Medical Education and Technology

ePortfolio: A Patient and Procedure Tracking System

MedEDTech and the Clerkship faculty have created a flexible and extensible electronic system for patient and procedure tracking in the clinical setting. The driving force behind this project was the third-year Medicine Clerkship, whose curricular goals required a tool to engage students in self-reporting of critical educational activities.

Objectives: MedEDTech's challenge was to develop a system to satisfy the functional specifications and content requirements of the Medicine Clerkship, while creating an application infrastructure readily customized for other clinical clerkships.

Methods: The resultant system, called ePortfolio, is a database driven, web-based application that is fully integrated into the content and user management systems of the curriculum and the student web portal. Built using ColdFusion and Microsoft SQL Server, new variations of the application can be configured dynamically with simple changes to database settings.

Discussion: Version 1.0, launched in July 2005, was subjected to a year of testing by the students, faculty, and staff of Medicine Clerkship. Version 2.0, implemented in 2006, managed student-patient tracking through a basic pull-down list of course-specified diagnoses (or an integrated ICD-9 look-up table  for the Primary Care Clerkship. Tracking of self-reported completion of written H&P’s (which may be uploaded for transmission to faculty preceptors), clinical evaluation exercises,  student topical presentations, preceptor validation, customizable surveys, and administrative tools were also added.

By 2008, all third-year clerkships have adopted the ePortfolio and Clerkships are increasingly taking advantage of the ePortfolio tracking capabilities to add clerkship-specific processes to the system. Multiple clerkships have linked their ePortfolio to interactive clinical case experiences. The Neurology Clerkship, working with MedEDTech, has authored 15 interactive clinical tutorials that mimic the types of patients and environments encountered by the students. The Primary Care Clerkship has authored similar modules to support many of their monthly seminar topics. Pediatrics 401 offers students opportunities to interact with 33 virtual patients via the commercially-available CLIPP cases (Computer-Assisted Learning in Pediatrics Project), cross-referenced with the 15 diagnostic ePortfolio categories students are expected to document in the clerkship. Medicine 401 has begun incorporating Simulated Internal Medicine Patient Learning Experience (SIMPLE) and Surgery 401 had adopted the Wise MD-Surgical Modules which have been licensed for UCSD from the same commercial vendor as the CLIPP cases.

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