Publication Date

2018

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Abstract

Background
Pediatric Urgent Care (PUC) serves as a rich environment to teach outpatient pediatric acute care. 96% of PUCs host trainees, but only 4% host medical students.1 Constraints on clinical teaching slots2 necessitate the utilization of novel settings.

Fall 2017, the University of Kansas (KU) School of Medicine approached the Division of Urgent Care at Children’s Mercy Hospital (CMH) in Kansas City, Missouri to host 3rd year medical students as part of their pediatric clerkship.

The PUC became a new site for medical student education, necessitating the development of a new curriculum.

Objective
Create a curriculum for pediatric clerkship students in PUC

Advantages • High patient volume • Pediatric acute care problems
Challenges • Rapid patient turnover • Multiple student preceptors

Setting
Starting July 2018, two of the three CMH PUC sites host 3rd year KU medical students for two weeks of ambulatory care out of their 8-week pediatric clerkship.

Design
Objectives were created through review of the Council on Medical Student Education in Pediatrics 3rd year objectives3 and KU pediatric clerkship objectives. We found multiple objectives could be met in PUC.

Expectations: • Review website • Supervised procedures • Two notes per shift • Student-led teaching • Passport • Evaluations

Working with multiple preceptors, objectives were formatted into a “passport”. Medical students expected to demonstrate these objectives at the “shows how” level of Miller’s Pyramid.4

The Passport functions as a checklist to ensure the student receives a broad education on acute pediatric concerns. Topics that are not covered by patient encounters are covered through brief teaching sessions.

Discussion
The curriculum will be evaluated through post-rotation surveys of the rotation and all preceptors. The last 60 minutes of each student’s last shift are reserved for evaluation completion. Evaluations will be anonymously compiled and, once enough have been collected to ensure that anonymity, distributed to the preceptors and discussed with UC leadership.

Conclusion
Medical students increasingly need more venues for hands-on education, and urgent care provides a unique opportunity to provide this education. As urgent care continues to grow as a field, it will become increasingly important to incorporate it into medical education. Our efforts represent the initial steps toward a goal of national urgent care education for medical students. Future work will include evaluation of how medical student education impacts patient turnover in urgent care and measuring student & preceptor satisfaction.

MeSH Keywords

Students, Medical; Education, Medical, Undergraduate; Ambulatory Care; Pediatrics

Keywords

Urgent Care; Children; Outpatient Acute Care

Disciplines

Emergency Medicine | Medical Education | Pediatrics

Notes

Presented at the Society for Pediatric Urgent Care Conference

References

1. Montalbano, A & Lee, B. “Organization for Urgent Care Health (OUCH) Database: 2016 Data” (Poster), Pediatric Urgent Care Conference. Orlando, FL. March 2018.

2. Beninger P, Salem DN, Boumil MM, and Jotwani R. Medical Schools’ Competition for Clinical Training Spots. Acad Med. 2016 Dec; 91(12):1588.

3. https://www.comsep.org/educationalresources/currobjectives.cfm

4. Miller G, The assessment of clinical skills/competence/performance. Academic Medicine 1990; 65;9: s63-67.

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