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National Survey of Pediatric Clerkship Directors Response
to LCME ED-2
Authors: Su-Ting T Li, MD, MPH, UC Davis and Sherilyn Smith, MD,
University of Washington
Objective: Describe pediatric clerkship directors response to LCMEs
ED-2.
Design/Methods: Web-based surveys were sent to all 142 US and Canadian
pediatric clerkship directors.
Results: 77% (109/142) completed the survey. Of the 36% of respondents
who had an LCME visit since ED-2 was reinterpreted, 65% reported that LCME had
concerns about their clerkships fulfillment of ED-2, including whether the clerkship
adequately specified types (41%) and number (47%) of patients required to be
seen, and whether an adequate system was in place to monitor (41%) and verify
(24%) that students had seen the required patients. Compared with clerkships
where LCME had no concerns, clerkships that received an unfavorable review were
more likely to broadly define types of patients required to be seen (eg., defining
types of patients required to be seen by only clinical setting or acuity rather
than specifying symptoms, organ systems, or diagnoses). Both groups defined
patient encounters to include real patients (100%), CLIPP cases (83%), standardized
patients (38%), case discussions (39%), attending rounds (28%), and paper/CD/web
cases (17-23%). Clerkships had an unfavorable review when neither patient logs
nor checklists were used to track patient encounters. While many (49%) clerkships
relied on an attending or resident to verify that the patient was seen, relying
on just student verification of patient encounters was reported as sufficient
for LCME.
Conclusions: Pediatric clerkship directors have successfully employed
many different techniques to implement ED-2 which may be adapated by other clerkships,
with special attention to specifying and monitoring quantified patient criteria.
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