LCME Update

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LCME Update

• At least its not JCAHO update.
• Tom Morrissey
• CDEM/CORD 2008

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Liaison Committee on Medical Education

• What is it?
• Why is it?
• Why do we care as CDEM?

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Why do we care as CDEM?

• We cant approach the clerkship from an
  EM-centric view alone
• We must work with the curriculum committee to
  build a functional, effective rotation
• Focus on how your school (as a whole) is dealing
  with LCME requirements

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Revised ED-1
The medical school faculty must define the
objectives of its educational program. The
objectives must serve as guides for establishing
curriculum content and provide the basis for
evaluating the effectiveness of the educational
program.
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Revised ED-1

• Whats this mean for us?
• We dont work in a vacuum
• Get involved in curriculum committee
• Look for ways your rotation can endear itself to
  your Deans office

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Will EM ever become a required rotation?

• Likely notbut thats OK
• LCME trying to move toward language that
  describes experiences and exposuresrather than
  discipline-specific mandates
• If you do it best, youre school can mandate that
  students come visit you!

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So whats new in the LCME?
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Most frequent citations

• Less institution-based, more Educational
  programbased
• At least this is somewhat under our control

• Insert pie chart

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Frequently Cited Standards2006-2007

• 1. ED-30
• Timely feedback
• 2. MS-24
• Student debt
• 3. ED-2
• Central oversight
• clinical objectives
• 4. ED-31
• Early evaluation

• 5. ED-32
• Narrative feedback
• 6. ED-33
• Integrated institutional
• responsibility
• 7. ER-4
• Buildings
• 8. ER-9
• Affiliation agreements

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Ways to improve feedback

• Central ownership for Clerkship evaluation
• Daily shift-evaluation forms
• Mid-rotation review (and discussion)
• Didactic sessions with CD
• Standardized tests/SIMs/table-top cases
• Tell them youre giving feedback
• Build action plan at end of feedback session to
  assure integrity of information flow

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New Std. MS-31-A July 2008

• Medical schools must ensure that the learning
  environment for medical students promotes the
  development of explicit and appropriate
  professional attributes (attitudes, behaviors,
  and identity) in their medical students.
• From Dan Hunt MD. LCME Secretary 2008-9

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Whats this mean?

• Professionalismbut,
• Grown from hidden curriculum rather that
  specific policies or formal teaching.
• Ex Trash talking
• Everything I ever needed to know I learned in
  Kindergarten

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New Std. IS-14-A July 2008
Medical schools should make available sufficient
opportunities for medical students to participate
in service learning activities, and should
encourage and support student participation.
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New Std. IS-14-A July 2008
Medical schools should make available sufficient
opportunities for medical students to participate
in service learning activities, and should
encourage and support student participation.
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Whats this mean?

• Need to make them aware of opportunities
• Service in homeless shelters
• School physical programs
• Some International rotations
• Disaster relief
• We dont have to pay to send them to Nepal

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New Std. ED-17-A July 2008
The curriculum must introduce students to the
basic principles of clinical and translational
research, including how such research is
conducted, evaluated, explained to patients, and
applied to patient care.
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Whats this mean to us?

• What do you get when you mix an elephant and a
  rhino?
• Make sure you understand how your curriculum
  committee is handling this
• May be able to endear yourself to your deans
  office
• Journal Clubs
• Informed consent in the ED
• Didactic sessions on EMB in EM

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Revised ED-2
There must be system with central oversight
to assure that the faculty define the types of
patients and clinical conditions that students
must encounter, the appropriate clinical setting
for the educational experiences, and the expected
level of student responsibility. The faculty must
monitor student experience and modify it as
necessary to ensure that the objectives of the
clinical education program will be met.
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ED-2Whats this mean?

• This one made us sweat
• Probably more than necessary
• Dont worry so much about specific numbers of
  patients, procedures, etc
• Do be cognizant of where you fit in your
  curriculum committees overall plan

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Revision ED-24
Residents who supervise or teach
medical students, as well as graduate students
and postdoctoral fellows in the biomedical
sciences who serve as teaching assistants, must
be familiar with the educational objectives of
the course or clerkship and be prepared for their
roles in teaching and evaluation.
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ED-24 Whats this mean?

• Probably no longer OK to say, Oh yeah, we tell
  them about teaching during orientation
• Esp. important to us because of our lack of
  long-term pairing of attendings, residents and
  students.

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Some ways to deal with this

• Provide written copy of GOs
• Guidance from CD/ Teaching elective
• Residents as teachers workshops
• Centrally monitor resident teaching
• LCME encourages
• Formal assessment (and remediation) of teaching
  skills)
• Direct observation
• Student feedback on resident teaching

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www.LCME.org

• Barbara Barzansky appointed as LCME Secretary
• Diversity
• Accreditation Status of Developing Medical
  Schools
• Accreditation Survey Schedules

• Would you like the LCME to come in person next
  year?