Monitor how many users have been logging over the last day or week. This gives an indication of the number of students (out of the total) that are actually logging their clinical activities.
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Instructions
Getting Started
The Clinical Rotation Evaluation and Documentation Organizer (CREDO) is fast, taking approximately 20 seconds per entry; efficient, for it continuously evaluates your status during a rotation; and is a critical part of your portfolio and maintaining the school’s accreditation.
Log in to CREDO using your school email address and the password you were assigned for this project; change your password after your first login.
Adjust your Rotation and Site or change your password as needed via the 'Account' option under the triple-bar icon in the upper left of pages. You can also tap the pencil on the main screen or the Rotation / Site indicator on the Patient Encounters screen.
Clarifying Requirements
CREDO was created by VCOM to improve student clinical training and assessment, and meet new medical school accreditation requirements. It began being phased in last year, with all third- and fourth-year students required to log their patient encounters.
This year, the phase-in continues. Required now for third-year students are:
- that all patient encounters (diagnoses, procedures and drugs) must be entered into CREDO;
- those entries are tallied in the Rotation and OMM Logs to automatically demonstrate fulfillment of items (clinical presentations, procedures, clinical skills, etc.) listed in those logs; each object in the logs also have a place for manual entries, for things like attending lectures, readings, etc.; and at the end of each rotation the student must digitally affirm that they have completed all entries contributing to those logs and have shown/discussed their entries and logs with their preceptors;
- preceptors must affirm that they have reviewed student’s CREDO entries and logs while determining their evaluation; and
- VCOM administration will only assign a grade after reviewing student entries and digitally signed logs in CREDO and having received Preceptor Evaluations.
All fourth-year students are required to log all their patient encounters. Also, students may complete their OMM Experience Logs which are now in the CREDO Dashboard.
When, Where, and How You Should Be Logging
- Entry into CREDO is the responsibility of each student. Log ALL patients you encounter, regardless of how many patients you see.
- Logging with CREDO should be done on breaks or after your shift, for your full attention should be on your patient and your preceptor during rounds.
- You must not be utilizing EMR systems to identify codes, for all entries are about your ability to document using the CREDO system.
- You are encouraged to discuss diagnoses, procedures and coding with your Preceptor, you should not be asking for specific help in making CREDO entries.
Fulfilling Rotation and OMM Log Objectives and Preceptor Evaluations
The objectives listed in Rotation and OMM Logs defined by the school can be fulfilled by an appropriate clinical diagnosis or procedural experience (via an entry, logged ICD code). As clinical experiences are logged, they will be automatically checked off. An objective can also be fulfilled by a Reading or Lecture as entered by the student.
For third- and fourth-year students, the rotation Preceptor completes an evaluation. This year, the Preceptor completes their evaluations on paper, in the portal. Next year, that evaluation will be done electronically, as part of the CREDO system.
For first- and second-year students, and International Outreach students, the appropriate faculty will review your entries.
Logging Clinical Experiences
For EVERY patient encounter, please create a new encounter entry. This begins with specifying a New Patient, and providing patient gender and age, the encounter environment by selecting either “Hospital” or “Ambulatory”, and any free text notes. Save this.
Then add a Primary Diagnosis for this patient encounter, an optional note, save it, and then you can enter additional diagnoses, procedures, and drugs (via ICD code descriptions) that are associated with that primary diagnosis for a given patient encounter. Please only enter the diagnoses, procedures and history pertinent to this patient encounter, not all from previous encounters or history.
There are several entry methods: Keyword Search, Hierarchical Categories, Smart Suggest, and Recent Entries. Most students use the Keyword Search to enter a diagnosis; alternatively the Smart Suggest provides a list of the most frequent diagnoses encountered in a given rotation. Since procedures and drugs are associated with a given Primary Diagnosis (and additional diagnoses that can be added), the Smart Suggest then includes the most frequent procedures or drugs associated with a given diagnosis. During a rotation, you may see patients that are similar; speed your entries using "Recent Entries."
