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Alternative Clinical Education Curriculum during COVID-19 Pandemic

  • 1.  Alternative Clinical Education Curriculum during COVID-19 Pandemic

    Posted 03-14-2020 04:56:00 PM
    As schools consider the need to pull students from clinical rotations, there may be a significant need for on-line alternative experiences to augment, or in some cases replace clinical rotations.  Rather than all schools developing alternative clinical experiences in isolation, do resources exist that can be leveraged by all schools?

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    Kevin Moynahan
    Deputy Dean, Education
    University of Arizona College of Medicine - Tucson
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  • 2.  RE: Alternative Clinical Education Curriculum during COVID-19 Pandemic

    Posted 03-16-2020 09:51:00 AM
    Hello all, As the COVID-19 numbers multiply, and as PPE availability and other health care resources become tight, we will be forced to ​temporarily take students out of clinical rotations. This has a lot of downstream effects but this is where we are.
    We have heard several schools stopping clinical rotations.
    It would be nice to have a discussion around which schools have stopped it and how we would collectively plan to address this educational conundrum going forward.
    I am in New York and we are considering all possibilities at this time. Any thoughts would be most helpful.

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    Latha Chandran
    Vice Dean for Academic and Faculty Affairs
    Renaissance SOM at Stony Brook University
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  • 3.  RE: Alternative Clinical Education Curriculum during COVID-19 Pandemic

    Posted 03-16-2020 10:40:00 PM

    Tuiane notified all third and fourth year students today that all clinical activities were suspended about noon today.  New Orleans has become an epicenter for Covid-19 and in one week we have seen an exponential increase in cases, stresses on the healthcare system of the entire city and we made a decision that was in the best interest of the safety and health of our students and community.  In addition we were facing concerns about PPE's, restrictions on student responsibilities, and reductions in clinical opportunities.  The bars, restaurants and casinos of New Orleans will be closed as of tomorrow, schools are already closed.  Our clerkship directors discussed how we can maintain distance didactic activities (online videos, case-based discussions, etc.), and how students can even complete end of clerkship exams - ?self-assessments but we like everyone else are waiting to hear if/how the NBME can make accommodations.  We intend to delay the necessary clinical elements to later on to meet clerkship requirements.  Happy to discuss/comment further with any colleagues trying to meet the same challenges.
    Kevin



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    N. Kevin Krane
    Vice Dean for Academic Affairs
    Professor of Medicine
    Tulane University School of Medicine
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  • 4.  RE: Alternative Clinical Education Curriculum during COVID-19 Pandemic

    Posted 03-16-2020 10:56:00 PM
    I would very much like to know how many medical schools have continued rotations vs. how many have stopped. We have not pulled students yet. My concern for pulling students is that we do not know how long this may continue. Can we stop clinical rotations for 1 month, 3 months, 6 months?

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    Jennifer Christner
    Dean, School of Medicine
    Baylor College of Medicine
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  • 5.  RE: Alternative Clinical Education Curriculum during COVID-19 Pandemic

    Posted 03-17-2020 08:25:00 AM
    We pulled our students as of this morning.

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    Amy Kuhlik
    Dean of Student Affairs
    Tufts University School of Medicine
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  • 6.  RE: Alternative Clinical Education Curriculum during COVID-19 Pandemic

    Posted 03-17-2020 08:29:00 AM
    At the University of Toronto we have removed all pre-licensure health care students from the clinical environment as of March 16 for a three week period.   This was done to address the following principles:  keeping patients safe, keeping students safe, effective use of limited PPE resources, inability to deliver an appropriate educational experience as all elective work if cancelled.   It was a very difficult decision.   Having the support of the community of UME Deans across Canada has been essential at this time.   Be well and take care.

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    Patricia Houston
    Vice Dean MD Program
    Professor Dept of Anesthesiology and Pain Medicine
    University of Toronto
    Vice Dean MD Program
    University of Toronto
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  • 7.  RE: Alternative Clinical Education Curriculum during COVID-19 Pandemic

    Posted 03-16-2020 10:53:00 PM
    Hi, On the AAMC-LCME call it was asked if you could do a clinical rotation without clinical experiences and the answer was no. So while there are ways to augment clinical dx/px we expect students to see we can't use them as the sole source of a rotation. Aquifer has developed clinical cases for a number of specialties. There is a cost for those however.

