Over the years that Clinical Distinction has been a TUCOM course, we have had only positive feedback from faculty who have been involved. They tell us that they enjoy working with students who are engaged in adult learning, that they are impressed by the students creative and passionate work, that they are interested in the student focus on EPAs and competencies.

While it might take some explanation, adjunct faculty who hear “I’m excited to work with you at your clinic and have drafted a contract of learning which describes a specific area I would like to focus on while I’m here” often have one or more of the following reactions:

• Who is this student who is taking initiative to create learning goals for themselves?
• This will make my job easier, since I know the student is looking to be engaged and self motivated
• This might be a more interesting month

Of course there are often questions like

• What do I have to do?
• Is it more work for me?
• Am I qualified to assess entrustability?

But these questions are easy to answer:

Work for the Preceptor:

• For specialty tracks, rather than completing a Preceptor Evaluation Form, the preceptor sponsoring a student would complete the narrative evaluation form.
• The exit interview, which should be part of any clerkship, is a strongly suggested part of Clinical Distinction. This is a live or virtual meeting between the preceptor and student to review the project plan, successes and obstacles, and the student’s self-evaluation.

Qualification for assessing entrustability

• Physicians are uniquely qualified to assess a student’s level of entrustability
• The rubric is so intuitive it rarely requires any training.
• Here’s a translation of the levels of entrustability to the language a preceptor might more readily recognize:

Level 1: Not allowed to do the EPA

• 1a Not allowed to observe –> “Please wait here and do some reading.”
• 1b Allowed to observe,–> “Watch me do this.”

Level 2: Do with full direct supervision

• 2a Coactivity with supervisor –> “Let’s do this together.”
• 2b Supervisor in room ready to help–>  “I’ll watch you.”

Level 3: Do with supervision on demand

• 3a Supervisor immediately available all findings checked –>   “You go ahead, and I’ll double-check all of your findings.”
• 3b Supervisor immediately available key findings checked–>  “You go ahead, and I’ll double-check key findings.”
• 3c Supervisor distantly available (phone) findings reviewed –> ( in most instances, a student must be licensed ( intern), for a supervisor to allow this level of supervision, therefore most students can only reach this stage hypothetically.