and other learning resources in the same manner as other hospital personnel and that utilization of those resources is provided or in the service training plan.
- With the on-campus faculty and administration, cooperatively evaluate the educational programs to ensure their relevance and effectiveness for clinical clerks.
- Provide regular feedback to the College regarding clinical clerks' preparation for the clinical training program.
- Implement and maintain a system for review of clinical clerks' history and physicals, consultations, and progress notes. Regularly provide feedback to clinical clerks on their development regarding these components of the training program.
- Conduct regular administrative meetings with clinical clerks to discuss in-house problems, controversial issues in medicine, etc.
Student Orientation And Responsibility
The essential feature of the Clinical Clerkship Program is the clerk's participation as an active member of the patient care team on the service to which s/he is assigned. It is recognized, however, that typical MSU/COM students entering the Clinical Clerkship Program have had very limited exposure to the clinical environment, particularly in the institutional setting. The role of the clinical clerk in patient care must be explicitly defined and explained to the student. The clinical clerk is directly responsible to the attending physician for his/her patient care performance and to the Director of Medical Education for following training center policies and fulfilling general trainee obligations.
The clinical clerk will be oriented to his/her roles and responsibilities through:
- general policy statements published in College documents
- a formal orientation to the training center by the Director of Medical Education
- training center and/or service written guidelines
- on-service orientation by the training coordinator
Implementation Of The Program
A. Scheduling Assignments
The Clinical Clerkship Office will coordinate student scheduling with the Director of Medical Education, prepare appropriate forms, and distribute final schedules for each student.
B. Rotation Hours
The clerkship rotation week is Monday through Sunday. Duty hours for each rotation and assignment of students on weekends and holidays during a scheduled rotation are determined by the hospital's Medical Education Office. Night duty may be required.
C. Documentation of Evaluation
The Director of Medical Education will review and sign evaluation forms submitted by clinical supervisors and forward the forms to the Clerkship Office. The Clerkship Office will log receipt of the forms and forward them to the sponsoring department for appropriate administrative action. Clerks have continual access to the status of rotation evaluation forms submitted to the Clerkship Office, by noting a completion date posted to their "on-line" schedule.
D. Communication of Administrative Problems
The Clinical Clerkship Office maintains the master schedule for all students in the Clinical Clerkship Program. Questions regarding locations of students and notice of changes in student rotation schedules should be referred to this office.Student training problems should be directed first to the Director of Medical Education, who in turn may consult with College administrators as s/he deems appropriate. Student absences, illness or injury, etc., should be promptly reported to the Clinical Clerkship Office, which will notify appropriate College administrators. Serious problems of student professional behavior should be referred directly to the Associate Dean for Academic Programs.