BLHU-4003 - Clinical English/Spanish Interactive Language Exchange Course UTMB & UDEM

BLHU-4003 - Clinical English/Spanish Interactive Language Exchange Course UTMB & UDEM

Elective Title: Clinical English/Spanish Interactive Language Exchange Course UTMB & UDEM
Course Number: BLHU-4003
Elective Type: career Duration/Weeks: 11 months Max Enrollment: 8
Prerequisites: Successful completion of Year 3
Additional Requirements: C-form required, send forms to Ms. Berengaria Navarre ( & must be of Intermediate to Advanced Spanish Oral Proficiency. Must test with Dr. Norma A. Perez Raifaisen. (4 weeks of elective credit will be given with satisfactory completion)
Responsible Faculty Director: Norma A. Perez-Raifaisen, MD Periods Offered: 1 excluding holiday period 8 Offered 100% Online
Coordinator: Not available Other Faculty: Soham Al Snih, MD;
Location to Report on First Day:

To expose and engage medical students in medical dialogue to improve clinical language during students clinical years longitudinally; 4th years for UTMB and 6th years for UDEM.

Objective 1: Provide and exchange on clinical cases, current health care policy and reform, from neighboring countries.
Objective 2: Familiarize students with main health conditions, treatment and management, lack of or access to healthcare resources, and health policies prevalent among Latino patients from bordering countries.

Description of course activities
The US/Mexico border cities and states have shared and continue to share a binational patient population across the health care services due to the proximity. The continued exchange or the continued flow of patients between the two countries has opened a window of opportunity for the academic institutions, the University of Texas Medical Branch (UTMB) and the Universidad de Monterrey (UDEM), to partner and provide an innovative approach to rich and engaging learning among students from both academic institutions.

The language exchange virtual sessions provide students the opportunity to utilize the target language with native speakers in a noncritical format and to develop strategies of oral compensation and the significance of negotiations critical in clinical practice.
Students will meet twice each period for 10 periods virtually with UDEM MS6 medical students.
UDEM - MS6 (undergraduate Intern)
Module 1-9 (1st sessions):
Guest speaker
1. They will be no longer than 25 min talks
2. Students from lead school will be responsible for recruiting and inviting the guest speakers, which will present in their native language. Guest speaker may present live via Zoom
3. 25 minutes for Q&A
4. Talks will range from clinical cases to health policy and follow the topics in the modules
5. Lead school will provide Zoom link with the entire group via email to join talk. Presentations will be recorded and provided via Google Drive
6. First half of session will be discussed in tongue of lead school
7. 10 minute break before Article Discussion begins
Article discussion
1. Guest speakers from both academic institutions will be responsible for sharing 2 articles to the group; one from Latin America and the other from US at least one week prior to the session
2. 5-minute article presentations will happen in second half of session and presented in tongue of lead school from the students and open for discussion in tongue of other school
3. Guest speaker may stay to engage in live discussion with students or faculty facilitator will moderate the discussion
4. Article will be shared via Google Drive for future use and reference
Module 1-9 (2nd sessions):
Clinical case discussion
1. Each school will be responsible for selecting the clinical case up for discussion and de-identifying the material
2. Lead school will share summary of clinical case in PPT or no more than 2-page Word document. The lead school will share documents for all to view 1 week prior to session. Documents will be stored in Google Drive
3. Lead school leads presentation of clinical case
4. The first half of discussion is in lead school native tongue then swaps the second half to other school native tongue
5. The faculty facilitator/moderator will moderate the small group discussion mimicking clinical case presentation with interactive dialogue amongst the students
Module 10 (1st session):
1. 75% of the small group share their discussion on reflections. Students may present in non-native tongue
2. Lead school will begin discussion and then swap
Module 10 (2nd session):
1. The remainder of the small group share their discussion on reflections
2. Lead school begins continuation of presentations and then swap
3. Students from both schools will work on program evaluation.
Modules Calendar Discipline
Module 1 UDEM leads Pediatrics
Module 2 UTMB leads NeuroPeds
Module 3 UDEM leads Internal Medicine
Module 4 UTMB leads Endocrinology
Module 5 UDEM leads Family Medicine
Module 6 UTMB leads Surgery
Module 7 UDEM leads OB/Gyn
Module 8 UTMB leads COVID and Infectious Disease
Module 9 UDEM leads Binational Healthcare Industry
Module 10 UTMB leads Reflective Writing of Course Experience and Course Evaluation

This course satisfies the Bilingual Health Concentration.

Type of students who would benefit from the course
Students interested in: 1) improving their Spanish clinical oral proficiency discussion; 2) international healthcare discussion; 3) improving their clinical oral presentations; and 4) students pursuing the Bilingual Health Scholarly Concentration

Weekly Schedule
  Clinical Activities (estimated schedule)  
Day of Week   AM   PM

 Average number of patients seen per week: None (discuss clinical cases virtually
 Call Schedule: No

Research Activities (estimated schedule)
Activity Hours per Week
Faculty Contact-Time 20
Self-Directed Study 10
Other student contact and preparation hours 10

Method of Student Evaluation
1.  Clinical Observation
  A. Where are students observed on this elective?
    Inpatient Service   Ambulatory   Surgery   Standardized patients
Patients simulators   Other
  B. Frequency - How often are students observed clinically?
    2 hours per session, twice per module, a total of 20 times observed
  C. Format - What method(s) are used to document the student's clinical performance?
    Daily oral feedback   End of period oral feedback   Written feedback

2.  Oral Presentation
  A. Audience - To whom does the student present?
    Dr. Perez
  B. Frequency / Duration of Presentation(s)?
    no more than 3 minutes at a time
  C. Format - What guidelines are set for the student's presentation?
    oral presentation
  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)?
    Clinical Cases Power Point summarizing the clinical case addressing the CC, PHI, PMH, & past & current treatment & management. Manuscript Power Point or Word document summarizing main points of article Reflective Paper Word document of 300 words maximum
  B. Format - What guidelines are set for the student's written work?
    Clinical Cases Summary in Power Point addressing CC, PHI, PMH & past & current treatment and management. Power Point template will be provided to students Manuscript presentation Power Point template summarizing overview of the article will be provided to students 1. Summarize abstract 2. Summarize methods 3. Summarize results 4. Summarize conclusions 5. Identify weaknesses and strengths c. Reflective paper presentation 1. 1-page, 12 points, New Times Roman or Arial, 300 word essay using APA recommendations Purdue guidelines: Link will be given at time of elective. 2. Will be submitted to each school faculty for review and will be stored in Google Drive 3. References will be required using only current top medical journals
  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?
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
  F. Audience - Who assesses the student's written performance?
    Peer Assessment     Faculty Assessment     Other

4.  Examination
    Oral   Written multiple choice   Written essay / short answer   OSCE

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)?
    Active participation in oral interactive dialogue

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.

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.
2. Give or receive patient handover to transition care responsibility.
3. Recognizing a patient requiring urgent or emergent care and initiating management.
4. Obtaining informed consent for tests and procedures.
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.