1. Interventions Considered/Recommended
2x2 Resource vs. Impact Diagram
Impact
Clinical Advising Tool for Students & Advisors (CATSA)
Developing & Implementing a Web Based Approach to Clinical Advising Using a Quality Improvement Model
Alison Martin, M.Ed., Jen Rachow, A.A., Nathan Beucke, M.D., Steve Thompson, B.S., Rachel Brown, MBBS, Jason Cox, M.D., Linda Headrick, M.D.
The Problem (2008)
Clinical Advising is often viewed as an activity, yet it is a process involving a complex series of
connected steps or actions with starting and end points. MU has numerous clinical advisors with
varying experience who represent a wide range of specialties. Gaps in information can lead to
advising shortfalls.
Baseline Data
 Career Advising Coordinator Hired (2007)
 LCME Independent Student Survey (June 2007)- Career Counseling- “only 43% students
were satisfied with the quality of resources available” Response rate of 88% (316/360)
 GQ AAMC 2003-2008- Only 45% of our students were satisfied with career planning services
 Baseline Student/Advisor Survey (2009)- Measuring Discordance
(52%) M-4 students; (52%) advisors returned surveys
 Students overwhelmingly don’t meet with advisors because they feel advisors are very busy
and don’t want to bother them, only 20% of advisors named clinical or other duties as
barriers to meet with students.
 Greater than 1/3 of advisors felt students didn’t seek help.
 35% of students and only 15% of advisors feel that the program didn’t meet student needs.
 The majority of advisors felt they are preparing students for interviews while
> 50% of students felt advisors did not help them prepare.
 Both students (65%) and advisors (80%) felt more structure in the program would improve
advising.
 33% of advisors felt they did not have adequate resources to optimally advise students.
 63% of advisors and 71% of students felt an advisement checklist would improve the
quality of advising.
What is *Quality Clinical Advising?
• Avoid harm from process intended to be beneficialSAFE
• No unnecessary delay in effort to begin and complete
components of the residency preparation/application process
TIMELY
• All students receive equal access to resources and advisingEQUITABLE
• Activities based on best practices and resources that have
been validatedEFFECTIVE
• Activities are relevant to individual needs with timely
outcomesEFFICIENT
• Activities are responsive to individual preferences, needs and
valuesSTUDENT-CENTERED
*Adapted from IOM Report: Crossing the Quality Chasm, National Academy of Sciences, 2001
MU Quality Improvement Training
Identify team members
 M4 Medical Student
 Coordinator of Advising Services
 Assistant to Dean of Students
 Dean of Student Programs
 Dean of Education
Identify a health care problem
 Adapted to educational problem
 Survey advisor & students- M3/4
advising process
 Develop process flow chart
Design an intervention
 2x2 resource v. impact
 Paper based checklist became web
based content aggregating tool w/
checklists
Implementation /Challenges (2009-
2014)
 Gather validated resources
 Dedicated IT personnel
 Dedicated content personnel
 Beta test students/advisors(2012)
 Train advisors and students (2013)
 Train departmental liaisons (2013)
 Maintain, update and market (2014)
Measure the Outcome
GQ AAMC- Satisfied/very satisfied
w/career planning services
 2006-2009: 41%
 2010- 2013: 71%
M3/M4 Survey, Feb. 2014 (N=127)
 66% accessed CATSA viewing
these sections the most- C.V.,
Electives, P.S., LoRs, MSPE,
ERAS, Residency Programs
Advisor Survey, Feb. 2014(N=17)
 61% know about CATSA
 39% have used the CATSA
 46% encourage CATSA use
 20% say it has improved their
advising
High Low
High Create
clinical
advisor
development
program
Create
advisors
who stay
with
students all
four years
Low
Advisement
Checklist
Improve
advisor
orientation
materials
Resources
Clinical Advising Process Flow Chart
Initial Clinical Advisor
Meeting RE: Residency
Application
Letters of Rec- Strategies
Review “deliverables” & deadlines
CV, Personal Stmt., MSPE, Step 2
CK & CS, Scheduling interviews,
Review Residency Interviews
Graduation Requirements
Accept MSPE By
9/30
Confirm Faculty
LOR’s Being
Written
Discuss & Review
with Advisor
CV
Submit MSPE
after advisor
review
Discuss & Review
with Advisor
Written Personal
Statement
Discuss & Review
with Advisor
MSPE
Request & have
transcripts sent to
OME
Review possible
Residency
Interests
Strategies
Program selection
order, types
how to focus/limit
top priorities
Back-up Plan
Needed?
YES
Enter ROL and
Certify
Complete ERAS
application
Register for Match
National
Residency
Matching Program
(NRMP)
Select Residency
Programs and
Submit ERAS
Application
Chase Up
Outstanding
Documents
Decide which
interviews to
attand
Review Interview
Experiences
Determine
strategies for the
Rank Order List
(ROL)
Did I Match
SOAP
Meet with
designated faculty
in Clinical Dept.
MATCH DAY
NO
YES
NO
Add Programs to
MyERAS
Review and
Accept SOAP
offer
Sign Residency
Contract
Color Legend
Yellow – Student
Turquoise – Advisor
Red – End Point
Meet with
Dr. Brown
NO