PEDU-4027 - Adolescent Medicine

PEDU-4027 - Adolescent Medicine

Elective Title: Adolescent Medicine
Course Number: PEDU-4027
Elective Type: clinical Duration/Weeks: 4 Max Enrollment: 2
Prerequisites: Successful completion of Year 2
Additional Requirements: C-form required to enroll, send to Tiffany Swain (trswain@utmb.edu)
Responsible Faculty Director: Richard Rupp, MD Periods Offered: 1-13 including holiday period 8 
Coordinator: Tiffany Swain Other Faculty:
Location to Report on First Day:
Pediatrics, Primary Care Pavilion, Team Room C

Goals
1. To learn about the cognitive and pubertal changes that occur during adolescence and their interplay with the health needs of the patient.
2. To explore methods of addressing high risk adolescent behaviors such as substance abuse, sexual activity, gang activity, etc., in a primary care setting.

Objectives
1. The student will become competent in performing an appropriate psychosocial interview and complete physical on an adolescent.
2. The student will become familiar with and learn how to address common adolescent health problems such as acne, chest pain, back pain and sports injuries.
3. The student should become more comfortable in dealing with common high risk activities such as substance abuse, sexual activity, delinquency, etc.

Description of course activities
The student will work closely with the Adolescent Medicine specialists in various outpatient settings including school-based clinics and University clinics. The student will interview and examine the patients and present them to the faculty. The student will be included in daily discussions of areas of medical care.

Type of students who would benefit from the course
All medical students.

Weekly Schedule
  Clinical Activities (estimated schedule)  
Day of Week   AM   PM
Monday 8:00 am 5:00 pm
Tuesday 8:30 am 5:00 pm
Wednesday 8:00 am 5:00 pm
Thursday 8:00 am 5:00 pm
Friday 8:30 am 5:00 pm
Saturday
Sunday

 Average number of patients seen per week: 36
 Call Schedule: None

Research Activities (estimated schedule)
Activity Hours per Week
Faculty Contact-Time
Self-Directed Study
Data-Collection/Analysis
Other 24 hours/ week direct faculty time, 12 hours/ week allied health time

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?
    daily
  C. Format - What method(s) are used to document the student's clinical performance?
    Daily oral feedback   End of period oral feedback   Written feedback
Other

2.  Oral Presentation
  A. Audience - To whom does the student present?
    Student presents patients to faculty, allied health professional and resident. Once a week there may be a brief presentation of a learning issue.
  B. Frequency / Duration of Presentation(s)?
    Each clinic half day.
  C. Format - What guidelines are set for the student's presentation?
    Informal, following the standard presentation format used for patients.
  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)?
    Expected to write clinic notes on each patient seen.
  B. Format - What guidelines are set for the student's written work?
    Typical format is the SOAP.
  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
  Format
    Oral   Written multiple choice   Written essay / short answer   OSCE
Other

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)?
    This elective utilizes a variety of clinical settings. Monday, Wednesday, Thursday and Friday are spent in the university-based Teen Clinic. Tuesday, Wednesday and Friday afternoons, students rotate through different school-based clinics located on the island. Driving to the clinics is required. Usually a topic is discussed each morning prior to Teen Clinic. Length of discussion is 30 minutes. Students and residents are expected to participate. They are to use information from experience and from their readings. The groups are small and everyone answers. This occurs 3 times a week. In addition, the students and residents, as a group work on learning problems. Usually 1-2 during the rotation. They are expected to use resources such as the internet and textbooks.

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".
    None

7.  Other Modes of Evaluation
  Please explain below.
    Students will be assessed by the preceptor rating of skills interviewing and examining patients. Also their ability to handle difficult or uncomfortable situations with families. Finally, their knowledge base is looked at throughout the evaluation. Close contact with faculty and careful review of their soap notes allows for this.

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.
   
 
B.
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.
   
 
C.
How specifically will this AI build on developing skills from the clerkship year to prepare students for internship?
   
 
D.
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)?
   
 
E.
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?
   
 
F.
How is the student demonstrating drawing clinical conclusions and/or developing a management plan and documentation as an intern would do?
   
 
G.
How and by whom will midpoint feedback be provided to the student? How will you remediate deficiencies identified at midpoint?
   
 
H.
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.