University Clinical Skills & Simulation Center
Undergraduate Medical Education Programs
The UCSSC develops, produces and evaluates simulation components of the undergraduate medical school curriculum. In working with the Dean of the medical school, the UCSSC team has developed, supported, and evolved many simulation-based teaching and evaluation programs that cover the scope of the undergraduate years in a longitudinal manner. We are striving to become the recognized leaders in this field.
Key Points in UME Simulation Curriculum
- All student-physicians at Jefferson, currently over 1000, use the UCSSC on a regular basis and as a component of a graduated, longitudinal clinical skills curriculum
- Averaged over the 4 years of their medical school education, each medical student will spend a minimum of 72 hours per year of structured Clinical skills teaching and evaluation per year in the UCSSC
- There are no fewer than 47 UME programs currently being performed in the UCSSC
- The UCSSC has developed and produced evaluation and assessment tools including our “high stakes”, end-of-third year OSCE to make certain that our graduates are not only competent, but exceptional, in their clinical skills
- Faculty from the UCSSC are international leaders in the teaching and study of the skills in Physical examination
Examples of Programs in the JMC Preclinical Years
- 16 site specific surface anatomy sessions in the Human Form and Development (HF and D) course. (Course Co-directors, Vince Armenti and Hector Lopez). These sessions use SPs. All students spend at least 1 hour in 6 small groups, in a round robin fashion with Joseph Majdan, Katherine Berg and Dale Berg teaching surface anatomy. Each student (n = 262) performs this 16 times over the duration of the course-topics include back, spine, heart, lungs, abdomen, liver, elbow, shoulder, lymph nodes, thyroid, CN 7, CN5, ankle, knee, pelvis and hernia. This program is unique to Jefferson and has been reported in abstracts to the NEGEA, SGIM, and Ottawa Conference. Curriculum and checklists designed and implemented by Dale Berg and Katherine Berg. We work directly and intimately with anatomy faculty in the course. In addition, we supply SPs for each anatomy practicum.
- Teaching History taking to the first year students (Course directors Chris Jerpbak and Bill McNett). All students have an encounter with a standardized patient who has been trained with a specific diagnosis and thus can give a specific history. The SP trained to evaluate history via checklist and gives feedback to student; student-SP encounter is videotaped, via the DAVS system. Video clips are given to student for review and to take to small groups for evaluation by peers and faculty.
- One-week immersion course to teach physical examination skills. (Course Director, Sal Mangione; Course Co-Directors Kate Berg and Dale Berg) Day one demonstrates the entire physical examination checklist designed for second years on a SP using video projection. This is followed by a through demonstration of each section of the physical examination with ample time for skills attainment and some structured practice using checklists and scenarios developed by faculty at the UCSSC. SPs from our pool in addition to Harvey and other low fidelity simulators are used in this teaching; all under the tutelage of UCSSC faculty.
- Small group clinical skills for skills attainment and structured practice. The skills sessions are composed of 4 venues of 45 minutes each and are directly coupled to the topics being taught during the student’s Foundation of Clinical medicine course. Each M2 student rotates in a round-robin fashion in the UCSSC to work on a standardized checklist with a trained SP, to use simulation to learn abnormal findings( e.g., the use of Harvey to teach heart sounds), specific difficult parts of the checklist with faculty member and specific, more challenging aspects of the examination, on simulated and standardized patients under the supervision of Center faculty.
- End of second year physical examination OSCE. At the end of second year, every second year student-physician must pass a one station physical examination OCSE based upon the checklist.
Examples in the JMC Clinical Years
- Orientation Program for Surgery third year clerks. Every 6 weeks (8 times/year) the UCSSC supports and sets up simulations to teach basic skills including IV, Foley catheters, ABG, suturing using both standard boards and “Pigs-feet”, NG tube placement, scrubbing in, sterile technique.
- Orientation program for OB/GYN third year clerks. Every 6 weeks (8 times/year) the UCSSC supports and sets up simulations to teach basic skills in OB/GYN.
- Advanced Physical Diagnosis Course (Medicine 474). Immersion course in advanced clinical skills, especially physical examination-has teaching venues and formats that include the classroom, simulation and bedside teaching. UCSSC supports this course and it is run by the Co-Directors of the UCSSC. Offered for the months of September, December and February. Immensely popular course, involves over 110 hours of direct faculty teaching time and has significant interdisciplinary components. The course is unique to Jefferson; it is the signature course of the UCSSC.
- Objective Structured Clinical Examinations: For the past 5 years, JMC has had an end of 3rd year, high-stakes 11 station OSCE. All students must pass this OSCE. If they do not, they are required to take a Clinical skills remediation course in the Fall of their 4th year. Cases are developed with Clerkship directors from every clerkship in the 3rd year. Skills assessed include communication, history-taking, and physical examination.
- Simulation skills sessions for 4th year students in Emergency Medicine (Dr. Paul Kolecki). This program utilizes Simman and low fidelity simulation to foster emergency specific skills attainment and structured practice of these skills.