SURU-4067 - Minimally Invasive Surgery Elective

SURU-4067 - Minimally Invasive Surgery Elective

Elective Title: Minimally Invasive Surgery Elective
Course Number: SURU-4067
Elective Type: clinical Duration/Weeks: 2 Max Enrollment: 2
Prerequisites: Successful completion of Year 2
Additional Requirements: Intended for 3rd year Clerkship students. Contact Amy White with additional questions
Responsible Faculty Director: Richard Lu, MD Periods Offered: 1AB - 7AB, 9AB - 13AB excluding holiday period 8 
Coordinator: Amy White Other Faculty: Sara Samreen, MD
Location to Report on First Day:
Jeannie Sealy OR

Students on the Minimally Invasive Surgery Elective will be introduced to minimally invasive surgical techniques with focus on abdominal wall reconstruction, bariatric, and foregut surgery.

A. Knowledge base
1. Anatomy
A. Abdominal wall anatomy as it pertains to hernia - Ventral hernias and Inguinal hernias
B. Bariatrics and Foregut - Esophagus, Stomach, and Small bowel,
2. Technology - Basics of laparoscopic surgery and Basics of robotic surgery

B. Patient care and Clinical Decision Making
1. Clinic - Focused H&P of surgical patients, Patient selection, Preoperative planning, Postoperative care
2. Operating Room - Understand the multidisciplinary workflow of minimally invasive cases; Understand critical anatomy and key portions of the procedures; Assist in basic operative tasks (i.e. skin closure, robotic instrument exchange, laparoscope handling, and rudimentary laparoscopic skills)
3. Wards - Perform thorough postoperative assessments; Formulate sound patient care plans

Description of course activities
Students will be involved in the perioperative care of patients including clinic and postoperative assessments. They will also have intraoperative exposure to a variety of minimally invasive surgical procedures.

Type of students who would benefit from the course
This elective is best for students who have established an interest in surgery and wish to be engaged in highly specialized minimally invasive procedures that are typically outside the realm of most general surgery practices.

Weekly Schedule
  Clinical Activities (estimated schedule)  
Day of Week   AM   PM
Monday 7 5
Tuesday 7 5
Wednesday 7 5
Thursday 7 5
Friday 7 5

 Average number of patients seen per week: 10
 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)?
    1 hour daily
  C. Format - What guidelines are set for the student's presentation?
    H&P and SOAP format. May be asked to make a power point presentation on a surgical topic.
  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?
    Complete a H&P and clinical progress notes as taught in the MS1/MS2 clinical curriculum.
  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.?
    related to cases
  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)?

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.