Information Management Skills within a Medical Curriculum: Defining the Competencies

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1 THE FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE Information Management Skills within a Medical Curriculum: Defining the Competencies Nancy B. Clark Director Medical Informatics Education FSU College of Medicine

2 FSU CoM Background 2001 Legislative Mandate: Educate 21 st century physicians responsive to community needs Mission: Patient-centered care to elder, minority, & underserved populations in Florida Years 1&2 in Tallahassee Pensacola Years 3&4 at 6 regional campuses + 2 Rural Sites Marianna Tallahassee Daytona Beach Orlando Sarasota Fort Pierce Immokalee 2

3 Guiding Principles Integration of information and technology fundamental to College s mission COM students will Become information masters use medical information technology clinical decision support tools at the point of care. COM will be a leader in the development of curriculum for the use of all forms of medical information technology. The 21st century medical library is mobile.

4 Original IT Plan FSU CoM June 2001 Director of Medical Informatics Education Develop and deliver UME integrated informatics curriculum Work closely with Course Directors to integrate topics relevant to courses Director of Office of IT to select equipment and software Director of the Medical Library to select appropriate resources for curriculum Asst. Dean for Faculty Development to develop and deliver informatics faculty development 4

5 Technology Provided by College Library is Virtual (online and mobile) Student laptops tablet PCs Student mobile devices and mobile medical references Innovative in 2001 common to most medical schools now

6 1 st Informatics Curriculum Advisory Committee define competencies and identify where taught Build Consensus membership includes admin, clinicians, key course directors, librarians, students Used MSOP Informatics Objectives as structure Curriculum Committee endorsement Informatics integrated into most courses

7 Adopted AAMC MSOP Recommendations Issue When to Teach Structure Who Teaches Breadth of Coverage Assessments Sequence Ideal State Throughout all four years Embedded in all courses All faculty All students; all objectives Assessment is built into overall evaluation schema Cumulative, with increasing sophistication of tasks

8 Implementation Overseen my Informatics Curriculum Director (champion) Recruit content experts to deliver when available: i.e. Chair Family Medicine is EBM content expert teaches in all Doctoring Courses, Health Issues, etc. Work with course directors in planning Every time a course director changes, start over.

9 Informatics Clerkship Directors (2006) Hired.2 FTE MD clinical faculty One for each regional campus Oversee informatics integration into Longitudinal Chronic Care Clerkship and Doctoring 3 lecture/small group Documentation/EMR skills, decision support, EBM

10 THE FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE Time Passes..

11 11 Years Later Things Change 2010: Adopted ACGME Competencies 2011 major curriculum revision begins, post LCME reaccreditation Moving to integrated, developmental, competency-based curriculum 90% Yr 1 & 2 course directors new Technology time warped

12 Reconvene Curriculum Advisory Committee Curriculum Committee endorsement Tasked to update informatics competencies New membership includes admin, clinicians, key course directors, librarians, students building consensus Use ACGME competencies, define goals and milestones

13 Reviewed Current Publications Some Suggestions: AAMC-HHMI Scientific Foundations for Future Physicians AHIMA-AMIA Joint Work Force Task Force. Core competencies for individuals working with electronic health records. Various articles (Academic Medicine)

14 Define Competency Statements 3-7 statements for each of the following Patient Care Medical Knowledge Practice-based learning Communication Professionalism Systems-based practice Took old ones and reclassified them, added new, deleted outdated

15 Sample Competency Statements 1. Patient Care Informatics Competencies 1.1. Identify the types of information needed for appropriate documentation and document a clinical encounter Access and maintain patient medical information electronically using an electronic medical record (EMR/EHR) 1.3. Identify, evaluate and use appropriate Patient Education materials at the point of care Locate and utilize clinical practice guidelines and decision support resources in the clinical decision making process.

16 Sample Competency Statements 2. Medical Knowledge Informatics Competencies 2.1 Assess the reliability and validity of health information on the Web and other media. 2.2 Use the FSU Virtual Medical Library resources, i.e., journals, books, databases. 2.3 Conduct appropriate literature searches and apply results to answer clinical and research questions. 2.4 Demonstrate the ability to critically review the medical literature applying levels of evidence to the decision making process.

17 Develop Milestones Form multidisciplinary subgroups of volunteers (2-3 people) with interest in area to each of the 6 competency areas Task each subgroup to develop Milestones for each statement for each year of the curriculum Suggest courses to integrate Define assessment strategies to demonstrate developmental competency

18 Sample Milestones 1.3. Identify, evaluate and use appropriate Patient Education Materials at the point of care: First year: Identify three patient education sources/sites that are appropriate for patient education. Course: D1; Assessment: D1 small group participation, D1 exam questions Second year: Evaluate the quality and appropriateness of patient education materials. Course: D2; M&B2, Pharm; Assessment: Ad evaluation for Pharm. Pt Ed Handout assignment for M&B2. OSCE. Exam questions. Third year: Use patient education resources clinically at a patient-centered level (i.e. language, reading level.) Course: Family Medicine Clerkship or D3 Small Group; Assessment: Documentation in BB and portfolio as a reflective paper; Elective: Develop a unique educational set of materials for a chronic disease for the student portfolio including a cultural and literacy assessment of original work. Assessment: Review educational resources by faculty and advisor

19 Sample Milestones 2.1 Assess the reliability and validity of health information on the Web and other media. First Year: identify and apply unbiased criteria to online information resources to determine their value for clinical and research activities. Course: D101; HI1 Assessment: MCQ; Review several websites on a single topic and determine inter-rater reliability of reviews with peers and faculty. Second Year: Demonstrate the process of systematic gathering of information on a disease related topic and forming conclusions on the validity of the information. Course: HI2; Pharm; Assessment: annotated bibliography that supports or refutes a position on a specific topic. Drug ad assessment. Third Year: Locate and validate web or media-based resources to use for patient education. Evaluate web and media-based information resources being used by patients. Course: Clerkships or D3; Assessment: Prepare list of appropriate websites for patient education in the preceptor s practice.

20 Bring it together 1. Subgroups present recommendation to full advisory committee 2. Full committee makes adjustments, then approves 3. Recommendations taken to Curriculum Committee for adoption in progress

21 THE FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE To Come: Implementation into New Curriculum New Model (?) announced in April Expected roll out

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