August 2011 Newsletter
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Dear MedU Subscribers, MedU is always looking for opportunities to further our mission of collaboratively advancing medical education through the innovative use of technology. This year, we're investing in new ways to teach clinical reasoning and assess student learning with guidance from internationally recognized experts in these fields. For information about these developments and other MedU news, click on the links below. Subscription Season Complete New Assessment Tools MedU Editorial Board Meeting - September 2011 New Student Usage Report System Visit MedU at ... fmCASES Update SIMPLE at CDIM - Introducing the SIMPLE Key Features Exam  Subscription Season Complete! Thank you all for renewing your subscriptions. With most of you using our new online renewal system, we lowered our renewal costs and completed the subscription season earlier than ever before. Your help allows us to keep your costs down while we expand the number of courses and institutions. When all is said and done, we will have over 150 institutional subscribers from the US, Canada, the Caribbean and as far away as Qatar and Singapore. We're well on our way to 2 million case completions, adding more than 12,000 cases a week. New Assessment Tools We're working on new several new assessment tools including an exciting new summative assessment approach for Internal Medicine clerkships, see SIMPLE at CDIM below. We’re continuing to expand opportunities for collaborative educational scholarship, including validation of a assessment tool originally developed at Rush Medical College for use with CLIPP and evaluating peer response feedback within MedU cases. MedU Editorial Board Meeting - September 2011 One of the highlights of our year is our week-long MedU meeting hosted here in Lebanon NH in mid September. Bringing together the editorial boards for all five case sets provides an incredible opportunity to advance MedU's cross-disciplinary mission in medical education. Following a keynote, renowned educator Geoff Norman will lead a day-long workshop to help us better understand how to develop clinical reasoning skills and integrate those techniques into our cases. We'll also spend time with each board planning their research and development efforts for the academic year and looking for more opportunities to work across specialties to address tomorrow's challenges in health care education. New Student Usage Report System A new reporting system for student use data is now available for CLIPP, SIMPLE, fmCASES and CORE. Integrating a lot of your feedback, the new report system is now available directly from the same web page as the cases - look for "Reports" at the bottom of your "Decision" tab. You no longer need to go through the Instructors' Area of the MedU site to get student log use data. The new reports offer more information, improved navigation, and more advanced export functions to Microsoft Excel and PDF formats, and, addressing one of your most significant requests, the ability to define a subset of the students as "My Students" that will filter all the different reports for just the selected students. Please visit us! We'll have a booth in the exhibit areas and attendees at the sessions of the following conferences. Please stop by, say "Hi!" and let us know how we can help you with your medical education challenges.
Join us on Facebook! MedU now has a home on Facebook. You can 'like' us there or on the MedU web site home page. Feel free to post on our wall, add links to relevant resources and connect with others through the ultimate social network.  Important fmCASES Updates Case Revisions: All 29 original of the original cases were reviewed to ensure accuracy, currency and consistency. New Cases: To broaden the coverage of STFM's curricular guidelines, the editorial board added 4 new cases, bringing the total number of cases to 40 (33 fmCASES-specific cases, 5 cases from CLIPP and 2 cases from SIMPLE). Final Exam Question Bank: Over the last two academic years, a team of educators has created and validated an exam bank of 360 questions assessing understanding of the content of all 40 cases. The question bank is available to fmCASES subscribing institutions free of charge. For those who would like a standardized exam, MedU has created a 100 question exam that covers the content of all 40 cases. We also provide an extra-cost scoring service for that standardized exam. More details on these fmCASES enhancements are available on our web site.  SIMPLE at CDIM - Introducing the SIMPLE Key Features Exam Members of MedU's Simulated Internal Medicine Patient Learning Experience (SIMPLE) Editorial Board together with members of the SIMPLE Key Features Development Group will present "Using a Key Features Exam to Assess Medical Students' Clinical Decision-Making" at the 2011 CDIM National Meeting in Anaheim, California. If you are interested in learning more about the SIMPLE Key Features Exam and how to integrate this exam into your clerkship curriculum, please consider attending this workshop (#105) from 10:30 a.m. to 12:00 p.m. on Friday, October 21. Please also visit the iInTIME booth in the exhibition hall to learn about all the new SIMPLE developments. Thank you for your support and helping us help you train tomorrow's doctors. We welcome any feedback anytime at info@i-intime.org. The Staff and Collaborators of MedU
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fmCASES Update August 2011
Maintenance and ongoing development of fmCASES
During the past year, fmCASES completed its first comprehensive evaluation and improvement of the original fmCASES. The Editorial Board and 29 case editors reviewed each case to ensure accuracy and consistency of information, conveyed with a consistent style. The editors also responded to many inquiries and suggestions for improvement from preceptors and students.