For each diagnosis or procedure entry, you must input at least three digits of specificity; when searching, more digits may automatically be provided. You can enter more specificity than three digits if you desire.
After each diagnosis or procedure entry, they are automatically checked to see if they qualify to fulfill an object in the Rotation and OMM Logs for your rotation, and if so, you will be notified. You can also go to the Logs page of the dashboard to review your progress.
Optionally enter notes for patients, diagnoses, procedures or drugs; never enter any Patient Identifiable Information (PII). This can help your recall of a case to discuss with your preceptor, and help those studying your entries to identify possible new diseases, traits, public health issues, etc&ellip;
Once you have submitted all the diagnoses, procedures, and drugs for a given patient encounter, you can enter a new patient, or go back to the list of patient encounters, where you can review and also edit any of your previous patient encounters.
Using the Dashboard
Review, interact, and edit your Rotation and OMM Logs, diagnosis, procedure, and drug entries from the My Entries page in the Dashboard.
In the Dashboard you can review the summary sheet for each rotation, which is part of the Rotation Log for each rotation. That sheet summarizes the number of patients you encountered, quantifies the variety of diagnoses and procedures you experienced. The Rotation and OMM Logs, and summary must be shown and discussed with your Preceptor prior to them completing their evaluation.
The Rotation and OMM Logs, My Entries, and other functions in the dashboard are particularly useful for you to review your progress, and to stimulate learning dialogs between you and your preceptor.
Use the 'Support' option on the right menu to review instructions, view the getting started video, ask questions, report bugs, usability issues, and suggestions.
You can access pages that provide statistics for the entire school and your peers.
Frequently Asked Questions
What are the rotation period dates?
| Rotation No. | OMS III Dates | OMS IV Dates |
| (1) July | 7/23 – 8/2 | 7/8 – 8/2 |
| (2) August | 8/5 – 8/30 | |
| (3) September | 9/2 – 9/27 | |
| (4) October | 9/30 – 10/25 | |
| (5) November | 10/28 – 11/22 | |
| (6) December | 11/25 – 12/20 | 12/2 – 12/27 |
| (7) January | 1/6 – 1/31 | |
| (8) February | 2/3 – 2/28 | |
| (9) March | 3/2 – 3/27 | |
| (10) April | 3/30 – 4/24 | |
| (11) May | 4/27 – 5/22 | N/A |
| (12a) CRCM | 5/25 – 5/29 | N/A |
| (12b) COMSAE | 6/1 – 6/5 | N/A |
| PDC | N/A | 7/1 – 7/5 11/25 – 11/29 12/30 – 1/3 4/27 – 4/30 |
What is CREDO and why do I have to use it?
The Clinical Rotation Evaluation and Documentation Organizer (CREDO) is a Web-based system developed to teach VCOM students about billing codes and EMR systems. There are few medical schools that integrate EMRs/EHRs into their curriculum. As of this year, the procedure logs are no longer located on the VCOM portal, but can be found through CREDO, which is another reason to use and interact with CREDO.
Is there an app in the iOS App and Google Play Stores?
As of right now, no, there is not a stand-alone app, though it can be accessed via the browser of your device and will adjust to the smaller screen accordingly. If you are having trouble with network connectivity, you can write down the patients you see (adhering to HIPAA guidelines) and then when you have a secure connection, you can enter all your patients.
I forgot my password. What do I do?
Hit “Forgot Password” on the login screen – this allows you to reset your forgotten password. Make sure to check your Junk, Spam and/or Clutter folders as the email gets sent to those folders frequently.
I need help.
Help is always available. You can select from the upper right menu on the login screen to see a Quick Start Guide PowerPoint presentation, a User Guide video, an Instructions pop up and this FAQ PDF. If you can’t find your answers through there, you can fill out a Support Request and one of our Development Team members will contact you within 24 hours or contact Araba Wubah, our CREDO Support Liaison, directly at (540)-449-5503.
My location isn’t listed. How can I add it?
You can add your location by clicking the ‘Can’t find it?’ next to Current Site under Account Settings. Type in the address of your preceptor’s location and press ‘Save.’
