Tl1 clinical experience orientation 2015
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Orientation for CCTSI Clinical Experience (TL-1) first year fellows.
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Tl1 clinical experience orientation 2015
- 1. Marion Sills, MD, MPH marion.sills@childrenscolorado.org Orientation: the Clinical Experience
- 3. Orientation Overview • Clinical Experience • Goals • Structure • Policies • Your experience
- 4. Orientation Overview • Clinical Experience • Goals • Structure • Policies • Your experience
- 5. Clinical Experience: Goals • Silos • training • research • practice
- 7. Clinical Experience: Goals • What: bridge silos • When: • Now • Future: sustained during your research career • Why: translation key to advancing health
- 9. Orientation Overview • Clinical Experience • Goals • Structure • Policies • Your experience • Clinic schedule • Your role in clinic • Deliverables • Role of clinical mentor • Certification • Meetings • Evaluation
- 10. Orientation Overview • Clinical Experience • Goals • Structure • Policies • Your experience • Clinic schedule • Your role in clinic • Deliverables • Role of clinical mentor • Certification • Meetings • Evaluation
- 11. Clinical Experience: Structure • Clinic schedule • ~ 1/month • frequency tailored to • your desires/needs • the clinical situation (e.g., clinical continuity may require varied frequency of clinic attendance) • Attendance required every day you arrange with your clinical mentor unless illness or emergency
- 12. Orientation Overview • Clinical Experience • Goals • Structure • Policies • Your experience • Clinic schedule • Your role in clinic • Deliverables • Role of clinical mentor • Certification • Meetings • Evaluation
- 13. Clinical Experience: Structure • Your role in clinic • YES • shadow the clinical mentor • discuss dynamics of patient care with mentor a priori, e.g.: • how would you like me to introduce myself? • when would we discuss my questions? • patient encounters will be the starting point for discussing real patients’ medical problems relevant to your research • NO • No clinical or charting responsibilities • No language translation
- 14. Orientation Overview • Clinical Experience • Goals • Structure • Policies • Your experience • Clinic schedule • Your role in clinic • Deliverables • Role of clinical mentor • Certification • Meetings • Evaluation
- 15. Clinical Experience: Structure • Deliverables related to each clinic attendance • Students • Clinical mentors
- 16. Clinical Experience: Structure • Student deliverables related to each clinic attendance • A1-2 page report based on each clinic attendance (journal) • Why: • stimulate discussion with clinical mentor • provide notes for writing the clinical chapter in your thesis • helps you and us discuss and advocate for your learning in clinic • What: • submit report to • clinical and basic mentors • the Clinical Experience Committee
- 17. Clinical Experience: Structure • Example of a journal entry • In my July clinic attendance, I saw JB (no PHI) with Dr. Wu. • JB was being seen for [medical condition] and presented with [some features of the history and exam and testing]. • Problems JB faces related to [medical condition] include [problem(s) that engaged your research interest]. • In considering JB’s [problem(s)], one approach to improving JB’s outcomes might be [propose a translational project approach to improving outcomes for the problem(s), including relevant references]. • Example only—explore formats with your mentors
- 18. Clinical Experience: Structure • Clinical mentor deliverables related to each clinic attendance • >1 relevant peer-reviewed clinical research paper • You and your clinical mentor discuss the paper in the context of patient(s) seen in clinic • a relevant clinical research protocol for the student to review and critique • You and your clinical mentor discuss the clinical protocol outside of the clinic • Basic science mentor(s) will be invited to these meetings
- 19. Orientation Overview • Clinical Experience • Goals • Structure • Policies • Your experience • Clinic schedule • Your role in clinic • Deliverables • Role of clinical mentor • Certification • Meetings • Evaluation
- 20. Clinical Experience: Structure • Clinical mentor • On your thesis committee, attends thesis defense • Regular meetings with you • Is encouraged to meet with you and your basic research mentor • This may result in additional translational collaborations • Is expected to model principles related to • ethical conduct of research • privacy issues in research
- 21. Orientation Overview • Clinical Experience • Goals • Structure • Policies • Your experience • Clinic schedule • Your role in clinic • Deliverables • Role of clinical mentor • Certification • Meetings • Evaluation
