Docent Handbook

Richardson K. Noback, MD Founding Dean, UMKC School of Medicine Table of Contents

2 Message from Dr. Richardson K. Noback 3 Message from Dean Drees 5 Message from the Chairman of the Department of Medicine 6 Leadership Organization 7 Governance Structure 8 Council on Curriculum 10 Diversity Council 11 Council on Evaluation 12 Faculty Council School of Medicine Core Competencies 13 Selection Council 14 Coordinating Committee 15 Student Affairs Interpersonal and communication skills 16 Important Student Responsibilities 17 Weather Policy Professional behavior 18 Subject Examinations Student Personal Holiday Policy Medical knowledge 19 Residency Interviewing and Excused Absences from Clinical Rotations Dress Code Practice-based learning and improvement skills 20 Docent Team Composition and Placement 21 Good Ideas for Strong Teams Systems-based practice Advising Principles 22 The ETC Patient care A23 FERP FERPA Top 10 24 Constructive Criticism – Giving It 25 Students in Academic Difficulty www.med.umkc.edu Wellness Program 26 Career Advising 27 Educational Environment 29 eCare/Powerchart 30 Navigating OASIS: A Docent Cheat Sheet To Look Up A Student’s… 33 Docent Clinics: Quick Docent Guideline 35 Docent Rotation 38 A Day in the Life… Docent Best Practices 39 Faculty Development Academic Promotion 42 Helpful Tips for Residency Compliance 43 Internal Medicine Residency Program

University of Missouri-Kansas City School of Medicine 2013 Docent Handbook Increasingly, we all depend on multiple services from many others in our daily lives. Worried and ill humans seek and deserve the highest quality health care in settings which provide respect, concern, and compassion as well as thorough, coordinated, effective, and efficient services. Patients need a full understanding of their own health conditions for their active participation in their own health care.

Those who prepare themselves for roles in health services must acquire the competences necessary for these future roles together with the abilities to function well within their professions and the larger society. All of us need to be able to deal well with ongoing changes both in our professions and in our roles as Richardson K. Noback, MD citizens. Such performance competences require that future physicians acquire Betty Drees, MD proper standards, proper responses to clinical challenges, and the means to be effective as the future unfolds.

The docent system has special features to help learners achieve the understandings and competences necessary for the previous desiderata. Other university medical centers have adopted many features of the docent system. Six years for professional maturation, a combined baccalaureate-medical education continuum, team efforts in an environment within which no one may hide, the interlinking of humanities and medicine, the cooperative efforts between Founding Dean Richardson K. Noback members of the health professions, the junior senior partnerships, continuity of patient, student and docent contacts over years, the full use of information Message from Dean Betty Drees resources, open communication between all team members, and the impacts of the docent teams are key features. All of these are means to assist each member The University of Missouri-Kansas City (UMKC) School of Medicine opened in of a docent team to develop the attitudes, beliefs, value systems, information, 1971 as part of a wave of new medical schools that were founded in the 1960s habits, competences, and internal standards most conducive to a long life as a and 1970s to meet physician shortages. However, planning for the new school in competent, safe physician. Kansas City began in the late 1950s. Many of the new schools of the time brought new innovations to medical education, and none did so more than UMKC. The Docents carry responsibilities as role models and team leaders to help all team docent system of education in longitudinal, small group, learning communities members achieve the highest levels of performance of which each individual is is an innovation that forms the bedrock and remains the hallmark of the medical capable. This is both a privileged and a demanding role. It is a very stimulating education system at UMKC. It is fitting to name the senior docents after Founding and rewarding one. All those in the School of Medicine help excellent individuals Dean of the School of Medicine Richardson K. Noback, MD, since he was one of prepare to care for their fellows over professional lifetimes while the public the pioneers and drivers of the development of the medical education program at continues to seek more and increasingly complex health services. UMKC. He came with a background of experience in starting new medical schools.

For more than 40 years, the docent system of care and education has been tested. In 1952, he became the assistant director of the Comprehensive Care and It has proved to be successful. The reality is that more than 3,000 graduates Teaching Program at the Cornell University Medical College, the first modern effort is small in number in comparison with the number of all practicing physicians, to put new principles of medical education into practice. He also helped with which means that many docents must learn about the system as they move into opening the University of Kentucky College of Medicine and other medical schools. their new key roles. In 1963, he became a consultant to the University of Missouri and the new hospital organization that ultimately converted General Hospital to the Truman The School has decided to establish a special role for outstanding docents Medical Center of today. In 1964, Dr. Noback became the executive director of who are to have the privilege and responsibility to work with newer docents Kansas City General Hospital and associate dean of the University of Missouri to strengthen the docent program. Reviews of performances and changes for Medical School in Columbia, Mo. In 1969, he became the acting dean of the new improvements are hallmarks of sound organizations. UMKC School of Medicine. After the Missouri Legislature gave final approval of the new school in March 1971, Dr. Noback became the first dean of the UMKC School I am honored that some docents will carry our family name. I wish the new of Medicine on April 1, 1971, and the first students entered that fall. He served docents and all members of the School of Medicine every success in the years as dean until 1978, when he resigned from the deanship to become a senior ahead. docent. He served as a docent until 1990. According to Dr. Noback, “I wanted to break up the natural tendency in most of academia that being the section head of Richardson K. Noback, MD a department or department chair or dean was more important than doing your fundamental job1.” As the founding dean and a docent, Dr. Noback is known for his belief that the textbooks are the patients, his emphasis on assisting students continued on page 4

2 3 to develop the competencies for direct patient care, and his commitment to a The UMKC docent system is a unique and outstanding program for training team approach to the care of patients. These principles of medical education and physicians. It embodies many concepts that serve our students well throughout patient care continue through the docent system to this day, and the success of their professional lives including teamwork and peer-to-peer teaching. It is what the program is reflected in the quality of the more than 3,000 graduates who are makes the UMKC School of Medicine different and better than other medical superlative physicians serving communities across the country. schools.

The term “docent” to describe the mentoring physicians in the new medical At the head of this academic family is the docent. The docent must be a clinical school came about during the planning of the medical school building, which was teacher as well as mentor and advisor to his/her students. Perhaps most designed to accommodate the new teaching method of longitudinal, small group, importantly, the docent must be a role model for these physicians of the future. learning communities. As described by Dr. E. Grey Dimond, the author of the School’s Academic Plan2 and founding provost for Health Sciences, here is how The demands of the docent are great, but the rewards are even greater. We are George Reisz, MD the term “docent” came about at the School of Medicine3: fortunate to have a tradition of outstanding clinical educators as docents at UMKC. New docents (and established docents) can draw on that long line of excellence M3-303A “There was no suitable title in academic life for these group leaders. It seemed for inspiration and direction. 816-235-1904 ponderous to call them ‘Professor.’ ‘Physician’ was equally stiff. At first I wanted 816-404-5024 to call these units simply ‘Clinical Teams’ and the leader ‘The Clinician.’ Others did It is fitting that we have named the Noback Docent Program after Richardson K. not feel this had quite enough distinction. We tried various terms: ‘Scholar’s Units,’ Noback, docent and founding dean of the UMKC School of Medicine. Not only was ‘Firms,’ and ‘Health Care Learning Teams’ was one awful suggestion. I even came he an architect of the docent system, Dr. Noback was the ideal docent. up with the word ‘Propaeduetist,’ and this received its warranted burial. This handbook provides the concrete resources to being a docent. It is a dynamic “To get on with the planning, we agreed to give each team a color recognition. resource that successive docents should not only use but continually improve. With this we could provide identity and a sense of belonging. Thus, we divided the whole student body into four colors, Blue, Red, Green, Gold…. George Reisz, MD Chair, Department of Internal Medicine “This gave us a way to plan, to organize, and to get on with the buildings. But we still needed a noun, an appellation. While working with the architects in Chicago, one of the architects, leaning across the blueprints, said, ‘Now here is our design on these docent units.’ And that was the moment the Docent was invented.” Council of Docents http://www.med.umkc.edu/councils/docent_council Dr. Noback may not have invented the docent concept, but he perfected the role, especially that of senior docent. Effective March 2012, the UMKC School of The purpose of the Council of Docents is to provide a venue for collaboration and Medicine is proud to recognize Dr. Richardson K. Noback’s essential contributions information sharing. The Council is comprised of docents and other faculty and to medical education by naming the School’s senior docents the “Noback elected student representatives. Additionally, there are invited guests who provide Docents.” updates pertinent to the practive of being a docent.

