Non-VSLO External Elective Process
Acting Internship in Orthopedic Surgery-Pediatric
Successful completion of Year 2
Additional Requirements: None
Responsible Faculty Director:
David A. Yngve, M.D.
Kelly Carmichael, M.D.
to Report on First Day
Contact Bryanna Branch(firstname.lastname@example.org) or 409-747-5701. 2.316 Rebecca Sealy
including holiday period 8
|To gain experience in the evaluation and treatment of patients with pediatric orthopedic problems including those involving spine and reconstruction with emphasis on Cerebral Palsy.
|To learn how to examine the spine and extremities; to learn how to apply splints.|
|Description of course activities|
|The student will attend clinics approximately 2 days a week and surgery approximately 2 days a week. The student will see and examine patients independently and assist in surgery. Pediatric specialties include patients with cerebral palsy, scoliosis and pediatric spine cases between the ages of 0-18.
|Type of students who would benefit from the course|
|All students. This course meets the requirements for the Senior Acting Internship in Surgery.|
|Clinical Activities (estimated schedule)|
|Day of Week||AM||PM|
|Tuesday||PCP clinic||PCP clinic|
|Wednesday||Jennie Sealy OR||Jennie Sealy OR|
|Thursday||League City Campus Clinic||League City Campus Clinic|
|Friday||League City OR||League City OR|
|Average number of patients seen per week: 20|
|Call Schedule: n/a unless interested|
|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?|
|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?|
|Pediatric Orthopedic Faculty and residents|
|B.||Frequency / Duration of Presentation(s)?|
|Once during the rotation|
|C.||Format - What guidelines are set for the student's presentation?|
|Present 5 minute case presentation at a Wednesday 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)?|
|B.||Format - What guidelines are set for the student's written work?|
|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|
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)?|
|Journal Club and resident lecture attendance|
|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.|
|Clinical evaluation by upper-level residents and faculty with possible grades, Pass/Fail.|
|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.
|Clinical skills will be directly supervised by faculty and residents.|
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.
|Students will do physical exams of bones, tendons, ligaments and neuromuscular structures.|
How specifically will this AI build on developing skills from the clerkship year to prepare students for internship?
|Surgical skills - assisting and suturing|
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)?
|Students will study anatomy for cases and synthesize history and exams for a differential diagnosis.|
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?
|Students will learn surgical anatomy, exam skills, and orthopedic diseases.|
How is the student demonstrating drawing clinical conclusions and/or developing a management plan and documentation as an intern would do?
|One week into the rotation, students will schedule a midpoint evaluation session with faculty. Faculty will remediate as needed.|
How and by whom will midpoint feedback be provided to the student? How will you remediate deficiencies identified at midpoint?
|Students will be with 1 faculty for 20 days with direct faculty/student interaction.|
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.
Classes are a 1 for 1 ratio.
In general, the AI student will work directly with Dr. Yngve and the resident assigned during most of the rotation. If Dr. Yngve has episodes of no clinical activity during the rotation for whatever reason he will coordinate with other orthopedic faculty to provide clinical and surgical education when he is out.
Other faculty may get to interact with the student but not enough to provided letters of recommendation.
Dr. Yngve will provide feedback weekly during the rotation and will advise the student of their performance as well as if a letter of recommendation is or is not advisable based on such performance.