We conducted a detailed analysis of the content covered by fmCASES, and compared the coverage to national curricular guidelines. The national objectives used were primarily from the Society of Teachers of Family Medicine’s (STFM’s) Family Medicine Clerkship Curriculum (originally entitled C4) and the STFM’s Family Medicine Curriculum Resources (FMCR) family medicine clerkship curriculum. This detailed analysis guided edits to all the cases this year and also led to the creation of four new cases that are available as of July 2011:
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Case #30: 27-year-old female - Labor and delivery - Mrs. Gold
Author: Wetona Suzanne Eidson-Ton, M.D., M.S., University of California, Davis
Editor: Jason Chao, M.D., Case Western Reserve University -
Case #31: 66-year-old female with shortness of breath - Mrs. Hernandez
Author: Ellen Miller, M.D., New York Medical College
Editor: David Anthony, M.D., M.Sc., Brown University -
Case #32: 33-year-old female with painful periods - Ms. Tomlin
Author: Jessica Servey, Lt. Col, USAF, MC, Uniformed Services University
Editor: Katherine Margo, M.D., University of Pennsylvania -
Case #33: 28-year-old female with dizziness - Mrs. Saleh
Author: Theresa Woehrle, M.D., M.P.H., Keck School of Medicine at University of Southern California (USC)
Editor: Stephen Scott, M.D., M.P.H., Weill Cornell Medical College in Qatar
Beginning July 2011, subscription to fmCASES includes the 29 original cases and the four newly developed fmCASES, in addition to 5 CLIPP and 2 SIMPLE cases that covered core objectives. These cases were assembled to represent the full breadth of care of family medicine, to the depth of knowledge expected by a 3rd year medical student.
Currently, we have 82 institutions subscribing to fmCASES, including 72 allopathic schools, 7 osteopathic schools, 1 PA program, and 2 Canadian schools.
Written exam questions and a final exam created
A team of family medicine educators led by Roger Berkow and Kent Sheets constructed a database of 300 multiple-choice questions during the first half of 2010, so that subscribers to fmCASES will be able to create written examinations that test student mastery of this content. These questions were validated during 2010-11, and revised based upon item analysis. New questions were constructed to cover all 40 cases in the fmCASES’ curriculum.
As of this academic year, fmCASES subscribers have the option to use the 360-item exam bank, free of charge, as part of their fmCASES subscription. A clerkship director can use these questions to create an institution-specific exam that assesses the student's understanding of the cases used at that school. Alternately, a clerkship director may choose to subscribe to a standardized 100-item exam that covers the complete content of all 40 cases in the fmCASES’ curriculum. iInTIME provides an exam-scoring service for this exam for a fee of $250. iInTIME will be able to provide comparison data to institutions that use the scoring service.
We are investigating solutions to address the variance in clerkship lengths and curriculum coverage. With programs that range from 4 to 8 weeks, a single standardized exam, whether a shelf exam or the fmCASES exam, may not meet the specific needs of each individual clerkship program, as the fmCASES exam is intended to cover a student's knowledge of the entire curriculum. The fmCASES Editors-in-Chief are working with the Society of Teachers of Family Medicine (STFM) to evaluate potential solutions to this challenging problem.
To learn more about the fmCASES exam, please visit MedU at http://www.med-u.org/virtual_patient_cases/fmcases_final_exam_faq.
Keeping STFM community informed of the fmCASES
At both of the 2011 STFM meetings, the medical student education-focused conference and the annual spring conference, we held an integration workshop and a poster session to inform STFM members about the progress of fmCASES and to assist users to integrate fmCASES effectively into clerkships. We plan to continue this outreach during 2012. And, also in 2012, we will offer a special invitation workshop at STFM’s Conference on Medical Student Education to help case editors understand their role within the larger project, as well as to provide an opportunity for the Case Editors to meet and work with the Associate Editors and Editors-in-Chief.
Looking to the future
To enhance the value of fmCASES, the editorial board has been developing plans to improve the polling questions and to create precepting tools.
Polling questions are designed to force the learner to make one choice, but there is no one absolutely right answer. These questions can help the student expand the repertoire of behavior appropriate in clinical care, and to build new approaches to managing complexity, uncertainty, and ambiguity. We will use student feedback as well as interviews and focus groups to learn how students are viewing the polling questions, and then convene the case editors and associate editors to generate a plan for improvement.
In recent years, a significant portion of medical education has shifted to the ambulatory setting. Many of the family medicine clerkships in the U.S. depend upon volunteer, community preceptors. It can be difficult enough to have a student working side-by-side with you in a busy outpatient practice, and so how can this physician have time to pull in content from fmCASES? Using interviews and focus groups, we plan to identify the needs of ambulatory preceptors and develop tools and resources to facilitate their teaching of medical students. We hypothesize that well-designed tools based on fmCASES will improve student learning and enhance the preceptor’s pride in ensuring that the student learns the required content. We hope that the preceptors will also find increased efficiency in teaching if they can integrate fmCASES’ content into discussion about patients' health.