LCME Element 10.8 – Visiting Students
A medical school does all of the following:
- Verifies the credentials of each visiting medical student
- Ensures that each visiting medical student demonstrates qualifications comparable to those of the medical students the visiting student would join in educational experiences
- Maintains a complete roster of visiting medical students
- Approves each visiting medical student’s assignments
- Provides a performance assessment for each visiting medical student
- Establishes health-related protocols for such visiting medical students
- Identifies the administrative office that fulfills each of these responsibilities
Hidden Curriculum
Face it, Element 10.8 requires medical schools to deploy a battery of functions in a condensed timeline for a very transient student population. It is understandable if an institution questions the energy expended to host visiting students, except when the value of these experiences is placed in the larger context of career exploration, residency recruitment, and institutional reciprocity. Through this element, the LCME seeks to ensure that visiting students are vetted prior to arrival and then afforded the same safety and educational measures as home students. Comparability is a key takeaway for this element. Visiting student qualifications must be clearly defined and comparable to those of home students, and services and clinical supervision must also be comparable. Visiting students cannot be an afterthought. Achieving these aims requires an explicit workflow with clearly delineated roles and responsibilities to ensure that there is equitable and organized access to professional opportunities.
Best Practices
Make a policy, an LCME oldie but goodie! Create a policy that outlines the requirements and qualifications for visiting domestic and international students, defining the coursework and board exams they must complete for eligibility. Ensure these qualifications are comparable to those of your institution. For instance, many schools only extend clinical elective capacity to visiting students, requiring successful completion of core clinical courses and the Step 1 exam. Within the policy, document the entire process, indicating the responsible parties for the management of application, approval, arrival, and assessment (unintentional alliteration). Clearly mapping the workflow will allow an institution to more easily respond to DCI questions. Here are other topics that a policy can clarify: provision of housing; coordination of institution-specific assessments (more on this later); and course allowance per student (e.g. limit one course per student to mitigate a VSLO flood).
Lean into centralization. There are many moving pieces involved in the review and acceptance of visiting students. It is in a program’s best interest to centralize functions as much as possible for efficiency, and clarity. The AAMC-sponsored Visiting Student Learning Opportunities (VSLO) is an excellent tool to streamline the process. Students can submit application materials, including transcripts, health documents, and institutional certification of malpractice insurance, through a single portal. Further, the platform enables the exchange of affiliation agreements between schools in an expedited fashion, as well as offers a reliable data source for rosters.
Keep on centralizing. Identify the staff member(s) responsible for managing the intake of applications, communication with clinical departments, and student onboarding. Ideally, the position is centrally located within student affairs to better facilitate the collection of health documents and dissemination of health protocols. A centralized team can also conduct rolling orientation sessions at the start of each new wave of students – another best practice that is highly recommended. If your program opts to centralize operations, it is essential that the clinical department and regional campus leadership understand the common approach to visiting students and are well-connected to central staff. Clinical departments/regional campuses and their coordinators are key partners in verifying capacity and approving visiting students’ assignments.
Figure out assessment logistics. Assessment is a dimension of visiting students that can grow in complexity and it is a common accreditation pitfall. A school has an obligation to ensure that every student receives an assessment and accommodating every institution’s unique assessment may not be sustainable. A more practical approach is to establish that all visiting students will be assessed using your program-specific form. If visiting students have institution-specific evaluations, then establish whether and how your program will accommodate such requests. For instance, is it the visiting student’s responsibility or does your program have resources to manage an array of evaluations?
Continuous Quality Improvement
Clinical capacity is a precious resource, and many programs struggle to secure it for their own students as the economic pressures on healthcare systems increase. A program must first ensure its home students have secured clinical assignments before offering capacity to visiting students. As part of CQI, a program should schedule an annual review of the previous year’s use of clinical capacity to determine what specialties and locations require expansion and if visiting students can be accommodated.
Additionally, design student feedback forms in a way that allows the program to filter and aggregate input from visiting students in a de-identified manner. As part of the evaluation process, schedule agenda time for the relevant curricular committee to review the data and respond to issues. Since the focus of these forms centers on student feedback about the clinical experience, a program may also consider sending visiting students an evaluation about onboarding and support provided by central staff. Data from this type of evaluation allows staff to take greater ownership of their operations, creating student-centered processes.
0 Comments