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Syllabus - ACMD  512- 2014

Page history last edited by winmay@usc.edu 6 years, 1 month ago

Master of Academic Medicine

Competencies in Academic Medicine and Health II

ACMD 512

January, 2014

COURSE SYLLABUS

 

Instructors – Dr. Wood and Dr. May are the instructors of record

Dr. Olson and Dr. Vincent are co-instructors

 

Beverly P Wood, MD, PhD      Win May, MD, PhD      Michelle M Olson, MD, MACM   Dale Vincent, MD,MPH, MACM

 

bwood@usc.edu                  winmay@med.usc.edu     miolson@carle.com dvincent@hawaii.edu

 

Home: 818-952-2876,             Home: 626-447-4113         Work/cell: 217-552-5025      Home/mobile: 808-741-0793

Work: 909-558-4281               Work: 323-442-2381     Cell: 570-394-3588      Work: 808-433-6793

Cell 818-209-7748                  Cell 626-617-8073

 

 

 

Course Overview

 

ACMD 512 - Competencies in Academic Medicine and Health II (3 units): The focus is on the clinical competencies related to interpersonal and communication skills, practice-based learning and improvement, systems based practice, and patient care. In relation to these competencies, the course will address the conceptual framework and teaching and assessment techniques. Development and use of learner portfolios to reflect skill levels and skill development is an important adjunct to training in the competencies. Onsite skills development sessions will address teaching skills for small groups, large groups, groups on rounds, feedback, microskills of teaching, empathy in patient care, developing standardized patients for learning and assessment, case-based teaching, teaching and learning portfolios and dealing with learners in difficulty. 

 

 

 

COURSE GOAL AND OBJECTIVES

 

Goal: By the end of the course the participants should be able to:

Plan a learning program that incorporates the competencies into the teaching of medicine and the health professions in their specialty areas.

Objectives:  After attending class sessions, reading the assigned materials and completing assigned exercises the participants should be able to:

Define professional competence and proficiency. 

Relate professional competence to health care outcomes.

Identify trust as an essential element in diagnosis, treatment, and healing  

        Use competencies as a basis of training for practice 

        Define the established guidelines for health literacy in doctor-patient communication.

        Discuss the reasons for communication breakdown between health professionals and  patients

 

Apply the principles of the microskills in teaching situations.

     Formulate specific feedback for learners.

Develop cases for learning: practice in problem solving.

Formulate a case for student skills assessment.

Develop cases for scenario based learning

Define and illustrate the levels of professional development  

Discuss the role of experiential learning in Practice based learning and improvement

Discuss PBLI as it relates to physician self-directed learning

Design strategies for teaching and assessment of PBLI

   Define the factors that constitute systems based practice.

Discuss incorporation of quality improvement in SBP.

Discuss the skills utilized in SBP

Design strategies for teaching and assessment of SBP

Describe the components of a learning portfolio and how portfolios  are used in training programs.

Define the development and utilization of a learning plan 

 

Face to Face sessions are on February 25-27 at USC, Keck School of Medicine

Analyze the advantages and challenges to the learner of collaborative learning and small group learning.

Develop learning experiences for small groups and for large groups.

Experience active and engaged learning 

Develop and deliver an interactive teaching activity

Define the microskills of teaching

Utilize the microskills in a simulated teaching activity

 

Develop a patient case to be used for teaching and/or assessment of learner skills.

 Explain the use of standardized patients in teaching and assessment situations

Describe active listening as a teaching method

Develop skills in dealing with learners in difficulty and needing remediation.

Identify the elements of difficult conversations and apply the skills of reflective listening.

              Apply the principles of case development to create teaching cases

Develop and utilize learning portfolios in counseling and evaluating learners

              Describe methods for assessing a) professionalism, b) interpersonal & communication skills c) practice-based learning and improvement and d) systems-based practice.

 Design and implement learner reflection and self-assessment exercises within a clinical context.

Create personal teaching portfolios for academic development

              Discuss conceptual frameworks to define professionalism

Design strategies for teaching and assessment of professionalism

 

 

SCHEDULE*

(Activities, Session Objectives, Required Reading, Assignments Due)

 

 

Session # Session Topic/

Activities Session objectives Reading Assignment at each session

1

Jan 14 Introduction of participants and the course ACMD 512

Discuss competence,  proficiency, and the next accreditation system  in medicine

Readings #1

2

Jan 21 Competence and proficiency 1. Define professional competence and proficiency. 

2. Relate professional competence to health care outcomes.

3. Use competencies as a basis of training for caring practice. Readings #2 Assign #2

Select one area of competency and describe how you would develop a teaching plan for your learners.

