Multidisciplinary Ambulatory Experience (MAX)

The purpose of the MAX project is to examine a health problem from a societal and public health perspective. It provides an opportunity for students to bring together the range of clinical and community experiences of the 3rd year to develop comprehensive approaches to health care problem solving. The project culminates in a 20 minute PowerPoint presentation to faculty and peers.

All physicians should have a good understanding of the epidemiology and risk factors for health problems commonly encountered, as well as the influences of the particular ethnic, racial, environmental, and socioeconomic culture of the populations they serve. In addition, community health resources are often essential for patient care.

The purpose of the project is to examine a health problem from a broad perspective. In their clinical experiences, students have given presentations on the clinical management of common diseases. The MAX Project provides an opportunity for students to bring together the range of clinical and community experiences of the 3rd year to develop comprehensive approaches to health care problem solving.

The MAX project should take students' knowledge and skills to the next level (i.e., to identify ways of addressing a problem in prevention or disease management for a population of patients).

The project should:

• build on skills from clinical care, community experiences, case presentations and evidence based medicine,
• demonstrate an understanding of the epidemiology,
• identify the social, psychological and cultural context of the issue,
• include the patient's perspective as well as the physician's,
• identify controversies, future directions and make recommendations,
• utilize literature, attendings, and discussions with community programs, and
• develop a comprehensive approach to a health care problem.

The project culminates in a 20-minute oral presentation in PowerPoint and electronic submission of the presentation and references, including three to four annotated references.

The topic chosen for this project should be a health condition that is fairly common in ambulatory care, and that is amenable to improvement through changes in doctor or patient behavior, new health care delivery and/or information for patients.

Selection of the topic may be based on a:

• primary care topic in which the student has an ongoing interest - this might lead to a 4th year Selective project,
• patient seen during clinical experiences, or
• problem suggested by clinical preceptors.

Students must discuss the project (to identify ideas, approaches and resources) with one of the committee members listed below. For those uncertain about where to begin, discussions with the faculty on the committee or with Dr. Brown may be helpful. The committee consists of faculty from the major clinical disciplines. They can help students select a topic and address the project guidelines. They are available for telephone and email consultation. 

Students will receive a reminder to consult with a MAX Project Committee member. At least 4 weeks prior to the presentations, students must submit their project topic. This should include the title of the presentation, brief description of the topic and name of the committee member with whom the project was discussed. In addition, students must submit a draft of the PowerPoint a minimum of one to two weeks before the Homeweek presentations. This will allow time for feedback from the MAX Projects committee. The final PowerPoint presentation must be submitted during the Homeweek. All submissions should be emailed to Rasy Mar (mar@uchc.edu). Presentations will not be allowed if work is not submitted.

The presentation must begin with why the topic is important to the overall health of the population. It must also include:

• General Epidemiology: overview of the incidence and prevalence of the condition and risk factors; race, ethnicity, geographical, age, family history, etc.
• General Clinical: discussion of diagnosis, treatment and management in a primary care setting
• Community: a brief description of community resources that have relevance for this condition (strategies, programs, target population); and specific information collected from two community organizations/services. (Note: the latter should not be clinical care or a list of websites, although a few websites can be included as references.)
• The focus of discussion should be on the key issues for improving care or prevention for the topic. Ways to focus this might be:
• controversies in medicine (i.e., prostate or colorectal cancer screening),
• emerging problems intervention (i.e., multi-drug resistant tuberculosis, or West Nile virus),
• alternative medicine (i.e., value of specific herbal remedies, referral to other providers),
• doctor-patient relationship (i.e., working with translators, improving patient adherence), or
• answers to commonly asked questions (i.e., how to reduce cholesterol, whether to take aspirin to reduce CV risk).
• Costs and outcome considerations
• The student's recommendations on the topic
• References and a brief annotated bibliography of three to four references (this means providing a short description of the type of article, major value, weaknesses)

The presentation will be evaluated based on coverage of the above areas, as well as the organization, clarity and quality of visual materials, presentation skills and references.

The presentation will be limited to 20 minutes and must briefly cover all of the above areas. Students should pick one area of focus and devote more time to this. There will be 10 minutes of discussion following the presentation. The presentation will be evaluated for content (including level of recommendations), clarity, organization, relevance, use of appropriate audiovisual materials, general oral presentation skills and quality of discussion. The references and annotated bibliography will also be evaluated. Committee members will evaluate the presentations and electronic submissions.

In addition to the library, the Community Based Education Office has resources that may be useful for projects. These are MAX projects from previous years, patient information materials, community programs and other information. Students may access this information during regular workday hours, by appointment (Joanne Lamothe, 860-679-3482) or by visiting the community based education website. In addition, PowerPoint assistance is available through the Information Technology Support Services Department.

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PowerPoint presentations, overhead transparencies, and slides can enhance a presentation. These are some guidelines to insure effective visual aids:

• Type sizes of 18 point (this print is 18 point) and preferably 24 or higher are easier to read
• There are two styles of type: Serif (with extra lines/squiggles accenting the letters i.e., Times New Roman) and Sans Serif (without the extra lines/squiggles, i.e., Arial). Sans serif styles are easier to read.
• Lower case letters have better letter recognition.
• Avoid underlining, italics or other font treatments that make for difficult reading.
• Additional spacing between lines and letters increases the readability of the text.
• Stay away from the edge of the page – allow a minimum of one and a half inches around the page.
• Use small amounts of information to avoid visual confusion (i.e, use key phrases or concepts, not complete sentences and paragraphs).
• Do not read slides, use them as points of reference for the audience.
• When using material from a text, such as a table, enlarge it or re-enter it before putting it in a slide— scanned material doesn't automatically enhance a presentation.
• Avoid materials that require apologies: "I know you can't read this, but…"
• Make sure there is contrast between the type font and the background
• Do not use a background that distracts from the written information
• Remember the Golden Rule of Presentations: "Present to others as you would have them present to you." Or, put another way, remember all the lectures you have complained about during your education and put into practice engaging methods.

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MAX Committee Members

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