Outpatient Medicine Curriculum Review

1
Outpatient Medicine Curriculum Review

• Vik Agarwal
• Chris Ryerson

2
General Survey Information

• 38 surveys returned out of possible 52
• 73 response rate
• Surveys distributed by email/in person
• Clerkship groups 7,8,1,2 completed rotation
• All surveys filled out completely

3
Format of Survey

• 3 sections
• Generic questions regarding rotation as a whole
• Scored 1 - 7 (1 strongly disagree, 7 strongly
  agree)
• Questions specific to each subspecialty rotation
  
• Questions regarding overall structure of
  internal medicine rotation
• Section also provided for any other comments

4
Section A

• General Questions

5
Question 1

• Objectives and expectations were clearly detailed
  from the start of the rotation with an initial
  orientation.
• Results
• Average response 4.87
• Standard deviation 0.94
• Mode 5

6
Question 2

• The supervisors were well aware of the learning
  objectives appropriate for a clerk within the
  rotation.
• Results
• Average response 4.76
• Standard deviation 1.17
• Mode 6

7
Question 3

• There was an optimal amount of formal teaching
  sessions (modalities may include rounds, rotation
  packages, web-based tutorials etc) to cover major
  topics in the specialty.
• Results
• Average response 4.42
• Standard deviation 1.41
• Mode 5

8
Question 4

• There was optimal amount of informal clinical
  teaching surrounding patient encounters.
• Results
• Average response 4.63
• Standard deviation 1.20
• Mode 5

9
Question 5

• As a clerk, I had an appropriate level of
  independence in seeing/treating patients.
• Results
• Average response 4.63
• Standard deviation 1.18
• Mode 5

10
Question 6

• Evaluation methods were clearly detailed.
• Results
• Average response 4.95
• Standard deviation 1.18
• Mode 5

11
Question 7

• Evaluation methods were at an appropriate level
  of difficulty for clerkship training.
• Results
• Average response 5.18
• Standard deviation 1.04
• Mode 6

12
Question 8

• Feedback was given either formally or informally
  throughout the rotation.
• Results
• Average response 4.43
• Standard deviation 1.32
• Mode 5

13
Question 9

• The block coordinator was available and
  responsive during the rotation.
• Results
• Average response 4.21
• Standard deviation 1.23
• Mode 4

14
Question 10

• The rotation focused largely on education rather
  than service.
• Results
• Average response 4.55
• Standard deviation 1.31
• Mode 4

15
Question 11

• The rotation has provided me with a firm
  background in this field of medicine.
• Results
• Average response 4.14
• Standard deviation 1.33
• Mode 5

16
Question 12

• The rotation consisted of an excellent variety of
  patient problems.
• Results
• Average response 4.89
• Standard deviation 0.98
• Mode 5

17
Question 13

• The patient-centred approach was modeled by the
  faculty on this rotation.
• Results
• Average response 4.61
• Standard deviation 1.08
• Mode 4

18
Question 14

• Teachers in this rotation model exemplary
  attitude towards gender and diversity issues.
• Results
• Average response 4.47
• Standard deviation 1.31
• Mode 4

19
Question 15

• Overall this rotation was an excellent
  educational experience .
• Results
• Average response 4.36
• Standard deviation 1.25
• Mode 5

20
Section B

• Geriatrics

21
Geriatrics

• Overall rating of geriatrics.
• Results
• Average response 4.39
• Standard deviation 1.41
• Mode 5

22
Geriatrics

• What can be done to improve the geriatrics week?
  Please provide comments.
• Response highlights
• MMSE learned and applied in multiple settings
• Good exposure to geriatric issues including
• polypharmacy (good session with pharmacist)
• failure to thrive
• dementia
• social factors affecting disease

23
Geriatrics

• Response highlights (cont.)
• Much of CTU already geriatrics
• Could be made 2-week selective does not need to
  be a mandatory block
• Incorporate formal teaching sessions into CTU
• Mixed feedback regarding usefulness of videos

24
Geriatrics

• Is the amount of time dedicated to geriatrics
  appropriate?
• Responses
• Just right 15
• Too little 5
• Too much 18

25
Geriatrics

• Was the workload appropriate during the
  geriatrics week?
• Responses
• Just right 30
• Too little 7
• Too much 1

26
Section B

• Physiatry

27
Physiatry

• Overall rating of physiatry.
• Results
• Average response 3.89
• Standard deviation 1.37
• Mode 5

28
Physiatry

• What can be done to improve the physiatry week?
  Please provide comments.
• Response highlights
• Good review of anatomy
• Good exposure to chronic pain and different
  clinician perspectives on chronic pain
• Excellent attitude from clinicians toward
  teaching

29
Physiatry

• Response highlights (cont.)
• Could be made a 2-week elective
• Include more formal teaching during CTU -
  especially regarding MSK exam
• More autonomy/responsibility

30
Physiatry

• Is the amount of time dedicated to physiatry
  appropriate?
• Responses
• Just right 17
• Too little 2
• Too much 19

31
Physiatry

• Was the workload appropriate during the physiatry
  week?
• Responses
• Just right 27
• Too little 11
• Too much 0

32
Section B

• Oncology

33
Oncology

• Overall rating of oncology.
• Results
• Average response 4.95
• Standard deviation 1.54
• Mode 6

34
Oncology

• What can be done to improve the oncology week?
  Please provide comments.
• Response highlights
• Good exposure to multiple types of Ca
• Great experience to see patients at this stage of
  disease/treatment
• Good exposure to outpatient medicine
• Well-organized

35
Oncology

• Response highlights (cont.)
• Time could have been used more efficiently
• radiation session
• formal teaching over lunch / mornings
• In present state could be condensed to 1 week
• Interdisciplinary rounds often not at appropriate
  level for clerks

36
Oncology

• Is the amount of time dedicated to oncology
  appropriate?
• Responses
• Just right 25
• Too little 0
• Too much 13

37
Oncology

• Was the workload appropriate during the oncology
  week?
• Responses
• Just right 21
• Too little 15
• Too much 2

38
Section C

• Structure of Rotation

39
Overall

• Is 4 weeks of CTU appropriate?
• Responses
• Just right 7
• Too little 30
• Too much 1

40
Oncology

• Is 4 weeks of electives appropriate?
• Responses
• Just right 28
• Too little 5
• Too much 5

41
Section D

• Comments

42
Comments

• Increase CTU to 6 weeks
• Keep electives at 4 weeks
• Make geriatrics and PMR electives
• Add more teaching to oncology weeks
• More case-based teaching through-out rotation

43
Conclusions

• Internal medicine rotation generally an excellent
  experience
• Interest in internal medicine as a career
  specialty are very high in Meds 2004