Albert Einstein College of Medicine
Academic Year 2012-2013
PART C. REQUIRED CLERKSHIP FORM
Clerkship title:
Sponsoring department
or unit:
Name of clerkship director:
Family Medicine Clerkship
Department of Family and Social Medicine
Maria Teresa Santos, M.D./ William Jordan, M.D., M.P.H.
Clerkship Objectives
Are there written objectives for the clerkship?
Yes
X No
Were the clerkship objectives developed internally or adopted/adapted from external sources? If the
latter, please provide the source of the objectives.
The clerkship objectives were developed internally by the core teaching faculty of the department.
Provide a sample of about 10 learning objectives, including a selection of those related to the knowledge,
skills, and professional behaviors (as relevant) that are expected of students by the end of the
clerkship/clerkship rotation.
Clerkship Objectives:
By the end of this clerkship, the student will be able to:

Obtain a relevant patient history on patients with health problems commonly seen in the Family
Medicine practice setting.

Conduct an accurate physical examination relevant to the patient’s reason for seeking care in the
Family Medicine practice setting.

Demonstrate the clinical reasoning skills needed to assess acute and chronic care issues commonly
seen in the Family Medicine practice setting.

Formulate patient-centered management plans that integrate bio-psychosocial considerations.

Develop an evidence-based health maintenance plan based on an individual patient's age, gender, and
risk factor status.

Describe the clinical expression and basic management principles of common acute and chronic care
problems in primary care.

Locate, review, and appraise evidence-based studies related to health problems and interventions in
both clinical and community settings.

Define and analyze a health problem in a specific population from an individual, family, community and
public health levels.

Determine when it is appropriate to include other members of the health care team (e.g., nurse, health
educator, social worker, subspecialist).
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine

Academic Year 2012-2013
Demonstrate effective communication with patients, families, and communities that take into account
socioeconomic status, and cultural background, and health literacy.
How are the clerkship objectives provided to students?
All of the materials for the rotation, including the clerkship objectives, are housed in eMED,
Einstein’s medical education database system. Prior to the start of the clerkship, the link to the
clerkship materials is provided to the students via email. During orientation, the clerkship director
provides an overview of the objectives, with specific highlights, to the students. The Community
Outreach Director also reviews the objectives pertaining to the community project during her
introductory session. The site directors include clerkship objectives in their review of clinical
expectations when they orient each new student to the site.
At what point during the clerkship are individual students’ clinical experiences (required patient
encounters and procedures) reviewed to ensure that the learning objectives are being met? Who conducts
that review?
The site director (or designated faculty if site director is not available) meets with the student for
the mid-cycle feedback session at the end of the second week or the beginning of the third week of
the rotation. At this time, the student’s logs of the required patient encounters and procedures are
reviewed. Formative feedback on the student’s clinical performance up to this time is also given to
the student during this session.
Who is responsible for ensuring that each student’s clinical experiences are appropriate to meet the
objectives of the clerkship? Describe the actions that would be taken if a student were not making
satisfactory progress in meeting clerkship expectations for clinical experiences (required patient
encounters and procedures)?
The clerkship director and the site director are responsible for ensuring that the student’s clinical
experiences are appropriate to meet the objectives of the clerkship. Students’ logs are monitored
weekly by the clerkship director’s office, and reminders are sent to the students if they are not
logging the appropriate clinical experiences. Site directors monitor the students’ progress through
review of the patient encounters/procedures during the mid-cycle feedback session and help
students find patients for any missing diagnoses or procedures. If needed to meet encounter
requirements, students are provided with additional evening or weekend clinic sessions at one of
several clerkship sites with extended hours. Alternate educational experiences are provided online
through eMED for students to complete if they were unable to see a required diagnosis or perform
a required procedure by the end of the third week.
Preparation for Teaching
If resident physicians teach in the clerkship or otherwise supervise medical students, how are they
informed about the clerkship objectives and prepared for their teaching role?
In four of our 19 clinical sites, resident physicians have an occasional role in the teaching and
supervision of the medical students. The clerkship objectives, teaching expectations and teaching
resources are all included in an online manual – Teaching Star --, which is made available to the
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
residents through eMED. There are annual resident-as-teacher training sessions at these clinical
sites to help prepare the residents for their teaching responsibilities, including a review of
objectives. Beginning with the academic year 2013-2014, the deans at our affiliate hospitals have
taken on the responsibility of giving the initial teaching skills session, including a review of
objectives, for all the incoming interns (across all specialties) at their sites.
How are faculty members across instructional sites oriented to the clerkship objectives and the methods of
student assessment?
All of our faculty members have direct access to the clerkship objectives and the methods of student
assessment through eMED. The site directors of our clinical sites also receive the clerkship
objectives and methods of assessment via email before the start of each academic year, as part of
the updated manual, and are expected to disseminate this information to their faculty. The
clerkship directors conduct scheduled visits to the clinical sites and use this time to review
important clerkship updates or changes, including learning objectives and methods of assessment.
Our department hosts an annual faculty development session on relevant topics, including student
assessment and evaluation, tied to the educational objectives.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
REQUIRED CLERKSHIP FORM (Continued)
Clerkship title:
Family Medicine Clerkship
Methods for Assessing Student Performance
Describe the methods used in the clerkship to assess students’ core clinical skills (e.g., OSCEs, miniCEXs, observation by faculty or residents). How does the department ensure that such assessment occurs
for all students?
All students are directly observed during the rotation to assess their history taking, physical exam,
communication and clinical skills. This observed clinical encounter (OCE) is required for all
students, and a small group of core faculty members and fellows is responsible for completing all
OCEs each month. The faculty observer sends the completed observation form to the course
director’s office for the student’s file. Students are instructed to contact the clerkship director if
they have not heard from their assigned OCE observer by the end of the second week of the
clerkship.
Students are required to complete two OSCE stations designed to assess their communication skills.
Participation in the OSCE is required for successful completion of the clerkship.
The main method for assessing students’ core clinical skills is through the faculty’s ongoing
precepting interactions with students during the provision of patient care. The students’ clinical
skills are assessed through their oral presentations and through observation of interactions with
patients and staff. Preceptors complete a per clinic session evaluation of students, and the site
director compiles these with his/her own observations for the assessment included in mid-cycle
feedback and the final evaluation.
Knowledge and understanding of core clinical concepts are assessed through three quizzes (during
team-based learning sessions) and the final exam.
How are students provided with mid-clerkship feedback? What mechanisms are in place to ensure that
mid-clerkship feedback is provided?
The site director (or a designated faculty if site director is not available) meets with the student in
person to provide the required mid-cycle feedback. The clerkship uses a standardized form that
includes a self-assessment and faculty assessment of the core clinical skills. Both the site director
and the student must sign this form after the session, and the student sends the completed form to
the course director’s office for filing. The student is contacted if the form is not received to ensure
that the mid-cycle feedback session had occurred.
Describe who determines a student’s final grade in the clerkship (e.g., clerkship director, site director,
other).
The clerkship director assigns the final overall clerkship grade after compiling the grades from the
different components of the clerkship: clinical performance, team-based learning quizzes, final
exam, and community project. Community project grades are determined by the community site
advisor, in combination with a panel of faculty who observe the final presentation. The clinic site
director determines the clinical performance grade after consulting with all the attendings and
residents, if applicable, with whom the student worked.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
Provide the results of any customized NBME or NBME subject (shelf) examinations for the previous
three years.
2010-11
Year
N/A
Score
N/A
Percentile*
* National percentile, if relevant
2011-12
N/A
N/A
2012-13
N/A
N/A
Is a narrative assessment of student performance submitted in addition to or as a component of the
clerkship grade?
Yes
X No
Clerkship Outcomes/Evaluation
Comment on the adequacy of faculty (full-time, part-time, and volunteer), patients, and other resources
for this clerkship.
Our core faculty includes a clerkship director, associate director, and assistant director (all
involved in didactics, observed clinical encounters, objective structure clinical exams), in addition
to a full-time graduate-level educator, and a graduate-level public health educator devoted to
community projects. Additional faculty have protected time for team-based learning didactics and
observed clinical encounters. With the exception of three of our larger practices, there is only one
student assigned to each site. This ensures that the preceptors can focus all their attention on the
student. Clinical site directors in our main affiliate (Montefiore) have protected time for oversight
of student education. Clinical site directors at small group and solo practices receive a stipend to
offset productivity losses and carve out time for student education. Our clinical sites provide care to
a large number of patients, and our students have not had any difficulty in completing the diagnosis
and procedure requirements for the clerkship. They often exceed the minimum patient
requirements. We have a good working relationship with our community partners, and they are
invested in advancing our students’ understanding of the work done in community settings.
Provide a summary of student feedback on the clerkship (and any other evaluation data) for the past two
academic years; include the percent of students providing evaluation data. Note any recent changes in the
clerkship. If problems have been identified by student evaluations or other data, describe how these are
being addressed.
Completing the clinical rotation evaluations has been mandatory for all Einstein students for the
past several years; therefore, 100% of the students provided evaluation data. Students have
consistently rated the rotation as a positive educational experience and the Family Medicine
clerkship received a global rating from 4.07 to 4.37 out of 5 for the past two academic years. We
have provided intensive faculty development, and when necessary, jettisoned sites that were not
providing optimal educational experiences. We decreased the number of monthly students at our
Jamaica site from 4 to 3, so that each student would have more time with attendings (and less with
residents).
Students greatly value the outpatient clinical experience and comment on the independence and
responsibility they have caring for a diverse patient population. They appreciate the dedication and
the quality of teaching and attention they receive from their preceptors.
