Non-VSLO External Elective Process
Closing the Gap in Diabetes Care with Quality and Safety Research
Successful completion of Year 2
Additional Requirements: A R-form must be submitted 60 days in advance of all research electives. Completion of an Internal Medicine Clerkship is required
Responsible Faculty Director:
Maria L. Belalcazar, MD
to Report on First Day
Medical Research Bldg. 8.138
including holiday period 8
|To learn the basics of quality improvement and apply this approach to understand and address a problem or gap affecting the care or safety of patients with diabetes within our healthcare system|
|1. Identify a gap or deficiency in diabetes care and understand its underlying determinants
2. Become familiar with current guidelines and standards of care for the specific aspect of diabetes care that has been identified as deficient
3. Learn the basic tools of quality of care assessment and participate in the proposal and/or implementation of an intervention to improve an unfavorable diabetes-related outcome
|Description of course activities|
|Complete an online CITI training to be able to participate in research (certificate awarded)
a). Identify a problem or gap in care related to diabetes management
b) Use quality tools including a Fish Bone Cause and Effect diagram, a Swim Lane chart of Processes of Care and a Pareto Chart , as applicable, to understand and describe the problem
c). Review pertinent literature, including guidelines and published work on the issue. Summarize key findings in a table format.
d) Collect pre-intervention data
e) Design an intervention and define your quality aim
f) Depending on the intervention, project may end in the pre-intervention phase or after completion of the intervention and analysis if the data
g) Submit project findings in abstract form to a meeting for presentation. If project completed, consideration may be given (optional) to proceed to publication
|Type of students who would benefit from the course|
|Medical students with an interest in opportunities to improve patient care and develop clinical scholarship.|
|Clinical Activities (estimated schedule)|
|Day of Week||AM||PM|
|Average number of patients seen per week:|
|Call Schedule: none|
|Research Activities (estimated schedule)|
|Activity||Hours per Week|
|1. Clinical Observation|
|A.||Where are students observed on this elective?|
Patients simulators Other
|B.||Frequency - How often are students observed clinically?|
|C.||Format - What method(s) are used to document the student's clinical performance?|
Daily oral feedback
End of period oral feedback
|2. Oral Presentation|
|A.||Audience - To whom does the student present?|
|B.||Frequency / Duration of Presentation(s)?|
|C.||Format - What guidelines are set for the student's presentation?|
|Project progress; expectations are discussed on first day of the elective by faculty preceptor|
|D.||Assessment - Who assesses the student's presentation performance?|
|Self-assessment Peer assessment Faculty assessment|
|E.||Method of content selection|
|Current cases Student-selected topic Assigned topic|
|3. Written Assignment (H&P's, notes, papers, abstracts, etc.)|
|A.||Frequency of written assignment(s)?|
|ONCE: Abstract submission for presentation at regional/national meeting|
|B.||Format - What guidelines are set for the student's written work?|
|Faculty will provide examples and guidance|
|C.||Length of written assignment(s)?|
|Abstract Annotated bibliography 1 - 2 page paper 3+ page paper|
|D.||Are recent references required? No If yes, how are they selected?|
|E.||Method of content selection - e.g. student-selected, relate to cases, etc.?|
|F.||Audience - Who assesses the student's written performance?|
|Peer Assessment Faculty Assessment Other|
Written multiple choice
Written essay / short answer
|5. Extra Course Activities|
|What expectations do you have for the student to demonstrate participation in the elective (e.g. small group activities, seminars, thoughtful questions, providing resources, journal club, resident lecture attendance)?|
|Abstract for submission for presentation at regional/national meeting|
|6. Additional Costs|
|Please list any additional costs and/or purchases (books, materials, movies to watch, etc.) that are required for this course. Include an estimated total cost. If there are no additional costs, please enter "None".|
|7. Other Modes of Evaluation|
|Please explain below.|
|8. If this course is an Acting Internship, please complete the following:|
|A.||Objectives for the AI should relate directly to the Entrustable Professional Activities (EPAs).
Each AI should describe how the four key Year-4 EPAs that our school has identified as being Year-4 skills are
assessed. The Year-4 objectives are:
1. Entering and discussing orders/prescriptions.Specify how the student will be given formative feedback on their clinical skills.
Year-4 students should demonstrate mastery of EPAs they developed in the clerkship year, including recommending and interpreting common diagnostic and screening tests, and performing general procedures of a physician. They should be able to demonstrate masterfully and independently skills they mastered in Years 2-3, including efficiently performing comprehensive admission-notes and succinct daily progress notes and perform accurate, concise, and hypothesis-driven clinical presentations, form clinical questions and retrieve evidence to advance patient care. They should be able to demonstrate basic understanding of and beginning mastery of collaborate as a member of the interprofessional team and identify system failures and contribute to a culture of safety improvement.
List advanced clinical skills that a student will be assured an opportunity to practice.
How specifically will this AI build on developing skills from the clerkship year to prepare students for internship?
What opportunities will typically be available to all students who take this AI (procedures, required presentations, etc.)? What opportunities may be available based on patient load/presentation or student initiative (ie. Writing a case report)?
An AI should have expectation of a minimum of 32 hours per week of clinical responsibilities. Duty hours should be capped at ACGME limits for an intern, thus up to 24 hours followed by 4 hours of activities related to patient safety, education, and handoff. Students cannot work more than 80 hours per week averaged over 4 weeks. They can only have 1 day off in a 7-day work week with 8 hours off between shifts.
Clinical responsibilities will vary depending on specialty, but how is the student functioning with work commensurate to a PGY1 with an appropriate level of training?
How is the student demonstrating drawing clinical conclusions and/or developing a management plan and documentation as an intern would do?
How and by whom will midpoint feedback be provided to the student? How will you remediate deficiencies identified at midpoint?
Acting Internship students often seek letters of recommendation following their experience. How many different Faculty will work directly with the student and have knowledge of the student's abilities to detail in a written evaluation? Describe the degree of supervision and interaction with faculty vs. residents or other providers and how feedback will be obtained if more direct work is with residents or other providers.