Betty M. Drees, MD, FACP Meetings are on the fourth Wednesday of every month. Seventh Dean in Honor of the First Dean

1. Panorama, Winter 1999 2. Dimond, E Grey, The Academic Plan for the School of Medicine, University of Missouri- Kansas City. 1969 (last edited, Betty M. Drees, 2009). 3. Dimond, E Grey, Take Wing! Diastole-Hospital Hill, Inc, Kansas City, MO. 2005

4 5 School of Medicine Leadership Organization School of Medicine Governance Structure

Dean of SOM Dean of SOM

Director Alumni/ Faculty Research Administration Development Council Graduate Studies Faculty Council

Office of Finance/ Marketing & Coordinating Council Business Administration Communications Student Appeals Subcommittee Associate Dean – TMC Associate Dean Department Chairs Assistant Dean – Curriculum TMC Lakewood Anesthesiology Graduate Medical Docent Selection Continuing Medical Honor Education Council Council Council Education Council Council Associate Dean – Associate Dean Saint Luke’s Basic Medical Science Graduate Medical Education Diversity Evaluation Curriculum Associate Dean – Emergency Medicine Council Council Council Children’s Mercy Hospital Associate Dean Family Medicine Associate Dean – Diversity & Clerkship Course Center for Behavioral Medicine Community Directors Directors Partnership Biomedical & Subcommittee Subcommittee Sr. Associate Dean Health Informatics Academic Affairs & Chair Coordinating Senior Internal Medicine Committee Associate Dean Docent Council Faculty Affairs Women’s Health Evaluation Council Ophthalmology Educational Resources Associate Dean OB/GYN Assistant Dean Student Affairs Graduate Studies & Education Assistants Allied Health Assistant Dean Orthopaedic Surgery Masters of Science in Admissions Anesthesia Selection Council Masters of Medical Science Assistant Dean Pathology Physician Assistant Career Counseling Pediatrics Director of Medical Education & Support Services Psychiatry Office of Continuing Medical Education Youngblood Medical Skills Radiology Laboratory Media Center Surgery Assistant Dean Years 1 & 2 Neurology

Assistant Dean for Medical Humanities & Faculty Development Social Science

6 7 Council on Curriculum http://www.med.umkc.edu/curriculum/

The goal of the Council on Curriculum is to provide centralized oversight of a Useful measures for monitoring student progress in studying for Step 1 include: coordinated curriculum that supports the educational objectives of the School of performance on question banks (USMLEWorld: 60% or greater; Kaplan: 65% Medicine, including the competencies stated in the Experience-Based Curriculum or greater; Exam Master: 65% or greater), performance on USMLE mock Guide. The Council is responsible for the design and management of the core examinations, and adherence to planned study schedule. If the student is curriculum leading to the MD degree, as well as for the review and approval performing consistently <60% on question banks and not making progress, he or of elective courses. The Council is also responsible for the regular review of she may need a curriculum change and should meet with the associate dean of the entire curriculum and components therein, evaluating learning outcomes, Council on Curriculum. Stefanie Ellison, MD examining pedagogy, and attending to vertical and horizontal integration of content. It approves student petitions for changes in curricular plans as necessary. The SOM provides several resources for students struggling with Step 1. M5-CO1 Docents are in a position to identify trouble early and point students to these 816-235-1850 Members of this council include basic and clinical scientist faculty, docents, resources: social science and humanities faculty, and students. The bylaws ensure wide • Kathy Phillips, education specialist: School of Medicine – 816-235-1807, representation of medical fields and disciplines relevant to the practice of Volker – 235-8831, [email protected] medicine. The chair of the Council on Curriculum is Stefanie Ellison, MD. • Helps with study methods and study schedules • Assists with approach to questions Tips: • Shares resources for study material and preparation courses 1. The Curriculum Council monitors individual student curriculum plans in • Niloofar Shahmohammadi, Wellness Program Coordinator – 816-235-1862, conjunction with the student, docent and ETC to ensure that all promotion [email protected] and graduation requirements are completed. • Assists with school-life balance and stress issues 2. Guidelines for the curriculum are available on the SOM website: http://www. • Based at the School of Medicine med.umkc.edu/curriculum. They are particularly important to review if a • Weber Ingersoll: Counseling Center – 816-235-5185, [email protected] student has a unique or unusual request. Paperwork completion, deadlines • Teaches auto-relaxation techniques for test anxiety and curriculum requirements are adhered to strictly, so working with the ETC • Available in the Health Science Building on Tuesdays from 1-5 pm and curriculum office can be very helpful. 3. The ETC and curriculum office staff are very knowledgeable about The process applied by the associate dean for Council on Curriculum when requirements and are a supportive resource. Sometimes students have a advising students who perform 60% or less on CBSE or for those who fail a particular curriculum goal and the ETC and office can assist with developing second CBSE includes the following: a realistic plan to assist in achieving that goal. Advance planning is important • CBSE score (by curriculum policies) when working with a student’s curriculum. • 66 or above: Ready to sit for the USMLE Step 1 Exam 4. Representatives from the Curriculum Council and the Evaluation Council • 61 to 65: Must retake the CBSE Exam but cleared to obtain a USMLE meet regularly to discuss student requirements that overlap between the two Step 1 window councils. The goal of these meetings is to provide a consistent expectation • 60 or less: Must show readiness (see below) and retake the CBSE for the student. A representative from the Office of Student Affairs is also in Exam attendance to provide the student perspective. • 60 or less or a second failure on CBSE must meet with the associate dean 5. Students are required to take USMLE Step 1 by September of their Year 5. for curriculum Docent involvement in developing a study schedule for Step 1 and holding • Readiness requirements to take a 2nd CBSE after obtaining a score of 60 or regular meetings on student progress will be necessary and beneficial during less (also for IPP after a 2nd CBSE score of 65 or less) this important time in their curriculum. The majority of students take at least • Must complete 90-100 question per day (depending on which question one study month in Year 4 to prepare for Step 1, and students are required bank is used) for 14 consecutive days; in timed general question mode, to design a study schedule with input from their docent. Below is some with sufficient daily scores: additional information regarding Step 1 advising: • Kaplan: 65% or greater • Exam Master: 65% or greater Students are required to take a Comprehensive Basic Science Examination (CBSE) • USMLEWorld: 60% or greater between December and August of Year 4, to show readiness to sit for USMLE Step • Scores must be submitted weekly to the associate dean of curriculum 1. CBSE is written by the National Board of Medical Examiners, is highly predictive as well as the curriculum coordinator. of Step 1 scores, and provides each student an item analysis of their performance. • Once students have submitted 14 days’ worth of scores, Dr. Ellison will Students should consider this a practice examination for Step 1 and should plan approve them to sit for a 2nd CBSE. to study for CBSE. The current curriculum policy states that students must score • If students are completing questions after a 2nd CBSE fail, they will 66 or higher in order to sign-up for Step 1. Because the examination is arranged receive clearance to take the IPP exam. with the NBME, there are deadlines to sign-up and withdraw for test dates which are managed by the Office of Medical Education and Research.

8 9 Diversity Council Council on Evaluation http://www.med.umkc.edu/odcp http://www.med.umkc.edu/councils/coe/

The Diversity Council serves to create an environment for diverse, nondiscrimi- The purpose of the Council on Evaluation is to develop policies and procedures natory learning and working. This is accomplished by advising the dean of the to assess the academic and professional development of students as they move School of Medicine on policies that promote cultural competency, awareness, in- through the curriculum and to apply those standards in evaluating student clusion, respect and equity through training and other resources. Subcommittees performance at all year levels. It originates recommendations for student on education, faculty and staff recruitment and retention, and student success and promotion, non-promotion, graduation, and dismissal. This council meets monthly retention help the Diversity Council to achieve its goals. throughout the year, typically on the second Wednesday of the month. The document, “Policy Manual and Guidelines for Promotion,” is available online in pdf Susan Wilson, PhD, MBA Council members are both elected and appointed by the dean of the School format. Sara Gardner, MD of Medicine with consultation from the Council chair. Members represent the M1-103C School’s hospital affiliates, governance councils and major departments. Student The Council on Evaluation chair is Sara Gardner, MD. Members of this council M1-215 816-235-1780 organization leadership also elect student members to the Council. Susan Wilson, include faculty elected by their peers from the basic sciences, clinical medicine, 816-235-5386 PhD, MBA, chairs the Diversity Council. and the social sciences and humanities. It also includes elected representatives from the student body, the dean’s appointments, and ex-officio members. Tips: 1. The Diversity Council meets bi-monthly in January, March, May, July, Tips: September and November with additional meetings called at the discretion of 1. In addition to the review of student performance, the Evaluation Council the Council or subcommittee chair. Voting members serve staggered three- is responsible for tracking grades, student course completion, individual year terms. grades and reviewing individual student transcripts while performing the MD 2. The Diversity Council works with existing councils and community resources degree audit. This office regularly monitors individual student performance to to provide educational experiences that prepare students, trainees and ensure that students are successful in their coursework and that grades are residents to practice medicine in a culturally competent manner. It also available for each student course or clerkship. supports and enhances faculty skills in providing culturally competent 2. Information about performance on USMLE Step exams is monitored by the mentorship and instruction. Evaluation Council and outcomes are updated weekly as available from 3. The Diversity Council promotes the recruitment of faculty, staff and students USMLE. from underrepresented groups to assure a support system that facilitates 3. At times, one of your assigned students may fail to meet the promotion and/ success and retention. or graduation requirements of the SOM. If that occurs, you will be asked for 4. Subcommittees develop and implement workshops, seminars and other information regarding your opinion of a student’s situation and to assess programs on professional enhancement and personal development, monitor his/her performance. As a docent, you will receive a lot of information about student success trends and outcomes, and develop and recommend policy your student’s progress to assist in his/her success. The ETCs work closely and processes to recruit and retain underrepresented students, faculty and with the docent and evaluation office staff when a specific student situation staff. arises, so utilizing the ETC is very helpful. 4. A subcommittee of the Council on Evaluation is the Honors Council. This council is responsible for monitoring that student behavior in compliance with the Standards of Professional Conduct. (The Standards are included in the Council on Evaluation Policy Manual and Guidelines for Promotion.) It is expected that students adhere to the Standards of Professional Conduct; failure to do so results in assessment by the Honors Council. The current Honors Council chairman is Jeffrey Hackman, MD.