In response to students’ request for more clinical time and fewer lectures, three additional patient
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
care sessions were added to the rotation beginning with the 2011-2012 academic year. This extra
time was created by decreasing the number of lectures (which were also moved later in the
morning, after team-based learning, to improve our faculty on-time record). Team-based learning
sessions were incorporated into the clerkship about three years ago to foster more student-centered
learning and increased interaction among the students, but these were also decreased from 4 to 3
sessions in response to student requests for more clinic time and fewer assignments. Two OSCE
stations on communication skills were added two years ago, as well as a palliative care clinical
experience.
Students have commented that there were too many components to the clerkship and have also
requested some logistical changes regarding the timing of the exam, project presentations and
OSCEs. The clerkship is only four weeks long, and we honored the students’ frequent suggestion
for more clinical time. Providing them with the extra clinic time meant stacking several aspects of
their final evaluation on one day. We have removed the nutrition assignment for the clerkship and
have addressed some of the other logistical complexities, by putting all palliative care clinical
experiences on Monday afternoon, and through a streamlined online presence that allows easy
access to all aspects of their schedule.
Finally, we have an internal grant from 2013 to 2015 to reorganize the community project to
provide greater continuity from one rotation to the next, addressing concerns about depth and
impact of the projects.
Students' Overall Evaluation of the Family Medicine Clerkship:
June 2011-May 2013
4.5
4.43
Scale: 5=Strongly Agree; 1=Strongly Disagree
4.4
4.37
4.3
4.2
4.22
4.21
4.14
4.1
4.13
Teaching/Teacher
s
4.12
4.21
4.13
4.07
4.06
Orientation/Orga
nization
4.29
4.32
4.2
4.18
4
4.3
4.02
3.89
Feedback/Evaluati
on
Global
Assessment
3.9
3.83
3.9
3.8
3.7
(6/11-11/11)
(12/11-5/12)
(6/12-11/12)
LCME Medical Education Database 2014-2015
(12/12-5/13)
5/13 All
Clerkships)
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
2012-2013
Areas of Strength:
Major strengths of this clerkship expressed in student comments include:








Clinical experience
Large number and variety of patients
Teaching/quality of teaching
Independence/responsibility
Time spent with attendings
Interactions with patients
Exposure to outpatient medicine
OCE/OSCE
Suggested Areas For Improvement:







Logistical - Schedule exam, OSCE, and presentation on different days
Increase clinic time
Improve/remove project
Improve/remove ECHO
Too many components/evaluations/surveys/assignments
Improve organization of clerkship presentation
Omit presentation or make requirements less rigid
2011-2012
Areas of Strength:
Major strengths of this clerkship expressed in student comments include:






Clinical experiences (clinical sites, patients, out-patient care, emphasis on primary care –
best part of the clerkship)
Excellent attendings (working one-on-one, feedback, role models, etc.)
Relative autonomy, responsibility for patients
TBL sessions
Lectures
COPC project
Suggested Areas for Improvement:






Too many program elements, assignments, evaluations, “busy work” (25 comments);
Team-based learning (too many sessions, too long, not efficient, etc.) (18 comments);
Community project (rushed, superficial, not productive, move to another year)
(15
comments);
Grading, assessments (too much weight to community project, quizzes, etc.) (15 comments);
Not enough clinical time (8 comments);
Lectures (too many, lecturers come late, etc. (8 comments).
Identify major successes in the clerkship and challenges to be overcome (see instructions page).
The Family Medicine clerkship provides an excellent exposure to primary care medicine and an
opportunity for the students to interact one-on-one with family doctors. They gain an appreciation
of the benefits and challenges of taking care of the whole family in our current healthcare system.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
With the increasing number of students matriculating, we are continually searching for quality
clinical sites and enthusiastic preceptors to teach our students. We are piloting a program on a
volunteer basis for students during the first two years to have longitudinal primary care
experiences working with a complex patient over 18 months, and we have developed a blueprint for
transforming the clerkship into a longitudinal experience spanning the third year. We believe that
these innovations would strengthen students’ experience of primary care by enhancing the key
feature of continuity with patients, while also allowing our students greater involvement in systems
issues that contribute to the health of patients.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
PART C. REQUIRED CLERKSHIP FORM
Clerkship title:
Sponsoring department
or unit:
Name of clerkship director:
Geriatrics
Department of Medicine
Claudene George, M.D.
Clerkship Objectives
Are there written objectives for the clerkship?
Yes
X No
Were the clerkship objectives developed internally or adopted/adapted from external sources? If the
latter, please provide the source of the objectives.
Developed internally.
Provide a sample of about 10 learning objectives, including a selection of those related to the knowledge,
skills, and professional behaviors (as relevant) that are expected of students by the end of the
clerkship/clerkship rotation.
Clerkship Objectives:
By the end of this clerkship, the student will be able to:
1.
Identify medications, including anticholinergic, psychoactive, anticoagulant, analgesic, hypoglycemic, and
cardiovascular drugs that should be avoided or used with caution in older adults and explain the problems
associated with each.
2.
Differentiate among clinical presentations of delirium, dementia, and depression, and create appropriate
patient-centered treatment plans.
3.
Perform and interpret a cognitive assessment in older patients for whom there are concerns regarding memory
or function.
4.
Assess and describe baseline and current functional abilities (instrumental activities of daily living, activities of
daily living, and special senses) in an older patient by collecting historical data from multiple sources and
performing a confirmatory physical examination.
5.
Ask all patients > 65 y.o., or their caregivers, about falls in the last year, watch the patient rise from a chair and
walk (or transfer), then record and interpret the findings.
6.
Define and differentiate among types of code status, health care proxies, and advanced directives.
7.
Identify the psychological, social, and spiritual needs of patients with advanced illness and their family
members, and link these identified needs with the appropriate interdisciplinary team members
8.
Identify potential hazards of hospitalization for all older adult patients (including immobility, delirium,
medication side effects, malnutrition, pressure ulcers, procedures, peri- and post-operative periods, and
hospital acquired infections).
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
9.
Academic Year 2012-2013
Gain knowledge in and begin to assess and manage common diseases and syndromes in geriatrics. These
include but are not limited to Depression, Dementia, Delirium, Falls, Incontinence, Osteoporosis, Pressure
Ulcers, and Pain.
10. Discuss the unique aspects of care for the Geriatrics patient as it pertains to healthcare finance, community
resources, and transitions of care **
**New Objective for the 2013-2014 Academic Year
How are the clerkship objectives provided to students?
A written copy is provided during orientation and is available on the Einstein website designated
for the Geriatrics Clerkship
At what point during the clerkship are individual students’ clinical experiences (required patient
encounters and procedures) reviewed to ensure that the learning objectives are being met? Who conducts
that review?
The clerkship director reviews the student’s clinical experiences between the first and second week
of the clerkship.
Who is responsible for ensuring that each student’s clinical experiences are appropriate to meet the
objectives of the clerkship? Describe the actions that would be taken if a student were not making
satisfactory progress in meeting clerkship expectations for clinical experiences (required patient
encounters and procedures)?
Alternative encounters (readings, cases, lectures) or exposures are suggested to the student to
satisfy the requirement.
Preparation for Teaching
If resident physicians teach in the clerkship or otherwise supervise medical students, how are they
informed about the clerkship objectives and prepared for their teaching role?
Fellows are provided with the learning objectives during their orientation and receive instructions
that will prepare them for their teaching role.
How are faculty members across instructional sites oriented to the clerkship objectives and the methods of
student assessment?
Faculty are provided with the goals and objectives of the clerkship, as well as resources that offer
instruction on appropriate assessment.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
REQUIRED CLERKSHIP FORM (Continued)
Clerkship title:
Geriatrics
Methods for Assessing Student Performance
Describe the methods used in the clerkship to assess students’ core clinical skills (e.g., OSCEs, miniCEXs, observation by faculty or residents). How does the department ensure that such assessment occurs
for all students?
Students participate in a Gait and Functional Assessment OSCE and completed 2 Mini-CEXs. This
is a clerkship requirement.
How are students provided with mid-clerkship feedback? What mechanisms are in place to ensure that
mid-clerkship feedback is provided?
Students receive ongoing as well as mid-clerkship feedback from the precepting attending. Faculty
and students are encouraged to provide and receive such feedback. The Mini-CEXs and OSCE
provides such evidence.
Describe who determines a student’s final grade in the clerkship (e.g., clerkship director, site director,
other).
This clerkship is Pass/Fail.
Provide the results of any customized NBME or NBME subject (shelf) examinations for the previous
three years.
2010-11
Year
N/A
Score
N/A
Percentile*
* National percentile, if relevant
2011-12
N/A
N/A
2012-13
N/A
N/A
Is a narrative assessment of student performance submitted in addition to or as a component of the
clerkship grade?
Yes
X No
Clerkship Outcomes/Evaluation
Comment on the adequacy of faculty (full-time, part-time, and volunteer), patients, and other resources
for this clerkship.
Faculty, patients, and other resources are adequate for supervision of the students. Resources far
outnumber the number of students each cycle.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
Provide a summary of student feedback on the clerkship (and any other evaluation data) for the past two
academic years; include the percent of students providing evaluation data. Note any recent changes in the
clerkship. If problems have been identified by student evaluations or other data, describe how these are
being addressed.
Students' Overall Evaluation of the Geriatrics Clerkship:
June 2011-May 2013
4.5
4.4
4.4
Orientation/Or
ganization
4.3
4.2
4.2
Teaching/Teac
hers
4.2
Feedback/Eval
uation
4.2
4.1
4.1
4
4
4.1
Global
Assessment
4.1
4
4
4
4
4
4
3.9
(6/11-11/11)
(12/11-5/12)
(6/12-11/12)
(12/12-5/13)
Overall the students gave the Geriatrics Clerkship an excellent rating. Over 80% of the students
completed the evaluation and reported the following as major strengths: Clinical teaching, breadth
of exposure to the field, multiple learning opportunities, organization, and learning from ancillary
staff. Students expressed concerns about some transportation issues when travelling between sites
and expressed a desire for more patient contact.
