ORSU-4001 - Applied Orthopedics Principles in Lower Extremity Surgery

ORSU-4001 - Applied Orthopedics Principles in Lower Extremity Surgery

Elective Title: Applied Orthopedics Principles in Lower Extremity Surgery
Course Number: ORSU-4001
Elective Type: clinical Duration/Weeks: 2 Max Enrollment: 1
Prerequisites: Successful completion of Year 2
Additional Requirements: None
Responsible Faculty Director: Jie Chen, MD Periods Offered: 1AB-13AB including holiday period 8 
Coordinator: Bryanna Branch Other Faculty:
Location to Report on First Day:
starting on a Monday, go to OR in League City, if starting on a Tuesday, go to Ortho Clinic in League City

To learn the basic science and principles behind common orthopedic conditions afflicting the lower extremity. Will learn basics of fracture healing, implant science, mechanisms of injury, classification systems.
2. To be present in the operating room and learn including basic knowledge of setup, positioning, assisting, and closing.
3. To assist faculty/residents in the care of patients seen on call including hip fractures, femur fractures, ankle fractures. While most of the pathology will be foot and ankle conditions, there will also be other lower extremity injuries who present from the emergency room.

Attend a thorough history and physical examination of a foot and ankle patient in clinic. Participate treatment plans for patients with a variety of lower and upper extremity conditions including hip fractures, femur fractures, tibia fractures, foot and ankle pathology

Description of course activities
Students will shadow the attending and or residents, observe, learn and practice history taking and physical exam skills. They may participate in minor procedures such as application of splint, removal of superficial hardware, wound debridement's. Students will accompany residents and faculty on daily rounding of patients. Students may scrub in and assist with surgery.

Type of students who would benefit from the course
Any student who may be interested in Orthopedics

Weekly Schedule
  Clinical Activities (estimated schedule)  
Day of Week   AM   PM
Monday Wk 1,3,5 -JS OR; Wk 2,4-LCC OR Wk 1,3,5 -JS OR; Wk 2,4-LCC OR
Tuesday League City Campus clinic League City Campus clinic
Wednesday League City Campus OR League City Campus OR
Thursday TDCJ League City Campus OR
Friday PCP Clinic League City Campus

 Average number of patients seen per week: 50
 Call Schedule: No

Research Activities (estimated schedule)
Activity Hours per Week
Faculty Contact-Time
Self-Directed Study

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?
  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?
    Faculty and Residents
  B. Frequency / Duration of Presentation(s)?
  C. Format - What guidelines are set for the student's 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)?
  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

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)?
    Attend Weekly didactic conference, morning rounds, Fracture conference

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.