10 11 Faculty Council Selection Council http://www.med.umkc.edu/fa/faculty_council http://www.med.umkc.edu/councils/cos.shtml

The Council serves as the representative of the School’s faculty to the University. The Council on Selection has been charged with the major responsibility of The Council meets once per quarter as a forum for exchange between faculty and selecting students for admission to the BA/MD Program, MD Program and administration. The Council is also responsible for initial faculty appointments, the Oral Surgery/MD Program. It is also responsible for the development and yearly promotions and maintaining faculty records and files. It also develops and implementation of policies and procedures for selecting students. Its meetings coordinates continuing medical education activities. The current Chairman is coincide primarily with the selection cycles. The chairman of the Selection Council David Hermanns, MD. is Steve Griffith, MD.

David Hermanns, MD Tips: The Council consists of faculty elected by peers or appointed by the dean from Steve Griffith, MD 1. Even as a new docent, planning for career development and eventual the basic and clinical sciences, the humanities and social sciences, docents, M1-304 academic promotion should be a priority. Promotion guidelines and community representatives and students. The dean may also appoint additional 816-235-1870 816-235-1817 assistance in preparing for promotion is available from the Faculty Council members not exceeding the number of regular members. representative. It is recommended to develop a process of maintaining records and pertinent information from the beginning of your academic Tips: career; the collection of this information years later is daunting and labor 1. The Council members interview prospective student applicants for the three intensive. MD degree programs available at the SOM. (These three are the combined 2. Continuing Medical Education activities are available regularly to SOM BA/MD Program, the MD Program and the Oral Surgery/MD Program.) After faculty, and information about these activities is available from the Faculty extensive interviewing by Council members as well as additional faculty and Council. staff, the Selection Council members meet to select the members of the incoming class. 2. Additionally, the Selection Council is responsible for the selection process in its entirety. Annually, the application for admission, the criteria desired for consideration of an applicant, the personal interview process and the selection process itself are discussed and reviewed, and changes are implemented. 3. The Selection Council recommends a list of students for the Coordinating Committee and dean to review, but the ultimate responsibility for the selection of the incoming class lies with the Selection Council. 4. The Selection Council actively recruits students year round, so information about the School and student interest meetings is provided regularly. 5. The docent can become involved with the Selection Council by volunteering to interview applicants or applying for membership on the Council. Training for both is provided and required.

12 13 Coordinating Committee Student Affairs http://www.med.umkc.edu/sa The Coordinating Committee provides oversight and review of all SOM council and committee work. Its members are representatives from each council and Mission – The Office of Student Affairs is a referral and resource for all students committee, a clinical scientist, a basic medical scientist, the associate deans for in the School of Medicine. medical education and student representatives. The chairman of the committee is Paul Cuddy, PharmD, senior associate dean for the School of Medicine. Staff This committee meets monthly and coordinates efforts and projects among the Brenda Rogers, MD Red Unit different committees and councils. The coordinating committee reports directly to Associate Dean for Student Affairs Gladys Zollar-Jones, MA Paul Cuddy, PharmD the dean of the School of Medicine. M4-207, 816-235-1782 Education Team Coordinator Brenda Rogers, MD [email protected] M5-125, 816-235-1906 M1-119 Tips: [email protected] M4-205 816-235-1833 1. The Student Appeals Subcommittee provides an appeal option for students Blue Unit 816-235-1920 whose academic or professional performance has resulted in adverse Mary Pirotte, MA Cherie Burton consequences. Students who have performed or whose behavior is less Senior Education Team Coordinator Administrative Assistant than expected are first evaluated by the Council on Evaluation or the M5-329, 816-235-1957 M4-101, 816-235-1940 Honors Council, respectively. If the Council recommends remediation and/ [email protected] [email protected] or separation from the school, the student may appeal that decision to this subcommittee. Steve Pankey, MS Purple Unit a. As a docent, you may interact with this subcommittee if you have Senior Education Team Coordinator Marge Weimer, MEd a student who necessitates such a meeting. You will be asked for M4-205A, 816-235-1966 Education Team Coordinator information about the student’s performance and your assessment of [email protected] M5-225, 816-235-1963 the student’s situation. Once again, the ETC is a valuable resource for [email protected] assistance during this process. Chrystal Headd Administrative Assistant Functions M5-301, 816-235-1950 • Academic Support [email protected] • Advising • Announcements Gold Unit • Career Planning Cassie Shaffer Johnson • Class Meetings Education Team Coordinator • Degree Verification M4-225, 816-235-1921 • Electives [email protected] • Financial Planning • Graduation Michelle Schrader • Holiday Requests Administrative Assistant • International Medicine Support M4-201, 816-235-1920 • Residency/Match [email protected] • Scholarships • Selection (Admissions) Green Unit • Student Organizations Petra Bricker, MA • Student Representatives Education Team Coordinator • Student Travel M4-429, 816-235-1931 • Wellness [email protected]

Stephanie Singleton Administrative Assistant M5-201, 816-235-1960 [email protected]

When in doubt the Office of Student Affairs can probably assist in pointing students in the right direction.

14 15 Weather Policy Should the chancellor determine that classes are to be cancelled and/or the University closed due to inclement weather, the following steps shall be implemented for courses and clerkships by the School of Medicine: Important Student Responsibilities If UMKC Volker Campus has closed, there will be no School of Medicine course Your students have certain responsibilities that must be met before they can activities that day. This includes regularly scheduled lectures, laboratories and engage in clinical activities with you. Student Affairs will communicate directly learning activities. with the students about these responsibilities. Occasionally students fail to meet these expectations, at which point we will let you know that they cannot Clinical activities will also be suspended in the following way: participate in clinical activities. 1. If notification occurs by 5:30 am using the UMKCAlert! System, students • All students must have a background check are excused from clinical duties. The UMKC SOM will communicate an • All immunization records must be up-to-date including an annual TB test announcement from the dean’s office by email to course directors, clerkship • Some preceptorship and elective sites require your students to have drug directors, program directors, and UMKC faculty and staff. Clerkship directors screens. Student Affairs can assist with this process. will also make efforts to communicate to faculty and to students on their • Student must regularly check their UMKC email. UMKC relies on email as the rotation either by email or through Blackboard when clinical duties are official means of communicating with students. Please make students use suspended. Students should not be expected to report for clinical duty for their UMKC email when communicating with you. that day. Students will also receive communication from the dean’s office by • Information that is important to students is communicated in intentionally email but may call or communicate with their clerkship director, attending or redundant ways. Besides individual advising, students must attend supervisory resident, or the coordinator for the clerkship to confirm. mandatory class meetings as well as Year 1, MD-Only, Year 3 and Year 2. If notification occurs during the day or before 3 pm for evening events and 5 orientations. They also receive weekly announcement emails, which classes, the UMKC SOM will communicate an announcement from the can all be found at http://www.med.umkc.edu/sa/announcements.shtml. dean’s office to course directors, clerkship directors, program directors, and Nonetheless, we all hear students say they were never informed about a UMKC faculty and staff. Specific information regarding the weather status policy or opportunity. Whenever possible, please point them toward these at the School of Medicine will be placed on the SOM website and SOM communication tools. primary telephone number (816-235-1808) to reflect the same weather • All students must be registered in Pathway to be covered by the University’s closure information on the UMKC primary website. The site and telephone medical malpractice insurance. Advisors clearly communicate registration recording will reflect information regarding any testing schedules that may information and deadlines but students are occasionally pulled from rotations be affected. Students should be excused immediately from clinical duties if they are not officially enrolled. in order to return home safely. Clerkship directors should also make efforts • The School of Medicine takes its educational responsibilities very seriously to communicate to faculty, residents, and to students on their rotation by and actively seeks out the opinions of students through regular and email or through Blackboard when clinical duties are suspended, especially mandatory class assessment. Additionally, UMKC and the School of Medicine if students will be coming to the hospital for clinical duties after business send mandatory and optional assessments to students on an ad hoc basis hours. Students will also receive communication from the dean’s office by in an effort to improve policies, services, etc. One example of this is the email but may call or communicate with their clerkship director, or attending Graduation Questionnaire, which is completed by Year 6 students. or supervisory resident, or the coordinator for the clerkship if before 5 pm If the closure occurs during a scheduled internal clerkship examination, Students are held to the Standards of Professional Conduct as well as the UMKC contact the coordinator for information on when the examination will be Conduct Code. Copies of both can be found in the School of Medicine Student rescheduled. Handbook.