In response to the students’ concerns, the medical school increased transportation services and
travel between sites was decreased whenever possible. Didactic sessions attended by all students
were updated to allow for more uniformity in teaching of required information.
Identify major successes in the clerkship and challenges to be overcome (see instructions page).
In an effort to increased uniformity across all sites, additional online resources were made available
to all students. Didactic sessions attended by all students across all sites were updated in order to
include core required content. The major challenge of this 2-week clerkship is to maintain adequate
patient contact while allowing for sufficient didactic sessions that will ensure that objectives are
being met by all.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
PART C. REQUIRED CLERKSHIP FORM
Clerkship title:
Sponsoring department
or unit:
Name of clerkship director:
Medicine Clerkship
Medicine
Amanda C. Raff, M.D.
Clerkship Objectives
Are there written objectives for the clerkship?
Yes
X No
Were the clerkship objectives developed internally or adopted/adapted from external sources? If the
latter, please provide the source of the objectives.
Developed internally.
Provide a sample of about 10 learning objectives, including a selection of those related to knowledge,
skills, and professional behaviors (as relevant) that are expected of students by the end of the
clerkship/clerkship rotation.
1. Describe the clinical expression and basic management principles of common acute and chronic
medical problems encountered on the inpatient internal medicine service.
2. Obtain a complete history and physical exam for an adult patient admitted to the internal
medicine service.
3. Order and interpret appropriate diagnostic tests applying the principles of sensitivity, specificity,
pre-test and post test predictive value probabilities, test performance characteristics, and cost.
4. Formulate a complete differential diagnosis for an adult patient admitted to the internal
medicine service based on the interpretation of the history, physical exam, and diagnostic testing.
5. Design a rational treatment program under appropriate supervision including assessing the
risks, benefits, and costs of treatment, selecting medications from within classes, using critical
pathways when appropriate, and taking into consideration the values and preferences of the
patient.
6. Follow patients daily assessing the patient's response to the treatment program and adjusting
the treatment program as indicated by clinical changes.
7. Communicate clearly with patients and their families including establishing rapport, recognizing
psychosocial issues, identifying hidden agendas, eliciting and educating patients on behavioral
changes with sensitivity to the patient's values and preferences.
8. Communicate clearly with all members of the care team including physicians, nurses, physical
therapists, nutritionist, social workers, and support staff. Communication skills include oral
communication in person, on the phone, and via clearly written, legible daily progress notes.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
9. Incorporate ethical practice into the care of your patients through the active application of
ethical principles, professionalism in all relationships, and participate with your team in discussion
with patients when delivering bad news, reviewing advanced directives, and obtaining informed
consent for procedures.
10. Continue to develop your skills in self-directed, life long learning including active reading about
medical diseases, identifying and utilizing high quality sources of information, critical reading of
the medical literature, application of evidence-based medicine to patient care, and utilization of
technology to further patient care.
How are the clerkship objectives provided to students?
The Medicine Clerkship goals and objectives are provided to each student at the initial orientation
session with the clerkship director. Each objective is reviewed during the orientation. The goals and
objectives are also posted on the eMED clerkship page and included in the online syllabus.
At what point during the clerkship are individual students’ clinical experiences (required patient
encounters and procedures) reviewed to assure that learning objectives are being met? Who conducts that
review?
Students are required to keep an online log of required clinical encounters and procedures. It is
expected that the students will meet the learning objectives for most of the required clinical
conditions and procedures in the care of actual patients. However, in the event that a student does
not have direct contact with a patient with a required condition, a list of alternate experience on
line cases are provided to the students. Three levels of supervision are provided to ensure the
students are meeting the learning objectives:
1. The clerkship administrator sends weekly reminders to students to be sure to log their cases.
2. The students meet face-to-face with the site leader for mid-cycle feedback and to review their
logs and make a plan to ensure they are exposed to all required clinical conditions and procedures.
3. The clerkship director checks the logs periodically throughout the clerkship and contacts any
students who are not logging patients or have missing required encounters.
Who is responsible for ensuring that each student’s clinical experiences are appropriate to meet the
objectives of the clerkship? Describe the actions that would be taken if a student were not making
satisfactory progress in meeting clerkship expectations for clinical experiences (required patient
encounters and procedures)?
The clerkship site leaders and clerkship director are responsible for ensuring that each student's
clinical experiences are appropriate to meet the objectives. Equivalency of the clinical experience
exposure is tracked by the clerkship director via the log of required clinical conditions and
procedures, and all students in the clerkship will be exposed to all required conditions and
procedures.
If a student is found to be lagging in the required clinical encounters, the first intervention is a
discussion with the site leader to clarify the problem: is the student not seeing the clinical conditions
or simply not logging them? If not logging, the student is reminded to log. For a student missing a
clinical condition, a plan is made with the student on how to remedy the deficit, either through a
clinical encounter or via an online case as an alternate experience.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
Preparation for Teaching
If resident physicians teach in the clerkship or otherwise supervise medical students, how are they
informed about the clerkship objectives and prepared for their teaching role?
The goals and objectives and general overview of the Medicine Clerkship are provided to every
resident via email with a signed receipt required centrally by the medical school.
Albert Einstein College of Medicine has a resident and non-faculty instructor teaching development
program: Teaching Star. As part of this program, a resident-as-teacher presentation is given to all
interns during orientation and offered yearly to all residents.
How are faculty members across instructional sites oriented to the clerkship objectives and the methods of
student assessment?
The goals and objectives and general overview of the Medicine Clerkship including methods of
student assessment are provided to every faculty member by the leaders.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
REQUIRED CLERKSHIP FORM (Continued)
Clerkship title:
Medicine Clerkship
Methods for Assessing Student Performance
Describe the methods used in the clerkship to assess students’ core clinical skills (e.g., OSCEs, miniCEXs, observation by faculty or residents). How does the department ensure that such assessment occurs
for all students?
The Medicine Clerkship offers both summative and formative assessment for the students.
Summative assessment includes:
1. Direct observation by faculty and residents assessed via the competency-based Einstein
Clinical Performance Evaluation.
2. The NBME Medicine Shelf Exam
Formative assessment includes:
1. A required Observed Clinical Exam (OCE)
2. A group Observed Structured Clinical Exam (G-OSCE)
3. Faculty feedback on 7 required formal History and Physical write-ups
4. Faculty feedback on an evidence-based medicine (EBM) presentation
The summative assessments are used to generate the final grade as described below. Each Site
Leader is responsible for collecting the evaluations of the faculty and residents. All students must
take the shelf exam or receive an Incomplete in the clerkship.
How are students provided with mid-clerkship feedback? What mechanisms are in place to ensure that
mid-clerkship feedback is provided?
The formative assessments are built into the curriculum. The OCE is a requirement of the College.
Each student knows he or she must complete the OCE, and site leader reviews that it was done on
the mid-cycle feedback and on the final grade report. The G-OSCE is scheduled centrally on
campus on a single day for all students. All students attend the G-OSCE. The faculty feedback on
the History and Physical write-ups and EBM presentations is incorporated into the weekly
preceptor sessions, which are provided at all sites.
Describe who determines a student’s final grade in the clerkship (e.g., clerkship director, site director,
other).
The final grade is determined by the Medicine Clerkship Grade Committee comprising the seven
site leaders and clerkship director. A grade meeting is held after each module. Each student is
presented by the second site leader, and consensus on the appropriate grade is reached by the
committee. The components of the grade include the Einstein Evaluation of Clinical Performance
and Professional Attributes and the shelf exam score.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
In the event that a student appeals his or her grade, a committee of the five site leaders who did not
work directly with the student is convened to review the evaluations and scores of the student. The
grade determined by the grade appeal committee is final.
Provide the results of any customized NBME or NBME subject (shelf) examinations for the previous
three years.
Year
2010-11
78.1
Score
60
Percentile*
* National percentile, if relevant
2011-12
77.5
54
2012-13
78.4
56
Is a narrative assessment of student performance submitted in addition to or as a component of the
clerkship grade?
Yes
X No
Clerkship Outcomes/Evaluation
Comment on the adequacy of faculty (full-time, part-time, and volunteer), patients, and other resources
for this clerkship.
The Einstein Medicine Clerkship has the full support of the Department of Medicine at each
affiliated hospital. Each site provides a site leader with protected time and administrative support.
The vast majority of the faculty who teach the students are full-time academic faculty at each site.
They serve as ward attendings, preceptors, and lecturers. The academic mission of the affiliated
hospitals supports the time commitment needed for attendings to provide meaningful teaching and
feedback to the students.
Students are exposed to a wide spectrum of diseases and disease presentations as a result of the
patient population served by our hospitals. The students have exposure to the required Clinical
Conditions and Procedures almost entirely in the context of actual patient encounters. Very few
alternate experiences are required.
Provide a summary of student feedback on the clerkship (and any other evaluation data) for the past two
academic years; include the percent of students providing evaluation data. Note any recent changes in the
clerkship. If problems have been identified by student evaluations or other data, describe how these are
being addressed.
Students are required to fill out an evaluation of Medicine Clerkship after completing the rotation.