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    Jennifer Christner
    Dean, School of Medicine
    Baylor College of Medicine
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  • 8.  RE: Alternative Clinical Education Curriculum during COVID-19 Pandemic

    Posted 03-17-2020 11:16:00 AM
    We are currently holding the line so to speak as much as possible and keeping students on rotations. Being a distributed model, we have had some sites ask students to stay home for a period of time, but we are working with them to get students back on rotation ASAP. We are tracking missed time and plan on utilizing elective / selective weeks to remediate this. But in general our intent is to maintain students' education and try to minimize the disruption to their timeline.

    Our biggest problem at sites has been a lack of PPE. So we have worked with sites to try to come up with student roles that allow them to observe situations that require PPE, and continue providing patient care in situations that do not.

    We have secured new contracts with online content providers, and are developing more internally. I have been most impressed with iHuman, a Kaplan product. Very good interactive cases, and quite a few of them. Plus analytics on how students progress through the cases.

    Thanks to everyone for the communication. Having networks like this are incredibly helpful in times like this. No one wants to navigate this stuff alone!

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    Brigham Willis
    Senior Associate Dean of Medical Education
    University of California Riverside SOM
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  • 9.  RE: Alternative Clinical Education Curriculum during COVID-19 Pandemic

    Posted 03-18-2020 08:30:00 AM
    I'm cross posting the following that I recently placed on another discussion thread.  At Nebraska, we have removed students from clinical rotations and were planning on doing so before the AAMC guidance document.  Our rationale is multi-fold but primary centers around the student desire to contribute and do good, which is what we want to engender.  Proactively removing them from a sub-optimal learning environment (our clinical systems are appropriately focused elsewhere) and building curricular elements and infrastructure that will allow them to positively contribute to the efforts while significantly enhancing their professional learning was the goal.  There will always be time to come back and learn the clinical medicine down the road.  Here is my prior post:

    At the University of Nebraska College of Medicine, we had been proactively planning for removing students from the clinical environment for, as you mention, several months.  As a transition, we are developing a new rotation for all clinical students that encompasses learning objectives critical to disaster preparedness and emerging infectious diseases (e.g., leadership, professionalism, ethics, population health, social determinants, etc.) while building in a heavy dose of service learning throughout our community and health system.  Some of this service will be supporting the front lines while others may be away from the hospital/clinics.  Reflection will be a key component of this rotation.  Our overarching goal is to help students continue to learn while channeling their extensive skills and energy to support the greater good.  We aim to have this rotation launched by the first week of April. 

    Kelly Caverzagie, MD
    Associate Dean for Educational Strategy
    University of Nebraska College of Medicine

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    Kelly Caverzagie
    Associate Dean for Educational Strategy
    University of Nebraska College of Medicine
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  • 10.  RE: Alternative Clinical Education Curriculum during COVID-19 Pandemic

    Posted 03-22-2020 09:47:00 AM
    Kelly,
    I am very interested in the proposed class you are describing.  My colleague Dave Henderson and I are discussing doing something similar at UConn School of Medicine. Would you be interested in collaborating? 

    Zita Lazzarini, JD,MPH
    Dir.Social and Behavioral Sciences
    UConn School of Medicine

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    Zita Lazzarini
    Assoc. Prof.
    University of Connecticut School of Medicine
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  • 11.  RE: Alternative Clinical Education Curriculum during COVID-19 Pandemic

    Posted 03-19-2020 10:41:00 AM
    Kevin you are right. Like many other schools, we have been using the Aquifer cases ( CLIPP SIMPLE WISEMD etc) just as an alternative experience in case our students don't get the required list of clinical conditions for each clerkship. We are now using our fourth year students in our Teaching in Medicine elective to tag ALL of the cases in this group of cases- so we know which conditions as well as the degree of interactive assessments that are available for all these cases. If we were to have a more prolonged suspension of students returning to clinical activities ( which I think is inevitable in New York unfortunately) we will need to use such resources with a deeper understanding of what they provide.​ Another resource that we are exploring now is the OnlineMedEd CaseX which they are offering for free for three months.

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    Latha Chandran
    Vice Dean for Academic and Faculty Affairs
    Renaissance SOM at Stony Brook University
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