College of Medicine Undergraduate Education Chipper Griffith MD

College of Medicine Undergraduate Education Chipper Griffith, MD Vice Dean for Education Professor of Internal Medicine and Pediatrics

Entrustable Professional Activities Core Principle Phase: 8 activities • Obtain a complete history for a patient being admitted to the hospital • Appraise a research article for validity, importance and applicability to a patient care question Application Phase: 33 activities • Interpret an EKG • Provide accurate and complete documentation of a hospital admission Advanced Development Phase: 11 activities • Write, dictate, and/or enter safe and appropriate patient orders • Obtain informed consent for low-risk procedures

EPA Assessment Cannot perform Cannot complete even with close supervision; restricted to shadowing experiences Direct Supervision Requires close supervision Requires advance preparation and/or physician guidance to successfully complete Indirect Supervision (Direct supervision immediately available) Requires minimal supervision Successfully completes with feedback and/or clarification by a supervising physician Indirect Supervision (Direct Supervision available) Performs independently Competent at an intern level, rarely needs feedback or clarification afterwards Oversight

CORE PRINCIPLE PHASE

Contemporary Practice Advanced Clinical Medicine ACM (con’t) April May ICM (con’t) Vacation Research & Clinical Elective Experiences Behavioral Basis of Medicine (3 weeks) Musculoskeletal & Integumentary Systems (5 weeks) March Application Phase Begins ICM (con’t) Spring Break Neurosciences (8 weeks) February Vacation USMLE Step 1 Research & Clinical Elective Experiences Multisystem & Integrative Concepts (3 weeks) January Assessment Week Introduction to Clinical Medicine Hematologic & Lymphatic Systems (4 weeks) December Endocrine & Reproductive Systems (6 weeks) Winter Break November Winter Break October Gastrointestinal System & Nutrition (6 weeks) Foundations of Infection, Disease & Therapeutics (10 weeks) Clinical Anatomy & Radiology (9 weeks) September Cardiovascular System (5 weeks) Renal & Urinary Systems (4 weeks) Respiratory System (5 weeks) August June July

Clinical Anatomy & Radiology Monday Tuesday 8: 00 Podcast Musculoskeletal Development 9: 00 Lecture Demonstration Superficial Back & Upper Extremity Shoulder Physical Exam 10: 00 Lecture Axilla & Arm 11: 00 Lecture Forearm Lecture Hand Independent Study Wednesday Case-Based Radiology of the upper limb Thursday Friday Small Groups Back & upper extremity prosection lab Back & upper extremity ultrasound cases (Sono. Sim) Podcast & Quiz Shoulder, Elbow & Hand Physical exam ultrasonographic Physical exam practice of back & anatomy & upper extremity physiology

Introduction to Clinical Medicine Patient Education Week – – Reading: Literacy and numeracy skills of Americans Video: Health literacy and patient safety Class activity: Discussion and design patient education material Assignment: Describe three approach to overcome literacy difficulties Breaking Bad News Interview Week – Reading: Interview tips for breaking bad news and angry patients – Video: Example of diabetes diagnosis, pregnancy diagnosis – Class activity: simulated patient interviews Breaking Bad News Interview Lab Longitudinal Clinical Experience (LCE): students come to your clinic twice a semester; CONSIDER VOLUNTEERING FOR THIS! These students are capable of interviewing and basic physical exam; contact jfwilson@uky. edu

Gastrointestinal System & Nutrition Monday Tuesday Wednesday Thursday Friday 8: 00 Podcast Hepatobiliary & pancreatic anatomy Podcast Viral hepatitis Podcast Digestion Podcast Team-based Hepatobiliary & learning cases pancreatic masses Liver, Biliary System, Pancreas 9: 00 Lecture Hepatobiliary physiology Case-Based Viral hepatitis cases Lecture Neurohormonal control of digestion Small Groups Hepatobiliary ultrasound cases (Sono. Sim) 10: 00 Lecture Case-Based Pathology of acute Complications of & chronic liver Cirrhosis failure Lecture Biliary & pancreatic pathology 11: 00 Case-Based Liver pathology examples Case-Based Acute & chronic pancreatitis cases Case-Based Hepatobiliary imaging

Advanced Clinical Medicine Lecture: thorax & lung cases Workshop: advanced cardiovascular & lung exam Workshop: cardiovascular & lung ultrasound Small group – Interview a patient and complete focused CV/lung exam – Focused patient write-up – Patient presentation to faculty preceptor – Examination of patient with preceptor