This data is made available in semi-annual summaries. For December 2011 - May 2012 204
students completed the evaluation. For June - November 2012 170 students completed the
evaluation. For December 2012 - May 2013 216 completed the evaluation. The numeric scores are
a 5 point Likert Scale where 1 = unsatisfactory and 5 = excellent. In interpreting these date, means
> 3.5 are considered to be positive, 2.6 - 3.4 are equivocal, and < 2.5 are negative.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Evaluation Criteria
Learning objectives clear
Adequate site orientation
Conferences / seminars valuable
Participate appropriate level in patient care
Not assigned excess non-educational tasks
Clinical interactions supervised
Attendings effective teachers
Attendings good role models
House staff effective teachers
House staff good role models
Understand evaluation criteria
Received constructive feedback
Clerkship fostered growth
Overall positive learning experience
Overall organization/orientation
Overall teaching/teachers
Overall evaluation/feedback
Global assessment
Academic Year 2012-2013
December
2011 - May
2012
4.31
4.32
4.21
4.27
4.32
4.10
4.40
4.51
4.34
4.39
3.93
4.02
4.47
4.43
4.30
4.27
4.03
4.45
June November
2012
4.23
4.17
4.04
4.16
4.18
4.16
4.29
4.35
4.02
4.08
3.93
3.67
4.34
4.29
4.20
4.16
3.80
4.32
December
2012 - May
2013
4.37
4.27
4.18
4.39
4.38
4.37
4.39
4.42
4.42
4.42
4.11
3.88
4.40
4.40
4.32
4.37
3.99
4.40
Recent Changes in the Clerkship:
New clerkship director as of August 2012
New site leader Jacobi Medical Center as of September 2012
New Site Leader at North Shore-LIJ Health System as of January 2013 and August 2013
No major problems have been identified in the Medicine Clerkship.
Identify major successes in the clerkship and challenges to be overcome (see instructions page).
The Medicine Clerkship is the longest clerkship in the third-year curriculum and is a key formative
experience for the medical students. A major success of the clerkship is the consistent high quality
clinical education provided across 7 affiliated hospitals.
Two structural challenges have been presented to the Medicine Clerkship:
1. Conversion to electronic medical records at most sites:
At this time many of the sites have either completed or are in the progress of conversion to
electronic medical records. No sites allow third-year medical students to write notes in the EMR.
This presents a challenge as the creation of the History and Physical Admission Note and daily
Progress Note are tremendously valuable learning experiences for students.
This challenge has been addressed via clear explanation to the students about the continued value
of their notes as learning experiences. At sites that continue to have a paper record, students write
notes in the record. At sites with an EMR, students write paper notes using a number to refer to
each patient to ensure the notes are de-identified. At the end of the rotation these educational notes
are appropriately discarded. It is a clearly communicated expectation of the rotation to the
students, house staff, and faculty that the notes must be reviewed with the students daily by the
intern or resident.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
2. Conversion to a "Drip System" of floor-based teams and admissions at many sites:
In efforts to comply with work-hour regulations as well as to provide organized patient-centered
care, several sites have converted to a "Drip System" whereby the teams are floor-based with
assigned beds. Admissions can occur any day that a discharge makes a bed available. There is no
longer a "Q Day" admitting schedule, and admissions are no longer assigned in the ER (the team
sees the patient only upon arrival to the assigned floor bed). The Drip System is a current trend in
residency programs and is quite sensible in terms of patient care and resident workflow. However,
it poses problems in ensuring that each medical student has enough admissions and presentations to
the team attending.
This challenge is being addressed by instituting a more flexible on-call schedule for the students so
that they can admit patients when a bed is available on their team, with the expectation that the
students’ work hours will mirror those of the interns. In addition, the students and team attendings
are being encouraged to add small topic-based presentations to the work rounds to ensure that the
students have sufficient opportunity to present and be evaluated fully by the attending.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
PART C. REQUIRED CLERKSHIP FORM
Clerkship title:
Obstetrics & Gynecology and Women’s Health
Clerkship
Sponsoring department
or unit:
Name of clerkship director:
Department of Obstetrics & Gynecology and Women’s
Health
Amy Kesselman, M.D.
Clerkship Objectives
Are there written objectives for the clerkship?
Yes
X No
Were the clerkship objectives developed internally or adopted/adapted from external sources? If the
latter, please provide the source of the objectives.
The Association of Professors of Gynecology and Obstetrics (APGO) reviews the objectives on a
regular basis to ensure their relevance, importance and helpfulness in assisting with the
development of obstetrics and gynecology clinical clerkship curricula.
Provide a sample of about 10 learning objectives, including a selection of those related to the knowledge,
skills, and professional behaviors (as relevant) that are expected of students by the end of the
clerkship/clerkship rotation.
Clerkship Objectives:
By the end of this clerkship, the student will be able to:
1.
Develop competence in the medical interview and physical examination of women and incorporate ethical,
social and diversity perspectives to provide culturally competent healthcare.
2.
Apply recommended prevention strategies to women throughout the lifespan.
3.
Recognize role as a leader and advocate for women and girls.
4.
Demonstrate knowledge of preconception care including the impact of genetics, medical conditions,
environmental factors on maternal health and fetal development.
5.
Explain the normal physiological changes of pregnancy including interpretation of common diagnostic studies.
6.
Describe common problems in Obstetrics.
7.
Demonstrate Knowledge of Intrapartum Care.
8.
Demonstrate knowledge of Postpartum Care of the mother and newborn.
9.
Describe Menstrual Cycle Physiology, discuss puberty & menopause and explain normal and abnormal
bleeding.
10. Demonstrate knowledge of, and participate in counseling patients about various forms of contraception
including sterilization and abortion.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
11. Demonstrate knowledge of common benign gynecological conditions.
12. Describe common breast conditions and outline the evaluation of breast complaints.
13. Demonstrate knowledge of perioperative care and familiarity with gynecological procedures.
14. Describe gynecological malignancies including risk factors, signs and symptoms and initial evaluation.
How are the clerkship objectives provided to students?
The clerkship objectives are provided to the students during the site-wide orientation and are
accessed by students on eMED.
At what point during the clerkship are individual students’ clinical experiences (required patient
encounters and procedures) reviewed to ensure that the learning objectives are being met? Who conducts
that review?
Each site leader meets with their assigned students individually during the third week of the
rotation (mid-cycle feedback). The clerkship director checks in with the entire group each Tuesday
to identify any problems at the site.
Who is responsible for ensuring that each student’s clinical experiences are appropriate to meet the
objectives of the clerkship? Describe the actions that would be taken if a student were not making
satisfactory progress in meeting clerkship expectations for clinical experiences (required patient
encounters and procedures)?
Each site leader is responsible for ensuring that each student’s clinical experience is appropriate
and that every student meets the clerkship objectives. There is central oversight by the clerkship
director. At the first sign of a problem, the clerkship director is contacted, and a plan of action is
put in place. The student will meet with both site leader and clerkship director to ensure
satisfactory progress.
Preparation for Teaching
If resident physicians teach in the clerkship or otherwise supervise medical students, how are they
informed about the clerkship objectives and prepared for their teaching role?
Residents receive the objectives at the beginning of every academic year. Twice a year, residents
receive a lecture about improving resident teaching, and an interactive session takes place to
remind residents of their role in education. The evaluation forms that are used are reviewed with
the residents including suggestions for useful constructive/formative feedback as well as useful
comments in the summative evaluation.
How are faculty members across instructional sites oriented to the clerkship objectives and the methods of
student assessment?
Faculty receive a copy of the clerkship objectives at the beginning of each academic year.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
REQUIRED CLERKSHIP FORM (Continued)
Clerkship title:
Obstetrics & Gynecology and Women’s Health Clerkship
Methods for Assessing Student Performance
Describe the methods used in the clerkship to assess students’ core clinical skills (e.g., OSCEs, miniCEXs, observation by faculty or residents). How does the department ensure that such assessment occurs
for all students?
During the course of the rotation, each student is observed by a faculty member eliciting a complete
obstetrics and gynecology history from a patient. The faculty member also observes the student
performing a physical examination on that patient. The student is then required to formulate an
assessment and plan for that patient and write a note. The student receives constructive feedback at
the end of the encounter.
The clerkship director observes each student perform a breast and pelvic exam on a model during
the last week of the rotation. The assessment is summative, and the students are graded objectively
using a checklist format.
The students also are tested in an oral examination format. The students are given two case
vignettes – one in obstetrics and one in gynecology. The student needs to elicit a history from the
examiner based on the chief complaint presented. The student describes the physical exam that
needs to be performed in such a case, as well as the labs and imaging that need to be ordered in
order to make an assessment and plan.
How are students provided with mid-clerkship feedback? What mechanisms are in place to ensure that
mid-clerkship feedback is provided?
The site leader meets individually with each of the students rotating at his/her site in order to
provide feedback during the third week of the rotation. The site leader informs the students that
they are receiving mid-cycle feedback, and the form is signed by both the student and the site
leader. During that mid-cycle feedback session, the site leader reviews the student’s progress based
on the evaluations received from residents and faculty. Each student fills out a self-assessment sheet
that is reviewed with the faculty member. The patient log is reviewed with the student to make sure
that the student is involved in a variety of patient encounters and is meeting the clerkship
objectives. The site leader identifies areas of strength as well as areas that may need improvement.
Learning goals are set for the remainder of the rotation.
Describe who determines a student’s final grade in the clerkship (e.g., clerkship director, site director,
other).
The site leader compiles the grade based on the student’s clinical performance, OSCE and oral
exam grade, as well as the grade from the shelf examination. Included in the clinical performance
are the evaluations that the students received from faculty and residents during the course of the
clerkship, evaluations of participation in didactic sessions, and case presentation grades. The site
leader will then write constructive comments as well as a narrative summary describing the
student’s performance. Before the grade is submitted to the Registrar’s office, the clerkship
director reviews the assigned grade and narrative. The clerkship director will then submit the
grade to the registrar.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
Provide the results of any customized NBME or NBME subject (shelf) examinations for the previous
three years.
2010-11
Year
77.8
Score
67
Percentile*
* National percentile, if relevant
2011-12
77.6
65
2012-13
78.6
68
Is a narrative assessment of student performance submitted in addition to or as a component of the
clerkship grade?
