Authors: Ryan Palmer, EdD; Joy Checa, MD, MSc, MBA
Medical education is increasingly moving off-campus. Reasons for this shift are many, but some reasons include mission-driven programs such as rural and community track programs that require students to spend a significant portion of their clinical education off-site, and increased clinical productivity pressures for on-campus faculty that shift clinical teaching to off-campus preceptor sites. Many institutions without local clinical sites require that all student rotations take place away from the home campus. Schools with extended distance education needs often struggle with how to create a sense of community with a spatially dispersed student body, many of whom do not return to campus for months, or even years, at a time. The question is how does an institution create a sense of community with on-campus faculty and peers when their students are at a distance for a prolonged period of time?
American University of the Caribbean School of Medicine (AUC) approached this issue head on with a Transition to Clinical Medicine (TCM) Community Mentorship Program. AUC has created interactive, longitudinal virtual peer groups for a student body that does all of its third- and fourth-year clinical rotations off-campus. Students at AUC spend their first two years of medical school on a geographically contained campus in Sint Maarten and report high levels of camaraderie and sense of community with peers and faculty during this time. Upon entering their clinical rotations, these same students are dispersed for the next two years on clinical rotations that take place in varying locations across the US, Canada and the United Kingdom. This transition can be jarring for students who are used to seeing their peers every day, and many students reported feeling “lost” and “on their own” as a result.
To address this issue, AUC’s Executive Dean Heidi Chumley enlisted Dr. Ryan Palmer (one author of this post) to build a new program for AUC based on his unique approach to synchronous, real-time online education, called the Palmer Method For Delivering Synchronous Online Education. In this approach, small groups of learners meet in a live, online meeting environment and participate in interactive student-focused educational activities designed to build community and professional camaraderie. This approach was applied at scale to help create the TCM Community Mentorship Program. In the TCM Community Mentorship Program, 7 recent AUC graduates, in the role of Clinical Fellows, are employed full-time by AUC to facilitate small groups of 8-10 third-year students in synchronous online meeting spaces once a week for five weeks just before the start of clinical rotations and then monthly for a year. Students and Fellows meet for 1-2 hours at a time using an inexpensive, cloud-based videoconferencing technology called Zoom (www.zoom.us) that is easily accessible on laptops, tablets and smartphones so participants can connect anytime and anywhere using only an Internet connection (free dial-in options are also available if Internet connectivity is unavailable). Curricular activities of these group meetings are deliberately designed to foster a sense of virtual community. Fellows also meet weekly with Dr. Palmer and Dr. Checa, AUC’s inaugural Chief Fellow and now Clinical Sciences Project Manager, to foster their own virtual community, sharing best practices and emulating the online learning environment they will bring to their student groups. The TCM Community Mentorship Program is now in its second year, with over 500 students in over 60 small groups having participating in the program. Program evaluation is ongoing. This innovation has been presented at several regional, national, and international conferences and received a consistently positive response from medical educators.
This curriculum and technology, which are being used across two continents and multiple time zones, can also be used effectively at other institutions for learners in close proximity.
Check out our interview with Dr. Palmer for more information!