PATU-4016 - Overview of Pathology

PATU-4016 - Overview of Pathology

Elective Title: Overview of Pathology
Course Number: PATU-4016
Elective Type: clinical Duration/Weeks: 4 Max Enrollment: 3
Prerequisites: Successful completion of Year 2
Additional Requirements: A C-Form signed by the course director must be completed and submitted to Enrollment Services.
Responsible Faculty Director: Dr. Stephen Cheney Periods Offered: 2-13 including holiday period 8 
Coordinator: Tracy Wilkins Other Faculty: Dr. Felicella Dr. Muthukumarana Dr. Nawgiri Dr. Okorodudu Dr. Williams-Bouyer Dr. Zahner
Location to Report on First Day:
Room 5.144 Clinical Services Wing (CSW)

To introduce students to the breadth of the clinical specialty of Pathology and the role of Pathologists in patient care.

By the end of the rotation, students should be able to: 1. Describe the roles of the Clinical Pathologist and Anatomic Pathologist in patient care and the differences between Clinical Pathology and Anatomic Pathology. 2. Outline principles of laboratory medicine as they relate to the specific laboratory rotation. 3. View the steps of histopathologic preparation and participate in microscopic evaluation of patient samples. 4. Correlate results of laboratory tests and anatomic pathology specimen evaluation to patient diagnosis, prognosis and clinical decision-making 5. Discuss proper utilization and interpretation of laboratory tests relevant to specific laboratory rotation.

Description of course activities
The student will do four one week mini rotations; students will select which two Anatomic Pathology areas (autopsy, surgical pathology, cytopathology) and which two Clinical laboratories (Chemistry, Microbiology, Transfusion Medicine, Molecular Pathology, Hematopathology, Coagulation) they would like to visit (this will be determined through discussion with course director at time that C form is signed). Students will participate in division specific activities, including conferences, sign out sessions, didactic sessions, and rounds with clinicians. Students will interact with Pathology faculty, residents, and laboratory staff.
There will be about 5 hours of faculty time, 10 hours of self-directed study and about 25 hours working with residents or technologists on clinical activities relevant to the division.

Type of students who would benefit from the course
All students interested in clinical practice. Students considering Pathology as a career who wish to get an overview of multiple areas of Pathology.

    Weekly Schedule
          Estimated Course Activities (Start-Time/Finish-Time):
Day of Week   AM   PM
Monday 8:00 - 12:00 1:00 - 5:00
Tuesday 8:00 - 12:00 1:00 - 5:00
Wednesday 8:00 - 12:00 1:00 - 5:00
Thursday 8:00 - 12:00 1:00 - 5:00
Friday 8:00 - 12:00 1:00 - 5:00

 Average number of patients seen per week:
 Call Schedule:

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?
    Students will participate in conferences and diagnostic sign out sessions. Clinical examination of patients is not part of this elective.
  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?
    Students may present to divisional faculty and residents, depending upon specific rotation.
  B. Frequency / Duration of Presentation(s)?
    Maximum, once per week
  C. Format - What guidelines are set for the student's presentation?
    To be set by individual division
  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 (in lieu of oral presentation)
  B. Format - What guidelines are set for the student's written work?
    Should be a 2-3 page paper on a topic selected by the student. Expectations are that it will be appropriately in depth for a senior medical student, that it will discuss some clinical correlations of lab tests or anatomic pathology diagnosis, with additional information about epidemiology, pathology, pathophysiology, diagnosis, differential diagnosis. Information from the current literature should be included and appropriately cited. Students should discuss topic in advance with course director, who can help identify faculty experts, photographic images, or other resources.
  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?
    Student should do Medline search or equivalent on their own.
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
    Student-selected, related to cases or lab tests seen during elective.
  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)?
    Students are expected to attend and participate in all divisional conferences, sign out sessions, or Socratic teaching sessions. Being engaged, asking good questions, applying their clinical knowledge to the problem at hand, are all features that indicate good participation.

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.
    Attendance, level of interest demonstrated in weekly meetings. Standard elective evaluation form will be completed by 4 divisional faculty that the student interacted with and the course director. Results from these evaluations will be compiled into the final evaluation.

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.