Case-Based Learning (CBL) in the Transition to Clerkship will be different in several ways from what you have experienced up to this point. This page, combined with the orientation session, will alert you to the changes so that you can have the best experience possible.
Important Changes to be Aware of
The case will disappear from your iPad when the next part of the case is delivered (just like the words spoken in an exam room with a patient—you decide what to record).
You will be asked to add to the medical record in the EMR. See more details below.
When you have completed an assignment in which you document a patient note, you will have an opportunity to self-assess your documentation skills by comparing your work to a sample note written by a preceptor. The preceptor note for comparison will be found on E.Flo MD under resources for the CBL session during which you are prompted to participate in self-assessment. After your self-assessment, make notes to yourself (to be referred to when you are a clerk on the LIC) about changes you will make the next time you document a patient note in each clinical domain.
The Patient Medical Chart
Over the course of the Transition to Clerkship, you will use SimCapture software in conjunction with the CBL eBooks to update your patients’ medical charts, known as EMR or EHR. See the SimCapture EMR/EHR page for instructions. This activity is designed to prepare you for working with an electronic medical record during the clerkship.
EMR VS. EHR
EMR (Electronic Medical Record) and EHR (Electronic Health Record) are interchangeable terms and represent what you will experience in a clinical environment. There are many different electronic record programs, so you will see both terms used in these CBL cases.
Navigate the EMR
- On the main EMR/EHR screen, click the down carat to see a list of links to each patient and session.
- In the ebook, when you are prompted by the EMR button to check the EMR, follow the prompts with the specific tab to check (don’t peek at later tabs!).
- When you have your first encounter with a patient in CBL, you will see that patient’s chart in the EMR. Then, you’ll have the opportunity to perform tasks (enter orders and review X-rays and lab results) via the EMR.
Detailed instructions on which tasks to perform will be provided in the sessions.
Look for the EMR icon.
Not all days will include all navigation tabs.
Students will only enter information on the Documentation tab.
Pay attention to the tab title—the eBook will signal which tab has the information you are looking for.
All sessions will have an EMR. If there is no content, the EMR will state that on the Messages tab.
Messages are read-only.
The CBL eBook lets you know when a patient’s information has been updated. You may see a date on the message; this date corresponds to the date of your encounter with the patient (the date of CBL) and not necessarily the date according to the patient’s story; there are many time lapses in these cases. The session number is also at the bottom of the messages tab to keep you oriented.
The History Findings tab is read-only.
This tab shows your patient’s history and will be updated as the case progresses. Forms and other items may also be displayed in this section.
The Physical Exam Findings tab is read-only.
After you’ve completed the physical exam on a patient, your “preceptor” will provide a physical exam as well, so you can see what you missed.
All Results are read-only.
All lab tests, imaging studies, and other test findings will display under the All Results tab.
When results are revealed sequentially, the Results tabs may be numbered (e.g., Results #1, Results #2). Lab values will display in a landscape format, with each successive lab result listed to the right of the previous one.
The Documentation tab allows you to input content.
Under this tab, practice documentation.
Workflow Tips
Recommendations for managing multiple sets of materials
(do whatever works best for you!)
Consider bringing two devices: an iPad for reading the case + a laptop for using the EMR.
An alternative workflow is using Split View on the iPad.
Toggle between the case book and the EMR browser on your laptop.
Simulation in the Virtual Clinical Center (VCC)
Week 1 will be like your Clinical Skills Workshops—your APM facilitator will be in the room. Two students will be in the room at the same time; one will perform the history and the other will perform the physical exam. You are encouraged to ask for feedback. During the LIC, you are responsible to ask for feedback regularly. This will be an opportunity to refresh your clinical skills/ patient care skills after the 7-week break for Step Prep.
In Week 2, you are unlikely to know the standardized preceptor. We want you to ask the preceptor to provide feedback on your skills. This week you will be counseling a patient. You may request a WBA 1a or 1b from the preceptor this week. You must collect one WBA 1a and one WBA 1b by the end of this 5-week course.
In Week 3, you will not have a preceptor in the exam room with you—tell your peer which skill you are working on and give each other feedback. There will be a group debrief with a preceptor after the encounter.
In Week 4, you are unlikely to know the standardized preceptor. We want you to ask the preceptor to provide feedback on your skills. You may request a WBA 1a or 1b from the preceptor this week. You must collect one WBA 1a and one WBA 1b by the end of this 5-week course. You will have a summative assignment (document an adult ambulatory chart note) based on your patient encounter this week; make sure both students take notes on the history and the physical exam findings.
In Week 5, you are unlikely to know the standardized preceptor. We want you to ask the preceptor to provide feedback on your skills. You may request a WBA 1a or 1b from the preceptor this week. You must collect one WBA 1a and one WBA 1b by the end of this 5-week course. This is the final week of the Transition to Clerkship.
One afternoon during weeks 2–5, you will be assigned to pediatric simulation exercises in addition to your encounter with the CBL patient. This session is not connected to the CBL cases. Please refer to your individual E.Flo MD Learning Event for information about these sessions.
Large-Group Sessions
Workshops are designed to help with a skill you are being asked to perform in CBL or a with a skill you will soon employ during the LIC.
Resources
This introduction to our fictional Transition to Clerkship city has also been beamed out to your iPads.
There is a variety of resources here—different ones will be relevant for different patients whom you encounter in Wesford.
Questions?
For questions regarding assignments
Please contact Assessment.
For questions regarding the e-Chart
Please contact Chris Martin.