April 9, 2004

VUSM gets clinical training grant, adds new program

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Matt Hall

VUSM gets clinical training grant, adds new program

A new program in the School of Medicine will add an element of structure to the third and fourth years of education, a time that was primarily based upon uncertain patient exposures during clinical training.

The School of Medicine has been awarded one of six New York Academy of Medicine grants for the development of improved education in the clinical transaction.

The grant will allow the school to bolster its education by creating a system of checks to ensure that students encounter key presenting problems and that both students and faculty are confident in their ability to deal with them.

“The goal of the clinical transaction is to gather information, both from the history and the physical examination, in a way that establishes a good doctor/patient relationship, and then to use this information to formulate a differential diagnosis and management plan,” said Gerald S. Gotterer, M.D., Ph.D., senior associate dean for Faculty and Academic Affairs.

“The quality of the communication is as important as the information received. The project is concerned with the manner in which the transaction is carried out, what is done, and how the information is used.”

Currently, after their second-year course in physical diagnosis, students learn the skills of the clinical transaction as they participate in clinical rotations.

It has been assumed that over these two years they will be exposed to a sufficient number of different presenting problems to develop comprehensive skills. The new program will allow for more certainty.

“Our approach is to identify a master list of presenting problems and allocate these problems among the required clerkships. Each clerkship will provide teaching focused on its presenting problems. For example, chest pain would be allocated to the medicine clerkship,” Gotterer said.

“Either with real patients or simulations, every student will have a learning experience with chest pain during the clerkship. We can thereby be certain that each student is exposed in a controlled manner to a defined array of the most significant presenting problems.”

The program also involves the eleven Master Clinical Teachers, who are distributed among the departments responsible for the required clerkships.

Along with educating students, the teachers will work to enhance the teaching skills of the residents and faculty. They will also serve as mentors for the students, following their progress over the last two years of education and providing insight and support.

“The final component of the program is developing a learning portfolio,” Gotterer said. “This Web-based resource will allow students to record their experiences and their thoughts and reflections on their experiences and to share these with their mentors or others.

“It is our hope that this new program will lead our students to have even more satisfaction with their education based on the knowledge that they have been taught the skills of the clinical transaction by Master Clinical Teachers.”