Tracking Clinical Case Logs
and Professionalism in a
Distributed Education Model
Lise McCoy, MTESL, Curriculum Specialist
Frederic N. Schwartz, DO, FACOFP,
Associate Dean of Community Campuses
Medbiquitous Conference, Baltimore, MD
May 8-11, 2011
A.T. Still University
School of Osteopathic
Medicine in Arizona (SOMA)
Significance
To evaluate student electronic
case logs and evaluations for
our unique, distributed program
model.
Curricular goals included
encouraging diligence in
clinical case logging and
monitoring student
professionalism during rotations.
Accreditation standards require
review of clerkship requirements
Standard 6.13
The COM must develop a process that evaluates the clerkship in
regards to meeting the COM's mission and objectives. The COM
should hold the affiliated or educational site to its established
goals and objectives, and conduct routine, periodic visits to
ensure the goals and objectives are being met.
(Committee on Osteopathic College Accreditation, 2011).
Background
• Completing documentation such as
case logs is a mark of
conscientiousness, a trait linked to
professionalism.
(Summarized from McLachlan, Finn, and Sawdon 2010)
• Reviewing clinical case logs
improves accountability and
oversight with regard to student
clinical experiences (Spickard, et al. 2008)
How does a lack of professionalism
impact a physician’s career?
• Unprofessional behavior in medical school has
been correlated with later state medical board
actions. (Papadakis et al, 2005)
• Medical Board of Examiner infractions include lack
of proper documentation (Ainsworth and Szauter, 2006)
• To emphasize the importance of professionalism,
SOMA will tie the case log requirement to a
professionalism score, which is reported in the
student’s Medical School Performance Evaluation
(MSPE).
Study Methods
• MS3-MS4 students were required to log all patient
encounters (diagnoses and procedures) electronically.
• Case log data were collected from the SOMA E*Value
database.
• Authors compared records for 95 MS3 (2012) and 97 MS3
(2011)
• Using the same database, authors analyzed the student
annual average professionalism score from end-ofrotation evaluations.
• Study Question: Will there be a correlation between case
log quantities and professionalism scores, as rated by
preceptors?
Distributed Education Model
SOMA trains
students years
2-4 at eleven
regional
community
campuses,
affiliated with
National
Association of
Community
Health Centers.
MS3-4,
Students study
at more than
500 sites.
Sample Procedure Logs,
One MS4 Student
Students Log Procedures and Diagnoses
Electronically
Results – Average Scores
SOMA Class
MS3
(2012)
n=95
July 2010March 2011
Average number of
cases logged per
student
(annual)
Average Number of
Cases Logged per
Student Each
Rotation
Average Student
Professionalism Score
(Out of 5.0)
787
87
4.77
p<0.265
r=0.115
Degrees of
freedom =94
122
4.72
p<.01
r=0.264
Degrees of
freedom =95
Total case
log n=74,724
Correlation of case log
quantity and
Professionalism
(9 rotations)
MS3
(2011)
n=97
August 2009June 2010
(11 rotations)
1339
Total case
log
n=129,919
Results: Regional Variation – Patient Encounters
Results – Regional Variation - Professionalism
Average
Average
score =
score
4.72= 4.72
out of
maximum of 5
Professionalism Items - CPE
Concluding Remarks
• Although literature shows that
conscientiousness is linked to
professionalism1, we did not find a
correlation between professionalism scores
and quantity of case logs submitted.
• This validates the need to collect preceptor
perceptions of student professionalism.
• Electronic case logs have been successfully
integrated into our program.
• The next goal will be to certify certain skills.
1
McLachlan, 2010.
Individual Summary Report
References
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AAFP. What about the Medical School Performance Evaluation (MSPE)? 2011. Retrieved from
http://www.aafp.org/online/en/home/publications/otherpubs/strolling/prep/mspe.html
Advanced Informatics, E*Value. 2010. https://www.e-value.net/index.cfm
Ainsworth, M. & Szauter, K. Medical Student Professionalism: Are We Measuring the Right Behaviors? A
Comparison of Professional Lapses by Students and Physicians. Academic Medicine, 2006 October. (Vol. 81
(10).)
Committee on Osteopathic College Accreditation (COCA). Curriculum Standard Six. 2011.
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