Should I log a patient if other students log them?
Yes, this is a record of what YOU did and/or saw, and it is not a patient record, so you and other students may have seen the same patient, but you should log what you individually did and/or saw.
Do I still need to log if my preceptor is just making me sit and watch?
Yes, you still need to log even if you are just observing. As stated before, this is a record of what you have seen or done. Even if you are not seeing many patients, you should still record the few that you see.
What is ICD-10? What does the CM/PCS at the end mean?
ICD-10 stands for the 10 th revision of the International Statistical Classification of Diseases and Related Health Problems. It is a diagnostic and procedure coding system endorsed by the World Health Organization (WHO) in 1990. Internationally, the codes are used to study health conditions and assess health management and clinical processes. Although the term ICD-10 is commonly used alone, there are two parts to the system: ICD-10-CM (Clinical Modification) roughly ~68,000 codes used for diagnoses and ICD-10-PCS (Procedure Coding System), an additional ~87,000 codes for procedures in the US specifically.
Where can I find a complete list of ICD 10 CM/PCS codes?
You can find a complete list of ICD-10-CM/-PCS codes at ICD10Data.com.
How can I better my keyword search results?
You can use Boolean operators (the coding language behind CREDO’s search system) to tweak your keyword results:
- Leading Plus (+): This word must appear in a code description or synonyms to appear in the results
- Leading Minus (-): This word must not appear anywhere in the description and synonyms for it to appear in the results
- Leading Greater Than (>): Rows don't need to contain this word but rows that do will appear higher up
- Leading Less Than (<): Rows can contain this word but rows that do will appear lower down
- All of these are prepended with no space before the word, i.e. You could enter: myocardial -stemi +ventricle
Why can’t I find a general wellness check under procedures?
The WHO categorizes a general wellness check, amongst certain other procedures, as diagnoses. Here is a brief list of common procedures that can be found under the ‘Diagnosis’ tab.
- General Examinations:
- Adult Examination: Z00.0
- Newborn Examination: Z00.11x
- Child Examination: Z00.12
- Other Examinations:
- Pap Smear: Z01.419 (without abnormal findings)
- Abnormal Urinalysis (Diagnostic): R82.90
- Normal Urinalysis (Procedural): 0T9D7ZX
- Mammogram: BH4BZZZ (procedure); Z12.31 (diagnosis; for malignant neoplasm)
- Plastic Surgery:
- Encounter for cosmetic surgery: Z41.1
- Drugs used in procedures can be entered in ‘Prescribe’
What is WHO-ATC? Why can’t I find the drug I’m looking for?
The Anatomical Therapeutic Chemical Classification (ATC) system is how the WHO organizes drugs, based on the organ or system on which they act. The drugs are listed by their chemical names, rather than their trade names. However, we have added synonyms, so you may be able to find the appropriate drug quickly. If you have a trade name that is not listed, please send an email to the CREDO Development Team or fill out a support request and we will add it for you.
How do I see the entries I’ve made? How do I delete an entry?
Begin by going into your Dashboard; under User, you’ll see My Entries. There are additional links scattered throughout the logging interface. ‘My Entries’ will show you all of your entries; if you’d like to edit or delete an entry, you can click on an entry row. Make sure to click ‘Save’ if you make any changes.
Why isn’t my log autocompleting?
Please make sure that you’ve selected the correct rotation under the third-year options in your account settings. Once you’ve done that, all the entries you make in Patient Entries will autocomplete into your Rotation and OMM Logs. When you write a patient’s history in the demographic portion, this autocompletes the ‘Patients with History Note’. When you write physical or lab notes in the diagnosis portion, this autocompletes ‘Diagnoses with Physical/Lab Note’. If you are still having issues with it autocompleting, please fill out a support request and someone will get in contact with you shortly.
How do I print out my Rotation and OMM Logs?
While on the Procedure or OMM Log page, click on the triple horizontal bar icon in the upper left of the page to hide the menu. The logs should then occupy the entire page. You can now print the page as you would any page, Ctrl-P or ⌘-P. You can now either show/discuss the pages on your computer, or printed out with your preceptor.
