|Elective Title: Infectious Diseases-General ID Consultation Service for Adults - John Sealy Hospital|
|Course Number: MEDU-4016|
|Elective Type: clinical||Duration/Weeks: 4||Max Enrollment: 2|
|Prerequisites: Successful completion of Year 2|
|Additional Requirements: Successful completion of Internal Medicine Clerkship is advised, but not required.|
|Responsible Faculty Director: A. Scott Lea, MD||Periods Offered: 1-7, 9-13 excluding holiday period 8|
|Coordinator: Vicky Garcia||Other Faculty: Juan Carlos Sarria, A. Clinton White, Lucas Blanton, Miguel Cabada, Philip Keiser, Peter Melby|
|Location to Report on First Day:
Marvin Graves Bldg., Room 4.318 at 8:00am
|1. Learn to evaluate and treat patients with suspected bacterial, fungal, parasitic and viral (HIV, HCV) infections.
2. Learn to properly utilize the microbiology laboratory to diagnose pathogenic microorganisms and their sequelae.
3. Become familiar with the pathogenesis and natural history of the major infectious disease syndrome and the various microbial pathogens.
4. Understand the proper use and stewardship of antimicrobial agents.
5. Develop and practice good infection control habits for patient and personal protection and safety.
|By the end of the rotation the student should have developed the ability to properly evaluate, diagnose and treat a patient with an infectious disease. He/she should be able to recount the major syndromes as well as the major classes of therapeutic antimicrobial agents and adjuncts to the care of those patients afflicted by pathogenic microorganisms. The student will also be introduced to the concepts of infection control while practicing proper utilization of personal protective equipment as well as personal hygiene in the hospital environment.|
|Description of course activities|
|1. Daily evaluation of new infectious disease consultations and daily rounds within the hospital. This includes the collection and analysis of pathologic and radiologic tests as well as working with other primary and consultative services during the hospital stay of assigned patients.
2. Didactic lectures and teaching conferences designed to teach the student different infectious disease concepts, antimicrobial agents, and healthcare epidemiology.
3. Students will be working as a member of a specialized team of clinicians involved in the care of complicated, adult patients hospitalized at UTMB affiliated facilities on a daily basis.
|Type of students who would benefit from the course|
|This course is designed to introduce all students taking the elective to the evaluation and care of adult patients with an infectious disease. Any student who intends to care for adult patients will find subjects of interest on this elective. Students who feel they need to enhance their skills in the areas of antimicrobial usage, pharmacokinetics, and stewardship will be helped by this elective. Similarly, students who want to enhance their skills in microbiology and epidemiology will be interested in this elective. Students going forward with specialized training in Global Health Issues, HIV, HCV, and Tropical Medicine will benefit from this elective. Finally the elective will introduce all students to the role of the specialty consultant in modern medical practice.|
|Clinical Activities (estimated schedule)|
|Day of Week||AM||PM|
|Monday||0800 see consult and follow-up old patients||1300 Round with Attending|
|Tuesday||0800 see consult and follow-up old patients||1300 Round with Attending|
|Wednesday||0800 see consult and follow-up old patients||1300 Round with Attending|
|Thursday||0800 see consult and follow-up old patients||1300 Round with Attending|
|Friday||0800 see consult and follow-up old patients||1300 Round with Attending|
Average number of patients seen per week: 4-5 per student
|Call Schedule: students do not take call|
|Research Activities (estimated schedule)|
|Activity||Hours per Week|
|1. Clinical Observation|
|A.||Where are students observed on this elective?|
Patients simulators Other
|B.||Frequency - How often are students observed clinically?|
|Daily (Five times a week on Rounds)|
|C.||Format - What method(s) are used to document the student's clinical performance?|
Daily oral feedback
End of period oral feedback
|2. Oral Presentation|
|A.||Audience - To whom does the student present?|
|Attending physicians, assigned house staff, and students on the team|
|B.||Frequency / Duration of Presentation(s)?|
|Daily on rounds; Students are encouraged to make a presentation at the weekly ID patient care conference.|
|C.||Format - What guidelines are set for the student's presentation?|
|Students present their patients' initial evaluation and then their patients' progress on daily rounds. Patient Care Conference presentations are made in concert with the ID fellows assigned to that conference.|
|D.||Assessment - Who assesses the student's presentation performance?|
|Self-assessment Peer assessment Faculty assessment|
|E.||Method of content selection|
|Current cases Student-selected topic Assigned topic|
|3. Written Assignment (H&P's, notes, papers, abstracts, etc.)|
|A.||Frequency of written assignment(s)?|
