CLIPP Assessment Tools Validation Process

The CLIPP Assessment Tool Validation project is a joint project between MedU and Rush Medical College.  Keith Boyd, MD and Sharon Sholiton, MD of Rush created a case analysis tool for use with CLIPP cases that provides an assessment tool to evaluate student learning from CLIPP cases.  This project, funded and managed by MedU and led by CLIPP Editor-in-Chief Sherilyn Smith, MD, will research and further develop the tool to validate that it accurately discriminates between those who understand the CLIPP case content and can apply that knowledge in a structured assessment from those who cannot.

In an effort to create the highest quality tools for use in the pediatric clerkship, we will be conducting a validation study related to this assessment tool. This will be a multi-step process and will focus on establishing the validity of the model of assessment and the specific link of the assessment tool to CLIPP. We are convening a panel of experts to participate. These panelists will participate in a Delphi procedure to establish expert consensus about the method of assessment in the CLIPP Case Analysis Form, the ease of use of the assessment tool and the accuracy of answer keys associated with this new assessment tool. Over the course of the next year, MedU together with our partners at Rush and the panel of expert reviewers seek to make our results and the tool more widely available by producing scholarly work including manuscripts related to the project as well as workshops about the validation project and the specific methods used. The planned outcome is to make the tool widely available to clerkship directors who use CLIPP as part of their pediatrics clerkship program.

The following paragraphs describe the background and rationale behind the case analysis tool.

CLIPP cases provide an opportunity for M3 students to supplement their clinical patient experiences through interaction with a cadre of computerized simulations of patient encounters. These cases present a complement of classic pediatric diseases that may not be experienced individually by each student. As a clerkship director, this computerized bank of core patient encounters helps to provide a more uniform experience for students in diverse institutions throughout all seasons of the year.

The on-line platform allows clerkship directors to monitor time spent on each case by the student, but not to assess the student’s responses or provide direct feedback. Completion of a simple, structured written worksheet (the CLIPP case analysis tool) by the student will enhance his/her learning experience by facilitating direct communication between the clerkship director and the student regarding the case.

As the student works through each CLIPP case, use of the CLIPP tool facilitates the development of clinical reasoning skills by clearly delineating the steps involved in patient evaluation and clinical care. The student identifies and documents pertinent data obtained via history and physical exam, and then succinctly summarizes the key information into a problem statement. This focused patient assessment then drives the development of a prioritized differential diagnosis.  Finally, the student generates an initial diagnostic and treatment plan. This staged process parallels the structure of the cases themselves, as well as the process through which clinicians assess patients.  Using the tool requires the student to develop independent learning skills and allows the clerkship director to assess his/her clinical reasoning process and provide individualized feedback.

This tool was developed explicitly for use in conjunction with the CLIPP cases at Rush University Medical Center in Chicago, IL and has been used in that clerkship since July 2002. The CLIPP case analysis process and assessment tool reinforce the Problem Oriented Medical Record system that is utilized at Rush throughout the preclinical and clinical curriculum.

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:

  • 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.

 

CLIPP updates for 2011/12

Annual case updates underway

CLIPP Case editors are busy conducting the annual review of their cases to make sure medical content is up-to-date, accurate and , meets the curricular learning objectives for that case. In addition, case editors are working with the CLIPP Editorial Board to revise the case learning objectives to ensure clear and consistent wording across cases. We hope this will be especially helpful to clerkship directors as you plan your curriculum. Please note that whenever content changes are made to the case, the resources associated with that case (case summary/KTPs, Final Exam Questions, and Questions for Further Consideration) are subsequently reviewed and revised as needed.

We would like to thank CLIPP case editors and associate editors for their hard work to ensure both accuracy of case content and implementation of effective pedagogical practices.

Important changes to take place as of July 1

Please note the following changes that will be implemented on or before July 1.

CLIPP Case 24: The case of Matthew, a 2 year-old boy with altered mental status, has been extensively revised and should be available July 1st. The original case involved severe plumbism, whereas the revised case will focus on a broader view of toxic ingestions (including recognition of toxidromes and management of acute ingestions, curricular objectives that were not covered well previously within CLIPP). Lead screening is now covered in Case 3(3 year-old well child visit)

CLIPP Case 28: During the last week of June, Case 28 will be unavailable for a day as we implement substantial revisions. Although the learning objectives for this case about developmental delay will remain unchanged, the case editor and associate editor have implemented substantial improvements to the organization and flow of case content as well as important and comprehensive updates to developmental screening techniques.