- 22. Clinical Experience: Structure • Certification • Online training in human subjects research and privacy • http://www.ucdenver.edu/academics/research/AboutUs/c omirb/Submissions-and-Training-Portal/investigator %20responsabilities/Pages/Completing-CITI-Education-and- Acessing-InfoEd.aspx#refresh_education • Scroll to “New Investigators and Research Coordinators” and follow instructions
- 23. Orientation Overview • Clinical Experience • Goals • Structure • Policies • Your experience • Clinic schedule • Your role in clinic • Deliverables • Role of clinical mentor • Certification • Meetings • Evaluation
- 24. Clinical Experience: Structure • Meetings • National meeting of CTSA pre-doctoral trainees (TL1s)--an opportunity to • present research-in-progress posters • share experiences with peers • Network! • On campus: • professional development seminars, workshops, and Research- in-Progress meetings • relevant clinical-translational seminars, such as • Grand Rounds • Dean’s Distinguished Speakers Seminar • Meetings and seminars at your clinical site
- 25. Orientation Overview • Clinical Experience • Goals • Structure • Policies • Your experience • Clinic schedule • Your role in clinic • Deliverables • Role of clinical mentor • Certification • Meetings • Evaluation
- 26. Clinical Experience: Structure • Evaluation • Clinical mentors and students complete written evaluations on the clinical experience for CCTSI PhD trainees • Annual CCTSI Clinical Experience Committee meeting with mentors to review each students’ goals, experiences and achievements
- 27. Orientation Overview • Clinical Experience • Goals • Structure • Policies • Your experience
- 28. Clinical Experience: Policies • Policies • Clinical core policy • Clinical dress code • Honor code* • Professionalism • Settings vary • Badge access • Regulation • Dress code *if non-MSTP see Graduate Student Handbook
- 30. Clinical Experience: Policies • It is about respecting the patient – not fashion • Always display ID badge; white coat optional • Clothes must cover shoulders to knees • Dresses, suits, collared shirts, skirts and tailored trousers; scrubs if appropriate • No T-shirts, shorts and jeans • No slogans • Piercing jewelry limited to the ears • Cover tattoos • No open toed shoes • Heels <2” • Wear socks or hosiery • No strong perfume
- 35. Clinical Experience: Policies • Clinical context varies • Four major hospitals: CHCO, UCH, DHMC, VA • Others – AHEC, PSL, Rose, etc. • All sites vary • policies, paper work and rules • EMR systems • organizational culture • other requirements: PPD, BLS
- 36. Orientation Overview • Clinical Experience • Goals • Structure • Policies • Your experience • It’s different in clinic • Communication • Self-knowledge
- 37. Your Clinical Experience • It’s different in clinic • Patients entrust clinicians with confidential and private matters • their nakedness • their pain • their stories • their struggles • their shame • This trust is • an enormous privilege • a powerful opportunity to help • a terrifying responsibility • a source of many feelings • an inspiration • sometimes itself healing for the patient
- 38. Your Clinical Experience • It’s different in clinic • Physician-patient privilege is easily and too often violated • 30% of state medical boards have fielded complaints of online breaches of confidentiality • Pitfalls • social media • partners, BFFs • public space in clinical setting • online platform for discussing cases
- 39. Your Clinical Experience • It’s different in clinic • Learning opportunities are opportunistic and unpredictable • At times, your needs come second • your time is not always your own • you may have to rearrange basic things like meals, bathroom breaks, checking in with family/friends
- 40. Your Clinical Experience • Communication • Mentor: • ask questions • ask for feedback about your own communication • Patient: • introduce yourself—learn how best do do this • study how your clinical mentor communicates with and about patients • Clinical staff: • introduce yourself • an opportunity for learning about patients and about the system of patient care • Other students: share experiences
- 41. Your Clinical Experience • Self-knowledge • Clinical realm is a chance to learn about being • patient-focused • team-player in a multi-disciplinary team • self-directed, independent • flexible • an active listener • a researcher collaborator on a clinical team • building relationships with colleagues • It also can teach you about • your own limits • what works best for you to stay centered and balanced • other professional self-care skills key to professional longevity • Ask for help, guidance, advice
Editor's Notes
- Who tracks meetings?
- Is this correct?
- Who tracks meetings?
- Are the students evaluated using the professionalism feedback form?
- What does it mean that they are guests?