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.