Diagnostic Network Scoring:Cases with a diagnostic network include three important steps to help students hone their clinical reasoning skills. The student is first asked to identify key findings for the patient at the current point in time. Next, the student develops a differential diagnoses. Finally, the student rates the connection between each finding and each diagnosis using a five-point scale (“strongly speaks against” to “strongly speaks for”). In an effort to further hone the diagnostic reasoning process, we are modifying the networks across all CLIPP Cases where students will now be asked to rate the network connections using a three-point scale (does not speak for, neutral, speaks for). We hope this will provide even more clarity while reducing frustration and time spent working through the diagnostic networks.

New CLIPP Teaching Tool

In response to requests for additional teaching materials related to the CLIPP cases, we have created a series of questions that supplement and extend the teaching in CLIPP and we need your feedback!

Each CLIPP case now has additional questions (Questions for Further Consideration, or QFC’s) that target one or more of the following areas: basic science correlation, clinical correlation, clinical reasoning, management (includes diagnostic testing), ethics/professionalism, communication and/or biostatics.

These questions can be used in a variety of ways: topics for group discussion, student self-study, oral examination questions, supplemental clinical reasoning exercises, or for 4th year student curricula (to name a few). 

We encourage you to take a look at the QFC’s which have been published within the password-protected CLIPP Instructors’ Area at med-u.org. Please consider providing feedback about the QFC content and/or organization as we strive to make this a user-friendly and useful resource for the pediatric clerkship (email: qfc-feedback@med-u.org).

SIMPLE Exam Development

The Simulated Internal Medicine Patient Learning Experience (SIMPLE) virtual patient cases are in use in the Internal Medicine Clerkship at 75 medical schools. The 36 virtual patient cases in SIMPLE are designed to encompass the learning objectives of the Clerkship Directors in Internal Medicine (CDIM) – Society for General Internal Medicine Core Medicine Clerkship Curriculum and focus on teaching core internal medicine knowledge and clinical reasoning. Based on extensive feedback from the 75 schools that use SIMPLE, the SIMPLE Editorial Board developed an exam to assess student understanding of the content of the 36 virtual patient cases for Internal Medicine. But it's not just any assessment, the SIMPLE Exam will uses Key Features problems to assess students' ability to apply what they have learned to clinical decision making...and it will be administered online!

Key feature problems consist of a case scenario followed by one or more questions pertaining to the problem’s key features, or critical steps in the resolution of the problem. According to Page and Bordage a key feature “focuses on a step in which examinees are most likely to make errors in the resolution of the problem”, and represents “a difficult aspect of the identification and management of the problem in practice”.  Key features examinations have been shown to effectively assess the ability to make correct clinical decisions and are used in the Medical Council of Canada’s national qualifying examination, the Royal Australian College of General Practitioners certification examination for fellowship, and the American Society of Colon and Rectal Surgeons’ Colon and Rectal Surgery Educational Program Self-assessment Examination. A version of a key features examination has been developed for Canadian medical students, but there are no reports of key features examinations developed for on-line assessment of U.S. medical students.

Most medical schools, utilize the National Board of Medical Examiners Medicine Subject Exam to assess students’ knowledge at the end of the Medicine Clerkship.10  The majority of questions are constructed in a standard multiple-choice question format, and the exam is administered on paper.  The online Key Features Examination differs from the Subject Exam in its focus on clinical decision-making, alignment with the SIMPLE virtual patient cases and the CDIM curriculum, question format, and delivery method.  Therefore, the first step in validating the examination requires a study of the acceptability and feasibility of the examination.  Information from this study may be used to revise the examination delivery method, procedures, and orientation, or content.