16 17 Subject Examinations: Residency Interviewing and Excused Absences from Clinical Rotations 1. If classes are cancelled at the time a subject examination is scheduled, the The School recognizes there may be a need for Years 5 or 6 students to take Office of Medical Education and Research will not administer the subject time away from clinical responsibilities, i.e. emergencies, death in family, exam that day, but will reschedule it for the following evening. For CBSE on hospitalization, and in Year 6, residency interviewing. For residency interviewing, Saturdays, OMER will notify students and proctors by email that it will be the School recommends that students be allowed to interview for a period of no rescheduled and depending on the weather, possibly for Saturday afternoon more than five working days per month. Excused absences are subject to the or Sunday afternoon. approval of the clerkship director and will be accommodated only to the extent 2. For students on preceptorship, refer to the syllabus on the procedure for that such absences do not interfere unreasonably with the goals and objectives inclement weather that occurs in your area. established for the clerkship. The complete policy can be found at 3. Students will be responsible for providing up-to-date email addresses on http://www.med.umkc.edu/curriculum/clerkship.shtml#residency. OASIS and for checking their email. Dress Code Student Personal Holiday Policy Personal appearance, which includes hygiene, grooming and choices regarding All students shall receive the following holidays off of rotations: jewelry and clothing, is a reflection of attitude towards oneself and the people one Independence Day is likely to encounter. Christmas Day • In addition to the students, faculty administrators and support staff whose Labor Day workplace is the School of Medicine, there are important visitors to the New Year’s Day School on a daily basis whose impressions of the School will be formed, in Thanksgiving part, by the appearance of those who represent the institution. Memorial Day • There is a reasonable consensus within the School of Medicine family on the general guidelines for behavior regarding appearance. We generally • Students shall not take call and will be excused by 5 pm the night before agree that we should be clean, minimize body odor, avoid being sexually each of the above holidays. provocative, and avoid the use of appearance as a way of attracting undue • Students will resume rotation duties the morning after each of the above attention to oneself. holidays. • Examples of unacceptable dress on which there is broad consensus • Each student may also receive one personal day per school year (defined sa (students and faculty) are as follows: clothing with emblems, slogans and June 1 through May 31). symbols related to illicit substances, alcohol, tobacco products, obscene • With discretion of the clerkship director(s), students may also request other language or sexual connotations; micro-minis (more than three inches above days off in keeping with the current “Clinical Excused Absence and Interview the knee); crop tops, spaghetti strap tops or backless tank tops; bare feet; Policy.” and cutoff shorts. On the other hand, neatly tailored shorts and sandals • Clinical Clerkship Excused Absence forms must be obtained from the would be appropriate in most non-clinical, informal settings. Student Affairs Office and returned to the Student Affairs Office with required • Medicine, as a caring profession, would be expected to foster an attitude signatures. of concern for the well-being of individual members of the group and for • Student Personal Holiday Policy applies to Years 3, 4, 5, or 6 students for the reputation of the group as a whole. When a person belonging to the clinical experiences only. institution displays behavior, including appearance, unbecoming of the • The Student Personal Holiday Request Form must be filled out for the profession of medicine, it would be incumbent on the other members of personal day and turned in by the first day of the month prior to the the institution to guide, counsel and/or assist the person demonstrating beginning of the clerkship during which their holiday falls. Example: If the such behavior. Students, faculty, and staff will be expected to respond requested date is during a May clerkship (May 1-31), the deadline to submit appropriately to constructive criticism. An individual with concerns about the the Request Form is April 1. This deadline also applies to dates requested appearance of another may consider utilizing a third party (i.e. class officer, during the 2nd month of a two-month clerkship. For example, if the requested ETCs or faculty member, etc.) to express concern. Developed by the UMKC date falls in June during a May-June clerkship (May 1-June 30), the deadline School of Medicine, Student-Faculty Forum, November 2000. to submit the Request Form is April 1. • The teaching hospitals each have their own rules regarding appearance. • No student will be excused on the date of a scheduled subject exam or These rules are considerably more definitive and are not negotiable. rotation orientation. • Research laboratories may have their own rules regarding appropriate dress • Personal holiday forms can be found at the UMKC Student Affairs website at for safety and specialized procedures. http://www.med.umkc.edu/sa/student_holiday.shtml

18 19 Good Ideas for Strong Teams Your docent team and other group experiences are an integral part of the students experience at UMKC and can greatly influence how happy they are here. Great teams don’t just happen; people have to work at creating those unbreakable bonds. We have also found that many students crave experiences with their faculty that are outside the formal curriculum. Here are some ideas generated by staff and students alike: Docent Team • Eat together Docent Team Composition and Placement • Use humor to diffuse difficult situations New team members are assigned each year by the Office of Student Affairs. • Socialize outside clerkships and rotations Assignments of Year 3 students (and the occasional Year 5 oral surgery/transfer • Participate in school-related activities such as the MSAC Volleyball students) are done with the goal of balancing teams from the perspective Tournament of gender, race, ethnicity, undergraduate major and academic achievement. • Have non-medical conversations Placements are made with an eye towards the fixed schedule for docent rotations • Create fun internal traditions like Pajama Day or Ugly Tie Day and the students’ need for a Year 4 campus or an MD track student leave of • Respect each other even if you have different styles and abilities absence. Students with strong personal relationships are typically placed on • Celebrate each others’ achievements separate teams. We will also take precautions to avoid any strongly clashing docent-student personalities. Docents receive packets with information about The ETCs enjoy being part of the team as well, so consider involving them in some their students in June or July each year and are asked to assign Senior Partners. of the activities listed above. The placement of students on teams is a secret until the ceremony where Years 3-6 docents coat their new students and the School of Medicine welcomes their Advising newest clinical students. Advising Principles The UMKC School of Medicine White Coat Ceremony takes place each August • Approachability – Understand that students may be intimidated by you, even for the new Year 3 students and MD students who are joining clinical teams. though there may be no reason for it. Look for opportunities to allow students The White Coat Ceremony was established by the Arnold P. Gold Foundation to to approach you. welcome students as they begin their journey in medicine and to remind them of • Watch for signs of recognition and comprehension of concepts you discuss, the professional guidelines that will be expected of them. The Gold Foundation but be willing to explain ideas to students again if necessary. provides each student with a Humanism Pin to wear on the white coat as a • Show a personal interest – It may have taken a lot of courage for the student reminder of the humanism that each is to bring to the medical profession. At to approach you and the student chose you because they feel you have White Coat, that class’s Philosophy of Medicine is read by the Richard T. Garcia valuable input. winner from the previous year. Following the ceremony, students’ family, faculty • Listen carefully – The student may be seeking your advice because of a role and peers meet for a reception. you currently play in their education or they might want your opinion based on your specific credentials such as your specialty area, your experience with a certain school or residency program, or research you have participated in. • Connect students with opportunities – In an advising role, you often are cognizant of many opportunities on campus, within medicine, or within your specialty. It is our ethical duty to connect students with these opportunities that could have a profound effect on their education and experiences.

