PATU-4005 - Introduction to Laboratory Medicine

PATU-4005 - Introduction to Laboratory Medicine

Elective Title: Introduction to Laboratory Medicine
Course Number: PATU-4005
Elective Type: clinical Duration/Weeks: 4 Max Enrollment: 2
Prerequisites: Successful completion of Year 2
Additional Requirements: C-form required to enroll
Responsible Faculty Director: Anthony Okorodudu, Ph. D., MBA Periods Offered: 1-13 including holiday period 8 
Coordinator: Tracy Wilkins Other Faculty: Peter McCaffrey, M.D.; Stephen L. Cheney, MD; Kirill Lyapichev, MD; Jianli Dong, M.D. Ph.D.
Location to Report on First Day:
Clinical Chemistry Division 7.412 QA CSW (409) 772-3197

1. To aid the student in learning proper utilization and interpretation of laboratory tests. 2. To provide the student an overview of the structure and function of a large clinical laboratory

During the four-week elective, the student will:
1. Investigate and discuss the clinical findings of two to three patients per day who presents interesting or unusual laboratory findings.
2. By observation and participation, become familiar with selected tests performed in the Laboratory (Hematopathology, Chemistry, Microbiology and Blood Bank).
3. Learn the steps required for proper requesting, processing, and utilization interpretation) of laboratory studies in this hospital.

Description of course activities
The medical student will review and analyze cases from the daily patient material (approximately 2,000 specimens/day) and go to the patient's bedside and chart to review the significance of the laboratory findings in view of the total disease process when appropriate. The medical student will have experience at the bench under the supervision of the pathologists and/or clinical chemist with the assistance of medical technologists. The student will attend clinical pathology residents conferences and participate in quality assurance/administrative meetings

Type of students who would benefit from the course
All students interested in clinical practice. Informal consultation with the clinical laboratory faculty will be welcomed for students considering this elective.

    Weekly Schedule
          Estimated Course Activities (Start-Time/Finish-Time):
Day of Week   AM   PM
Monday 8-12 1-5
Tuesday 8-12 1-5
Wednesday 8-12 1-5
Thursday 8-12 1-5
Friday 8-12 1-5

 Average number of patients seen per week: 2,000 specimens/day
 Call Schedule: No

Research / Other Course 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?
    Case presentations and during rotation in the clinical laboratory
  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, Fellows, Residents and Technologists
  B. Frequency / Duration of Presentation(s)?
    Once per week for 1 hour each
  C. Format - What guidelines are set for the student's presentation?
    Powerpoint presentation using LCD
  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)?
    Once per rotation
  B. Format - What guidelines are set for the student's written work?
    Case report format for publication
  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.?
    Based on current and frequently encountered patient testing quality issues
  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 during clino-pathlogic correlation of laboratory findings with patient's condition. Evidence of preparedness for conferences as indicated by scope of presentation and questions by the student

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.
    Participation by the student, as judged by the Clinical Laboratories Technologists relative to involvement in bench work. Readiness to present cases and participate in case discussion. The student's participation in test results interpretations for services that include protein electrophoresis and toxicology.

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.