of the CLICS program: to provide third year students with a safe
environment in which to discuss issues of professionalism, ethics, and
communication with patients. The goals of the program are to
encourage students to
relationships with their faculty group leaders
transition to the third year
self-reflection during the core clerkships
learn about specific
topics that are not addressed elsewhere in the clinical curriculum.
First year of the
grant (October 1998-September
1999) – a planning year
Second year of the
grant (1999-2000) – Dr. Lewin
piloted four individual cases introduced in four separate discussion
sessions during the Primary Care Track (PCT) small groups. These were
spread over the year and occurred at three sites: University Hospitals,
MetroHealth Medical Center, and Henry Ford. Student performance was
evaluated through OSCE stations at the end of the third year, when all PCT
students take a Generalist OSCE. PCT students who attended CLICS sessions
outscored non-PCT volunteers who did not attend CLICS sessions on the OSCE
stations linked to the CLICS sessions. Dr. Lewin provided a summary of
the 1999-2000 CLICS pilot program for third year students at the September
14, 2000 CME meeting.
Third year of the
grant (2000-2001) – expansion
of the CLICS program to the entire third year class under the
co-leadership of Linda Lewin, M.D., and Kathy Cole-Kelly, M.S., M.S.W.
One two-hour session on Tuesday during each four-week clerkship block
(4:00 to 6:00 p.m. on the second Tuesday of the block) was set aside for
CLICS sessions. Attendance is required. There has been no problem with
clerkship directors objecting to pulling students off their clerkships, as
year one (2001-2002) – The
course was revised and continued. Everyone now has a CLICS
syllabus book containing the topics, related reading materials, and a list
of learning objectives for each session in advance. There is now
flexibility in the order of topic coverage. During CLICS sessions,
students are free to talk about what has happened to them on the
clerkships, particularly as the experiences pertain to the reading and
learning objectives of the sessions. In this way, they are encouraged to
discuss challenging clinical situations from an ethical and
professionalism perspective and develop strategies for dealing with them.
Evaluation table of
the CLICS program by students during the 2000-2001 and 2001-2002 academic
Dr. Lewin referred CME
participants to her handout containing a table of student ratings of CLICS
session topics during both years. Each session was rated for 9 different
categories. An average rating of each category as covered throughout all
the CLICS sessions appears at the bottom of the page. Scores improved in
most categories this year over last year. Students rated the following
categories as particularly high:
This topic is
relevant to medical students at the third year level.
The faculty leader
did a good job.
This was a
The group members
had an opportunity to discuss issues relevant to this topic in a climate
receptive to all perspectives.
CLICS is on its way to achieving
its stated goals. Students have been receptive. The clerkship directors
have been supportive. Student performance remains ungraded again this
year. Dr. Lewin is a proponent of the third-year whole-class OSCE that
many hope to see realized. One CLICS goal is to have closer contact and a
central structure; right now everything is spread out. Plans for the
future include adding more CLICS sessions.
continued the presentation. Some CLICS topics are addressed in the
first-two-year ICM (Introduction to Clinical Medicine) curriculum but are
not included in the regular third year core curriculum. Continuity can be
achieved when some ICM preceptors (Years I and II) continue as CLICS
preceptors with their same small groups. However, there is a pool for
those students wanting to belong to different small groups. M.S.T.P.
(Medical Scientist Training Program) students are randomly assigned to all
At a recent class
meeting of present third year students, Ms. Cole-Kelly solicited 29
enthusiastic student responses to earn elective credit as fourth year
student preceptors for Year I and Year II ICM, CLICS, and the Interviewing
Skills Program. The talents of Ms. Perry Williamson, who will come in to
teach small group facilitation skills for ICM interviewing preceptors,
will be made available to CLICS participants. Ms. Williamson demonstrates
techniques applicable to small group teaching.
Dr. LaManna invited a
recommendation from the CME to endorse CLICS as a worthwhile part of the
curriculum that should be continued under current plans. Both Dr. Lewin
and Ms. Cole-Kelly both sit on the CRDC steering committee. Dr. Brandt
praised the CLICS program as an invaluable asset in our attaining such a
good rating in the recent LCME review. When questioned about funding,
since the grant ended last fall, both Dr. Lewin and Ms. Cole-Kelly felt
optimistic that the Patient-Based Program would support the program.
Resources are needed to make 150 books for CLICS and for faculty
The motion that the CME strongly endorse the continuation of the
CLICS program as a valuable part of the curriculum passed unanimously.