Yes X No
Clerkship Outcomes/Evaluation
Comment on the adequacy of faculty (full-time, part-time, and volunteer), patients, and other resources
for this clerkship
The resources that are available for students to use during the rotation include a large number of
faculty and residents, the APGO website, which includes the Medical Student Educational
Objectives, as well as a question bank that prepares the students for shelf examination-type
questions. Students are also introduced to the ACOG website, which includes access to committee
opinions as well as technical bulletins on a variety of topics. Each student receives a copy of the
Beckmann textbook, 6th edition, for use during the course of the clerkship. A suture kit is loaned to
each student in order to facilitate practice in knot tying skills.
Provide a summary of student feedback on the clerkship (and any other evaluation data) for the past two
academic years; include the percent of students providing evaluation data. Note any recent changes in the
clerkship. If problems have been identified by student evaluations or other data, describe how these are
being addressed.
Students' Overall Evaluation of the Obstetrics & Gynecology Clerkship:
June 2011-May 2013
4.6
Scale: 5=Strongly Agree; 1=Strongly Disagree
4.38
4.4
4.3
4.27
Orientation/Organ
ization
4.29
4.16
4.2
4.14
4
4
4.15
4.08
Teaching/Teacher
s
4.21
4.12
3.91
3.95
3.95
3.94
Feedback/Evaluati
on
3.8
3.89
3.84
3.78
3.6
Global Assessment
3.71
3.4
3.39
3.2
(6/11-11/11)
(12/11-5/12)
(6/12-11/12)
LCME Medical Education Database 2014-2015
(12/12-5/13)
5/13 All Clerkships)
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
Identify major successes in the clerkship and challenges to be overcome.
The areas of strength that are frequently cited for the clerkship include excellent faculty, resident
teaching, wide spectrum of clerkship experiences, organization of clerkship as well as didactic
lectures.
The didactic sessions on Tuesdays allow students from all sites to come together and share
experiences. The students are exposed to several faculty from each of the department divisions. The
clerkship teaching day is designed so that all students have a uniformed didactic experience. This
enables the student to have more clinical time on the wards rather than being pulled away from
patient care for lectures.
Many of our students receive high scores on the shelf examination. The results of the oral exam
correlate well with the shelf examination and clinical performance grades. On average, 1-2 students
fail the shelf exam in any given academic year.
There are some areas that have been identified for improvement prior to the start of this academic
year and have already been implemented as change for the current year.
The Oral exam has been restructured so that there is a little less time pressure for the students.
Whereas last year they had five stations and 7 minutes at each station, we changed the oral OSCE
and divided it into separate components.
The clerkship director assesses each individual student’s ability to demonstrate the steps of
performing a breast and complete pelvic exam. The exam is objective, graded using a checklist and
all students are assessed by the same examiner (clerkship director).
The second part of the exam comprises two cases – one obstetrics case and one gynecology case.
The students are given a chief complaint and need to elicit a complete or focused history depending
on the case as well as ask for physical examination findings and lab/imaging results. The student is
required to formulate an assessment and plan for that scenario.
On the first day of orientation, the students are handed the 58 APGO medical student educational
topics and are informed that two of these topics will be tested during the oral exam. Examples of
the oral exam are given to the students by the clerkship director during the review session the last
week of the rotation. The oral exam tests the student’s knowledge of common clinical scenarios that
they have been exposed to during the rotation.
A common suggested area for improvement is that the students not be sequestered during the oral
exam. The students arrive at 7:45 am and are usually dismissed between 10:30am and 11:30 am,
depending on the size of the group. The students do not like that they are required to stay until the
last student has completed their exam. However, the exam is structured so that each student is
asked the same two questions. Each vignette is graded using a specific checklist. For the purpose of
exam integrity, we will continue to require that the students remain sequestered until the last
student has completed their examination.
The patient logs have also been simplified from last year, and there continue to be technical
difficulties that are not in the control of the clerkship.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
PART C. REQUIRED CLERKSHIP FORM
Clerkship title:
Sponsoring department
or unit:
Name of clerkship director:
Pediatrics Clerkship
Department of Pediatrics
Jeffrey Avner, M.D. and Miriam Schechter, M.D.
Clerkship Objectives
Are there written objectives for the clerkship?
Yes
X No
Were the clerkship objectives developed internally or adopted/adapted from external sources? If the
latter, please provide the source of the objectives.
Objectives for the Pediatrics Clerkship were developed internally by the clerkship directors and
site leaders with input from the APA/COMSEP General Pediatric Clerkship Curriculum.
Provide a sample of about 10 learning objectives, including a selection of those related to the knowledge,
skills, and professional behaviors (as relevant) that are expected of students by the end of the
clerkship/clerkship rotation.
Clerkship Objectives:
By the end of this clerkship, the student will be able to:
GENERAL OBJECTIVES:
1. Elicit a well-organized, accurate and appropriate history.
2.
Perform an accurate physical exam appropriate to the age of the child.
3.
Generate a differential diagnosis for commonly seen pediatric diseases.
4.
Select appropriate diagnostic studies.
5.
Interpret diagnostic studies.
6.
Formulate a patient centered management plan.
7.
Formulate a case summary.
8.
Document patient oriented information effectively.
9.
Employ clinical literature and basic texts in analyzing and understanding clinical problems.
10. Present all pertinent patient oriented information effectively.
11. Communicate effectively with patients, parents and families.
12. Demonstrate a fund of knowledge about the identified core conditions.
13. Establish productive, respectful working relationships with all health team members.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
14. Educate colleagues about pediatric conditions and clinical questions.
PEDIATRIC-SPECIFIC OBJECTIVES:
15. Distinguish between a well appearing child and one who requires immediate attention.
16. Differentiate the medical, emotional, and social needs of children of varying ages.
17. Recognize the common pediatric problems that require hospitalization.
18. Formulate and discuss the recommended pediatric clinical preventive services in a patient centered manner.
19. Evaluate children with the common problems found in an ambulatory setting.
20. Recognize normal childhood growth and developmental milestones.
21. Perform a normal newborn exam.
22. Illustrate the role that pediatricians and other health professionals play as advocates for children.
How are the clerkship objectives provided to students?
The objectives are provided to the students in printed form on the first day of the clerkship, and the
clerkship directors review the objectives with them in person at orientation for the rotation. In
addition, the objectives are available online on the clerkship page on eMED.
At what point during the clerkship are individual students’ clinical experiences (required patient
encounters and procedures) reviewed to ensure that the learning objectives are being met? Who conducts
that review?
Students’ clinical experiences, including required patient encounters, conditions, and procedures
are reviewed at the mid-point of the rotation during the mid-cycle feedback session. The review is
conducted with each student by the site leader.
Who is responsible for ensuring that each student’s clinical experiences are appropriate to meet the
objectives of the clerkship? Describe the actions that would be taken if a student were not making
satisfactory progress in meeting clerkship expectations for clinical experiences (required patient
encounters and procedures)?
It is the responsibility of the site leader to ensure the student is meeting objectives and fulfilling the
requirements for patient encounters, conditions and procedures. If satisfactory progress is not
being made, the site leader will provide the most appropriate of the following options to the student
for successfully completing all requirements: 1) directing the student or supervising faculty to seek
patients with the specific conditions/procedures needed, 2) directing the student to an alternate
experience, such as an online case or reading assignment covering the missing experience or 3)
informing the student of an existing clerkship teaching activity, such as the OSCE or problembased-learning sessions that can serve as the alternative experience.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
Preparation for Teaching
If resident physicians teach in the clerkship or otherwise supervise medical students, how are they
informed about the clerkship objectives and prepared for their teaching role?
At the beginning of the academic year, all residents at all clerkship sites receive, via email, a packet
of information regarding the clerkship. It includes the rotation objectives, a description of the
third-year student’s clinical experience and expectations, the teaching role of the residents, and the
residents’ role in student assessment. Instructions are provided for completion of the Einstein
Evaluation of Clinical Performance and Professional Attributes form. Residents must provide an
electronic signature acknowledging receipt and review of the packet.
As part of institution-wide intern orientations, all PGY1s attend a standardized session on student
teaching, entitled Teaching Star, produced by Einstein’s Office of Medical Education. Senior
residents also receive the Teaching Star lecture annually. Several sites provide additional resident
as teacher conferences and training sessions during the year covering topics such as adult learning
theory, giving feedback, inpatient teaching strategies. In addition, at program-based pediatric
intern orientations, site leaders review the clerkship objectives, the role of the student, and the
teaching and assessment expectations of the residents.
How are faculty members across instructional sites oriented to the clerkship objectives and the methods of
student assessment?
Site leaders at the clerkship sites provide faculty with the objectives annually, at the start of the
academic year through email. In addition, site leaders provide ongoing review of student
assessment methods for both the observed clinical encounter (OCE) and summative clerkship
evaluation. The OCE evaluation form and Einstein Evaluation of Clinical Performance and
Professional Attributes form, with instructions, are provided in paper and/or electronic form.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
REQUIRED CLERKSHIP FORM (Continued)
Clerkship title:
Pediatrics Clerkship
Methods for Assessing Student Performance
Describe the methods used in the clerkship to assess students’ core clinical skills (e.g., OSCEs, miniCEXs, observation by faculty or residents). How does the department ensure that such assessment occurs
for all students?
There are a number of methods utilized to assess students’ clinical skills. Students on the Pediatrics
Clerkship are routinely observed in the course of patient care. During inpatient rounds, students
are observed by faculty and residents, presenting and discussing their patients. All student
admission and progress notes must be reviewed by senior residents or attendings. In the outpatient
setting, including the emergency department and clinics, students also present the patients they
evaluate to an attending and have their notes reviewed. In addition, a directly observed clinical
encounter (OCE), including a complete history, physical exam and appropriate counseling, is a
requirement of the rotation, as per Einstein policy. This assessment is done by faculty only and the
site leader ensures that it takes place. As in all required clerkships, completion of the OCE must be
documented on the student’s final evaluation form.
