A reply from Grace.

Tim


------ Forwarded Message
From: Grace Paterson <[log in to unmask]">[log in to unmask]>
Reply-To: <[log in to unmask]">[log in to unmask]>
Date: Fri, 29 Jan 2010 12:34:35 -0400
To: Tim Fedak <[log in to unmask]">[log in to unmask]>
Cc: John Steeves <[log in to unmask]">[log in to unmask]>, Katrina Hurley <[log in to unmask]">[log in to unmask]>
Subject: Re: ELECTIVES curriculum review


Hello Tim,
The CMA publication was "Experiences from the forefront of EMR use: 20
Cancadian
physician case studies". Clinics selected represent all ten provinces and the
Northwest Territories and were across urban, rural and suburban settings. The
practitioners worked in multidisciplinary, primary care and specialty care
practices, and these could be categorized as large group, small group and solo
practice.

Clinics must have had an EMR system in place for a minimum of 2 years and must
be using it for patient and practice management functions such as charting,
generating prescriptions and referrals and clinical decision support ˜not
simply for scheduling and billing.

I can request print copies of this publication from CMA for every medical
student if we have a method for distribution. The online version is available
from http://www.cma.ca/index.cfm/ci_id/88114/la_id/1.htm

Thank you for remembering this Tim,

Grace



Quoting "Tim Fedak, PhD" <[log in to unmask]">[log in to unmask]>:

> While attending a recent presentation made by Grace Patterson, she showed us
> a publication produced by a group she is involved with – which shows how
> informatics is used in various specialities.  At that time, I mentioned to
> Grace that I thought the publication would make an excellent resource for
> students to provide an overview of different specialities... from a slightly
> different vantage point of considering the different informatics challenges
> that each faces.
>
> Resources like this might be useful the Longitudinal (elective) Unit
> experience... to allow students to prepare for the next phase of their
> training – by considering different specialities and the different
> challenges they face.
>
> I’ve cc: to Grace and Katrina Hurley (Director of Medical Informatics)... as
> I forget the title of the document, and to allow them to consider this idea.
>
> Tim
>
>
>
>
> On 28/01/10 6:01 PM, "Dianne Delva" <[log in to unmask]">[log in to unmask]> wrote:
>
>> We need to offer a comparable curriculum, not the same curriculum.  So if a
>> student were to claim they were disadvantaged in reaching the curriculum
>> goals this would be a problem.  The goal of the curriculum is not to create
>> subspecialists but to prepare students to enter the next phase of training.
>> Clearly the goal of the elective experience is partly to offer the students
>> some experience to explore different options but this does not guarantee
>> that all options are available.  Even here the students may not be able to
>> get a choice that they want because of capacity or the willingness of a
>> preceptor to supervise.
>>
>> Dianne
>> ----- Original Message -----
>> From: "Chris Vaillancourt" <[log in to unmask]">[log in to unmask]>
>> To: "Dianne Delva" <[log in to unmask]">[log in to unmask]>
>> Cc: "Watson, Wade" <[log in to unmask]">[log in to unmask]>; "Thomas, Dorothy"
>> <[log in to unmask]">[log in to unmask]>; "Rashid, Mohsin" <[log in to unmask]">[log in to unmask]>;
>> "Love,Susan" <[log in to unmask]">[log in to unmask]>; "Lambert, Todd "
>> <[log in to unmask]">[log in to unmask]>; "Kovacs, George " <[log in to unmask]">[log in to unmask]>; "Fedak, Tim"
>> <[log in to unmask]">[log in to unmask]>; "Detienne, Brenda " <[log in to unmask]">[log in to unmask]>; "Carver,
>> David" <[log in to unmask]">[log in to unmask]>; <[log in to unmask]">[log in to unmask]>
>> Sent: Thursday, January 28, 2010 5:34 PM
>> Subject: Re: ELECTIVES curriculum review
>>
>>
>>> > Diane    Only to say, will it be an issue for credentialing if the new
>>> > DMNB can't offer the same elective experience as in Halifax.  Only random
>>> > thought, likely not an issue.  Chris
>>> > ----- Original Message -----
>>> > From: "Dianne Delva" <[log in to unmask]">[log in to unmask]>
>>> > To: "Chris Vaillancourt" <[log in to unmask]">[log in to unmask]>
>>> > Cc: "Watson, Wade" <[log in to unmask]">[log in to unmask]>; "Thomas, Dorothy"
>>> > <[log in to unmask]">[log in to unmask]>; "Rashid, Mohsin" <[log in to unmask]">[log in to unmask]>;
>>> > "Love,Susan" <[log in to unmask]">[log in to unmask]>; "Lambert, Todd "
>>> > <[log in to unmask]">[log in to unmask]>; "Kovacs, George " <[log in to unmask]">[log in to unmask]>; "Fedak,
>>> > Tim" <[log in to unmask]">[log in to unmask]>; "Detienne, Brenda " <[log in to unmask]">[log in to unmask]>;
>>> > "Carver, David" <[log in to unmask]">[log in to unmask]>; <[log in to unmask]">[log in to unmask]>
>>> > Sent: Thursday, January 28, 2010 5:09 PM
>>> > Subject: Re: ELECTIVES curriculum review
>>> >
>>> >
>>>> >> Good questions and I hope we can continue to consider the goal of the
>>>> >> electives.
>>>> >> I have read the guidelines and suggest that Anna be invited to provide
>>>> >> comment.
>>>> >>
>>>> >> I anticipate the students will have a shorter menu of options initially
>>>> >> in Saint
>>>> >> John but there will still be an excellent and varied list.  The
>>>> >> subspecialites
>>>> >> question is interesting and I am unsure what this means.  We are
>>>> >> educating
>>>> >> students to graduate with an MD degree and meet our overarching
>>>> >> objectives. What credentials are we talking about.  Dianne Delva
>>>> >>
>>>> >>
>>>> >> Quoting Chris Vaillancourt <[log in to unmask]">[log in to unmask]>:
>>>> >>
>>>>> >>> Hey Guys  Couple of comments from the DMNB perspective before
>>>>> tomorrow's
>>>>> >>> meeting.  Great comments from everyone thus far.  My understanding is
>>>>> >>> year one will all be done in SJ.  Not sure if we have resources to
>>>>> >>> support electives in
>>>>> >>> 1.  Humanities
>>>>> >>> 2.  Some basic sciences
>>>>> >>> 3.  Some subspecialties eg; genetics, peds GI, immunology etc
>>>>> >>> Wondering if this will be an issue for credentials?   Other issues is
>>>>> >>> recruitment of clinicians, scientists and other profs to accept CC1's
>>>>> >>> for electives.  Will copy to John Steeves to keep him in
>>>>> loop.  See you
>>>>> >>> all tomorrow.  Chris
>>>>> >>>  ----- Original Message -----
>>>>> >>>  From: Rashid, Mohsin
>>>>> >>>  To: Carver, David ; Detienne, Brenda ; Fedak, Tim ; Kovacs, George ;
>>>>> >>> Lambert, Todd ; Love, Susan ; Rashid, Mohsin ; Thomas, Dorothy ;
>>>>> >>> Vallinncourt, Chris ; Watson, Wade
>>>>> >>>  Cc: [log in to unmask]">[log in to unmask]
>>>>> >>>  Sent: Tuesday, January 12, 2010 3:48 PM
>>>>> >>>  Subject: ELECTIVES curriculum review
>>>>> >>>
>>>>> >>>
>>>>> >>>  Hello Everyone,
