Introduction to the Clerkship Direct Observations

Introduction to the Palliative Care Clerkship Direct Observations

Introduction

Direct Observations (DOs) in the Palliative Care clerkship are designed to provide you with opportunities to demonstrate your communication skills and history-taking skills in an observed setting. You are also expected to demonstrate important interpersonal skills related to communication skills and history-taking in any patient encounter. The ultimate goal of these exercises is to provide you with formative and summative feedback on these skills identified by the clerkship director as critical to their particular field/discipline. Feedback is critical in every stage of development for a physician and we encourage you to use this chance to hone your clinical skills and also your ability to receive feedback thoughtfully.

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General Information

• The ISMMS Academic Integrity Policy, linked on page 3, governs this assessment.

• All encounters will occur at the Morchand Center on the 13th floor of Annenberg.

• All encounters are in-person with standardized patients (SPs) and/or part-task simulators.

  • You should treat all encounters with standardized patients (SPs) with the same respect, empathy, and concern that you would have with real patients.

• We expect professional behavior with the staff in the Morchand Center.

• Consumption of any candy, food, or gum in the Morchand Center is strictly prohibited.

• You will receive email notifications of the time and date of your DO from the Clerkship Coordinator.

  • Time slot assignments may change. Please check your email frequently.

  • There will be NO RESCHEDULING of late arrivals. You must arrive at your designated arrival time.

• Masking guidelines are aligned with Mount Sinai Health System Guidelines for the hospital/clinical setting.

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What to Expect at the Morchand Center

Prior to Arrival at the Morchand

• You will receive access to an ORIENTATION VIDEO shortly before the program.

  • The orientation video should be watched, in full, prior to your assigned arrival time.

  • Linked for review, at the end of the video, is the ISMMS Academic Integrity Policy.

  • As this policy governs all assessments, a digital honor code attestation is no longer required.

Orientation

• The Proctor will meet you for your ON-SITE orientation at the location indicated in the email.

• Please give the Proctor your full attention during orientation (no cell phone usage, etc.).

• The Proctor will be providing you with a letter badge to be worn outside of your coat. Make sure your letter badge can be clearly seen at all times.

• Wear your white coat and bring a pen.

• There are no diagnostic tools you are required to bring (i.e. no stethoscope).

• You will be provided clipboards and paper in case you want to take notes.

Exam Room Set-Up

• Upon arrival at the Morchand Center, your personal items, textbooks, study materials, phones, and smart watches with audio or video recording capabilities will be safely stored for you.

• When the encounters are over you will take all your belongings with you.

• Both of your DO encounters will be captured via the audio/visual equipment inside the exam room.

• DO NOT CLICK anything on the computers outside of your assigned exam room unless specifically told to do so by the Proctor. Doing otherwise will cause technical difficulties and significant delays.

• We are accommodating camera angles, so please sit on the stool provided and DO NOT MOVE it around.

• There is no write-up, so you do not have to take notes. If you do take notes you must leave them in the room at the end of your encounters.

Format and Timing of Encounters

• 10-minute encounter with SP (or part-task simulator if applicable).

  • You will receive a 5-minute warning prior to the end of the encounter.

• 15-minute waiting period while SP completes checklist.

• 10-minute in-person feedback with SP.

  • You will receive a 2-minute warning prior to the end of the feedback session.

• You will complete the cycle above for both the communication skills and history-taking portions of your DO.

Feedback Format

• Prior to delivering feedback, the SP will review your video and complete a paper checklist.

• During feedback, the SP will discuss concrete skills that were expected of you as well as their experience of empathy, concern, and respect from the perspective of a patient.

• For any discrepancy between SP feedback and personal recollection of your own performance, please let the SP know and it will be noted for secondary review.

• All encounters are recorded on video and available for the faculty to review.

Required Video Review

• The Clerkship Director (CD) alerts Aaron Yellin and Meghan Green ([e-mail], [e-mail]) to the need for remediation and confirms you have been notified.

  • If you require remediation, you must review your encounter video(s).

• Aaron schedules video review and remediation encounter(s) directly with you.

• Video review is scheduled for the soonest possible date.

• During video review, you complete the DO Self-Assessment Form.

  • If video review is required, you must share your form with your CD.

Elective Video Review

• You should send an email to [e-mail], addressed to Aaron Yellin.

• The DO Self-Assessment Form will be provided, but completing is optional.

NOTE: Video review is not to be used for score adjustments as these requests must be made immediately after the exam when you receive verbal feedback from your SP.

The ISMMS Academic Integrity Policy is linked HERE for your reference.