20 21 • Utilize referrals and resources – If an issue is out of your realm or, if you feel FERPA the student would benefit from consulting someone in addition to you, refer These are the two major concepts or building blocks upon which the Family them to those you think would be of help. Specifically, when the question Education Rights and Privacy Act (FERPA) was written: you must let the student revolves around policies or requirements, it may be best to refer the student see their own records, and no one but the student is permitted to see them. to his/her ETC. In addition, if you are not completely knowledgeable about a topic, refrain from speaking in definitive terms until the answer can be found. FERPA gives parents certain rights with respect to their children’s education Students will often take your word as gospel. records. These rights transfer to the student when he or she reaches the age of • Let students make their own decisions – When providing advice, let students 18 or attends a school beyond the high school level. Students to whom the rights know what you know about the topic and connect them with resources as have transferred are “eligible students.” Parents or eligible students have the right appropriate, but take care to not make a decision for a student. Encourage to inspect and review the student’s education records maintained by the school. them to seek out other sources of information as well. While students Schools are not required to provide copies of records unless, for reasons such sometimes want you to make the decision for them, it is best to allow them as great distance, it is impossible for parents or eligible students to review the to take ownership of their decisions. records. Schools may charge a fee for copies. • Provide feedback – If a student acted in an unprofessional manner with you, even as small an offense as sending an email without capitalizations, we Parents or eligible students have the right to request that a school correct records, owe it to the student to address the situation. When put in terms of the six which they believe to be inaccurate or misleading. If the school decides not to School of Medicine competencies, we can provide constructive criticism to amend the record, the parent or eligible student then has the right to a formal students that will ultimately benefit them in the profession. hearing. After the hearing, if the school still decides not to amend the record, • Follow-up in written format – Making sure that students fully understand the parent or eligible student has the right to place a statement with the record what was discussed in advising sessions is very important. ETCs and setting forth his or her view about the contested information. faculty should do their best to reiterate discussion topics in an email sent to students after the face-to-face meeting ends. When encountering a student FERPA Top 10 in person, it’s good to follow-up to ensure that a student has complied 1. Only the student must be given access to review their own records. Almost with the suggestions made by the ETC or faculty member. Students benefit all other access is restricted or an option that UMKC can approve or deny from reminders about advice or suggestions given, deadlines and the based upon our institutional policies. consequences of non-compliance. 2. Virtually all UMKC academic records that can be identified as belonging to an individual student by name, student number or some other identifier are The ETC covered by FERPA. The Education Team Coordinator (ETC), or adviser, helps students with academic 3. Posting grades is one of the most common challenges and one of the most scheduling and degree requirements, as well as serving as the main point of frequent times when FERPA is violated. Special caution must be used to contact for any questions, concerns, or interests a student has. ETCs connect distribute grades in such a way that only the student can ascertain their own students with School of Medicine, UMKC, and community resources. The ETC acts grade. as a student advocate and can serve as a liaison between the student and faculty 4. Students are protected by FERPA from the time they first register in UMKC members or docents. classes until they are deceased. UMKC continues to protect student privacy after a student is deceased, but may release information in special circumstances. 5. The student ID number is confidential. The Social Security number is also confidential. In fact, every piece of information UMKC has on file regarding a student may be confidential – if the student has invoked their right to classify “Directory” information as restricted from release. The only way to know if a student has restricted the release of directory information is to look on the student system. 6. It is sometimes possible to answer inquiries about a student’s record in such a way that you avoid FERPA violations. Some common approaches include: Answer using only generic information that is not specific to the student; if the student has not restricted the release of directory information, answer using directory information when possible; provide the answer to the student instead of to a third party; refuse to answer the inquiry if there is any doubt about violating a student’s privacy.

22 23 Students in Academic Difficulty The following recommendations are useful for students who are struggling academically:

• First and foremost, talk to the professor • Talk with an advisor • Seek out a learning resource specialist who can help you • Find a supportive learning community • Seek out a peer mentor • Speak with a staff psychologist at the Counseling Center

Additional information on each of these suggestions can be found in the Student Handbook or at http://www.med.umkc.edu/sa/academic_support.shtml. Wellness Program Niloofar Shahmohammadi, MA Wellness Program Coordinator 7. FERPA gives UMKC a “reasonable” amount of time to answer inquiries, not to [email protected] exceed 45 days. When you receive a request for student information (other 816-235-1862 than a subpoena), do not feel that you must respond immediately. If you have FERPA concerns, contact the Registration and Records Office. The School of Medicine recognizes the challenge students face in keeping up 8. Legitimate educational interest is defined by UMKC in broad terms to mean with their coursework while trying to maintain a balanced lifestyle. The wellness the following: employees who need personally identifiable information from program coordinator serves as a resource to enhance success for all learners student records to do their job may access only that information necessary while in medical school by offering wellness programs and workshops, as well as for them to do their job without first obtaining a signed written release from individual wellness coaching to help identify obstacles, manage your stress, and the student to access the information. Legitimate educational interest does connect learners with campus and community resources. not give an employee the right to access personally identifiable information from student records except that specific information that is necessary for them to do their job. 9. FERPA is a federal law or regulation and not a UMKC policy or local or state law. It is more than 30 years old and well established in policy, procedure and practice. 10. Whenever a UMKC employee is in doubt as to the privacy concerns of a request for information, that employee should do two things: do not give any information out and contact the Registration and Records Office for assistance immediately.

Constructive Criticism – Giving It Give criticism the way that you would want to receive it. • Be specific and use examples to illustrate the points you are trying to make • Focus on observable behavior • Avoid personalization or emotionally charged wording Wellness includes but is not limited to: • Describe the effect the behavior had on you • Physical Wellness • Offer alternatives for the behavior you are criticizing — explain how you • Environmental Wellness would have proffered things to go • Psychological Wellness • Point out both good and bad aspects of instruction to help the person • Social Wellness receiving the feedback to not become defensive and to help him/her improve • Financial Wellness • “I” statements (I feel______when you ______because ______and I • Spiritual Wellness want/need ______) • Occupational Wellness

Docents are welcome to avail themselves of all wellness services. Additional information can be found in the Student Handbook or at http://www.med.umkc. edu/sa/wellness.shtml.

24 25 Career Advising

The Career Services Office assists medical students at every class level in their career planning and residency match. Services are based on the Careers-in- Medicine program at https://services.aamc.org/careersinmedicine and include: • Individual counseling and class presentations • Establishment of a database of physician specialists in the Kansas City area and elsewhere who are willing to mentor students in their specialty exploration and choice. • Sponsorship of an annual Career Fair as well as residency program director Felix Okah, MD, MS panel presentations, to assist students in choosing a specialty and becoming Fariha Shafi, MD a well-prepared applicant for residency programs. • Meeting with the School of Medicine’s student interest groups, e.g., M5-221 Emergency Medicine, Family Medicine, Pediatrics, etc. to assist with 816-235-1962? members’ career planning process. • Preparation of the Medical Student Performance Evaluation (MSPE) for each graduating senior. • Processing residency application materials – including letters of recommendation, transcripts, board scores, etc. – via the national Electronic Residency Application Service.

Connie Beachler, MA Educational Environment M4-205 816-235-1811 Dr. Fariha Shafi

“An adviser can help students understand what the family cannot.” (Masterson, 2007 February 28) Generation 1.5 students: Recognizing an overlooked population. The Mentor: An Academic Advising Journal, 9(1). Retrieved February 18, 2008, from http://www.psu.edu/dus/mentor/.

1. Firstly, recognize your own biases. It is natural to have them. Ignoring them is an issue of not acknowledging them! 2. Understand that each student is different, even if they belong to a specific ethnic and cultural minority … never stereotype and NEVER assume. 3. Take cues from your student and keep an open mind, e.g. do they want to shake your hand or not? 4. Open up to them, make them feel comfortable. That will make them open up to you. 5. Some ways to do it: a. potlucks every week on DoRo b. attend a happy hour if invited c. meet outside the school in an informal environment and discuss things Match Day is the third Friday in March and is one of the most exciting days of besides academics the year. Senior students, along with their colleagues, faculty, family and friends, 6. Try to make your office times available per student schedule requirements. gather to hear the announcing of their residency placements. This same event Usually, all docents give out their pagers and are easily accessible any time happens all across the country at the same time. the student needs them.

One of the other issues we deal with is our younger student crowd compared to the regular MD program. It is wrong to assume that they are all immature, however, quite a few of them do need extra guidance. They are dealing with a lot of transitioning issues, moving from high school, etc. Belonging to a minority or being “different” can add additional stress.