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>  As you know, George and I have been asked to lead the group on
>>>>> >>> Longitudinal Experiences/Electives.  It is not clear what
>>>>> "Longitudinal
>>>>> >>> Experiences" implies and whether it is something totally
>>>>> separate from
>>>>> >>> Electives.  It does not seem to be a specific Unit but, I believe, it
>>>>> >>> encompasses Units that run throughout the first two years in the new
>>>>> >>> proposed curriculum.  These include Therapeutics, Pathology, Gross
>>>>> >>> Anatomy, Anatomy & Histology, Professional Competences, Population
>>>>> >>> Health, Community Engagement, Patient-Doctor Clinical Skills and
>>>>> >>> Electives.  Each of these is a separate Unit led by a team.   This
>>>>> issue
>>>>> >>> needs clarification.
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>  It seems that our primary job is to deal with Electives.
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>  I have been the Unit Head for MED-1&2 Electives for the last
>>>>> couple of
>>>>> >>> years.  In the last accreditation report, the Electives were
>>>>> rated as a
>>>>> >>> strength of the Undergraduate Programme at Dalhousie.  My
>>>>> meeting with
>>>>> >>> the LCME team was rather brief for this reason.  There were no major
>>>>> >>> concerns.  However, since the whole curriculum is now being
>>>>> revised and
>>>>> >>> the St. John site will be part of the programme, it is
>>>>> unavoidable that
>>>>> >>> the Electives will have to be revisited.  However, overall the
>>>>> Electives
>>>>> >>> have worked very well in the past and we should be careful
>>>>> not to make
>>>>> >>> too many unnecessary changes in what has worked.
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>  For a start, I am attaching the current Electives manual.
>>>>> (It is also
>>>>> >>> available on DalMedix).  This was updated last year based on
>>>>> >>> student/faculty suggestions and feedback.  For those of you
>>>>> who do not
>>>>> >>> know much about the Electives Unit, the manual will give you some
>>>>> >>> background information.  I am also attaching some relevant documents
>>>>> >>> regarding the newly proposed overarching objectives.  Some of you may
>>>>> >>> already have these documents.
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>  Here is a brief overview to how the Electives run.  The Unit is
>>>>> >>> essentially driven by the students and their preceptors.  I give a
>>>>> >>> one-hour presentation at the beginning of the academic year
>>>>> (September)
>>>>> >>> to MED-1 and MED-2 separately.  This is to introduce the Unit and to
>>>>> >>> answer any questions.  (For St. John, this can be videoconferenced).
>>>>> >>> All the information on the Electives is available to the students on
>>>>> >>> DalMedix including the list of potential preceptors and their
>>>>> areas of
>>>>> >>> interest. The student contacts the preceptor and then submits an
>>>>> >>> application on-line.  The Unit Head reviews the application and gives
>>>>> >>> approval.  This is done electronically.
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>  There are two types of Electives; Clinical and Research.
>>>>> The Research
>>>>> >>> one could be in a clinical discipline or basic sciences.
>>>>> Some students
>>>>> >>> develop a "hybrid".  They do a Research Elective but also attend some
>>>>> >>> clinics.  How this is done is between the student and the preceptor.
>>>>> The
>>>>> >>> requirements of the project that is submitted as part of the final
>>>>> >>> evaluations are different for each type of Elective.  The student can
> do
>>>>> >>> one Elective for the whole year (Sep-Apr) or two half Electives
>>>>> (Sep-Dec
>>>>> >>> and Jan-Apr).  At the end, the Unit Head looks at all the evaluations
>>>>> >>> and the reports/projects submitted.
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>  Lynsay Hardiman is the Electives coordinator at the Undergraduate
>>>>> >>> Medical Education office at Dalhousie.  She does most of the
>>>>> >>> administrative work, ensuring that students submit their
>>>>> proposals and
>>>>> >>> evaluations in time.
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>  There is an Elective Rep each for MED-1 and MED-2.  He/she will
>>>>> >>> communicate any concerns to the Unit Head during the Elective.  The
>>>>> >>> students do an evaluation at the end.
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>  Elective is the only unit in the curriculum where there is no formal
>>>>> >>> examination at the end.  The students get a PASS or FAIL based on the
>>>>> >>> assessment by their preceptor.  Currently, the final evaluation
>>>>> consists
>>>>> >>> mainly of assessing attitudes and professional behaviours.
>>>>> It has been
>>>>> >>> kept like this since students go to such diverse areas to do their
>>>>> >>> Electives that assessing knowledge, clinical skills, etc
>>>>> would be very
>>>>> >>> difficult and in some cases impossible.  As we develop new
>>>>> objectives,
>>>>> >>> we can certainly aim for the attributes of Professional, Life-Long
>>>>> >>> Learner and Community Contributor.  The fourth component i.e. Skilled
>>>>> >>> Clinician may not be directly applicable to the Electives.
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>  In my experience, the greatest strength of the Electives Unit is the
>>>>> >>> flexibility it provides to the students in not only choosing the area
> of
