Instructions

These instructions, and the attached documents, represent our best practices following our experiences so far and will be updated frequently. If you have any suggestions for changes/additions, please let us know.

Research/Surveys

If you implement this program yourselves, please have students fill out both our call logs and our pre- and post- surveys before they start calls and after two months of calls, or after they finish making calls, whichever is first. This will allow us to track the efficacy of this project.

  • Pre- and post- survey (https://mdd.li/studentcorpsstudy) — these allow us to gather baseline (anonymized) data on the students who are involved
  • Call log surveys (https://mdd.li/postcall) — this is a very short anonymous, PHI free, survey for students to fill out after each call, so we can see how many calls are made and measure features of those calls

Consenting Patients and Privacy

Patient consent can generally be obtained in the same way it would be for in-person clinical visits, even though these calls are non-clinical. Consent can be obtained either ahead of time during a clinical visit or by another member of the team, or it can be obtained by the student at the start of the call.

Student notes should be ideally made in the EHR. If this is not possible, we have provided sample templates for making notes in Word documents. However, it is critically important that these notes are stored in an institutionally PHI-approved way.

For calls, students need to be able to call from the clinic number. Thankfully, at this time Doximity is providing use of their dialer for free, which allows students (and other clinicians) to make calls from the cellphones that appear to come from the clinic number. Instructions for that are here. It is very important to use this method, or something similar, to avoid exposing the student’s number, which may result in patients accidentally calling students when they want to call the clinic.

Student Integration Into the Team

In our experience, we have found that preclerkship students are generally most comfortable working with a single clinical mentor, while clerkship-level students work well with multiple faculty members, which is more similar to the clerkship model and provides the best educational experience for them.

It is our belief that the most efficient way to implement this program is to integrate students, including preclerkship students, as completely as possible into the healthcare team to ensure closed-loop communication and to avoid duplicate work.

This means:

  • Medical assistants, nurses, and other team members should be aware of the program and student
  • Students should have access to the EHR (Epic instructions for students below) and should:
    • Log all calls in the EHR as an encounter
    • Make a note for each call that can be seen by the team, and will be explicitly shared with
    • Use the EHR to communicate with the primary clinician and other health team members, which allows fast access to the patient chart from any emails.
  • Students should ideally be included in team huddles, particularly involving any medical assistants or other team members who may be also making frequent calls. These other team members frequently have additional candidate patients to enroll in the program.
  • Clinical mentors need to commit to guiding students through the process. Note that this is intended to be an opportunity to educate future clinicians as well as an opportunity to provide support to vulnerable patients. Time savings to clinicians are not likely to come until the second or third weeks as students become more proficient team members.

Student Onboarding

We have provided an example student onboarding document that can be given to students to explain the process. You should edit this document to include appropriate contact information for faculty mentors.

Most students are highly motivated to help during this time of crisis, so the most important parts of the onboarding are making sure students know:

  • Not to provide medical care of any kind
  • How to use the medical record (or other note templates) and the Doximity app to securely communicate
  • When to urgently contact their clinical mentor

Clinician Onboarding

Similarly, clinicians who volunteer to mentor students must be made aware that students cannot provide any clinical care. We have provided another editable document with instructions for clinicians here.

Resources

All of the resources are .docx documents in the GitHub repository, it is highly recommended that you alter them to meet your practice environment.

You can download all the documents as a package here: todo

Clinician and Department Resources

  • Preceptor Guide: This document is a template for use in onboarding clinicians and familiarizing them with the program. It includes a copy of the Epic template.
  • Consent Template: This is an example of language that can be used for before-time patient consent.
  • Doximity instructions: Instructions for faculty and students who want to use Doximity to call from personal cell-phones using the clinic call back number.

Student Resources

  • Student onboarding: A template for student Onboarding. Should be edited by the department to match department policies prior to use.
  • Example preclerkship script: Guidelines to refer to on each call with example language to use on the call.
  • Doximity instructions: Instructions for faculty and students who want to use Doximity to call from personal cell-phones using the clinic call back number.
  • Epic Instructions: Instructions for how to use Epic to create a new phone call encounter and note. Instructions are specific to the Stanford Epic instance, but should be similar for other institutions.
  • Call Tracking Log: An Excel spreadsheet that can be used for tracking calls over time. Take care to store in a PHI-secure way.

Templates

These templates can be used for making notes on calls.

  • Epic template: A template that can be added to your Epic SmartPhrases and entered into your notes with the .wellphone dotphrase. Includes instructions at the top for how to add it to your Epic instance.
  • Word doc template: A Word document version of the Epic template for those without EHR access. Be sure to store in a PHI-secure way.