3

Jan 28 Health Literacy 1.Define the established guidelines for health literacy in doctor-patient communication.

2. Discuss the reasons for communication breakdown between Health professionals and patients

Readings #3 Assign #3

Discuss two reasons for communication breakdown between health professionals and patients and how they would be addressed

#4

Feb 4 Patient care and empathy 1. Describe strategies to teach and assess patient care.

2. Describe an approach to help physicians recognize empathic opportunities

3. Reflect on the relationship between empathy and quality of patient care. Readings #4 Develop a case to use for learners to demonstrate empathic responses to a patient encounter or similar non-patient oriented experience. 

Outline some strategies that you would use to teach and assess patient care in your area of specialty. 

 

 

 

#5

Feb. 11 Practice Based Learning and Improvement 1. Describe the levels of professional development  

2. Discuss the role of experiential learning and informal learning in Practice based learning and improvement

3. Discuss the basic knowledge and skills required for successful PBLI

4. Design strategies for teaching and assessment of PBLI Readings #5 Assign 5

Design a strategy for teaching and assessment of PBLI for learners in your specialty.

Relate the activity to teaching the skills of lifelong learning.

 

In groups of 2-3, develop an interactive exercise to teach an ACGME competency of your choice. You will present this in our face-to-face session.

Face to Face Sessions are from Feb. 24-26 (11:30 am) at Keck School of Medicine, USC

#6

March 11 Patient Safety and Quality Improvement 1. Evaluate patient care using the Institute of Medicine’s six dimensions of quality health care.

2. Identify methods to reduce medical errors.

3. Understand the planning and execution of a PDSA cycle and other standard methods.

4. Understand the implementation of an interdisciplinary care team and recognize the ways the allied health professions, social work, and nursing dovetail with the physician practice. Readings #6 Assignment #6

 Design a strategy for teaching Patient Safety and QI to your learners.

#7

March 18 Systems Based Practice 1. Define the major factors that constitute systems based practice.

2.Discuss the role and anticipated outcome of quality improvement in SBP.

3.Discuss the skills utilized in one aspect of SBP

4.Design strategies for teaching and assessment of SBP Readings #7 Assignment #7

Design a strategy for teaching and assessment of Systems Based Practice for your learners.

Presentations on April 8 and April 15 Post your class plan by April 1

Post your comments by April 7 Develop a class for your learners in which one of the competencies of Patient Care, Practice Based Learning and Improvement, Systems Based Practice, Patient Safety and Quality Improvement  are taught and assessed. Include Goals, Learning Objectives, Content to be included, Teaching and learning strategies, and Evaluation of learners and the course. How will you evaluate outcomes? 

Post on the Wiki by April 1. 

Please read the online postings, and choose one to critique and add comments by April 7.

 

REQUIRED READINGS

Class 1: Jan 8: Readings:

 

1.Dolmans DHJM, Tigelaar D. (2012). Building bridges between theory and practice in medical education using adesign- based research approach: AMEE Guide No. 60. Medical Teacher,  34; 1-10

2. Cutting MF, Saks NS. Twelve tips for utilizing principles of learning to support medical education. Medical Teacher, 34: 20-24

3. Hicks, PJ, Englander R, Schumacher DJ. (2010). Pediatrics Milestone project: next steps toward meaningful outcomes assessment. J.Grad Med Educ, 2(4): 577-584 

4. Carraccio C, Burke AE (2010).  Beyond Competencies and milestones: adding meaning through context. J.Grad Med Educ, 2(4): 419-422.

5. ten Cate O, Scheele F. Competency Based Postgraduate Training: Can we bridge the gap between theory and clinical practice? Acad. Med 2007, 82:542-547

 

Readings 2: Competence and Proficiency

 

1, Epstein R, Hundert E. (2002) Defining and Assessing Professional Competence. JAMA, 287 (2): 226-235 

2. Chapter 1 in Evaluation Of Clinical Competence

3.  http://www.acgme.org/outcome/e-learn/e_powerpoint.asp (ACGME project - informational)

4.  Fraser, S ( 2001). Coping with complexity: educating for capability.   BMJ 323: 799-803

5.  Jones MD, Rosenberg AA,  Gilhooly JT, Carraccio CL (2011) Perspective: Competencies, Outcomes, and Controversy—Linking Professional Activities to Competencies to Improve Resident Education and Practice. Acad. Med.86: 161-165. 

