|Elective Title: Community Medicine Clinical Immersion I|
|Course Number: CEEU-4002|
|Elective Type: clinical||Duration/Weeks: 2||Max Enrollment: 4|
|Prerequisites: Successful completion of Year 2|
|Additional Requirements: Successful completion of USMLE Step 1. C-form required to register, send form to Allie Murphy (email@example.com) or Laurie Looper (firstname.lastname@example.org).|
|Responsible Faculty Director: N. Miles Farr, MD, MPH||Periods Offered: 1A or B - 7A or B; 8B; 9A or B - 13A or B including holiday period 8|
|Coordinator:||Other Faculty: Nadia Ahmed, MD; Mary Suna Wilkerson, MD; Julian Quiceno, NP; Martha Diaz, RN|
|Location to Report on First Day:
St. Vincent's Hope Clinic, 2817 Post Office, Galveston, TX 77573
|To make a difference in our local community, while at the same time enhancing your clinical skills and improving your mastery of the art of medicine.|
|1. Elicits and reports a comprehensive history for common patient presentations, with guidance
2. Performs a general physical examination while attending to patient comfort and safety
3. Organizes and accurately summarizes information obtained from the patient evaluation to develop a clinical impression
4. Formulates management plans for a common chronic condition, with guidance
5. Demonstrates how to access, categorize, and analyze clinical evidence, with guidance
6. Demonstrates professional behavior in routine situations
7. Accurately documents comprehensive and current information
8. Demonstrate and apply a basic clinical knowledge of the diagnosis, treatment and management of common chronic illnesses and identify challenges to comprehensive care and treatment for uninsured individuals with these conditions.
9. Obtain knowledge of the important non-biological determinants of poor health and of the economic, psychological, social, and cultural factors that contribute to the development and/or continuation of maladies.
10. Learn from firsthand experience about the needs, structure, function, and resources of underserved communities in the greater Galveston area.
|Description of course activities|
|The student will rotate through the community clinics including St. Vincent's Hope Clinics, mobile community clinics affiliated with St. Vincent's Hope Clinic, and FQHC Coastal Health and Wellness. You will be expected to see patients independently, present to faculty, and teach and mentor junior students. Students will participate in a minimum of 32 hours of clinical time each week. Students schedule will vary depending on the selected clinics each week as there are a multitude of opportunities each week. The times listed in weekly clinical schedule includes the range of options for all the clinics, students and faculty will meet to discuss the rotation and assign clinics accordingly.
Note: Clinic schedule. You may not have to be in clinic the whole time, it will depend on the assigned clinics.
|Type of students who would benefit from the course|
|Students interested in enhancing their clinical skills in preparation for residency and interested in working with an under-resourced population. Students have an opportunity to practice at a higher level with dedicated teaching faculty.|
|Clinical Activities (estimated schedule)|
|Day of Week||AM||PM|
|Saturday||9:30||3:30 (not required every week)|
Average number of patients seen per week: 16 (8 clinic sessions x 2 patients)
|Call Schedule: No|
|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?|
|Daily in clinic with designated preceptors.|
|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?|
|B.||Frequency / Duration of Presentation(s)?|
|Every clinic session|
|C.||Format - What guidelines are set for the student's presentation?|
|Generally expected oral presentations skills taught in POM and Clerkships.|
|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)?|
|- H&Ps and progress notes on each patient they see as an acting intern, daily while on clinic days. - 1 reflection - based on specified criteria, assignment by end of course|
|B.||Format - What guidelines are set for the student's written work?|
|- Standard outpatient note expectations, templates to guide notes will be shared. - Reflection - based on specified criteria with detailed instructions, due by the end of the course.|
|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?|
|No, but the written assignment needs to be: - Standard H&P and progress notes - Reflection - ~ 1 page single spaced or a representative project with approval of course director|
|E.||Method of content selection - e.g. student-selected, relate to cases, etc.?|
|- Student choice, guidance provided on topic options|
|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)?|
|- As outlined above, no additional activities|
|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.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.