Table of Contents
- Welcome
- Unique Learning Opportunities – P4-1
- Unique Learning Opportunities – P4-2
- P4-1 Improvements
- P4 Improvements
WELCOME
On behalf of Senthil Kumar Rajasekaran, M.D., MMHPE., Senior Associate Dean for Undergraduate Medical Education and Curricular Affairs, we would like to welcome you to the "You Said, We Did" (YSWD) Newsletter. As a Continuous Quality Improvement organization, Wayne State University School of Medicine has directly utilized feedback from many of our key stakeholder groups, primarily you the students, to make significant changes over the last several years. The purpose of the newsletter is to highlight these changes made during your tenure as a student and to show our appreciation for your involvement in these accomplishments. As you progress in the path of becoming a physician, we want to let you know that as you are progressing in the path of becoming a physician, you are nurturing the growth of the institution through your feedback. One of the goals of YSWD is to let students know that we value your input and are continually incorporating it into our ongoing and new initiatives.
This week's edition: P4
Unique Learning Opportunities – P4-1
P4: Population, Patient, Physician and Professionalism (P4-1) is a pre-clinical course divided into two units for simplicity: Social Determinants of Health (SDOH) and Patient Communication.
The course utilizes suggested best practices from “Expert Consensus on Inclusion of the Social Determinants of Health in Undergraduate Medical Education Curricula,” one of which calls for alternate forms of student evaluation aside from multiple choice exams.
There were 12 total units that occurred on Thursdays between 8 a.m. and noon. Students were asked to identify social determinants of health found for populations in our community. They were taught how to examine outcomes from the micro, meso and macro level. They were asked to identify disparate clinical practices, research community organizations and examine policies that helped to mitigate the disparities; and present their findings to School of Medicine students, faculty and, in some cases, community members. The presentations were well-received by the community members. Feedback included support of the curriculum and a willingness to find other ways to interact with students as they progress through the curriculum.
An additional panel was designed to examine health systems, in partnership with Corktown Health Center, an LGBTQ+ centered clinic, and our SOM librarians as facilitators, examined the micro/meso/macro aspects of the health care system that are needed to create LGBTQ+ friendly spaces. They also discussed prominent media cases that highlighted ways our health care system failed to be inclusive in their service delivery models. Students were challenged to pose ways their future practice would be inclusive to all needs.
We are restructuring the patient panels for P4-1 this year and will re-introduce them to the curriculum after the revisions are complete.
P4-1 Improvements
- Recruitment of additional staff to oversee the course
- Clearer, simplified definition of course goals and objectives
- Clear presentation of course syllabus with requirement for students to sign off on reading and understanding before the start of each unit
- Advanced preparation of curriculum posted one block prior to presentation
- Intentional scheduling of P4 sessions and assignments to avoid conflict with other coursework and exams
- Intentional reinforcement of P4 topics with service learning, clinical skills and CEC via collaboration with the course directors
- Presence of the fourth-year medical students to reinforce the importance of P4 topics during their clinical learning experience, which de-emphasized the need for the topics to be related to STEP prep
- Initially opting out of MCQ assessments, allowing students to express understanding of the course goals using more creative measures. Given the need for feedback and the inclusion of more patient communication on STEP 1, we will return to MCQ assessments to facilitate student feedback.
Unique Learning Opportunities – P4-2
P4-2 is a pre-clinical that builds on the micro/meso/macro aspects found in healthcare delivery that both amplify and mediate poor outcomes associated with SDOH.
Populations that we study include: those who are food insecure, veterans, those who are living with disabilities, those who are homeless and those who have been involved in the correctional system.
P4-2 utilizes a community structure and our faculty guest speakers and case conference panels are designed to skip the textbook and take students right to the source. One of the most common sources of panel participants comes from Henry Ford Health System employee resource groups. This network has provided interprofessional team members to address food insecurity, veteran’s health and the care of those living with disabilities. One of our featured guests included, Dr. Ashina Singh a physician specializing in gastroenterology and transplant hepatology who shared her personal experience of what it is like to be a physician living with a disability.