6. Nasca TJ, Phillibert I, Brigham T, Flynn TC. (2012). The Next GME Accreditation System — Rationale and Benefits. NEJM. 366: 1051-1056.

7. Swing SR, Clyman SG, Holmboe ES, Williams RG. (2009). Advancing resident assessment in graduate medical education. J Grad Med Educ 1:278-286.

 

 

Readings 3: Health Literacy

 

1) 1. DeWalt DA, Callahan LF, Hawk VH, Broucksou KA, Hink A, Rudd R, Brach C. Health Literacy Universal Precautions Toolkit. AHRQ Publication No. 10-0046-EF. Rockville, MD. Agency for Healthcare Research and Quality. April 2010.

http://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/literacy-toolkit/healthliteracytoolkit.pdf

2) http://www.health.gov/communication/Default.asp

3) Deledda G, Moretti F, Rimondini M, Zimmermann C.  How patients want their doctor to communicate.  A literature review on primary care patients’ perspective. Journal of Patient Education and Counseling, 2012; 90(3):297-306.

4) Paasche-Orlow M.  Caring for Patients with Limited Health Literacy. JAMA. 2011; 306(10): 1122-1129

 

5) Mayer G, Villaire M. Enhancing Written Communications to Address Health Literacy. The Online Journal of Issues in Nursing, 2009; 14(3).

6) McCarthy DM, Waite KR, Curtis LM, Engel KG, et al. What did the Doctor Say? Health Literacy and Recall of Medical Instructions.  Medical Care, 2012; 50(4): 278-282.

 

 

Readings 4: Empathy in Patient care

1.Neumann M, Edelhauser F, Tauschel D, Fischer MR, Wirtz, M, Woopen C, Haramati A, Scheffer c. (2011) Emapthy decline and its reasons: A systematic review of studies with medical students and residents. Acad Med 86:996-1009.

2.  Hojat M, Louis, DZ, Markham F, Wender R, Rabiowitz C, Gonnella J. (2011). Physicians’ empathy and clinical outcomes for diabetic patients. . Acad Med 86: 359-364.

3. Colliver, J A. ,Conlee, M J., Verhulst, S J. ,Dorsey, J. K . (2010). Reports of the decline of empathy during medical education are greatly exaggerated: a reexamination of the research. . Acad Med.85: 588-593

4. Epstein RM, Hadee D, Carroll J, et al. (2007)  “Could this be something serious?” Reassurance, uncertainty, and 

empathy in response to patient’s expressions of worry. J Gen Intern Med; 22 (12); 1731-1739

5. Morse DS, Edwardsen EA, Gordon HS. (2008)  Missed opportunities for interval empathy in lung cancer communication. Archives of Internal Medicine; 168 (17): 1853-1858

6. Shanafelt TD, West C, Zhao X, et al. (2005) Relationship between increased personal well being and enhanced empathy among internal medicine residents. J Gen Int Med; 20 (7): 559-564

7. Larson EB, Yao Y. (2005) Clinical empathy as emotional labor in the patient–physician relationship. JAMA 293:1100 –1106.

 

 

 

Readings 5: Practice-Based Learning and Improvement

1. Ogrinc G, Hedrick LA, Morrison LJ, Foster T. Teaching and assessing resident competence in Practice Based Learning and Improvement. (2004) J of General Internal Medicine; 19:496-500.

2. Varkey, P, Karlapudi, S, Rose S, Nelson, R, Warner M. (2009). A systems approach for implementing practice-based learning and improvement and systems-based practice in graduate medical education. Acad Med 84: 335-339.

3. Varkey P, Natt, N, Lesnick T, Downing S, Yudkowsky, R (2008). Validity Evidence for an OSCE to Assess Competency in Systems-Based Practice and Practice-Based Learning and Improvement: A Preliminary Investigation. Acad Med 83:775-780.

4. Tomolo AM, Lawrence RH, Aron DC. (2009). A case study of translating ACGME practice-based learning and improvement requirements into reality: systems quality improvement projects as the key component to a comprehensive curriculum. (2009). Postgrad Med J. 85: 530-537.

5. Chapter 11 in Evaluation of Clinical Competence

 

 

Readings 6: Patient Safety and Quality Improvement

1) George WW, Denham CR et al. “Leading in Crisis: Lessons for Safety Leaders.” J Patient Saf 2010; 6

(1):24-30.

2) Weinstein MC and Skinner JA. “Comparative Effectiveness and Health Care Spending--Implications

for Reform” New Eng J Med 2010; 362(5):460-5.

