Groups & Initiatives
fmCases—Virtual Case Curriculum for Students
STFM has partnered with iIntime, a
non-profit institute out of the Dartmouth Medical School, to develop a
computer-assisted learning curriculum in family medicine, consisting of virtual
patient cases. The project, called fmCASES, is designed to teach the family
medicine core clerkship curriculum in a manner that permits the program to be
completed by an average medical student during an average clerkship in family
medicine.
What Is fmCASES:
Designed for the family medicine clerkship, fmCASES is a set of on-line, virtual patient cases that lead medical students through the full breadth and depth of family medicine. Each case typically leads the student through the initial history, physical examination, and laboratory assessment of a patient. The case engages the student with the story of this person’s care, and with clinical reasoning and management challenges.
The Cases:
The full set of cases includes 29 original cases, with 4 more under construction. In addition, 5 cases from CLIPP, the pediatrics clerkship cases, and 2 cases from SIMPLE, the internal medicine clerkship cases, are designated for family medicine clerkship directors to consider inclusion in their curriculum, if the student has not already completed those cases on other rotations. Each case consists of 20-30 “cards” or html pages. Typical time required to complete a case is about 50 minutes. The student can start the case, complete a few cards, and then stop. When the student returns to continue the case, the software remembers the stopping point, and brings the student to that card.
The Purpose of the Cases:
The clerkship director may choose to incorporate all or some of the cases into the clerkship curriculum. The director may require or
recommend some or all of the cases, to some or all of the students. Some directors, for example, require a specific collection of the
cases; and then assign other cases on an “as needed” basis to help students fill gaps in their clinical experience or knowledge base. Use of the cases provides the clerkship director with a convenient and effective way to address the Liaison Committee on Medical Education’s (LCME’s) requirements, including ED-2.
ED-2 stipulates that “... a system be established to specify the types of patients or clinical conditions that students must encounter and to monitor and verify the students' experiences with patients so as to remedy any identified gaps. The system, whether managed at the individual clerkship level or centrally, must ensure that all students have the required experiences. For example, if a student does not encounter patients with a particular clinical condition (e.g., because it is seasonal), the student should be able to remedy the gap by a simulated experience (such as standardized patient experiences, online or paper cases, etc.), or in another clerkship.”
One of the real benefits to the preceptor, in using fmCASES, is that the preceptor can work from this curriculum when teaching students. The preceptor can, for instance, say, “I know you completed the cases covering asthma and COPD already. So tell me – what’s the difference between the two? ”The preceptor can check understanding. But, beyond that, the preceptor can now spend time teaching the more varied aspects of practice, and say, for example, “So, knowing what you already know about Pulmonary Function Testing, what do you make of THIS patient’s PFTs?. And, therefore, what would you recommend for our management approach?”
Objectives:
fmCASES' objectives address the curricular objectives recommended by national projects. The objectives cover the core content recommended by the Society of Teachers of Family Medicine’s (STFM) task force convened in 2009 to create the Family Medicine Clerkship Curriculum document. Also informing the curricular objectives are those recommended by the Family Medicine Curriculum Resources project, a 4-year and 2 million dollar, HRSA-funded project completed in 2004. The objectives also include work completed by STFM’s task force to the National Board of Medical Examiners – convened to improve the NBME’s Family Medicine Clerkship Subject Exam.
Peer Review, Student Feedback, Continuous Improvement
All cases undergo rigorous peer review and student feedback, with revision to address recommendations. Once in final form, a Case Editor is appointed to keep content medically accurate and current with research findings and consensus recommendations. The Case Editor also continues to use feedback from faculty and students to improve the cases.
Click HERE to access fmCASES.