Do I still need to fill out paper logs or anything on the portal?
No, you no longer need to fill out paper logs or documents on the portal. Only preceptors are to use the portal for evaluations.
Are all boxes in the Rotation/OMM log required to be satisfied in some way?
No, as you will not see all types of patients in any given rotation. The objectives you’ve seen are used by the preceptor to review what you’ve done.
What about the clinical skills that will not autofill; do I have to manually enter something to satisfy that requirement?
Yes, you can manually enter those skills that do not have an i with a circle around it.
How do I optimize my rotation experience to fulfill the maximum number of objects in my logs?
It is recognized that each rotation is unique and varies according to the patients that present. As the Rotation Logs and their objectives should be a guide for you to get the most out of your rotation, they are a real-time guide which can help you be pro-active in working with the staff to be appropriately involved such that those objectives can be fulfilled.
What are the facts shown and how does that feature work?
When you log a code the system has curriculum details for, a fact will appear at the bottom of your screen. It will appear for only five seconds, unless you place your cursor over it, at which point it will display indefinitely until moved. Currently, facts are not shown on mobile devices or those with small screens. By default, you’ll be shown facts as often as one is found that you’ve not seen in the past two weeks. You can change this behavior, showing them always or never, under Account.
My location isn’t listed. How can I add it?
You can add your location by clicking ‘Can’t find it?’ next to Current Site under Account (upper-left menu). Type in the name of your preceptor’s location and press ‘Save.’
Are all boxes in the Rotation/OMM Log required to be satisfied in some way?
No, as you will not see all types of patients in any given rotation. The objectives you’ve seen are used by the preceptor to review what you’ve done.
What about the clinical skills that will not autofill; do I have to manually enter something to satisfy that requirement?
Yes, you can manually enter those skills that do not have an icon.
Do I still need to fill out paper logs or anything on the portal?
No, you no longer need to fill out paper logs or documents on the portal. Only preceptors are to use the portal for evaluations.
Publications
More information about CREDO can be obtained from our peer-reviewed publications:
- Rawlins F, Sumpter C, Sutphin D, Garner HR, Quantifying medical student clinical experiences via an ICD Code Logging App, Int J Med Inform. 2018 Mar;111:51-57. doi: 10.1016/j.ijmedinf.2017.12.017. PMID: 29425634 Read
- Araba A. Wubah, Jean A. Yankson, Cameron Sumpter, Fred Rawlins, Dean Sutphin, Kim Menier, Harold R. Garner, Evaluation of an ICD Logging System to Supplement an EMR in a Sub-Saharan Country, in press, Journal of Hospital Administration, 2018 Read
About Credo — Making Great Clinicians
The goal of the Clinical Rotation Evaluation and Documentation Organizer (CREDO) Clinical Learning Management System to track clinical learning progress in real-time and provide an environment where students, preceptors, and administrators can engage in a meaningful dialog to make adjustments to maximize the learning experience. This is accomplished by capturing the breadth, depth, and frequency of various patient encounters experienced during clinical rotations and simulated patient encounters and using these experiences to fulfill Learning Objectives defined by the school. The Learning Objectives can also be fulfilled by Readings and Lectures, which are also captured. It is important that you record all applicable diagnoses, procedures, and drugs as they accumulate for each patient during each of their visits or admissions. Please also record any free text notes, including relevant History/Physical/Laboratory data, and use these as a memory trigger for future discussions with your preceptor, but never enter any patient identifiable information. Please be thorough, for you will later be questioned about your experiences.
This information is valuable to you, for it will document your total clinical experience, thus aiding you now by giving you instantaneous assessment of your progress, and, in the future, new quantitative documentation for residency applications and interviews. The CREDO system also helps you prepare for board exams, by presenting facts and review questions triggered by and matched to your patient encounter entries. It aids the school, by allowing us to understand your individual and class training, and make adjustments so you are optimally prepared for your profession. It also aids the community, for information you record reflects the instantaneous public health status in the vicinity of the hospitals and clinics where you visited your patients.
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