26 27 1. We already have a set of questions in our semi-annual interviews that asks about stressful issues, finances, etc. Sometimes asking something simple such as, “how do you deal with stress?” Do you consider yourself religious? How does that play a role in you coping with your current issues? Do you have a good friend circle? What do you do for fun… If we ask questions in a related context and similarly to all students, they don’t feel as if they are being singled out. 2. If one feels that the student is hesitating to talk to them about something, or one feels that there are issues arising that might need someone with a better understanding of a particular cultural background, etc., the student can be referred to that faculty member. We have a diverse faculty and the School is continuously working on recruiting more diverse faculty. I would also say that this would be the time to contact the council on diversity and inclusion of myself, Dr. Wilson, etc., to see what else can be done. I think we need to make sure that all the students are aware who their representatives are and make a note of all the different councils and committees, e.g. MSAC, APAMSA ... where the students can also be referred, if needed. 3. The other thing is to have a written list of expectations and goals for each rotation and go over them as a group. eCare/Powerchart 4. During evaluation and assessment, objectively assess per the rubric. Receive and give feedback to the student on why you graded the way you did. A lot of Dr. David Hermanns the students complain about being discriminated against during assessment. We need to make sure that a set policy and pattern is followed that will stand Dr. Hermanns has the role of information technology liason. He works with IT up to questioning. in both design of the computer system and training of doctors, residents and students in its use. You may call him directly for computer related questions, Oh … some of the most important pointers I forgot to mention: though he does NOT do passwords. You should call TruHelp at 816-404-2055 for 1. Memorize student names. Dr. Brenda Rogers asks the students for their that. pronunciation for graduation. I’d suggest doing the same for each docent group. It’s a BIG deal to the students! Ask them what their full name is and The following link will take you to a directory of video clips and PowerPoint what they prefer to be called. presentations that you may find helpful. Some of the PowerPoint presentations are 2. Make sure that you pair them into diverse groups when you get assignment quite long and useful only if you have a block of time to commit to learning helpful opportunities. That gives the students a chance to learn more about each tips and processes in the system. other and interacting in different situations. 3. For faculty like me, who were not born and raised here, making sure that http://www.med.umkc.edu/eCare someone goes over the handbook with them, educating them about the school culture, discussing FERPA, plagiarism and our policies, etc., ahead of The video clips are SHORT and SWEET, aimed at teaching you a single process time might help. in 90 seconds or less. Some examples are: How to record an immunization; How to send a message to your nursing pool; How to make a personal address book; How to send a prescription electronically; How to create a macro; How to set up a personal document type list that shows only your frequently used documents; etc., etc., etc. ...

Remember: taking the time to learn to use the system efficiently will reward you every day from that day onward.

Dr. Hermanns’ personal motto: Inefficient use of the computer system is death by a thousand CLICKS!!!

28 29 Navigating OASIS: A Docent Cheat Sheet To Look Up A Peer Evaluations Student’s… Choose the Students option on the main menu. Use your Advisor Access to view https://umkc.oasisscheduling.com the Individual Student Report. Find the student’s name in the first drop down box, and choose the academic year during which the desired rotation took place from the second drop down box. Click the Evaluation button to list the student’s rotations during the academic year you’ve selected and the corresponding performance evaluations that were submitted. Click on a hyperlink to view a performance evaluation; it will display such details as the student’s performance in the clinical competencies, professionalism competencies, and any remarks recorded by the evaluator. Docent Rotation peer evaluations will be listed under the course Docent Team Assessment.

Schedule To Look Up Your Entire Team’s… Choose the Students option on the main menu. Use your Advisor Access to view the Individual Student Report. Find the student’s name in the first drop down box, Schedule For Any Single Month (Past, Present, or Future) and choose the desired academic year schedule from the second drop down box. Choose the Students option on the main menu. Use your Advisor Access to view Click the Schedule button to query the student’s schedule from the academic year the Current Course Report. The initial report that OASIS will display is a list of you’ve selected. courses that the students are currently doing as of “today’s” date.

Personal Information To see what all your students are doing during a future date, or were doing during Choose the Students option on the main menu. Use your Advisor Access to view a past date, adjust the Date as necessary to reflect the Month, Day, and Year the Individual Student Report. Find the student’s name in the first drop down box. desired. For example, to know what the students are/were/will be doing on July Choose an academic year from the second drop down box that the student was 30, 2013, set the date to 7-30-2013. actively enrolled in SOM coursework (i.e., not graduated). Click the Personal Info button to pull up information such as the student’s email, address, and phone To Complete Your Evaluations… numbers. For The Current Academic Year Coursework Grades or Rotation Grades Choose the Manage option on the main menu. Select Complete Evaluations. Take Choose the Students option on the main menu. Use your Advisor Access to view note of the academic year displayed on the initial screen, such as “Complete the Individual Student Report. Find the student’s name in the first drop down box, Evaluations for 2005-06,” in the lavender header. If this is the not the current and choose the academic year during which the desired rotation took place from academic year, click on Reselect Year to the right of initial academic year on the second drop down box. Click the Schedule button to list student’s schedule the purple header. Select the current academic year from the Select a Year: and corresponding grades from the academic year you’ve selected. You will not be drop-down menu on the next screen, and click the Select Year button. When able to open performance evaluations from this pathway. the evaluation list reloads to display the current academic year, scroll through the page of evaluations, subdivided by courses, to find the evaluation you wish Entire SOM Coursework Grade Summary to complete. Click on the desired student’s hyperlinked evaluation below the (Similar to a transcript without GPA) Evaluation header within the desired course subsection. Fill out the evaluation, Choose the Students option on the main menu. Use your Advisor Access to view particularly all required fields. If you need to exit the evaluation before you are the Individual Student Report. Find the student’s name in the first drop down finished completing it, scroll to the bottom of the page and click on the button, box, and choose the current academic year from the second drop down box. “Save but do not submit; I am not finished.” Once you finish the evaluation and Click the Course Requirements button to list student’s entire SOM history and assign a final grade, click Submit. Submitted evaluations cannot be changed corresponding grades and credits. You will not be able to open performance without contacting the Council on Evaluation. evaluations directly from this pathway.

Rotation Performance Evaluations Choose the Students option on the main menu. Use your Advisor Access to view the Individual Student Report. Find the student’s name in the first drop down box, and choose the academic year during which the desired rotation took place from the second drop down box. Click the Evaluation button to list the student’s rotations during the academic year you’ve selected and the corresponding performance evaluations that were submitted. Click on a hyperlink to view a performance evaluation; it will display such details as the student’s performance in the clinical competencies, professionalism competencies, and any remarks recorded by the evaluator.

30 31 Docent Clinics: Quick Docent Guideline Clinic clerkship is a unique longitudinal continuity ambulatory clinical experience for all students in Years 3-6.

Learning methods: • Ambulatory Medicine Clinic • Reading Curriculum: EKG and Internal Medicine • Clinic seminar & presentations • Midterm & Final • Patient encounter tracking Jennifer Bequette, MD Docents should: • Review the course learning objectives in Blackboard M4-317 • Be aware of the guided reading curriculum 816-235-6169 • Be aware of textbooks • Be fully aware of the evaluation criteria in this • Keep in mind the attendance requirements and report any student that is absent to an assigned clinic For A Past Academic Year Choose the Manage option on the main menu. Select Complete Evaluations. Take Continuity Docent Clinic is a rich clinical environment for students to learn the note of the academic year displayed on the initial screen, such as “Complete principles of outpatient internal medicine in teams of junior-senior pairs under the Evaluations for 2010-11,” in the lavender header. If this is the not the academic supervision of a docent. year you want, click on Reselect Year to the right of initial academic year on the purple header. Select the academic year you desire from the Select a Year: If you have any questions or concerns, contact the clinic clerkship director, drop-down menu on the next screen, and click the Select Year button. When the Jennifer Bequette, MD, FACP, at [email protected] or 816-235-6169, or evaluation list reloads to display the desired academic year, scroll through the the clerkship administrator, Jessica Fugate, at [email protected] or queue of unsubmitted evaluations, subdivided by courses, to find the evaluation 816-404-5035. you wish to complete. Within the desired course subsection, click on the desired student’s hyperlinked evaluation below the Evaluation header. Fill out the Evaluation: evaluation; all required fields must be completed before submitting. If you need to Docents should be familiar with evaluation grids and descriptors for each year exit the evaluation before you are finished completing the evaluation, scroll to the level in the areas of (review on Blackboard): bottom of the evaluation and click on the button, “Save but don’t submit; I’m not • Interpersonal and communication skills done.” Once you finish filling out the evaluation and assign a final grade, click the • Patient care Submit button at the bottom of the evaluation. A window will pop up to confirm • Medical knowledge if you’re sure; click the appropriate button according to your certainty. Submitted • Practice-based learning evaluations can only be modified once, and only by contacting an OASIS systems • Systems-based practice manager such as Dr. Jennifer Quaintance, Christy Dockweiler, or Angela Allen. • Professionalism

To Look Up An Evaluation You Submitted… It is essential that students receive timely feedback and remediation if needed. Every student should have a documented mid-term feedback and a final clinic Choose the Manage option on the main menu. Select Complete Evaluations. Take clerkship grade in OASIS system. note of the academic year displayed on the initial screen, such as “Complete Evaluations for 2013-14,” in the lavender header. If this is the not the academic Clinic release time: year you want, click on Reselect Year to the right of initial academic year on Students should leave morning clinic by 12:30 pm to report to afternoon the purple header. Select the academic year you desire from the Select a Year: educational or clinical obligations. drop-down menu on the next screen, and click the Select Year button. When the evaluation list reloads to display the desired academic year, click Show Submitted Students should be released from clinical duties no later than 12:30 pm if they Evaluations to the right of the desired academic year on the lavender header. have an afternoon educational obligation. The page will reload to display a list of all evaluations assigned to you for that academic year, including the submitted evaluations as well as the incomplete evaluations. Scroll through the list of evaluations, subdivided by courses, then by student, to find the evaluation you wish to look at. When you find the desired evaluation, click the View next to the evaluation and it will open in a new window.

