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Inefficiency Dissection

Case Log Blind Spots (UME)

Summary: 

Exposure gaps are discovered only at the end of the rotation, long after any meaningful corrective action is possible.

The Problem

Exposure gaps are discovered only at the end of the rotation, when it’s too late to fix them.

Case logs are often reviewed too late to help anyone. In many UME programs, students enter encounters by hand. Faculty sign off when they have time. Coordinators check for gaps at the end of the block, after the rotation has finished and the learning window has closed.

“We often do not realize a student has missed key experiences until the clerkship is over.”

“Most of our tracking is manual. By the time we see the gaps, we are already into the next block.”

Case logs should guide clinical learning. When they surface this late, they become record keeping instead of a tool for shaping the student experience. The program loses visibility during the moments when adjustment is still possible.

Where the Process Breaks Down

Across institutions, specific breakdowns show up again and again.