Guide for Attendings

Admissions

  • During Med 1, students are told to admit one case per call (approximately 2 per week, 8 per block). They have 24 hours to complete a full write-up which they are told should be fairly extensive (background basic text reading evident). They are told not to put these in EMR until a number have been reviewed by you and you have deemed them “fit”.
  • During Med 2, students are told to admit two cases per call (approximately 4 per week; 14-16 per block). They have until the following morning to complete a full write-up.
  • Students should conduct the interview and physical exam as independently as possible; ideally a portion will be observed periodically and feedback provided to the student on communication and exam skills.
  • Preceptor and student formally review one write-up per week. Students will turn in this corrected/reviewed write-up as part of their portfolio.

Day-to-day patient management

  • Present their patients on work rounds daily; present their new admissions post-call.
  • Please make every effort to involve the student in the decision-making beforehand (as if they were going to write the orders), or at least keep them informed of orders written on their patients.
  • Write daily progress notes on their patients.
  • Collaborate professionally with other members of the patient’s care team (social work, pharmacy, consultants, primary care physicians).
  • Students should be expected to present 3-5 minute “teaching bullet” on patient-driven question for team to be presented at start of each attending rounds (or work rounds, as appropriate).
  • Students have a didactic schedule- see calendar for site-specific activities.

Feedback

  • Sit-down feedback session with students at least twice: mid-way through and at the end of their time on service. Forms to facilitate mid-way feedback will be given to you by the student clerks. We encourage use of the E*value form attached to the midway feedback from the student knows exactly what your verbal feedback means in a Likert scale.
  • Additional, brief, "on-the-fly" feedback is strongly encouraged.
  • Completion of on-line E*value of the student within two weeks of the end of the rotation. We are under strict LCME deadline to have all evaluations completed in a timely fashion.
  • Structured observations- complete one Mini-CEX per block. Ideally this should be done by resident as a way to increase variety of methods residents gain exposure to and experience with. More frequent observation of history and physical skills is encouraged but students are required to turn in evidence of one structured observation session.

Quick Checklist

  1. Review all H and Ps- minimum 4 per block should have written comments from you.
  2. Assign 5 minute patient-based questions for students to review and report on for rounds.
  3. Meet for formative (midway) feedback – sign and fill out feedback form and the attached preliminary paper E*value.
  4. Complete summative (final) feedback with student- complete final E*value within 14 days of rotation end.
  5. Make attempts to review pertinent physical findings on student patients twice a week.
  6. One Mini CEX completed per block- resident should do this.