|Students are not required to turn in evaluations but their daily notes are part of the record and are scrutinzed by the attending physician and fellows for content and appropriateness.|
|B.||Format - What guidelines are set for the student's written work?|
|Students can compose progress notes in the electronic record and get appropriate constructive feedback from both house staff and faculty as needed.|
|C.||Length of written assignment(s)?|
|Abstract Annotated bibliography 1 - 2 page paper 3+ page paper|
|D.||Are recent references required? No If yes, how are they selected?|
|We encourage investigation of outcomes-based treatment using PICO technique, as well as utilization of the literature to help answer difficult and unknown questions regarding the students patients.|
|E.||Method of content selection - e.g. student-selected, relate to cases, etc.?|
|Students are encouraged to research questions and problems identified on daily rounds.|
|F.||Audience - Who assesses the student's written performance?|
|Peer Assessment Faculty Assessment Other|
Written multiple choice
Written essay / short answer
|5. Extra Course Activities|
|What expectations do you have for the student to demonstrate participation in the elective (e.g. small group activities, seminars, thoughtful questions, providing resources, journal club, resident lecture attendance)?|
|Students are required to attend all infectious disease conferences and Mdical Grand Rounds. This includes a weekly journal club and patient care conference. Students who become interested in a particular research project, or who encounter an interesting subject which they wish to present in a variety of professional forums are encouraged to do so and can sign up for additional electives designed to enhance their professional development in an area of special interest.|
|6. Additional Costs|
|Please list any additional costs and/or purchases (books, materials, movies to watch, etc.) that are required for this course. Include an estimated total cost. If there are no additional costs, please enter "None".|
|7. Other Modes of Evaluation|
|Please explain below.|
|Attending faculty will complete standard evaluation forms based on the student's ability to evaluate patients and learn and apply the basic principles of Infectious Diseases.|
|8. If this course is an Acting Internship, please complete the following:|
|A.||Objectives for the AI should relate directly to the Entrustable Professional Activities (EPAs).
Each AI should describe how the four key Year-4 EPAs that our school has identified as being Year-4 skills are
assessed. The Year-4 objectives are:
1. Entering and discussing orders/prescriptions.Specify how the student will be given formative feedback on their clinical skills.
Year-4 students should demonstrate mastery of EPAs they developed in the clerkship year, including recommending and interpreting common diagnostic and screening tests, and performing general procedures of a physician. They should be able to demonstrate masterfully and independently skills they mastered in Years 2-3, including efficiently performing comprehensive admission-notes and succinct daily progress notes and perform accurate, concise, and hypothesis-driven clinical presentations, form clinical questions and retrieve evidence to advance patient care. They should be able to demonstrate basic understanding of and beginning mastery of collaborate as a member of the interprofessional team and identify system failures and contribute to a culture of safety improvement.
List advanced clinical skills that a student will be assured an opportunity to practice.
How specifically will this AI build on developing skills from the clerkship year to prepare students for internship?
What opportunities will typically be available to all students who take this AI (procedures, required presentations, etc.)? What opportunities may be available based on patient load/presentation or student initiative (ie. Writing a case report)?
An AI should have expectation of a minimum of 32 hours per week of clinical responsibilities. Duty hours should be capped at ACGME limits for an intern, thus up to 24 hours followed by 4 hours of activities related to patient safety, education, and handoff. Students cannot work more than 80 hours per week averaged over 4 weeks. They can only have 1 day off in a 7-day work week with 8 hours off between shifts.
Clinical responsibilities will vary depending on specialty, but how is the student functioning with work commensurate to a PGY1 with an appropriate level of training?
How is the student demonstrating drawing clinical conclusions and/or developing a management plan and documentation as an intern would do?
How and by whom will midpoint feedback be provided to the student? How will you remediate deficiencies identified at midpoint?
Acting Internship students often seek letters of recommendation following their experience. How many different Faculty will work directly with the student and have knowledge of the student's abilities to detail in a written evaluation? Describe the degree of supervision and interaction with faculty vs. residents or other providers and how feedback will be obtained if more direct work is with residents or other providers.