References

  1. Page G.  Bordage.  Allen T.  Developing key-feature problems and examinations to assess clinical decision-making skills.  Academic Medicine.  1995;70:194-201.
  2. Page G.  Bordage G.  The Medical Council of Canada’s key features project:  A more valid written examination of clinical decision-making skills.  Academic Medicine.  1995;7(2):104-110.
  3. Tamblyn R. Abrahamowicz M. Dauphinee D.  Wenghofer E. Jacques A. Klass D. Smee S. Blackmore D. Winslade N. Girard N. Du Berger R. Bartman I. Buckeridge DL. Hanley JA.  Physician scores on a national clinical skills examination as predictors of complaints to medical regulatory authorities.  JAMA.  2007;298(9):993-1001.
  4. Trudel JL.  Bordage G.  Downing SM.  Reliability and validity of key feature cases for the self-assessment of conol and rectal surgeons.  Annals of Surgery.  2008;248:252-258.
  5. Wenghofer E. Klass D. Abrahamowicz M.  Dauphinee D. Jacques A. Smee S. Blackmore D. Winslade N. Reidel K. Bartman I. Tamblyn R.  Doctor scores on national qualifying examinations predict quality of care in future practice.  Medical Eduation.  2009;43:1166-1173.
  6. Farmer EA.  Hinchy J.  Assessing general practice clinical decision-making skills:  the key features approach.  Australian Family Physician, 2005.  34(12):1059-1061.

MedU at AAMC


Association of American Medical Colleges 2010 Annual Meeting
November 5-10, 2010
Washington DC

MedU will be represented at the AAMC 2010 Annual Meeting. Please join us at Exhibit Booth 809 to learn more about our virtual patient cases. iInTIME staff, MedU Editorial Board members, and editorial board members from CLIPP, fmCASES, SIMPLE, and WISE-MD will be available to answer any questions you may have. We hope to see you there!

SIMPLE at the 2010 CDIM National Meeting

San Antonio, Texas
October 14-17, 2010

MedU's Simulated Internal Medicine Patient Learning Experience (SIMPLE) will be featured in workshops at the 2010 CDIM National Meeting in San Antonio, Texas from October 14 to 17. If you are interested in learning more about MedU virtual patient cases or how to integrate them into your clerkship curriculum, please consider attending one of the following workshops or visit the iInTIME exhibit booth (Booth No. 3).

Friday, October 15 from 2:00 pm to 3:30 pm (#205).
SIMPLE integration Strategies: What works, What Doesn't - Sharing Tips and Solutions

This workshop, led by Dr. Amy Holsthouser, SIMPLE Associate Editor (University of Louisville School of Medicine), in partnership with Dr. James Nixon, SIMPLE Editor-in-Chief (University of Minnesota), Dr. Kirk Bronander, SIMPLE Associate Editor (University of Nevada), and Dr. Norm Berman, MedU Editor-in-Chief (Dartmouth Medical School), offers SIMPLE users guidance on how to integrate SIMPLE virtual patient cases into a clerkship. Presenters and attendees will be called upon to share their experiences and solutions will be offered by educating users on the resources available.


Saturday, October 16 from 2:00 pm to 3:30 pm (#301)
Coordinating with SIMPLE: Meeting the Needs of the Clerkship

Are you interested in learning to maximize the benefits and efficiency of using SIMPLE virtual patient cases and online integration tools in your clerkship? Do you find yourself wishing you knew more about SIMPLE case use reports and other online tools? iInTIME staff members Barrie Rosalinda and Audra Bucklin together with Alison Chander, Clerkship Coordinator from the University of Minnesota Medical School, will provide instruction and answer your questions about the SIMPLE user interface. The workshop will also feature open discussion where participants will be encouraged to share ideas with one another.

2010 MedU Annual Meeting

Lebanon, New Hampshire
September 20 -24, 2010

September marks the first annual meeting of its kind for MedU. The MedU Editorial Board Editors-in-Chief, Drs. Fall and Berman, and the Editors-in-Chief of each discipline make up the newly formed MedU Editorial Board. During the week of September 20th, the CLIPP, fmCASES and SIMPLE virtual patient cases editorial boards will convene in Lebanon, New Hampshire for their semi-annual meetings followed by and combined with the first annual meeting of the MedU Editorial Board. To learn more about the MedU Editorial Boards please visit http://www.med-u.org/about/editorial_board/.