Multisystem & Integrative Course Monday Tuesday Wednesday 8: 00 Lecture Approach to USMLE Step 1 Discussion Approach to fever 9: 00 Lecture Introduction to clinical reasoning Case-Based Discussion Small Groups Infectious disease Approach to cough Clinical reasoning case studies & dyspnea case write-up 10: 00 Case-Based Antibiotic choice 101 Immunology case studies 11: 00 Quiz & Review Infection & immunology Thursday Case-Based Pulmonary case studies Quiz & Review Pulmonary Friday Lecture Clinical reasoning case Discussion Approach to muscle weakness Case-Based Neurology case studies

APPLICATION PHASE

February Students rotate in 12 different rotation groups Each has a distinct order of rotations March April M 3 Capstone (2 weeks) January Internal Medicine (12 weeks) Emergency Medicine (4 weeks) December Obstetrics & Gynecology (4 weeks) November Winter Break October Family Medicine (4 weeks) September Neurology (4 weeks) August Psychiatry (4 weeks) July Surgery (8 weeks) Pediatrics (8 weeks) June May

Surgery Clerkship Monday Tuesday Wednesday Thursday Friday Round with team Discussion Critical Care Topics Round with team Lecture Orthopedics Round with team 8: 00 OR Clinic OR 12: 00 OR Clinic OR Independent Study OR Evening Rounds 6: 00 7: 00 1: 00 3: 00 Workshop Fractures & splinting 5: 00 Evening Rounds Wise-MD module Conference General Surgery Wound healing Evening Rounds Orthopedic Surgery Reading Orthopedic Quiz Due

M 3 Capstone Clinical Performance Exam (CPX) – 8 simulated patients to assess students’ basic clinical skills – Preparation to take the USMLE Step 2 CS Interactive sessions introduce advanced clinical skills – Write admit and daily orders – Write discharge notes – Provide cross‐coverage, assist with urgent/emergent medical issues – Transition patient care to another healthcare provider

ADVANCED DEVELOPMENT PHASE

Required Rotations Primary Acting Internship Secondary Acting Internship Transition to Residency Electives Elective Block Elective Block April May Transition to Residency March Block 10 February Block 9 January Block 8 December Block 7 November Block 6 October Block 5 September Block 4 August Block 3 July Block 2 Block 1 June Vacation/Interviews/USMLE Step 2 Vacation Block

Primary Acting Internship • • Perform the initial evaluation of patients assigned to the service Write admit and daily orders Develop their own diagnostic and therapeutic plans Write discharge notes Communicate care plans to the patient & family members Coordinate care with consultants & other healthcare professionals Provide cross‐coverage, assist with urgent/emergent medical issues Transition patient care to another healthcare provider

Transition to Residency Monday Tuesday Wednesday Thursday Friday Podcast Goals of care and DNR Podcast ACLS protocol Podcast Central line placement Podcast PALS basics Simulated patient cases Goals of care discussion Simulation Megacode on advanced human simulator Simulation Central line placement on task simulator Simulation Simulated patient Pediatric respiratory cases distress on Sim. Baby Informed consent discussion Pediatric bradycardia on Sim. Baby DNR discussion Reading Obtaining informed consent from patients

Curriculum Office Contacts Associate Dean for Curriculum Christopher A. Feddock, MD Cafedd 00@email. uky. edu Curriculum Research and Leadership Development Directors Helen Garces, MSEd (859) 218 -0013 helen. garces@uky. edu Michelle Lineberry, Ed. D (859) 323 -6437 michelle. lineberry@uky. edu Center for Excellence in Medical Education Dorcas D. Beatty (859) 257 -5286 dorcas. beatty 1@uky. edu Evaluations Coordinator Miriam Lightfoot, MSEd (859) 323 -4643 miriam. lightfoot@uky. edu Assistant Dean for Clinical Education John Ragsdale, MD, MS john. ragsdale@uky. edu Clerkship Development and Administration Amy Murphy-Spencer, Ed. S (859) 323 -1196 amspenc@uky. edu M 1‐M 2 Course Support Staff Ben Lawson (859) 323 -5779 joseph. lawson@uky. edu Katie Finch (859) 257 -1609 katiefinch@uky. edu Porsha Thomas (859) 257 -1572 porsha. thomas@uky. edu

