Emory University School of Medicine s2

Emory University School of Medicine

Independent Student Analysis Report

for The Liaison Committee on Medical Education

January 2015

Independent Student Analysis Committee:

Kevin Seitz, M4 (MD/MSCR), Chair Pearl Ryder, M4 (MD/PhD) Shruthi Rereddy, M4 (MD/MSCR) Zoë Julian, M4 (MD/MPH) Colin Washington, M3 Alexandra Reitz, M3 David Liddle, M3 Daniel Guidot, M2 Rachel McCandliss, M2 Sarah Streeter, M1 Max Goldman, M1 EXECUTIVE SUMMARY

In preparation for review by the Liaison Committee on Medical Education (LCME) in 2016, leadership of the Emory University School of Medicine (EUSOM) charged this Independent Student Analysis (ISA) Committee with conducting a comprehensive assessment of the student experience at EUSOM and an analysis to identify strengths and areas for improvement. This ISA report describes the distribution and interpretation of a survey questionnaire designed to those ends.

The ISA survey instrument captured both population-level measures of experience and individual insights from students who contributed comments in text. The 2007 Student Self-Study Report, completed for the 2008 LCME review of EUSOM, provides context for this report, but we deliberately focus on the experience of current students, and likewise, we acknowledge ongoing improvement efforts at EUSOM only when they are clearly demonstrated in student experience. Finally, recommendations for changes at EUSOM are included solely to illuminate areas for improvement, and they are not a primary aim of this report.

We conclude that the faculty, learning environment, and medical education programs at EUSOM provide robust and effective training to meet the clinical, research, public service, and leadership needs of our communities. The changes that have taken place since 2007 were a step forward for the missions of academic medicine and provide a foundation for continued development in education, patient care, and research.

In this ISA report, we provide demographic data on the student body for descriptive purposes, followed by six chapters that assess topic areas of relevance to the LCME including: learning environments, student services, and medical education programs. Each assessment chapter concludes with an itemized list for areas of strength and opportunities for improvement. In this self-assessment, we have identified the following as the primary areas of strength and opportunities for improvement.

Areas of Strength:

Faculty and administrators are enormously supportive of students in professional, academic, and personal matters. They provide accessible resources for mentorship and career opportunities. The small group leaders are exceptionally valued by students for these roles, while lecturers and module directors in the preclinical years are also highly accessible and responsive.

Institutional facilities at EUSOM provide ample space and tools for many educational modalities including large lectures, small group discussions, patient encounters, and simulations. Clinical training sites are perceived as safe and provide an outstanding diversity of settings, patient populations, and specialty care for medical education.

The learning environments at EUSOM provide for overall student well-being through active student interest groups and programs to support diversity in the student body.

Research opportunities and resources are readily available to EUSOM students across disciplines from basic to translational science and public health. The Discovery Phase in the fourth year is successful in structuring dedicated time for research, while the abundance of dual-degree students also speaks to a robust interdisciplinary academic research environment.

Library and IT Services staffs provide excellent training on available resources throughout all four years of education, and they are also highly accessible for individual student needs.

The infrastructure of student services for health, mental health, personal counseling, and disability are commended for their availability, adequacy, and confidentiality.

Small groups are a valued component of the EUSOM curriculum. Students feel that the structure creates an environment for learning, discussing, and developing that enriches the Emory experience. The small group also provides mentorship, personal support, and professional guidance through strong inter-personal relationships.

Clinical education is a core strength of medical education at EUSOM, as students are well trained in clinical reasoning and skills. Outstanding clinical faculty, early preclinical exposure through OPEX, and very highly rated core clerkships and sub-internships contribute significantly to this success.

Professionalism as a clinician is taught, valued, developed, and reinforced for students by effective feedback on clinical rotations and exemplary models across clinical sites.

Opportunities for Improvement:

Increasing efforts to create and support diversity within the student body and faculty are identified as important to students. Programs with these goals exist, but specific ethnic and socioeconomic groups have indicated reasons to strengthen their roles.

Communication regarding mistreatment and sexual assault does not adequately prepare all students to understand the mechanisms and processes for handling incidents that occur after a report has been made. Despite the heterogeneity of events, students report concerns about process transparency and confidentiality, which are crucial elements for effective policies.

Attendance and time off policies are perceived as barriers to appropriate balance of personal obligations and responsibilities with student and professional roles.

Financial services are the site of significant challenges given the high cost of medical education. Student responses highlight a need for early counseling in debt-management, scholarships, and grants, as well as efforts to increase awareness for predictability of aid.

Additional educational resources like lecture recordings, electronic study resources, and peer tutoring are supplementary resources that students feel may be better utilized to reinforce curriculum topics.

Integrated topics in preclinical education including biochemistry, embryology, microbiology, pharmacology, immunology need increased attention and coordination in preclinical education. Overall student satisfaction with these topics, confidence in material, and purchase of supplementary resources demonstrates this need.

Anatomy didactics and evaluation methods are cited as the cause of a recent decline in student satisfaction with this course. Suggestions call for increased clinical applications of anatomical concepts and reconsideration of the exam process in the context of students’ other simultaneous coursework.

Peer professionalism assessments as currently practiced are not effective peer feedback mechanisms due to timing, format, or execution. However, they retain the potential to model appropriate peer communication and improve student awareness of their own strengths and weaknesses.

Clinical clerkship performance evaluations with Likert scales are considered among students to be inconsistent across faculty and can undermine the sense of fairness for grades during the M3 and M4 years.

The Ambulatory Care clerkship received the lowest ratings from students in each of its adult, pediatric, and sub-specialty components. Our survey suggests room for improvement in the overall structure to reduce variability between primary care sites and to improve the fragmented educational experience when moving between subspecialty providers. Communication around career counseling is largely successful for students, but room for improvement exists in locating expertise for smaller subspecialties and improving confidence in the accuracy of content within Dean’s Letter.