Furthermore, all students on the clerkship participate in a formative Observed Structured Clinical
Exercise (OSCE) during which they receive immediate feedback from standardized patients and
faculty on communication skills, professionalism skills, interview and counseling skills, and notewriting skills. Additionally, all students at all sites participate in problem-based learning sessions
where knowledge, and skills such as clinical reasoning, teamwork, and patient management are
assessed by the attending facilitator. Finally, all students are required to submit two comprehensive
patient write-up assignments, which are reviewed by the site directors for proficiency in
documentation of an H & P as well as use of the literature, clinical reasoning, and patient
assessment skills.
How are students provided with mid-clerkship feedback? What mechanisms are in place to ensure that
mid-clerkship feedback is provided?
The site leaders at each site meet individually with each student at the mid-point of the rotation.
The required components of the mid-cycle feedback session, as per Einstein policy, are completed
(review of progress in completion of required activities, patient log, clinical performance including
student self-assessment, and learning goals for remainder of rotation). As in all required clerkships,
completion of mid-cycle feedback must be documented on the student’s final evaluation form.
Describe who determines a student’s final grade in the clerkship (e.g., clerkship director, site director,
other).
The site leader compiles evaluations (using the Einstein Evaluation of Clinical Performance and
Professional Attributes form) from all faculty and residents who supervised the student and
prepares a final, composite evaluation form, including a narrative and grade. This is reviewed by
the Committee on Student Education in Pediatrics, composed of all site leaders, before the
clerkship director submits the final grade.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
Provide the results of any customized NBME or NBME subject (shelf) examinations for the previous
three years.
2010-11
Year
79.7
Score
65
Percentile*
* National percentile, if relevant
2011-12
78.9
62
2012-13
79.0
60
Is a narrative assessment of student performance submitted in addition to or as a component of the
clerkship grade?
Yes
X No
Clerkship Outcomes/Evaluation
Comment on the adequacy of faculty (full-time, part-time, and volunteer), patients, and other resources
for this clerkship.
At all clerkship sites, the majority of the teaching faculty are full-time and hospital based
pediatricians who are readily available for student teaching in each of the clinical venues including
inpatient units, outpatient clinics (general and subspecialty), emergency department and newborn
nursery. Often they are the same faculty teaching the house staff at the site. Faculty also teach
students in lectures, small group conferences, and PBL sessions. In general, they are eager to
participate and be involved in the student program. Site leaders are intimately involved in
supervision and teaching of students and organization of the program at their sites. The
Department of Pediatrics also provides a Student Coordinator who provides administrative support
to the clerkship. Despite seasonal variations, there is more than an adequate number of patients for
our students to care for. This is because they are placed in multiple venues, including the inpatient
units, outpatient clinics, the emergency department, and newborn nursery, to ensure their exposure
to many high-volume patient care settings.
Provide a summary of student feedback on the clerkship (and any other evaluation data) for the past two
academic years; include the percent of students providing evaluation data. Note any recent changes in the
clerkship. If problems have been identified by student evaluations or other data, describe how these are
being addressed.
Students are required to complete clerkship evaluation forms at the end of their rotation. The
response rate for evaluations is at or near 100% for the past 2 years, per the mandatory evaluation
policy. Students are asked many questions about the clerkship which are summarized into four
main categories. Results in these areas for the past two years are shown in the table below.
Rated on a 5-point scale 1-lowest, 5-highest
June-Nov 2011
Dec 2011May 2012
N=94
N=86
Orientation/Organization 4.37
4.5
Teaching/Teachers
4.32
4.35
Feedback/Evaluation
4.13
4.23
Global Assessment
4.61
4.53
LCME Medical Education Database 2014-2015
June-Nov 2012
N=94
4.52
4.44
4.14
4.52
Dec 2012-May
2013
N=85
4.65
4.49
4.20
4.68
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
In summary, this rotation receives very high ratings in most areas. Student comments reflect an
appreciation for the organization of the rotation, the overall excellent and supportive teaching
environment, and the variety of clinical settings.
The biggest change in the clerkship since the last review is the replacement of one clinical site
(Flushing Hospital) with another (St. Barnabas Hospital). In addition, the site leader there has
changed twice in the last three years. The clerkship directors have worked closely with the site
leaders to ensure a smooth and successful transition. Additional changes include the incorporation
of the online interactive CLIPP (Computer Learning in Pediatrics Program) cases and a formative
Observed Structured Clinical Exercise using standardized patients into the clerkship.
Identify major successes in the clerkship and challenges to be overcome (see instructions page).
In general, the Pediatrics Clerkship has been highly successful; in fact, it is often the highest rated
clerkship in the College. We believe our success lies in the dedicated, attentive site leaders, the
overall organization of the rotation, the variety of clinical experiences, the opportunity for first-line
patient care (i.e., in the ED and clinics), and the generally welcoming, supportive academic
environments at the sites.
We have also had much success with some specific programs in the clerkship, which are outlined
below.
Successes:
1) Write-ups: Integration of basic science- In the two patient write-up assignments, students are
required to discuss one of the items on their differential diagnosis at the cellular or molecular level,
based on material learned in the preclinical years. This helps them see the correlation of molecular
science to clinical medicine.
2) Problem-based learning (PBL): Clinical reasoning- Several years ago, a set of cases was
developed by the site leaders for use in problem based learning sessions which take place at all sites.
Students work as a “collective brain” to work through the cases, develop and then narrow a
differential diagnosis, and research and then teach each other learning issues, all under the
supervision of a faculty facilitator. Most recently, as part of a grant to teach palliative care to
medical students, an additional PBL case was developed and added, specifically covering the topic
of palliative care in a chronically ill child.
3) Observed Structured Clinical Exercise (OSCE): Adolescent care- Since July 2011, all students
participate in a formative Observed Structured Clinical Exercise (OSCE) midway through the
clerkship. The students interview a standardized patient playing an apathetic adolescent presenting
with vomiting who turns out to be pregnant. Student must get a history including a full social
history, provide counseling and later write a note on the encounter. They receive immediate
feedback from the SPs and observing faculty on their communication, professionalism, history
taking and note-writing skills. The evaluations from the students have been exceptionally positive
on the overall value of the experience and specifically the feedback they receive.
Challenges:
One challenge is having multiple (5) clerkship sites and ensuring that the large number of residents
and faculty who teach our students remain apprised of the clerkship objectives, clinical and
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
didactic components of the clerkship, student roles, and their own roles in education and
assessment of the students. This past year, we created a unified document that incorporates all
these topics to share with all the teachers who work with our students. In addition, the site leaders
take responsibility for communicating frequently and working closely with the house staff and
attendings at their respective sites to reinforce this important information. Furthermore, the site
leaders are a cohesive group who meet on a regular basis to discuss updates, troubleshoot and share
ideas to maintain the flow of information.
An additional challenge at times is the fluctuation in numbers of students assigned to the clerkship
for different cycles throughout the year. When we are given students beyond our usual capacity,
this results in crowding on the inpatient units. When there are far fewer students assigned than
usual, there may be several sites with only 2-3 students making group learning (such as PBL) more
challenging.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
PART C. REQUIRED CLERKSHIP FORM
Clerkship title:
Sponsoring department
or unit:
Name of clerkship director:
Psychiatry Clerkship
Department of Psychiatry & Behavioral Sciences
Audrey Walker, M.D.
Clerkship Objectives
Are there written objectives for the clerkship?
Yes
X No
Were the clerkship objectives developed internally or adopted/adapted from external sources? If the
latter, please provide the source of the objectives. Developed internally.
Provide a sample of about 10 learning objectives, including a selection of those related to the knowledge,
skills, and professional behaviors (as relevant) that are expected of students by the end of the
clerkship/clerkship rotation.
Clerkship Objectives:
By the end of this clerkship, the student will be able to:
1.
Demonstrate patient interviewing technique, incorporating a mental status examination.
2.
Elicit and elaborate a chief psychiatric complaint, a psychiatric history, a general medical history, and a
personal and family history.
3.
Demonstrate an understanding and integration of the components of a mental status examination into a
diagnostic formulation and/or differential diagnosis.
4.
Demonstrate an attitude of empathy, respect, and concern for your patient regardless of patient problems or
behavior. This includes a demonstration and understanding of similarities and differences between student
and patient that contribute to the therapeutic relationship.
5.
Demonstrate an understanding of core psychiatric disorders
6.
Demonstrate a working knowledge of psychopharmacology principles and treatments in core psychiatric
disorders.
7.
Collaborate with sub-specialists in medicine and psychiatry.
8.
Demonstrate meticulousness in eliciting history appropriate to issues of suicide, homicide, substance and
alcohol abuse, domestic violence, and child abuse or neglect.
9.
Demonstrate the capacity to integrate information elicited and observed into an organized and
comprehensive format in both oral and written presentation.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
How are the clerkship objectives provided to students?
These objectives are sent electronically to the students in the week prior to the beginning of the
clerkship and are reviewed at the clerkship orientation.
At what point during the clerkship are individual students’ clinical experiences (required patient
encounters and procedures) reviewed to ensure that the learning objectives are being met? Who conducts
that review?
Ongoing review by clerkship director and administrative assistant on a weekly basis via eMED. If
inadequacies are identified, the appropriate site director is notified.
Who is responsible for ensuring that each student’s clinical experiences are appropriate to meet the
objectives of the clerkship? Describe the actions that would be taken if a student were not making
satisfactory progress in meeting clerkship expectations for clinical experiences (required patient
encounters and procedures)?