32 33 Docent Rotation

Docent Rotation (hospital inpatient medicine) and the Docent Continuity Clinic are the key clinical and teaching functions of the docent. Each docent does one month of Docent Rotation with their docent team. Docents with two teams do one month of Docent Rotation with each of their teams. In addition, docents may do one to two months of additional Docent Rotation with another docent team, severing as the “secondary” docent. Years 4, 5 and 6 students participate in Docent Rotation. Teams at TMC typically will have one supervising resident and two interns with eight to 10 Years 4-6 students. Teams at Saint Luke’s Hospital will typically have one supervising resident and one intern with four to five students. Docent David Bamberger, MD teams may have an assigned PharmD and/or clinical medical librarian. If so, it is important to include them in the teaching activities. M4-125 816-235-1942 Docents must familiarize themselves with:

The Docent Rotation Blackboard site, including the Docent Rotation syllabi for students: http://www.umkc.edu/blackboard If patient care is going to be compromised by student departure at 12:30 pm (which should be a rare situation in an ambulatory setting like clinics), then the The curriculum and information for the Internal Medicine Residency Program: docent should sign a late excuse form and give to the student to present to the http://www.new-innov.com/pub/ - for the curriculum afternoon coordinator or course director to be excused for late arrival. Those http://www.med.umkc.edu/sharepoint - information and schedules forms will be tracked for any trends. The main goal is to ensure that students are not making claims of late departure from clinic every time they arrive late for For student teaching and evaluation, special emphasis should be placed on: an afternoon course and also to avoid any negative consequences for students i) the required conference schedules, including seminars, ACLS, chairman’s who are late because of clinic. The students will be instructed to request from rounds and exams, and the certainty that there are no scheduling conflicts their docents at 12:30 pm to leave for afternoon obligations with hand-off of any with these activities patient-care issues. ii) the caps on student patient care and responsibilities iii) the student call systems, and the caps on the number of calls Grading overview: iv) the year’s specific learning objectives for students on the Blackboard site • Presentation – 5% v) the year’s specific competency grids utilized for evaluation of students • Midterm Exam – 10% vi) the required year’s specific patient encounters and CLEX tracking system for • Final Exam – 25% the encounters • Clinical Performance Evaluation – 60% Docents must provide teaching to both residents and students, directed at their Students should follow the Personal Appearance and Dressing Policy for UMKC. level, at least some of which should be at the bedside. Docents must involve residents and students in patient care activities and patient discussions, in the Students are required to have patient encounters in specific categories recorded development of differential diagnoses and treatment plans, and evaluate and in CLEX system. Docents should follow progress of their students regarding provide feedback to learners in regards to these activities. The docent must be documented clinical encounters. Students who do not meet required CLEX able to provide teaching at all levels without compromising the level of teaching encounters will be subject to one final grade drop per UMKC school policy. for the senior resident or going over the head of the junior students. This often There are alternative learning experiences for students who are unable to requires separate sessions for differing learning groups. The residency program encounter the required clinical experience. requires that learning must be appropriate for the level of the resident. Similarly, student teaching must be done at the level appropriate for the student. Students still attend clinic while on inpatient Docent Rotation based on scheduled sessions in the afternoon to avoid conflict with inpatient rounds and care. The clinic, during inpatient Docent Rotation, provides an opportunity to have a smooth transition of care between inpatient and outpatient as well as maintain continuity.

It is useful for all docents to review the article, The University of Missouri-Kansas City School of Medicine: Thirty-Five Years of Experience with a Nontraditional Approach to Medical Education, from Academic Medicine, Vol. 82, No. 4/April 2007. The article highlights the unique, longitudinal ambulatory experience in a learning team system.

34 35 Students must be observed by their docents in their clinical encounters, and these observations must be documented in CLEX by the student. Each Years 4, 5 and 6 student must be observed in at least one documented clinical encounter each month by a faculty member. The mechanism by which to do so is with the mini-CEX. Recognize that a complete encounter does not need to be observed. The intent of these exams is to observe pertinent portions of the exam, lasting on Docents must evaluate each learner in each of the year-specific competencies average 10 minutes, and provide feedback, as is done for graduate education. utilized for the evaluation of students, reflecting the ACGME competencies. If docents split the month with another, ensure that there is a mechanism with Docents must spend a sufficient amount of time in the observation of student your partner by which all students are observed each month. The timing of these performance in order to provide a cogent evaluation. Docents should also encounters is left to the individual docent. These are in ADDITION to the observed incorporate feedback from the residents regarding student performance. Docents mini-CEX done in the clinic while students are on Docent Rotation that is done for must orient the residents and the students that the residents will evaluate the the clinic course. In addition, the supervising resident will perform one mini-CEX students at the end of each month of Docent Rotation. It is the responsibility on Year 6 students during even months of the year, and one mini-CEX on Year 5 of the docent at the end of the month to obtain these evaluations. All docents students during odd months of the year. Docents must orient supervising resident must submit their evaluation for each student in Oasis in a timely manner (at a at the beginning of the month that this is their responsibility. minimum 30 days after the end of the rotation). Docents should orient their students and residents at the beginning of the month Docents must evaluate each of the students at the end of their tenure that is both to ensure that all know their expectations for responsibility, timeliness, and the formative and summative, and provide feedback to the students. Additionally, evaluation process. Docents must have a system of reviewing and evaluating mid-rotation feedback must be done in the middle of each docent’s evaluation the notes of the students before they have been amended or corrected by the period, enabling students to know their strengths and weaknesses. Mid-rotation residents. I ask that at least some notes be sent to me before the resident has feedback must be documented by the primary docent at the end of the first month corrected or incorporated them into their notes. into Oasis.

The patient encounter logs for students (CLEX) must be reviewed by the primary docent at the end of the first month to ensure students are on track in meeting the required encounters, and at the end of docent rotation to certify (in Oasis) that the required encounters have been accomplished. Docents need to orient students so they understand their grade will be docked if they have not accomplished and documented the required encounters.

36 37 Faculty Development http://www.med.umkc.edu/faculty/development/

A faculty development committee is active at the School of Medicine. The committee chair and assistant dean for faculty development is John Foxworth, PharmD, from the division of clinical pharmacology, Department of Medicine. Membership of the committee comprises representatives from the various affiliates. A faculty development webpage may be found at http://www.med.umkc. edu/faculty/development/. This page contains videos of many important lectures, including interviews with historically important figures involved in founding the School, AOA speakers from the past several years, speakers for many named John Foxworth, PharmD annual events, a news column, link to searchable lecture database, links to promotion information, and much more. M40133 816-235-1925 Academic Promotion A Day in the Life… Docent Rotation The School of Medicine does not have a tenured faculty or system by which if one does not get promoted or tenured the employment contract is terminated. Examples of Docent Best Practices: However, it is an expectation that School of Medicine faculty members seek and • Provide a list of expectations one week before DoRo. promote scholarship, which is broadly defined. The promotion of scholarship and • Have students and residents set goals. academic promotion is especially vital for docents, who are key faculty members • Vary who presents the patients on rounds between the students and within the School of Medicine. It is key to recognize that the School of Medicine residents. Allow the interns to present at least half the patients and then the defines scholarship broadly, and in four arenas: teaching, service, clinical practice students do the other half of the list. The students that will present do not and research. One does not have to advance scholarship in all arenas to promote. get a heads up. They all have to be prepared. Let the students and interns However, publication in peer-reviewed literature which is indexed within database present to the resident so that the residents learn to assume their leadership services (eg., PubMed or Scopus) is required. roles. • Finish early enough for residents and students to be able to attend noon The guidelines for promotion of are found in the UMKC SOM Faculty Affairs conference (ideally by 11:30 am). webpage: http://www.med.umkc.edu/fa/ • Have students and residents prepare and give PowerPoint presentations about their patients or have students review a teaching case in a morning One should become familiar early with the requirements for promotion, and report type format on a weekly basis in the afternoon. be especially familiar with Appendix C. Note that, for example, to promote in • Have radiology interpretation rounds. teaching, one needs to be more than a good teacher. One needs to demonstrate • When good clinical questions arise on rounds, have a student/resident leadership and/or demonstrate dissemination of knowledge or techniques perform a search on the topic and then present their findings to the group. regionally or nationally. Use your clinical medical librarian to help teach this process. • Consider having dedicated teaching rounds from 9-9:45 am Specific criteria to advance to associate professor includes scholarship in three • Encourage student attendance to the various learning opportunities available areas, with Level 2 activity, per Appendix C, in two areas. Regional expertise and (Morning Report, Noon Conference, Journal Club). recognition is important, and highlights the importance of networking among your • Have students/residents give presentations every morning before the rounds academic colleagues. Promotion to professor requires one to be in Level 3 in one or in the afternoon for 15 minutes about clinical problems encountered in arena and Level 2 in two others. National recognition or leadership is desired. patients. • Do afternoon rounds as a team and observe physical exams for each student As per Appendix C in the document, Level 2 activities in teaching include: separately and comment on and/or correct the technique. • Supervises or coordinates teaching by other faculty, fellows or residents • Meet with Years 4 and 5 students once a week primarily to review (course director). observations as group conducting history and physical exams on patients • Invited lecturer at other academic sites with abnormal findings. (This is an opportunity to do their mini-CEX as well). • Receives local or regional teaching award • Give an oral exam to all students in which questions are asked of the • Supervises or mentors graduate students (MS, PhD, residents or fellows) patients they have seen during the month. • Serves as Senior (Noback) Docent