MedU at AMEE

Association for Medical Education in Europe
September 4-8, 2010
Glasgow, UK

MedU will be represented at the AMEE eLearning Symposium in a Plenary panel presentation. Dr. Martin Fischer (Witten/Herdecke University in Germany) will chair the session joined by panelists Dr. Terry Poulton (St. Georges University in London), and Dr. Norm Berman (Dartmouth Medical School and MedU Editor-in-Chief).

Additionally, Dr. Berman will demonstrate iInTIME's collaborative development and maintenance model at a Secrets of Success presentation at AMEE.

MedU at MedBiquitous Annual Conference

2nd International Conference on Virtual Patients
County Hall, London


Secrets of Creating and Maintaining Virtual Patient Case Collections
Monday, April 26, 2010

In their presentation entitled Secrets of Creating and Maintaining Virtual Patient Case Collections, Dr. Martin Fischer from Witten/Herdecke University in Germany and Dr. Norm Berman, Executive Director of the Institute for Innovative Technology In Medical Education and MedU Editor-in-Chief, discussed the importance of developing and maintaining curriculum based virtual patient cases (VPs) as well as the importance of integrating VPs effectively at the program level. In addition to suggestions for overcoming potential integration barriers, Drs. Fischer and Berman highlighted opportunities for VPs to cover the curriculum and addressed the impact different learning styles have on integration.

fmCASES at STFM’s Annual Spring Conference

How to Integrate fmCASES Into Your Clerkship, Seminar S15

Sunday, April 25, 2010 at 4:00 PM

MedU's Family Medicine Computer-Assisted Simulations for Educating Students (fmCASES) will be hosting an integration seminar at STFM's Spring Meeting in Vancouver, British Columbia from April 24 to 28. This seminar will begin with a presentation on published and effective methods for integrating e-learning into the traditional curriculum including a demonstration of the online Family Medicine Computer-assisted Simulations for Educating Students (fmCASES). The group will also highlight additional resources available in the fmCASES Instructors' Area, effective strategies for using the cases within the clerkship, and the use of final exam questions based on the cases. Common barriers and effective methods for implementing pediatric CLIPP and internal medicine SIMPLE cases will be shared and participants will be encouraged to explore potential opportunities and impediments to implementing fmCASES at their own schools. For more information, please visit the Society of Teachers of Family Medicine. You can also find fmCASES at the STFM Village!

fmCASES Editorial Board Members and Seminar presenters include: Jason Chao, MD, MS; Shou Ling Leong, MD; John Waits, MD; Stephen Scott, MD, MPH; Alexander Chessman, MD; Leslie Fall, MD

WISE MD at Surgical Education Week 2010

The practical application of on line educational tools to the Surgical Clerkship:  a user’s guide to WISE-MD and the PowerPoint Teaching Modules.

Friday, April 23 at 1:30 PM and again at 3:30 PM

This workshop is designed to help clerkship directors to incorporate WISE-MD and the Association of Surgical Education (ASE) PowerPoint Teaching Modules for more effective integration of such computer-assisted learning innovations into their clerkship.  With learners’ and educators’ time at a premium, these tools allow for flexibility and cover a wide range of topics.  Participants will discover ways in which these tools can enhance and broaden learner knowledge, enable educators to cover a wide range of topics in both small and large group formats, and permit ongoing assessment and feedback to the learners.  We will also encourage those clerkship directors currently using these tools to share their experiences with, and thoughts on the surgical modules. This workshop will help to benefit both novice and experienced educators  

You can also stop by and see us at Booth #14 in the exhibit hall. We will be happy to tell you more about our surgical modules and answer any questions you have about integrating them into your clerkship.

CLIPP at COMSEP 2010

MedU's Computer-assisted Learning in Pediatrics Program (CLIPP) will be featured in workshops at the 2010 Council on Medical Student Education in Pediatrics (COMSEP) Annual Meeting in Albuquerque, New Mexico from March 25 to 28. If you're interested in learning more about MedU virtual patient cases or how to integrate them into your clerkship curriculum, please consider attending one of the following workshops:

  • Friday, March 26 from 1:30 to 3 pm: Strategies and Tools to Teach About the Medical Home: Professionalism, Culture, and Communication. This workshop, led by Jerold Woodhead, M.D., eCLIPPs Co-Project Director, will focus on the family-centered partnership that is central to the Medical Home identifying gaps in the curriculum at individual schools regarding Medical Home components by introducing different teaching models and comparing and contrasting the models.
  • Saturday, March 27 from 9 to 11 am: Coordinating With CLIPP: Meeting the Needs of the Clerkship. iInTIME, creator of CLIPP and MedU, together with Donnita Pelser, Clerkship Coordinator from Kansas University School of Medicine, will provide instruction and lead discussion and idea sharing to help maximize the benefits and efficiency of using CLIPP in your clerkship.

fmCASES at 2010 STFM Meeting

MedU's Family Medicine Computer-Assisted Simulations for Educating Students (fmCASES) will be attending STFM's 36th Annual Predoctoral Education Conference from January 28 to 31 in Jacksonville, Florida. If you're interested in learning more about fmCASES' virtual patient cases or how to integrate them into your clerkship curriculum, please join the fmCASES Development Group for an integration workshop on Saturday, January 30 at 11:15 a.m. (Session S6) or visit us at our information table throughout the meeting. You can also learn all about how the cases were developed and hear the latest feedback received from students and faculty during Friday's poster session beginning at 7:15 a.m. (Posters P54 & P53). For more information, please visit the Society of Teachers of Family Medicine.

MedU at AAMC 2009

MedU will be exhibiting at the AAMC National Meeting in Boston from November 6 through 11, 2009. If you're interested in learning more about our virtual patient cases in Pediatrics (CLIPP), Internal Medicine (SIMPLE), Family Medicine (fmCASES), Surgery (WiseMD) or how to integrate them into your clerkship curriculum, please visit us at booth 230 in the exhibition hall. For more information about the conference, please visit the Association of American Medical Colleges.

SIMPLE at CDIM 2009

MedU's Simulated Internal Medicine Patient Learning Experience (SIMPLE) will be exhibiting at the CDIM National Meeting, part of Academic Internal Medicine Week, in Philadelphia from October 22 to 24. If you're interested in learning more about SIMPLE virtual patient cases or how to integrate them into your clerkship curriculum, please visit us in the exhibition hall. For more information, please visit the Alliance for Academic Internal Medicine.

fmCASES Now Available for Pilot Testing

The fmCASES are here and ready for ‘no fee’ pilot testing!

Family Medicine educators are realizing a dream with fmCASES, a set of online cases to teach the core curriculum of the family medicine clerkship. iInTIME released 8 of 29 cases for pilot testing through the MedU website on July 1, 2009.  This number continues to grow as case development is finalized. fmCASES are available free of charge to all CLIPP, SIMPLE and WISE-MD subscribers and upon request by non-subscribers subscribers involved in medical education. The cases will remain available for use, without a fee, until subscriptions begin in July of 2010. During the pilot phase, an on-line evaluation form is provided at the conclusion of each case. Simultaneous to the pilot testing process is an extensive peer review of each of the cases, involving both medical content and pedagogical experts from the field.  During this time, the cases will continue to be refined.

fmCASES will build clinical competency, fill educational gaps, and model the core values of family medicine. The cases will also help clerkship directors meet LCME’s ED-2 and ED-8 standards. Using the FMCR (Family Medicine Curriculum Resource), NBME Task Force curriculum topics, and the Future of Family Medicine as resources, these cases were carefully designed to cover common topics for the Family Medicine Clerkship. fmCASES fosters self-directed and independent study, emphasizes and models clinical problem-solving, and teaches an evidence-based and generalist approach to patient care.  Each case is designed to draw the learner into the encounter, through dialog, questions, and answers. Diagnostic networks stimulate clinical reasoning and critical thinking.

fmCASES is designed for use by third-year medical students and can also be an excellent learning tool for many other health care professionals. If you are interested in accessing the cases or serving as a peer reviewer and have not yet contacted us, please do so by clicking here: www.med-u.org/support/ask_medu_support

To learn more about fmCASES and other iInTIME projects including information on individual cases or their extensive development through strategic partnerships, please visit their new home at http://www.med-u.org For m.ore information about the iInTIME organization and its unique approach to delivering effective medical education through computer assisted learning applications, please visit www.i-intime.org.