Each site director is responsible for ensuring that students’ clinical experiences are adequate. At
the mid-clerkship evaluation meeting, the site director reviews patient logs and identifies the areas
of clinical experience the student needs to have in the remainder of the clerkship.
Preparation for Teaching
If resident physicians teach in the clerkship or otherwise supervise medical students, how are they
informed about the clerkship objectives and prepared for their teaching role?
Resident physicians who teach medical students in the clerkship receive orientation sessions run by
the site director at the beginning of the academic year. In these sessions, clerkship objectives are
reviewed and orientation to the teaching role is provided.
How are faculty members across instructional sites oriented to the clerkship objectives and the methods of
student assessment?
Orientation of faculty members is provided by the site director at each clinical site. Interested
faculty members and senior residents are also invited to attend the tri-annual site directors
meeting.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
REQUIRED CLERKSHIP FORM (Continued)
Clerkship title:
Psychiatry Clerkship
Methods for Assessing Student Performance
Describe the methods used in the clerkship to assess students’ core clinical skills (e.g., OSCEs, miniCEXs, observation by faculty or residents). How does the department ensure that such assessment occurs
for all students?
Observed clinical exams; observation of patient interviews conducted by faculty and teaching
residents; case conferences.
How are students provided with mid-clerkship feedback? What mechanisms are in place to ensure that
mid-clerkship feedback is provided?
Each medical student has an individual meeting with the site director at mid-cycle.
Describe who determines a student’s final grade in the clerkship (e.g., clerkship director, site director,
other).
The site director determines the student’s final grade; the clerkship director reviews all
components and the final grade. The clerkship director is available to discuss the final grade with a
student if a dispute over this grade cannot be resolved by the student and site director.
Provide the results of any customized NBME or NBME subject (shelf) examinations for the previous
three years.
2010-11
Year
81.6
Score
60
Percentile*
* National percentile, if relevant
2011-12
80.5
55
2012-13
81.1
56
Is a narrative assessment of student performance submitted in addition to or as a component of the
clerkship grade?
Yes
X No
Clerkship Outcomes/Evaluation
Comment on the adequacy of faculty (full-time, part-time, and volunteer), patients, and other resources
for this clerkship.
Faculty and resources for the Psychiatry Clerkship are currently adequate.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
Provide a summary of student feedback on the clerkship (and any other evaluation data) for the past two
academic years; include the percent of students providing evaluation data. Note any recent changes in the
clerkship. If problems have been identified by student evaluations or other data, describe how these are
being addressed.
Students' Overall Evaluation of the Psychiatry Clerkship:
June 2011-May 2013
4.7
Scale: 5=Strongly Agree; 1=Strongly Disagree
4.6
4.56
4.52
4.52
4.56
4.5
4.4
4.4
4.36
4.45
4.41
4.3
4.29
4.2
4.31
Orientation/Orga
nization
4.37
4.3
4.36
4.29
4.21
4.1
4.15
4.16
4
4.02
Teaching/Teache
rs
Feedback/Evalua
tion
Global
Assessment
3.89
3.9
3.9
3.8
3.7
(6/11-11/11)
(12/11-5/12)
(6/12-11/12)
(12/12-5/13)
5/13 All Clerkships)
Identify major successes in the clerkship and challenges to be overcome.
Strengths:
Excellent teaching by attendings and residents
Variety of patients (adults, adolescents)
Interaction with patients/variety of patients
Level of responsibility/autonomy (like a sub-intern)
Multiple learning opportunities (small groups, lectures, etc.)
Suggested Areas for Improvement
More exposure to child and adolescent psychiatry at selected sites
Exposure to consultation – liaison psychiatry at all sites.
More feedback/interactions with site directors
Emergency room experience for all clinical sites
Standardization of all didactics across sites
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
Changes in Clerkship:
1). Emergency Room Shifts are now scheduled for all psychiatry clerkship sites.
2). One afternoon on first day of the clerkship required for clerks from all sites where
centralized lectures on the Psychiatric Interview and the Mental Status Exam . This is in response
to student feedback.
3). New Site leader at Four Winds Hospital: Dr. Sarah Klagsbrun.
New Site leader at Montefiore Hospital: Dr. Howard Forman
New Site leader at Bronx Lebanon Hospital: Dr. Katya Frischer
4). The Maimonides site was added in 2012. The site leader there is Dr. Joseph Carmody.
5). The Beth Israel site was removed as of the current academic year.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
PART C. REQUIRED CLERKSHIP FORM
Clerkship title:
Sponsoring department
or unit:
Name of clerkship director:
Radiology
Department of Radiology
Marjorie Stein, M.D.
Clerkship Objectives
Are there written objectives for the clerkship?
Yes
X No
Were the clerkship objectives developed internally or adopted/adapted from external sources? If the
latter, please provide the source of the objectives.
The objectives were developed internally
Provide a sample of about 10 learning objectives, including a selection of those related to the knowledge,
skills, and professional behaviors (as relevant) that are expected of students by the end of the
clerkship/clerkship rotation.
Clerkship Objectives:
By the end of this clerkship, the student will be able to:
1. Interpret CXRs.
2. Identify findings in common radiologic emergencies such as misplaced tubes, pneumothorax,
pneumoperitoneum
3. Identify normal anatomical landmarks and common diseases on plain films and crosssectional modalities.
4. Identify the most appropriate imaging exam for a given clinical condition and when in doubt,
located evidence-based resources to find this information.
5. Discuss radiation safety and ALARA.
6. Discuss uses and contraindications of intravenous contrast
7. Discuss various types of imaging exam/procedures including their indications,
contraindications, and complications.
8. Demonstrate presentation skills for effective communication of radiologic findings of disease
processes
9. Describe the role of the radiologist as a consultant
How are the clerkship objectives provided to students?
a. Listed in Radiology Clerkship syllabus on Einstein learning management system (eMED).
b. Students are given an introductory letter the first day of the clerkship containing the objectives.
c. The site director then discusses the nuts and bolts of the clerkship, including the objectives,
with the students on the first day of the clerkship.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
At what point during the clerkship are individual students’ clinical experiences (required patient
encounters and procedures) reviewed to ensure that the learning objectives are being met? Who conducts
that review?
Site director reviews each student’s required patient encounters and procedures during mid-cycle
feedback session.
Who is responsible for ensuring that each student’s clinical experiences are appropriate to meet the
objectives of the clerkship? Describe the actions that would be taken if a student were not making
satisfactory progress in meeting clerkship expectations for clinical experiences (required patient
encounters and procedures)?
Site director is responsible. If a student is not meeting requirements, he (she) is specifically told
where and when within the department the specific encounter/procedure would be taking place.
For example, if the student had not seen a required procedure such as an upper GI series, the site
director would inform the student where to go within the department, who would be conducting the
procedure, and what time the procedure would be occurring. The site director would likely
personally take the student to the fluoroscopic suite.
Preparation for Teaching
If resident physicians teach in the clerkship or otherwise supervise medical students, how are they
informed about the clerkship objectives and prepared for their teaching role?
The residents all receive a copy of the clerkship introductory letter listing the objectives. They also
receive a didactic lecture on the medical student radiology clerkship, which includes objectives and
teaching tips.
How are faculty members across instructional sites oriented to the clerkship objectives and the methods of
student assessment?
They all receive a copy of the clerkship introductory letter specifying the objectives and methods of
student assessment.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
REQUIRED CLERKSHIP FORM (Continued)
Clerkship title:
Radiology
Methods for Assessing Student Performance
Describe the methods used in the clerkship to assess students’ core clinical skills (e.g., OSCEs, miniCEXs, observation by faculty or residents). How does the department ensure that such assessment occurs
for all students?
Student assessment is made via direct observation by faculty. Site directors elicit feedback from
faculty who have interacted with the students.
How are students provided with mid-clerkship feedback? What mechanisms are in place to ensure that
mid-clerkship feedback is provided?
The site director meets with each student to provide mid-clerkship feedback. Students are required
to meet with the site director midway through the clerkship and provide a copy of their logs in
progress. The log must be signed by the student and site director, and a copy is kept by the
radiology administrative assistant.
Describe who determines a student’s final grade in the clerkship (e.g., clerkship director, site director,
other).
The site director determines final grade, which in our clerkship is Pass/Fail only.
Provide the results of any customized NBME or NBME subject (shelf) examinations for the previous
three years.
2010-11
Year
N/A
Score
N/A
Percentile*
* National percentile, if relevant
2011-12
N/A
N/A
2012-13
N/A
N/A
Is a narrative assessment of student performance submitted in addition to or as a component of the
clerkship grade?
Yes
X No
Clerkship Outcomes/Evaluation
Comment on the adequacy of faculty (full-time, part-time, and volunteer), patients, and other resources
for this clerkship.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
Resources are very adequate. We have a large number of dedicated faculty, a plethora of patients
with a vast array of pathology, and excellent technology and educational resources.
Provide a summary of student feedback on the clerkship (and any other evaluation data) for the past two
academic years; include the percent of students providing evaluation data. Note any recent changes in the
clerkship. If problems have been identified by student evaluations or other data, describe how these are
being addressed.
Students' Overall Evaluation of the Radiology Clerkship:
June 2011-May 2013
4.9
4.8
4.8
4.8
4.7
4.7
4.7
4.7
Orientation/Or
ganization
4.7
4.6
4.6
4.5
4.5
4.4
4.5
4.5
4.6
Teaching/Teac
hers
Feedback/Eval
uation
4.5
4.5
Global
Assessment
4.4
4.5
4.3
4.3
4.2
(6/11-11/11)
(12/11-5/12)
(6/12-11/12)
(12/12-5/13)
The data indicate that levels of student enthusiasm for the overall clerkship remains high at all
sites. Overall, students gave the Radiology clerkship a rating of 4.7-4.8 out of 5.00. 84 students
who participated in the Radiology clerkships at Jacobi, Montefiore and North Shore – Long Island
Jewish Heath System between December 2012 and May 2013 responded.