3) Botwinick L, Bisognano M, Haraden C. Leadership Guide to Patient Safety. IHI Innovation Series white

paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2006. (Available on

www.IHI.org)

4) “Healthcare Costs: A Primer” Kaiser Family Foundation. March 2009. (Available online at: http://

kff.org/insurance/upload/7670_02.pdf)

 

Readings 7: Systems-based Practice

1. Dunnington GL, Williams RG. (2003) Addressing the new competencies for residents surgical training. Acad Med;78 (1): 14-21.

2. Ziegelstein RC, Fiebach N. (2004). "The Mirror" and "The Village": A New Method for Teaching Practice-Based Learning and Improvement and Systems-Based Practice. Acad. Med. 79: 83-88.

3. Davison SP, Cadavid JD, Spear SL.(2007) Systems based practice; education in plastic surgery. Plastic and reconstructive surgery. 119 (1): 410-415.

4. Moskowitz EJ & Nash DB (2007). Accreditation Council for Graduate Medical Education Competencies: practice based Learning and systems-based practice. Am J Med Qual.22: 351-382

5. Chapter 10 in Evaluation of Clinical Competence

6. Lurie S J,  Mooney, C J, Lyness, J M (2009). Measurement of the General Competencies of the Accreditation Council for Graduate Medical Education: A Systematic Review. Acad Med 84: 301-309

7.  Kocher and Sahni. (2010) Physicians versus Hospitals as Leaders of Accountable Care Organizations  NEJM, 2579, Dec 30

8. Hawkins RE, Weiss KB. Building the Evidence Base in Support of the ABMS MOC Program (2011). Acad. Med. 86:6-7

 

 

 

 

Assignments (Performance and Written)

 

Session # Points

Session 1 8

Session 2 8

Session 3 8

Session 4 8

Session 5 8

Session 6 8

Session 7 8

Face-to-face 20

Final Project 14

Total 90

 

Grading

• Course grade is based on mastery of the material as defined by performance on all class assignments. 

• All written homework assignments are due the day of class or the week following the session.  

• No late assignments will be accepted.

• All assignments are to be posted on the class WIKI and each student is expected to make appropriate substantive comments and critique of posted work in the following 2 weeks. Please follow the directions given for each  session.

• All content will be archived when the next assignment is due to be posted. The content can be accessed throughout the course. 

• No late assignments may be posted.

• Assignments will be graded based on creativity, depth of thought, attention to detail, and thoroughness of development.

 

Final Grade is determined by number of points.

Grade Points

A 85 or Above

A- 78-84

B+ 73-77

B 70-72

C 56-71

F Below 55

 

Last Revised December 12, 2012

 

Appendix

USC Policies

 

Policy on Accommodations for Students with Disabilities

 

The University of Southern California is committed to full compliance with the Rehabilitation Act (Section 504) and the Americans with Disabilities Act (ADA). As part of the implementation of this law, the university will continue to provide reasonable accommodation for academically qualified students with disabilities so that they can participate fully in the university’s educational programs and activities. Although USC is not required by law to change the “fundamental nature or essential curricular components of its programs in order to accommodate the needs of disabled students,” the university will provide reasonable academic accommodation. It is the specific responsibility of the university administration and all faculty serving in a teaching capacity to ensure the university’s compliance with this policy. 

 

The general definition of a student with a disability is any person who has “a physical or mental impairment which substantially limits one or more of such person’s activities,” and any person who has “a history of, or is regarded as having, such an impairment.” Reasonable academic and physical accommodations include but are not limited to: extended time on examinations; substitution of similar or related work for a nonfundamental program requirement; time extensions on papers or projects; special testing procedures; advance notice regarding booklists for visually impaired and some learning disabled students; use of academic aides in the classroom such as notetakers and sign language interpreters; accessibility for students who use wheelchairs and those with mobility impairments; and need for special classroom furniture or special equipment in the classroom. 

 

Procedures for Obtaining Accommodations: Students with disabilities are encouraged to contact Disability Services and Programs (DSP) prior to or during the first week of class attendance or as early in the semester as possible. The office will work with Classroom Scheduling, the course instructor and his or her department, and the student to arrange for reasonable accommodations. It is a student’s responsibility to provide documentation verifying disability. 

 

Academic Accommodations: Students seeking academic accommodations due to a physical, psychological or learning disability should make the request to the course instructor prior to or during the first week of class attendance or as early in the semester as possible. Course instructors should require that a student present verification of documentation of a disability from Disability Services and Programs if academic accommodations are requested.