MedU Pilots Multi-Disciplinary Cases

Virtual patient cases teaching cultural sensitivity and provider-patient partnership building ready for no-fee pilot testing!

eCLIPPs, a set of online cases to teach cultural sensitivity as well as provider-patient and provider-family partnership building techniques was released for pilot testing on July 1, 2009.  Initially, 3 cases were offered, but this number continues to grow as case development is finalized. eCLIPPs cases are available free of charge to all CLIPP, SIMPLE and WISE-MD subscribers and upon request by non-subscribers involved in medical education. During the pilot phase, an on-line evaluation form is provided at the conclusion of each case. Simultaneous to the pilot testing process is an extensive peer review of each of the cases, involving both medical content and pedagogical experts from the field.  During this time, the cases will continue to be refined.

Through interactive and printable tools, eCLIPPs cases brings ‘culture in health’, ‘family centered partnership’, and ‘navigating the healthcare system’ concepts to the clinical bedside. eCLIPPs’ virtual cases promote cultural understanding, offer communications practice, and encourage self-reflection around students’ own biases and barriers to optimal ‘bedside’ performance.

eCLIPPs originally designed for CLIPP’s pediatric medical student users, has expanded its focus to MedU's virtual patient cases in family (fmCASES) and internal (SIMPLE). eCLIPPs offers interactive and experiential education in providing accessible, continuous, comprehensive, family centered, coordinated, compassionate and culturally effective primary care across disciplines.

To learn more about eCLIPPs and other MedU virtual patient cases and modules including information on individual cases or their extensive development through strategic partnerships, please visit www.med-u.org. For more information about the iInTIME organization and its unique approach to delivering effective medical education through computer assisted learning applications, please visit www.i-intime.org.

The 2009 STFM President’s Award goes to the fmCASES Project!

Each year the STFM President's Award is used to recognize STFM members who have made a significant contribution during the president's year in office or members who have had a significant impact on the president during his/her term. We are happy to announce that this year, the award went to the fmCASES Project Development Group (fmPDG) for their work on the fmCASES project!  We are all very thankful for their hard work and know that this award represents a tremendous accomplishment for the project leaders, authors, iInTIME, and their collaborators. Congratulations to all.

SIMPLE moves to subscription model for 2009/2010 academic year

iInTIME would like to welcome all the new subscribers to the Simulated Internal Medicine Patient Learning Experience (SIMPLE)!  As many of you may know, the SIMPLE project is transitioning from its pilot testing phase into a subscription model for the 2009/2010 academic year.  We have been very excited so far with the healthy number of schools who have already signed on to use the cases.  If you are interested in subscribing and have not yet contacted us, please email simplesupport@i-intime.org to learn more.

As we move towards the beginning of the subscription period on July 1st, the SIMPLE project development group is busy putting the final touches on the cases.  Currently, 27 of the 36 cases are available for immediate use.  We expect most, if not all, of the remaining cases to be ready by the beginning of the subscriptions.

CLIPP Editorial Board welcomes new Editors-in-Chief and Associate Editors

The 2009 COMSEP meeting in Baltimore was a momentous occasion for the CLIPP Editorial Board.  Drs. Leslie Fall and Norman Berman (Dartmouth Medical School), the founding Editors-in-Chief of the CLIPP project, stepped down and officially passed on leadership of the CLIPP Editorial Board to Drs. Michael Dell (Case Western Reserve University) and Sherilyn Smith (University of Washington).  Drs. Dell and Smith have been integral components of CLIPP’s present success, and we all look forward to the valuable new perspectives and energy they will bring to the future development of the cases!

In addition to welcoming new Editors-in-Chief, the CLIPP Editorial Board also welcomed three new Associate Editors: Dr. Robert Drucker (Duke University), Dr. Starla Martinez (Northeast Ohio University), and Dr. Elizabeth Stuart (Stanford University). Robert, Starla, and Elizabeth join Drs. David Levine (Morehouse Medical School), Lisa Leggio (Medical College of Georgia), and Gary Freed, M.D. (Emory University).  These new associate editors will also play a very important roll in not only maintaining the currency of medical content in the cases but introducing new innovations for students and instructors. 

Over the next 12 months, the CLIPP Editorial Board plans to complete a comprehensive review of the case content in order to move the cases towards their third complete edition.  This review will include focused attention to expanding resources for instructors and improving case elements such as the networks and question types.  Some of the original case authors will also be stepping down and new case editors will be brought on to add further value to the cases.  We look forward to their contributions as well.