38 39 Level 3 criteria for teaching include: • Editor/author of textbook adopted for teaching at other sites • Develops course, curricular materials, educational software or other materials which are used regionally or nationally • Invited to organize or participate in a regional national educational meeting • Supervises a training program, which has a regional or national audience • Receives regional or national teaching award

Level 2 criteria for service include: • Assistant dean • Section chief • Chairs a major hospital or SOM committee • Officer in local or state society • Independently directs or develops a major SOM program or clinical project • Chairs medical subspecialty or professional society committee • Attracts gifts Level 3 criteria for research include: • Officer or committee member in a regional or national professional society • High quality publications of original research in peer reviewed journals • Chairs a department faculty search committee • Directs scholarly activity of other faculty or post-doctoral appointees • Continued success in obtaining extramural grants or contracts Level 3 criteria for service include: • Organizes or participates in major research presentations at national or • Associate dean or other SOM administrative position international meetings • Department chair • PI or committee member in multi-center clinical trials • Key leadership role in a national professional society • Officer in national or international society Although the above tasks may appear daunting to a junior faculty member, it is • Chairs an academic council vital that your goals to achieve them be focused and planned. Some techniques to achieve these goals include the following: Level 2 criteria for clinical practice include: • Agree on your goals with your chief/chair. • Consulting physician at regional level • Look at the promotion criteria and see how your goals mesh with the criteria • Considered excellent clinician by peers at local and regional level for promotion. Identify Level 2 or 3 activities that, with effort, you could meet. • Develops and directs clinical program • Be realistic and focused. Depth is often more important than breadth. • Devises new procedures or methods for clinical patient care • Do you have the time and support to meet these goals? How will you get them? Negotiate. Level 3 criteria for clinical practice include: • Review your progress on a regular basis — at least every three months, • Established consultant who attracts patients regionally or beyond starting now. What have you accomplished now that will help get you promoted • Devises new care methods or procedures, which receive national or in three to four years? What are you working on? What is your timeline? international recognition • Observe others • Contributes significantly to board examinations or specialty certification • Observe yourself, and seek feedback • Obtains advanced health services degree (MPH or MBA) • Seek mentorship • Consults nationally • Keep your Faculty Activity Profile updated • Be a leader of a program and show how your leadership enhanced the Level 2 criteria for research include: program. Show and document results. • High quality publications in peer reviewed journals • Seek networking regionally and nationally. Seek regional and national • Success in extramural grants, peer reviewed or industry recognition. This is particularly helpful in attaining external reviews, which is • Recognition as an ad hoc reviewer, member of a study section or private required for promotion. sector consultant • Early in your career make plans to successfully publish your scholarly work • Presentation regionally and nationally in peer- reviewed indexed journals. This could be original research, clinical • Licenses and patents case series, innovative teaching methodology, or quality improvement work. • Oversees a major research project as PI Involve the IRB early in any project with plans for publication. • Serves as member of a national research or clinical review committee • Participant in multi-center clinical trials

40 41 Helpful Tips for Residency Compliance Internal Medicine Residency Program

Interns: By ACGME rules, interns cannot work more than 16 consecutive hours Didactic Schedules and should be out of the hospital for at least 10 hours between shifts. Intern • Morning Report: 8-8:45 am Mon-Thurs at SLH; Mon and Wed-Fri at TMC calls are shifts that do NOT change, meaning if the interns cap with their five • Noon Conference: Noon-1 pm daily. Originates at either UMKC or SLH and is admissions early, the next set of interns do not come in before their designated telecast to the other location. Please release residents from rounds no later times. This is different than the supervisors whose call information is listed below. than 11:45 am for noon conference. • Grand Rounds: 7:45-8:45 am Tuesdays (TMC) and Fridays (SLH). On the Supervisors: There are supervising residents assigned to “swing shifts” at both second Tuesday of each month, the Department of Medicine meeting campuses. They finish that shift at 10 pm so are not to be at the hospital until 8 replaces Grand Rounds at TMC. David Wooldridge, MD am the following morning to comply with duty hour rules. • Night Float Didactics: There is a rotating schedule of DoRo attendings that meets with Night Float residents Mon-Fri from 7:30-8:15 am for bedside SLH: 816-932-3409 Backup: A backup system is in place for supervisors. If the interns and teaching at both TMC and SLH. At TMC on Fridays, Night Float teaching TMC: 816-404-0955 supervisors that are on call cap, and there is no following shift of residents to do combined with Morning Report for all residents to learn from a case admissions, backup is called in. We have a backup supervisor assigned for every admitted overnight by the Night Float team. Chief Resident E-Mail: day, including weekends. A supervisor called in as backup must go home the next • Half day Didactics: Residents are divided into three groups. Each group [email protected] day by noon. meets for didactic sessions one afternoon each month from August to April. Half day didactic schedules will be set for the entire year by August of each Jeopardy: There are intern and supervisor jeopardy shifts scheduled for every academic year and emailed to faculty listservs. day of each month in case there is an emergent issue or illness precluding a scheduled resident from taking that shift. Depending on what the shift coverage Links is, the intern jeopardy could work no longer than 16 hours continuously and a • IM Residency Sharepoint site (access using your UMKC username/ supervisor no longer than 24+4 hours continuously. password): https://umkc.sharepoint.missouri.edu/SOM/internalmedicine/ • IM Residency website: http://www.med.umkc.edu/residency/im/ Suggestions to Faculty: Ask your residents what time they will be able to round • New Innovations: https://www.new-innov.com/Login/Login.aspx the next morning in compliance with their hours NOT what time they want to • Institution is “umkcsom” round. Although we cannot know what time they will be done with their work • Each faculty member is assigned a separate username and password. beforehand, the resident may need to contact the attending about what time they Contact Residency Coordinator Brie East (816-404-0525) with actually leave in order to plan rounds for the next day in order to ensure they are questions. out of the hospital for at least 10 hours between shifts. • ACGME public website: http://www.acgme.org/acWebsite/navPages/ nav_Public.asp Faculty should review and edit, as necessary, monthly “days off” calendars presented by the supervising resident on the first day of each rotation to insure Resident Evaluation all residents on the team get their allotted days off (at least one day in seven, Faculty should evaluate residents at the end of each monthly rotation and averaged over the month) and so faculty are aware of potential resident absences semi-annually for the continuity clinic. The evaluation system we used is New due to didactics/vacations/clinics/backup shifts/jeopardy calls, and day RIC Innovations, and it can be accessed at the link above. Faculty will receive email assignments. reminders from NewInnovations regarding pending evaluations.

Contacts • Office 816-932-3409 (SLH); 816-404-0955 (TMC). • Chief residents change annually. There are three IM Chief Residents, two based at TMC, and one based at SLH. The chiefs at TMC will split duties between ambulatory and inpatient management responsibilities. Any of the chiefs can be reached via the chief email address: [email protected]

42 43 Notes

Statement of Human Rights The Board of Curators and University of Missouri-Kansas City are committed to the policy of equal opportunity, regardless of race, color, religion, sex, sexual orientation, national origin, age, disability and status as a Vietnam era veteran. The Division of Diversity, Access & Equity is responsible for all relevant programs.

Division of Diversity, Access & Equity 5115 Oak Street Kansas City, MO 64110 Phone: (816) 235-1323 Fax: (816) 235-6537 Email: [email protected] www.umkc.edu/diversity OMC081413

44 School of Medicine 2411 Holmes Street Kansas City, MO 64108 816-235-1808 www.med.umkc.edu

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