RADU-4001 - Clinical Nuclear Medicine

RADU-4001 - Clinical Nuclear Medicine

Elective Title: Clinical Nuclear Medicine
Course Number: RADU-4001
Elective Type: clinical Duration/Weeks: 4 Max Enrollment: 2
Prerequisites: Successful completion of Year 2
Additional Requirements: N/A
Responsible Faculty Director: Javier Villanueva-Meyer, MD Periods Offered: 1-13 including holiday period 8 
Coordinator: Lycia Champagne-Buckley Other Faculty: Samuel Bezold, MD
Location to Report on First Day:
Lycia Champagne-Buckley, lcchampa@utmb.edu

At the end of the course the student will be expected to know the use of various radio pharmaceuticals, clinical indications and limitations of the more common Nuclear Medicine procedures and their relative values compared to other tests which might be considered for specific clinical problems. The student should know the proper sequence in which to perform tests and learn what a patient might experience when he/she comes to the clinic for a diagnostic or therapeutic procedure. The student will be able to request Nuclear Medicine procedures with greater and more appropriate discrimination, understand reports provided and its use to solve clinical problems.

At the completion of 4 or 8 week elective, the student should know the proper sequence in which to perform tests and learn what a patient might experience when he/she comes to the clinic for a diagnostic or therapeutic procedure. The student will be able to request Nuclear Medicine procedures with greater and more appropriate discrimination, understand reports provided and its use to solve clinical problems.

Description of course activities
Of the approximately 70 different procedures performed in Nuclear Medicine, nuclear imaging will be given the greatest emphasis. The students will learn handling of thyroid problems in the daily thyroid clinic, uses tests and applications of non-imaging procedures, and uses or radioassay tests and applications of non-imaging procedures. The student will work daily with faculty physicians and residents, take part in the daily imaging reading sessions and conferences. If the student chooses, he/she can see how to prepare or administer radiopharmaceutical to patients, learn how to operate instruments and confer with requesting physicians and students about the uses and results of Nuclear Medicine procedures.

Type of students who would benefit from the course
Nuclear Medicine procedures are of potential benefit to students from all specialties, in particular cardiology, oncology, surgery and endocrinology. The general type experience provided by this course will enable any type physician to use Nuclear Medicine procedures with better understanding and discrimination.

Weekly Schedule
  Clinical Activities (estimated schedule)  
Day of Week   AM   PM
Monday 8.30am 5pm
Tuesday 8.30am 5pm
Wednesday 8.30am 5pm
Thursday 8.30am 5 pm
Friday 8.30am 5pm

 Average number of patients seen per week: 150
 Call Schedule: n/a

Research Activities (estimated schedule)
Activity Hours per Week
Faculty Contact-Time 9am
Self-Directed Study
Data-Collection/Analysis 10

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?
    Responsible faculty
  B. Frequency / Duration of Presentation(s)?
    10-15 minutes
  C. Format - What guidelines are set for the student's presentation?
  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?
  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
    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.
    Progress of the student's knowledge, experience and understanding will be evaluated by daily contact with the faculty of the Nuclear Medicine Section.

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.