How do students feel about WISE-MD?

In a recent survey of WISE-MD users, at least 75% of respondents found that WISE-MD:

  • Enhanced their ability to recognize the signs and symptoms of disease.
  • Helped them to prepare for clinical activities during their surgery clerkship.
  • Enhanced their understanding of surgical techniques and anatomy.
  • Made them more eager to learn about the diseases presented in the modules.
  • Enabled them to learn about signs, symptoms, and management of diseases they were not otherwise exposed to during their clerkship.

Across the surveys, students expressed their appreciation for the rich, comprehensive, and accessible content, availability for just-in-time learning, and the thorough explanations by faculty of their clinical reasoning.

WISE-MD Modules

WISE-MD, a series of web-based modules designed specifically for the surgical education of medical students, was initially developed at New York University (NYU) Medical Center. Although production continues to be at NYU, content development is now in the hands of an editorial board of nationally-renowned surgical educators in conjunction with the American College of Surgeons (ACS) and the Association for Surgical Education (ASE).

In April of 2009, iInTIME and WISE-MD formed a partnership as a means to distribute these modules and advance medical education through collaboration with national leaders in computer-assisted instruction. To accommodate an increasing number of requests for access from teaching institutions, WISE-MD is moving from its pilot study phase to a subscription model beginning July, 2009. New features, such as self-assessment questions and case-based final assessments, will be added to enhance the modules. It is our belief that this unique partnership will help build a sustainable future for virtual patient cases and instruction for medical students across disciplines.   

fmCASES Project Development Group

fmCASES, Family Medicine Clerkship Curriculum Resources, Project Development Group (fmPDG) convened in Lebanon in August of 2008 along with the iInTIME leaders and staff. The meeting was the first official gathering of the group, who used this time to determine the goals and learning objectives of the case as well as the overall project timeline. It was decided that fmCASES will include cases from CLIPP and SIMPLE to minimize redundancy and complete the comprehensive coverage of the family medicine curricula.

Following a successful authoring workshop at the STFM meeting in Savannah, the fmPDG is now actively working with authors to finalize drafts, edit content, and implement the iInTIME Learning System (ILS) across all of the cases.  The work completed so far is very exciting!  Once the drafts are complete, we plan to make the cases available for free through pilot testing beginning July 1st, 2009.  The cases will remain available for use, free of charge, until subscriptions begin in July of 2010.  Simultaneous to the pilot testing process will be an extensive peer review of each of the cases, involving both medical content and pedagogical experts from the field.  During this time, the cases will continue to be refined.

If you are interested in becoming involved in the pilot testing or peer review processes, please contact us at info@i-intime.org. We welcome you to become part of this important initiative!

SIMPLE pilot testing

SIMPLE was released for pilot testing on July 1, 2008.  Initially, 10 internal medicine cases were offered, but this number continues to grow as case development is finalized. To date 43 institutions have requested access to SIMPLE and have reported consistently positive feedback from students. Concomitant to pilot testing, the SIMPLE cases are also being peer reviewed by both a content and pedagogical expert, verifying the medical content is up-to-date and accurate and the case is designed to teach third-year medical students effectively.

At the AAIM meeting in Orlando in October, 2008, the SPDG hosted a very successful integration workshop, guiding medical educators on the most effective methods to integrate the cases into their clerkships. iInTIME continues to work closely with each project development group to enhance the tools available to clerkship directors and instructors.

The SPDG is also actively seeking out research opportunities, so stay tuned for future news!

CLIPP Editorial Board

The Editorial Board held its 2008 fall meeting September 8-10 in Lebanon, New Hampshire. The board said goodbye to long-term members, Dr. William Wilson and Dr. Roger Berkow, and welcomed Dr. Lisa Leggio and Dr. Gary Freed as their newest members. The board discussed the completion of case revisions by the end of 2008 and the impending move of the CLIPP cases to the new version of CASUS in December. For next year, the board has begun implementing a more consistent approach to common case features, such as key teaching points and pre- and post-networks, which will enhance the functionality, effectiveness, and interactivity of the cases in the new CASUS software.