 

USC Academic Standards

 

Definition of Grades

The following grades are used: A -- excellent; B -- good; C -- fair in undergraduate courses and minimum passing in courses for graduate credit; D -- minimum passing in undergraduate courses; F -- failed. In addition, plus and minus grades may be used, with the exceptions of A plus, F plus and F minus. The grade of F indicates that the student failed at the end of the semester or was doing failing work and stopped attending the course after the twelfth week of the semester. Minimum passing grades are D- for undergraduate credit and C for graduate credit. Additional grades include: CR -- credit (passing grade for non-letter-graded courses equivalent to C- quality or better for undergraduate courses and B (3.0) quality or better for graduate courses); NC -- no credit (less than the equivalent of a C- for an undergraduate and a B for a graduate, non-letter-graded course); P -- pass (passing grade equivalent to C- quality or better for undergraduate letter-graded courses and B (3.0) quality or better for graduate courses taken on a Pass/No Pass basis); NP -- no pass (less than the equivalent of a C- for an undergraduate and a B (3.0) for a graduate, letter graded course taken on a Pass/No Pass basis).

 

The following marks are also used: W -- withdrawn; IP -- interim mark for a course exceeding one semester (failure to complete courses in which marks of IP [in progress] appear will be assigned grades of NC); UW -- unofficial withdrawal; MG -- missing grade (an administrative mark used in cases when the instructor fails to submit a final course grade for a student); IN -- incomplete (work not completed because of documented illness or some other emergency occurring after the twelfth week of the semester; arrangements for the IN and its removal should be initiated by the student and agreed to by the instructor prior to the final exam); IX -- lapsed incomplete.

 

A system of grade points is used to determine a student's grade point average. Grade points are assigned to grades as follows for each unit in the credit value of a course: A, 4 points; A-, 3.7 points; B+, 3.3 points; B, 3.0 points; B-, 2.7 points; C+, 2.3 points; C, 2 points; C-, 1.7 points; D+, 1.3 points; D, 1 point; D-, 0.7 points; F, 0 points; UW, 0 points; IX, 0 points. Wherever these letter grades appear in this catalogue or other university documents, they represent the numerical equivalents listed above. Marks of CR, NC, P, NP, W, IP, MG and IN do not affect a student's grade point average.

 

Grades of Incomplete (IN)

Conditions for Removing a Grade of Incomplete

If an IN is assigned as the student's grade, the instructor will fill out the Incomplete (IN) Completion form which will specify to the student and to the department the work remaining to be done, the procedures for its completion, the grade in the course to date and the weight to be assigned to the work remaining to be done when computing the final grade. A student may remove the IN by completing only the portion of required work not finished as a result of documented illness or emergency occurring after the twelfth week of the semester. Previously graded work may not be repeated for credit. It is not possible to remove an IN by re-registering for the course, even within the designated time.

 

Time Limit for Removal of an Incomplete

One calendar year is allowed to remove an IN. Individual academic units may have more stringent policies regarding these time limits. If the IN is not removed within the designated time, the course is considered "lapsed," the grade is changed to an "IX" and it will be calculated into the grade point average as 0 points. Courses offered on a Credit/No Credit basis or taken on a Pass/No Pass basis for which a mark of Incomplete is assigned will be lapsed with a mark of NC or NP and will not be calculated into the grade point average.

 

Extension of Time for Removal of an Incomplete

Removing the IN within the one-year period should be the student's highest priority. A student may petition the Committee on Academic Policies and Procedures (CAPP) for an extension of time for the removal of an IN. Extensions beyond the specified time limit are rarely approved if the student has enrolled in subsequent semesters.

 

In all cases, a petition for an extension of time for removal of an IN must have departmental approval and include a statement from the instructor explaining what is needed to complete the course and why the instructor feels the student should be given even further time for completion.

 

Missing Grades

All missing grades on a student's record should be resolved before his or her degree is posted. Missing grades can be resolved by the instructor of the course through the correction of grade process. Degrees will be posted for students who have missing grades (MGs) on their record if all other graduation requirements have been met. MGs cannot be resolved after a student has graduated.

 

Correction of Grades

A grade once reported to the Office of Academic Records and Registrar may not be changed except by request of the faculty member to the Committee on Academic Policies and Procedures on a Correction of Grade form. Changes should be requested only on the basis of an actual error in assigning the original grade, not on the basis of a request by the student or special consideration for an individual student. Students are not permitted to complete course work after the semester has ended.

 

Disputing a Grade

The teacher's evaluation of the performance of each individual student is the final basis for assigning grades. Through orderly appeal procedures, students have protection against prejudiced or capricious academic evaluation. See the student guidebook SCampus for details of the procedure.

 

 

 

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