By: Jeffrey Manko, MD | Director of GME Professional Development, Director WISE Programs, Medical Director of GME/CME at NYSIM, Associate Professor of Emergency Medicine | NYU/Bellevue Medical Center
WISE-OnCall is used by programs across medical and health professions education to help learners diagnose and manage clinical situations they are likely to encounter on clinical clerkships, advanced sub-internships, and during the transition to residency or practice.
Faculty, deans, and program directors note that the information, knowledge, and experiences in the modules apply to advanced practice providers in addition to physician trainees. A growing number of medical and physician assistant programs are currently using WISE-OnCall during their clinical rotations and to support the transition to practice.
About the Modules
WISE-OnCall’s symptom-based modules focus on acute medical conditions such as abdominal pain, dyspnea, oliguria, sepsis, and hypertension. Each of the nine symptom-based modules includes a review of the common underlying causes and the differentiating features of each. A video case presentation shows a realistic scenario where the learner performs a thorough step-wise evaluation–including a focused history and physical examination of the patient, review of the medical record, communication with the nurse, and management plan including appropriate diagnostic tests. Throughout the module, the scenario models communication, professionalism, and interprofessional cooperation. Each module concludes with practice cases and self-assessment questions.
- Abdominal Pain
- Acute Chest Pain
- Acute Pain Management
- Certifying a Death
- Documentation for Patient Safety
- Fever and Sepsis
- Loss of Consciousness
- Lower Extremity Pain
Integrating Across the Curriculum
We’ve heard from MD, DO, and PA students that the experience of going through these modules builds comfort and confidence in their ability to work in clinical settings. Increasing their exposure to these clinical scenarios provides a systematic approach to managing medical information and a deeper understanding of roles within interprofessional teams.
Below are some successful integration strategies that we’ve heard from faculty users:
1) Transition to residency or practice
Many students have completed their clinical rotations long before graduation and feel a need to refresh their skills prior to assuming the responsibilities of a junior resident or apprentice clinician. The WISE-OnCall modules provide an excellent source of information that is appropriate to prepare these learners for clinical duties. Some schools recommend a review of the modules near the time of transition. Teaching hospitals and clinical facilities also assign modules to incoming residents and allied health care providers as an adjunct to their orientation programs to ensure that incoming providers have a uniform baseline of knowledge.
2) Prep for clinical rotations & sub-internships
WISE-OnCall modules are an ideal prep tool for students entering a sub-internship or clinical acute care rotation or clerkship. The interdisciplinary content in the modules covers key topics in internal medicine, surgery, neurology, gynecology, critical care, and emergency medicine. The content helps learners prepare for patient encounters, providing them with an organized approach to evaluation and management of acute situations. The modules emphasize a thorough focused assessment of the clinical situation. More importantly, the WISE-OnCall modules stress the importance of recognizing life-threatening situations (pulmonary embolism, emergent hypertension, ischemic limb, sepsis, etc.) and escalating in order to assure prompt treatment.
Learners report that the WISE-OnCall modules improve their performance on the wards, and help them feel much more confident in being the first-line responders.
3) Prep for OSCE or other simulation activities
As simulation has become an integral part of medical school and allied health curricula, WISE-OnCall modules serve as excellent preparation for these encounters. Review of a specific module such as chest pain, hypotension, or loss of consciousness can greatly enhance the experience for the student in managing such a case in the simulation laboratory.
4) Just-in-time learning on the wards
With WISE-OnCall modules readily available, learners can access the WISE-OnCall modules for a quick review or reference when encountering a patient with an acute situation. These situations reinforce the important findings that should be considered, and a framework for arriving at an appropriate diagnosis and plan of management. They also highlight the most life-threatening and “can’t miss” diagnoses.
5) Flipped classroom teaching
The online modules provide an excellent opportunity for faculty to devote time with learners to discuss the intricacies of clinical presentations and work through a differential diagnosis rather than a didactic review. After students complete a module in advance, faculty can form a discussion or tutorial around the diagnosis and management decisions in the clinical scenario.
6) Incorporating clinical correlation in foundational courses
Although the management of acute clinical situations may be too advanced for beginning students, the portions of the modules addressing clinical presentation, the history and physical diagnosis, and inter-professional cooperation are excellent adjuncts to the teaching of anatomy, physiology, pathology, pharmacology, and practice of medicine. Reinforcing the clinical application of basic sciences helps to build a solid foundation for later courses and enhances students’ interest in the material. Early exposure to clinical scenarios while learning history-taking and physical examination skills provides increased knowledge retention.
To learn more about WISE-OnCall, please visit our website.