Meet Salvador Stethoscope.
Although Salvador isn’t a real IU School of Medicine Class of 2019 student, he represents a composite of aggregated feedback from actual Class of 2019 students.
After finishing the third year of medical school, Salvador, along with his Class of 2019 colleagues, reflected on his experiences by taking the 2018 Strategic Student Survey (S3). Salvador and his classmates identified both areas of improvement and achievement at IU School of Medicine.
Full Quantitative Student Response Results
Preparation for Clinical Experiences
Salvador thought his first two years of education with IU School of Medicine ensured he had the knowledge and ability to apply basic science knowledge, interpret clinical data and use appropriate resources to support patient care decisions. Salvador explained simply, “I felt adequately prepared for third year.” Salvador went on to add, “I appreciate the resources available through the Ruth Lilly Medical Library website; access to UpToDate and medicines lab diagnostics books are great.” He went on to explain that once he started clerkships, “preceptors do a good job of providing opportunities to look up materials and examine lab and imaging data.” However, Salvador noted that there were areas in need of improvement, “we did not learn a lot about writing progress notes and ordering labs, which I feel would have been extremely helpful for transitioning into the clinical phase.”
Response by Maureen Harrington, PhD, Associate Dean for Foundational Sciences
The Class of 2019’s suggestion to have more time to write progress notes and order labs aligns with the Phase 1 education team’s overarching goal for students to have patient encounters earlier during training. Students now perform a complete history and physical by the end of year one, practice writing Subjective Objective Assessment Plan (SOAP) notes several times in their second year and write admissions orders and hospital notes in Transitions 2, which orients students to clinical training at the start of Phase 2. Moving forward, we will be integrating more experiences in ordering labs and working with the tEMR during the Phase 1 Year 2 of training.
Overall, Salvador was happy with the variety of patient encounters, availability of required clinical experiences and the quality of clinical teaching. Salvador wrote, “Overall, I had a great third-year experience; plenty of patient interactions and a wide variety of clinical scenarios.” Salvador also offered several suggestions for improving clinical education, “more specific feedback from residents and attendings would be helpful.” Salvador was also concerned the feedback he received was too subjective to be used in grading. He explained, “It is a source of stress how subjective our grades are in third year” and “how a student is evaluated is often luck-of-the-draw (i.e., getting a preceptor who grades generously versus someone who interprets the rubric strictly).”
Response by Jennifer Schwartz, MD, Assistant Dean for Phase 2
The clinical education team continually works to improve evaluation forms and processes. For example, we plan to use student feedback about resident evaluations to improve resident teaching courses. Our clerkship directors meet regularly to ensure we share best practices and learn from one another. We are committed to a process of continuous quality improvement in student education. Additionally, in response to student concerns regarding the effectiveness of clinical skills evaluations, there is now a site director for each clerkship on every campus. These directors implemented a new clinical evaluation form in 2017 and are focused on ensuring comparability across all nine campuses.
Behavioral Health Education
Salvador identified some successful behavioral health initiatives, “the poverty simulation created by Fostering Awareness of the Community by Engaging Students (FACES) at the start of third year was immensely helpful.” Salvador also wrote about areas in which behavioral health education at IU School of Medicine could be improved, “I wish we had a bit more insight into behavioral health in the first two years” and went on to add, “I’m learning on the fly now on rotations and I always fear like I am ignorant.”
Response from Maureen Harrington, PhD, Associate Dean for Foundational Sciences
and from Ken Lazarus, MD, Senior Academic Content Specialist
The school’s Medical Student Education team has recognized that appropriate quantity and quality of behavioral health curriculum is imperative to produce well-rounded and residency-ready students. The creation of the Phase 1 Neuroscience and Behavior course is a direct result of student feedback requesting more behavioral health education. Additionally, a team of faculty and students has been charged with looking at opportunities for more behavioral science content in the Phase 1 curriculum, notably in the Foundations of Clinical Practice 1 and 2.
Overall, Salvador was satisfied with the availability of counseling about careers, career preference assessment, information about specialties, and career planning services. However, he was concerned with the responsiveness of some staff, explaining, “I emailed multiple potential career counselors two months ago and I have not heard back from them; checked spam too.” Salvador added, “I want to go into a specific specialty and the staff they have listed as career mentors are awful about getting back to me, giving me advice and helping me get involved in research. Finally, Salvador explained, “I didn’t get a career mentor until a faculty member offered while I was on an elective.” One of Salvador’s classmates had a more favorable impression though, saying “I appreciate the career development website and easy access to career mentors.”
Response by: Debra Rusk, MD, Assistant Dean of Career and Professional Development
To reflect the importance of early and robust career mentoring, I have worked to expand the medical Student Affairs Career Development Office staff, adding Sacha Sharp, MA, the associate director of career development and cultural inclusion, who provides support in areas such as mock interview, CV reviews and more. Together, we have created a professional development plan for students during each phase of medical school, which is now available on our MedNet career development pages. My team also travels to each campus to provide personalized residency interview coaching to fourth-year students. Finally, because we know that establishing a connection with a career mentor has sometimes been difficult, we have created a new career mentor request process to ensure students receive timely responses from career mentors.