(l-r) Michael Szul, Heather Nostrant, Ashish Pathak (on the tablet), Sara Elizabeth, Mark Moody. (Not pictured: Robert Pastor and Ethan Preston.)
Over the past year, you have heard about the development and rollout of Virginia Medicine (VMED), an integrated learning-, curriculum-, and student-management system. Last year, we discussed the first iteration of the interactive Clinical Activity Navigator (iCAN). I wanted to share with you a few improvements associated with the release that went live last month.
Our medical students are required to acquire specific clinical skills, called entrustable professional activities (EPA). These are 13 core skills a physician should be able to perform (with indirect supervision) by the time they graduate. These include taking a patient history, performing a physical exam, determining a differential diagnosis documenting, documenting an encounter, performing basic procedures, collaborating as part of an interprofessional team, and others.
A recent impactful change to the iCAN tool is the addition of “Required Clinical Encounters.” These are clerkship-specific lists of Clinical Skills and Clinical Conditions that students need to complete and get approved by clinical faculty.
Previously, clinical faculty were required to digitally approve students’ checklist of encounters and experiences. This approval involved reminder emails to faculty which required them to sign into Oasis and approve the student’s work. The process, however, was an exercise in basic workflow. It added no value for the faculty or the student, or to the validation of the work. It was wasteful.
As of February, iCAN now relies on the University’s strict honor code for the fulfillment of the clinical skills and clinical conditions checklists. If our students say they have experienced these encounters, we trust them. We have no reason to doubt our students’ integrity.
Why did we remove the faculty approval, though? It was only a simple login and a checkmark, right? How is this change helpful? While it only takes a faculty member a minute to perform the approval, the math bears out the waste when viewed in the aggregate. At an estimate of one-minute per item, cutting out the 33,686 checklist items from the flow of work, we will see an annual savings of 561 hours, affecting 876 physicians. Broken down per individual, it may not seem like much, especially over the course of a year. But the time savings is only part of the equation. While the freed-up time is nice, just as important is removing the “one more thing” interrupting our educators’ days.
Other new features of the latest iteration of iCAN include supporting EPA #3, which covers a student’s ability to recommend and interpret diagnostic and screening tests. iCAN also now allows for EPA assessments by our Family Medicine and Ambulatory Internal Medicine preceptors, many of whom are often in remote locations.
I am enthusiastic about iCAN and, of course, VMED as a whole. This latest iteration is an example of how we’re improving the student experience (by exhibiting trust), providing value for educators in the clinical setting (by removing waste), and making things within our work systems simpler (one less thing to do).
iCAN and VMED will continue to be refined. Feedback is always welcome, though, so please reach out to Mark Moody and the application development team (Sara Elizabeth, Heather Nostrant, Robert Pastor, Ashish Pathak, Ethan Preston, and Michael Szul) at mededweb@virginia.edu with questions or suggestions.
Thanks to Dr. Maryellen Gusic for being the driving force behind iCAN, and to Mark and the development team for their dedication to our students and faculty.
R.J. Canterbury, MD, MS, DLFAPA
Wilford W. Spradlin Professor
Senior Associate Dean for Education