M 1 & M 2 Course Directors MD 810 Foundations of Infection, Disease, and Treatment Paul Murphy, MD, Course Director Pathology and Laboratory Medicine pmurphy@uky. edu John Wilson, Ph. D Behavioral Sciences jfwilson@uky. edu Todd Cheever, MD MD 813 Psychiatry Behavioral Basis of Medicine Tbchee 0@uky. edu Wayne Cass, Ph. D MD 814 Anatomy and Neurobiology Clinical Anatomy & Radiology Wacass 1@uky. edu Paul Murphy, MD MD 816 Pathology and Laboratory Medicine Hematologic & Lymphatic Systems pmurphy@uky. edu Sam Franklin, Ph. D MD 817 Anatomy & Neurobiology Neurosciences sfranklin@uky. edu MD 818 Brian Higgins, Ph. D, Course Director Musculoskeletal & Integumentary Microbiology & Immunology bphi 223@g. uky. edu Systems MD 811 Introduction to Clinical Medicine Scott Morehead, MD MD 821 Internal Medicine/Pulmonary Advanced Clinical Medicine smore 2@uky. edu MD 823 Paul Murphy, MD Hematologic and Lymphatic Pathology and Laboratory Medicine Systems pmurphy@uky. edu Michael Kilgore, Ph. D MD 824 Pharmacology & Nutritional Sciences Endocrine & Reproductive Systems mwkilg 0@uky. edu Brian Jackson, Ph. D MD 825 Physiology Renal and Urinary Systems Brian. jackson@uky. edu Mike Piascik, Ph. D MD 826 Pharmacology and Nutritional Sciences Cardiovascular Systems mtp@email. uky. edu Scott Morehead, MD MD 827 Pulmonary Respiratory System smore 2@uky. edu MD 828 Dexter Speck, Ph. D Gastrointestinal System & Physiology Nutrition dfspeck@uky. edu MD 829 Chipper Griffith, MD Multisystem & Integrative Internal Medicine Concepts cgriff 00@uky. edu

M 3 & M 4 Course Directors MD 830 Pediatrics MD 831 Emergency Medicine MD 832 Neurology MD 833 Psychiatry MD 834 Family and Community Medicine MD 835 Internal Medicine Berry Seelbach, MD Pediatrics berry. seelbach@uky. edu Jonathan Bronner, MD Emergency Medicine j. bronner@uky. edu Amy Hessler, DO Neurology aehe 222@uky. edu Todd Cheever, MD Psychiatry tbchee 0@uky. edu Ginny Gottschalk, MD (effective Sept. 1) Family & Community Medicine glgott 2@uky. edu Andrew Hoellein, MD Internal Medicine arhoel 0@uky. edu MD 837 Surgery MD 838 Obstetrics & Gynecology MD 840 Transition to Residency SUR 862 Acting Internship: Surgery PED 859 Acting Internship: Pediatrics MED 870 Acting Internship: Medicine Joseph Iocono, MD Pediatric Surgery Jioco 2@uky. edu Mark Hoffman, MD Obstetrics and Gynecology Mark. hoffman@uky. edu Tom Mc. Larney, MD Anesthesiology jmcla 00@uky. edu Jitesh Patel, MD Surgery Jitesh. patel@uky. edu Berry Seelbach, MD Pediatrics berry. seelbach@uky. edu Adam Gray, MD Internal Medicine ajgray 2@uky. edu

Center for Excellence in Medical Education • Faculty Development Workshop Series • Individual Workshops • Medical Education Grand Rounds • Abraham Flexner Teaching Awards given at Fall Convocation -for achievements in Educational Leadership and Administration, Outstanding Teaching Contribution and Mentorship, Educational Innovation and Curriculum Development, Educational Evaluation and Research, Faculty Development in Education https//meded. med. uky. edu/center-excellence-medical education

Source: Kentucky Health News, 2014.

M. D. Program Applicant Pool Increased National Interest 26

M. D. Program Total Enrollment 2011 - 2016 17% growth

Center for Health Education and Research Morehead, Kentucky

The Medical Center-WKU Health Sciences Complex Bowling Green, KY

Rationale: • • KY has a shortage of physicians. UK COM has a deep applicant pool. UK COM is at its enrollment capacity on the Lexington campus. These University partnerships provide the educational space (Western KY University, Morehead State University, ? TBA). These clinical partnerships provide sites for clinical education (Medical Center at Bowling Green; St. Claire Regional Medical Center; King’s Daughters Medical Center, ? TBA) These regional partnerships are the only way that UK COM can greatly expand class size to produce more doctors for KY. This partnership provides the parameters for expansion possibility. Details of this implementation will be worked out with faculty, staff, etc. in the coming months to years.