Interprofessional Wayne State guest lecturers are professors who introduced our units and represented the Departments of Public Health, Law School, and the College of Liberal Arts and Sciences. Within medicine, we had the chief medical officer for the Michigan Department of Corrections and the former Medical Director of a Juvenile Detention Center in Houston, Texas – both of whom are part of our SOM staff.
One of our most popular units has been the veteran’s unit which is known for the level of interprofessional learning that takes place. This year, we partnered with students from nursing, pharmacy, occupational therapy, physician assistants and social work to host panels and participate in interprofessional case studies where students were able to share about their training and how they will interact on an interprofessional hospital team together. During the implementation of the curriculum, we worked closely with Dr. Aline Saad, Coordinator of Interprofessional Education and IPE Champion of the Michigan Area Health Education Center, who was pleased with the outcomes and mapped our curriculum to national competencies.
This year, we offered a unique opportunity for motivated SOM 4th year students to participate in the curriculum as small group facilitators. Though the facilitators received academic credit for their participation, many reported satisfaction with their service, could easily link P4 topics to clinical cases they had seen in their 3rd and 4th year of training, and one even mentioned that had she participated in this newest P4 curriculum, “then she might not have felt the need to pause her training to pursue an MPH”. In addition to working with 4th year students, we also solicit support from our student organizations – American Medical Association, Michigan State Medical Society House Coordinating Committee members assisted with policy writing and ARIE Co-Curricular students facilitated breakouts related to disability awareness training.
In addition to assisting with the curriculum, students have regularly pursued and received mentorship with P4-related scholarly activity in the areas of food insecurity, spirituality in medicine and most recently, a manuscript published in the International Journal of Disease Reversal and Prevention entitled, “Rooting for Wellness: An Initiative Introducing Plant Based Nutrition to First Year Medical Students”.
By far, the most popular aspect of P4 is our case conferences that are filled with local and regional volunteers. Our staff contacts local agencies to solicit volunteers to cover our veterans, people living with/families caring for those living with disabilities and returning citizens. Each panel has around 20 participants, but given our class size, we have learned to be creative and design panels that will minimize the number of students in each room to allow for more student interaction with our guests.
P4 Improvements
- Recruitment of additional staff to oversee the course
- Clearer, simplified, definition of our course goals and objectives· Clear presentation of course syllabus with requirement for students to sign off on their reading and understanding before the start of each unit
- Advanced preparation of our curriculum posted 1-block prior to presentation
- Intentional scheduling of P4 sessions and assignments to avoid conflict with other coursework
- Whenever possible, non-multiple choice-based assignments that are assessed using a milestone-based rubric (P4-2)· Intentional reinforcement of P4 topics with service learning, clinical skills and CEC via collaboration with the course directors
- Presence of the 4th year medical students to reinforce the importance of P4 topics during their clinical learning experience which de-emphasized the need for the topics to be related to Step prep
- Utilization of interprofessional facilitators to reinforce the concept of a medical team and its role in patient care
- Mentored academic scholarly projects that are being presented at national conferences
- We initially opted out of MCQ assessments and allowed students to express understanding of the course goals using more creative measures – resulting in more of a reflective / peer teaching format with assessment being performed via depth or reflection or milestone-based rubric aligned to course goals. Given the need for feedback and the inclusion of more patient communication on Step 1, we will return to MCQ assessments to facilitate student feedback.
We want to hear from you
If you have any topics you would like to know about or have suggestions to how we can improve as a medical school, connect via the Warrior Med Suggestion Program.
The purpose of the Warrior Med Suggestions Program is to ensure each stakeholder of the School of Medicine has the opportunity to provide suggestions and feedback that may improve the organization’s mission. This program will serve as the mechanism that will drive the culture of Continuous Quality Improvement within the School of Medicine. These opportunities for improvement will drive cultural change and allow leaders to make a positive impact on a pathway to organizational excellence.
If you have any additional questions or concerns, feel free to reach us at oaacqi@med.wayne.edu. Thank you.
Kanye L. Gardner - Director of Continuous Quality Improvement - Office of Assessment, Accreditation and Continuous Quality Improvement
Volume 2 catalog of issues available here: Volume 2 - #1 - October 4, 2021 | Volume 2 - #2 - October 15, 2021 | Volume 2 - #3 - April 22, 2021 | Volume 2 - #4 - November 12, 2021
Credits:
Medical Communications