In response to the comment that some resident conferences are too advanced for medical students,
students are instructed that if they find a particular resident conference too advanced, they can
either return to their specific rotation (e.g., return to chest reading room if they are assigned that
day to chest interpretation), do their assigned on-line CORE case, or work on their required
PowerPoint presentations.
In response to requests for more exposure to various modalities as ultrasound, CT, and MRI,
students rotate through various radiologic subspecialties including CT/MRI and ultrasound. We
have added 15 required conditions that the students must see and document in the logs, which
guarantees increased exposure to cross-sectional imaging. Also, all students complete three
interactive virtual patient cases, which present different clinical scenarios and appropriate imaging
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
management strategies. Students receive a set of didactic lectures highlighting common conditions
as well as the appropriate imaging test.
In response to comments that some residents are not interested in teaching, the vast majority of
residents like teaching, and these are the individuals who are encouraged to work directly with the
students. I think the new evaluation system in which the students can formally evaluate the
residents will make all the residents more responsive to the education of Einstein students.
In response to complaints about scheduling structure and orientation, I spoke to site leaders about
properly orienting the students and making sure attendings and residents are aware of their lecture
times. The students also receive an introductory letter the first day of the clerkship orienting them
and specifically addressing the requirements of the rotation.
Identify major successes in the clerkship and challenges to be overcome (see instructions page).
Major successes in the clerkship include the introduction of more team-based learning activities,
such as interactive biopsy sessions with ultrasound phantoms. We also provide the students with
iPads on which are loaded numerous cases they can scroll through at their own pace, make findings
and diagnoses; immediate feedback is provided by faculty mentors. Other successes include the log
system and requirement of on-line cases to ensure uniformity across sites.
Challenges include convincing the administration to lengthen the clerkship from two to three
weeks.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
PART C. REQUIRED CLERKSHIP FORM
Clerkship title:
Sponsoring department
or unit:
Name of clerkship director:
Surgery Clerkship
Department of Surgery
Tyr O. Wilbanks, M.D.
Clerkship Objectives
Are there written objectives for the clerkship?
Yes
X No
Were the clerkship objectives developed internally or adopted/adapted from external sources? If the
latter, please provide the source of the objectives.
The objectives were developed internally.
Provide a sample of about 10 learning objectives, including a selection of those related to the knowledge,
skills, and professional behaviors (as relevant) that are expected of students by the end of the
clerkship/clerkship rotation.
Clerkship Objectives:
By the end of this clerkship, the student will be able to:
1. Elicit a well-organized, accurate and appropriate history.
2. Perform an accurate physical examination relevant to the patient’s reason for seeking care
3. Accumulate and analyze data to evaluate a potential surgical patient and formulate a differential diagnosis
4. Participate in the decision making process to devise an appropriate patient-centered surgical management plan
5. Select and interpret appropriate laboratory and diagnostic testing
6. Perform basic clinical procedures
7. Define the pathophysiology of common surgical diseases
8. Diagnose and manage surgical complications
10. Practice effective and respectful communication with patients and families
11. Present and discuss patients in a concise and logical fashion
How are the clerkship objectives provided to students?
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
The Surgery Clerkship manual containing the clerkship objectives is posted on eMED and sent to
students by email. The objectives are also reviewed by the clerkship director during orientation.
At what point during the clerkship are individual students’ clinical experiences (required patient
encounters and procedures) reviewed to ensure that the learning objectives are being met? Who conducts
that review?
Each site director reviews the patient logs of students rotating at that site during the mid-clerkship
evaluation to ensure that each student is on track to complete the requirements during the rotation.
Who is responsible for ensuring that each student’s clinical experiences are appropriate to meet the
objectives of the clerkship? Describe the actions that would be taken if a student were not making
satisfactory progress in meeting clerkship expectations for clinical experiences (required patient
encounters and procedures)?
The site director; if a student is having difficulty meeting some objectives/experiences, the site
director will make appropriate arrangements for the student to obtain additional
opportunities/exposures on the assigned service or may adjust or change the assigned unit, if
necessary.
Preparation for Teaching
If resident physicians teach in the clerkship or otherwise supervise medical students, how are they
informed about the clerkship objectives and prepared for their teaching role?
At the beginning of clerkship year, there is a didactic presentation on Residents as Teachers, and
residents are provided with written objectives for the clerkship, as well as information about the
appropriate methods for assessment of clinical skills.
How are faculty members across instructional sites oriented to the clerkship objectives and the methods of
student assessment? See above response.
The clerkship director holds two conferences each year with all site directors and interested faculty
teachers from each site, where goals and objectives, curricula, evaluation methods, grade profiles,
and student evaluations of the clerkship are reviewed.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
REQUIRED CLERKSHIP FORM (Continued)
Clerkship title:
Surgery Clerkship
Methods for Assessing Student Performance
Describe the methods used in the clerkship to assess students’ core clinical skills (e.g., OSCEs, miniCEXs, observation by faculty or residents). How does the department ensure that such assessment occurs
for all students?
The Evaluation of Clinical Performance and Professional Attributes form is completed for each
student by several residents and faculty instructors, based on their observations of the student over
4-8 weeks of the clerkship. In the Surgery Clerkship, the student’s clinical performance constitutes
50% of the overall assessment/final grade. The site director compiles a composite evaluation form,
and the clerkship director signs off on the final evaluation. Evaluations of students are kept on site
for review by the clerkship director, if needed. The clerkship director checks on each site at regular
intervals.
How are students provided with mid-clerkship feedback? What mechanisms are in place to ensure that
mid-clerkship feedback is provided?
Personal meetings with site directors.
Describe who determines a student’s final grade in the clerkship (e.g., clerkship director, site director,
other).
The site director compiles and assigns the final grade, and the clerkship director approves.
Provide the results of any customized NBME or NBME subject (shelf) examinations for the previous
three years.
2010-11
Year
77.2
Score
64
Percentile*
* National percentile, if relevant
2011-12
75.7
57
2012-13
76.5
59
Is a narrative assessment of student performance submitted in addition to or as a component of the
clerkship grade?
Yes
X No
Clerkship Outcomes/Evaluation
Comment on the adequacy of faculty (full-time, part-time, and volunteer), patients, and other resources
for this clerkship.
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
Resources are adequate. Sites have been selected based on the availability of faculty, patients, and
other resources; each site is reviewed twice annually at the conferences mentioned above. Any
deficiencies are addressed and remediated.
Provide a summary of student feedback on the clerkship (and any other evaluation data) for the past two
academic years; include the percent of students providing evaluation data. Note any recent changes in the
clerkship. If problems have been identified by student evaluations or other data, describe how these are
being addressed. See response below.
Students' Overall Evaluation of the Surgery Clerkship:
June 2011-May 2013
4.5
4.3
Scale: 5=Strongly Agree; 1=Strongly Disagree
4.3
4.29
4.06
4.1
3.97
4.21
3.89
3.9
3.5
3.73
Teaching/Teachers
3.9
3.83
3.79
3.7
Orientation/Organ
ization
3.77
3.65
Feedback/Evaluati
on
3.89
3.7
Global Assessment
3.4
3.55
3.26
3.33
3.41
3.3
3
3.1
2.9
(6/11-11/11)
(12/11-5/12)
(6/12-11/12)
(12/12-5/13)
5/13 All Clerkships)
Strengths:
Great teaching by attendings/residents (across all sites)
Hands-on experiences
Flexibility of scheduling
Variety of patients/cases
Time spent in the OR
Night float
Suggested Areas for Improvement:
Standardize student experiences/expectations across sites
More variety of exposures
Improve organization/orientation at some sites
Make lectures ore relevant to medical students
More teaching by attendings/residents
Clarify student role at the sites
LCME Medical Education Database 2014-2015
Required Clerkship Form
Albert Einstein College of Medicine
Academic Year 2012-2013
Identify major successes in the clerkship and challenges to be overcome.
Over the past few years, we have had both major procedural and outcomes improvements in the
clerkship. On the procedural side, we have instituted and operationalized much more central
oversight and provision of the education and evaluation of the students at the several sites. All
students receive a centralized orientation to surgery and the goals, objectives, policies, and
procedures of the clerkship. A centralized introductory workshop to basic surgical skills is also
provided at the beginning of the rotation. A centralized 32-lecture didactic series was introduced,
is revised annually and has been generally well received. The oral examination, which had
previously been entirely site-dependent, has been standardized. A bank of standardized patient
scenarios with a standardized grading form and rubric. Students are no longer examined at their
own sites but are examined either centrally or at different sites by faculty members not from their
own site. All these changes have resulted in a much more uniform experience for students under the
supervision of the clerkship director and administrator. As an outcome measure of success, the
student evaluations of our clerkship have been improving overall over the past two years. In
addition, the number of Einstein students interested in surgical careers and applying to surgical
residencies has been increasing.
The major challenge facing our clerkship, indeed facing surgical clerkships at major academic
centers all over the country, is being precipitated by the changing nature of surgical practice, the
redefinition of "General Surgery" and the resulting reorganization of the clinical departments of
surgery. Surgical services are being fragmented into Centers of Excellence (Cardiac, Endocrine,
Colorectal, Bariatric, Breast, etc.) While this results in better specialized care for complex surgical
patients, it means that students will no longer be able to receive a comprehensive surgical education
simply by rotating on a General Surgery service. In fact, General Surgery services are being
eliminated to make way for the specialized services mentioned above. In the coming years, we will
need to establish a rotation that provides experiences across a wide range of services, yet maintains
a longitudinal experience with key faculty members.
LCME Medical Education Database 2014-2015
Required Clerkship Form