T Clerk Tracking clinical activities in the Clerkship Lawrence Oppenheimer Co-Director Ottawa Clerkship
What is T Clerk? It is an electronic log of Patient Encounters and Procedures experienced in the clerkship Data can be entered on a hand held device (Palm Pilot or Pocket PC, Blackberry, Windows mobile device) OR via a web page. IPhone and other smart phones will be available shortly.
Who designed T Clerk? It was written in 2003 by a software company called Resilience Software and was developed in conjunction with the medical school at UBC It is in use in a large number of undergraduate (T Clerk) and postgraduate (T Res) programs in Canadian medical schools. The University of Ottawa version has been customized for use in our clerkship.
What is the rationale for a log? The clinical experience of clerks can be variable depending on the setting where students are placed. This is particularly a challenge as the size of medical schools increase and students rotate through a large number of sites and settings. Keeping track of students’ clinical experiences will help the faculty to adjust the curriculum as required to ensure that students receive a well-rounded education covering all the general aspects of medical practice
Why do you need to keep a log? A personal log will ensure that a student meets all the general clinical objectives within each medical specialty. Tracking of such clinical experiences is becoming mandatory in all medical schools, in order to ensure uniform standards in medical education. Personal learning logs are also becoming mandatory for CME in medicine and in many other professions and the completion of a log will become a necessary life-long habit.
How does it help the student? Journaling is a key way to facilitate reflective learning Program gets concrete information about an individual and (in time) how they compare to peers Sharing the log with faculty can help drive clinical teaching by focusing on areas not yet experienced by the student
What will be recorded in the log? Each rotation has decided what clinical encounters and procedures are mandatory and these items appear in the picklists. Items may also be counted if they are encountered in a different rotation. A minimum number for each encounter or procedure is also stipulated (in most cases just one needs to be seen) as well as the scenario (real patient or other) and the role of the student in the interaction.
Do students need to record all activities? Students need ideally to record ALL events so that we can establish a database of the average experience. Encounters or procedures that are not on the pick lists need not be recorded but it may be valuable to track these using the “others” pick for reflective leaning but these entries will not appear on the reports and will not count towards a students total activity.
Mid-rotation evaluation: • Students are requested to print out 2 reports from the Web in PDF format and bring them to the mid-rotation evaluation with their preceptor / rotation director. In addition the student will receive an email from the database during week 3 of each rotation reminding them of incomplete items thus it is important that their data entry is up to date.
End of rotation evaluation(1) • Students will receive a second e email generated again during week 5. The rotation director will receive a copy of the e mail and the student must follow up with the rotation director regarding any items which remain incomplete by the end of week 6. The director will advise on appropriate remediation of incomplete items.
End of rotation evaluation(2) • Students must hand in a final copy of their reports at the end of week 6. For any incomplete items a remediation plan must be documented and approved by the rotation director. (e.g. extra clinic, virtual case). Students must complete all required activities during the 3rd year Clerkship.
End of rotation evaluation(3) • In each rotation, the Rotation Directors Clinical Clerk Evaluation form includes a box marked: • “Clinical activity log completed” Yes/No • The coordinators should tick this box only when the student has completed all activities.
What happens if students do not fulfill the requirements? • The requirements should be easy to achieve in any given rotation • Students must complete all required activities during the 3rd year Clerskhip • Items that remain incomplete will continue to be tracked until completed and failure of the student to participate in the process may result in an evaluation remaining incomplete or other comments on their professionalism.
Will the e log be audited? • Completion of the log on T Clerk is an honors system. Honesty and professionalism are obviously integral to physician’s professionalism. • Just as CME is audited for practicing physicians, we may perform a random audit. Attendance at rounds or lectures covering mandatory cases will be audited through sign-in sheets. • Fabrication of data entry by the students will be grounds for failure as is any other dishonest action.
Orientation • All instructions for downloading and using T Clerk are available on the Faculty webpage.
Getting started • Check your email for log-in info, username & password • Log in to WWW.T-Res.Net • Use Web to record activities if you wish • PDA Users: • Download and install PDA application • Perform a Hotsync • It will ask for user name & password (install worked!) • After collecting activities, Hotsync and check the web
Getting started • Check your email for log-in info, username & password • Subject: T-Res welcome email • Dear (student name): • Welcome to T-Res! • Your username is: (username) • Your password is: (password) • You have been added to the Ottawa Undergrad program. • Please notify us at firstname.lastname@example.org if this is not correct. • You can login to our website at www.T-Res.net with your user name and password. • What is T-Res? • --------------
Explanation of the fields • Mandatory fields: • Patient Encounter / Procedure relate to Problem / Procedure fields respectively. These contain the alphabetical pick lists of items. These fields can be expanded for multiple entry using the + and the duplicate entry function helps if more than one item seen on seame patient. • Date defaults to current date • Rotation will stay as set until changed • Site and Setting • Scenario is the modality in which the encounter /procedure was experienced eg Real patient, simulation lecture etc. • Role of student in the interaction
Minimum No., Scenario & Role • A separate excel file is supplied which may be retained on paper or the PDA for reference which gives; • Minimum no. of each case to be seen in each rotation • Scenario: Whether case must be a real patient (if not real, it can be any other scenario) • Role of student for each type of case • Students may also wish to use a paper version of the excel file for recording and later entry into Web or PDA.
Tracking your progress • Students can log onto the web page to obtain reports on the cases seen and whether they have met the requirements for that rotation. • The global find feature in the PDA can also be used to sort and count cases seen in the intro screen in T Clerk. • Clerkship directors can print off reports on the class from the web and track students with incomplete logs
T Clerk Questions Student rep tba Dr. L. Oppenheimer email@example.com Technical Support MedTech University of Ottawa (tba) T Clerk Support@T-Res.net (604) 693-2323 or (866) 694-2323