>>>>> >>> interest but also how they plan and conduct their learning.
>>>>> The latter
>>>>> >>> is, of course, expected to be under the guidance of their preceptors.
> I
>>>>> >>> have tried to insist that there should be an element of
>>>>> scholarship to
>>>>> >>> the Elective.  You may be surprised to know that the academic
>>>>> output of
>>>>> >>> the Electives is substantial, with several presentations and
>>>>> >>> publications coming out of the student's work.
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>  The biggest anxiety that the students have is not being able
>>>>> to find a
>>>>> >>> preceptor in time.  To this end, the Dean should direct the
>>>>> faculty to
>>>>> >>> get more involved.  I have mentioned this to Dr. Delva.  I do
>>>>> send out
>>>>> >>> notices to all faculty well in advance asking them about their
>>>>> >>> availability and encouraging them to participate.
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>  As we brainstorm the Electives, we need to look at revisiting the
>>>>> issue
>>>>> >>> in the following three broad areas.
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>  (1). How do we modify the current objectives of the
>>>>> Electives to bring
>>>>> >>> them in line with the new overarching objectives of the curriculum.
>>>>> >>> Should the objectives be different for Clinical versus Research
>>>>> >>> Electives?
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>  (2). How can we improve on the evaluation methods to ensure that the
>>>>> >>> students do fulfil the objectives of the Elective.  Should there be a
>>>>> >>> separate evaluation tools for the first year (less
>>>>> experienced) versus
>>>>> >>> the second year students (more experienced)?
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>  (2). How will the Electives be applied to the off-site
>>>>> students in St.
>>>>> >>> John campus?  (There will be a paucity of preceptors in the basic
>>>>> >>> sciences at that site.)
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>  Should the MED-1 Clinical Elective more of an observership?
>>>>> Will the
>>>>> >>> system based curriculum have any impact on the Elective experience of
>>>>> >>> students?  There could be more areas to look at.
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>  We should look at how our team and the process will work.
>>>>> Do we need
>>>>> >>> to meet as a group regularly or can we do most things by e-mail? When
>>>>> >>> Chris and Todd from St. John are in Halifax next, we can try to get
>>>>> >>> together. George had suggested Susan Love as the lead individual to
>>>>> work
>>>>> >>> on the new objectives and evaluation of Electives.  This would be
>>>>> great.
>>>>> >>> Susan has considerable experience in these areas.  We will all assist
>>>>> >>> her in the process.  Dr. Wade Watson has also been suggested as a
>>>>> >>> resource expert. Dave Carver (Med II) and Dorothy Thomas (Med I) are
>>>>> the
>>>>> >>> students on our team and their input would be invaluable.
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>  Finally, it is important to remember that first year medical
>>>>> students
>>>>> >>> come from diverse educational backgrounds.  Many have no knowledge of
>>>>> >>> science at all.  Others may have a PhD in biomedical sciences.  This
>>>>> >>> fact must be kept in mind when developing any type of objectives.
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>  The next meeting of the team leaders with the Dean is in early
>>>>> >>> February. I am going to be away for the first three weeks in March.
>>>>> >>> Hopefully, we would have put our thoughts and recommendations
>>>>> together
>>>>> >>> before that.
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>  With best personal regards.
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>  Mohsin
>>>>> >>>
>>>>> >>>  12, January 2010
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>  (Please acknowledge receiving this email to everyone in the group so
>>>>> >>> that we know your contact information is correct)
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> ---------------------------------------------------------------------------
>>>>> ---------------------------------
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>  Dr. Mohsin Rashid MBBS, MEd, FRCP(C)
>>>>> >>>
>>>>> >>>  Division of Gastroenterology & Nutrition
>>>>> >>>
>>>>> >>>  Department of Paediatrics, Faculty of Medicine
>>>>> >>>
>>>>> >>>  Dalhousie University
>>>>> >>>
>>>>> >>>  Director, Paediatric Clerkship Program
>>>>> >>>
>>>>> >>>  Unit Head, MED-1&2 Electives
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>  Mailing address:
>>>>> >>>
>>>>> >>>  IWK Health Centre
>>>>> >>>
>>>>> >>>  5850/5980 University Avenue
>>>>> >>>
>>>>> >>>  P.O. Box 9700
>>>>> >>>
>>>>> >>>  Halifax, Nova Scotia
>>>>> >>>
>>>>> >>>  Canada B3K 6R8
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>  PH: (902) 470-8746
>>>>> >>>
>>>>> >>>  FAX: (902) 470-7249
>>>>> >>>
>>>>> >>>  Email:  [log in to unmask]">[log in to unmask]
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>>> >>>
>>>> >>
>>>> >>
>>>> >>
>>> >
>>> >
>>> >
>>
>>
>
>



Grace Paterson, PhD
Assistant Professor, Health Informatics and Medical Education,
Medical Informatics, Room 2L-C2 Tupper Building, Dalhousie University,
Halifax, NS, Canada B3H 4H7
Tel: 902-494-1764 Fax: 902-494-1642
http://informatics.medicine.dal.ca



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