SURU-4022 - Trauma Surgery

SURU-4022 - Trauma Surgery

Elective Title: Trauma Surgery
Course Number: SURU-4022
Elective Type: clinical • Direct Patient Care Duration/Weeks: 4 Max Enrollment: 1
Prerequisites: Successful completion of Year 3
Additional Requirements: Successful completion of Surgery Clerkship. (Periods 1, max enrollment is 2)
Responsible Faculty Director: Amy Mrazek, MD, PhD Periods Offered: 1-13 including holiday period 8 
Coordinator: Jason Reed Other Faculty: Steven Wolf, MD; Joshua Person, MD; Michael Erickson, MD; Peter Drevets, MD; Francis Welsh, MD
Location to Report on First Day:
Surgery Student Coordinator, Jason Reed, 6.132 McCullough

Goals
1. Become comfortable in the management of acute trauma patients.
2. Gain exposure to the ‘gatekeeper’ role of the trauma service in oversight and coordination of multiple subspeciality services in the care of complex polytrauma patients further complicated by underlying medical comorbidities.
3. Appreciate the use of many resources to successfully set up a patient for discharge to their next phase of care in recovery from their traumatic injury.

Objectives
1. Learn how to systematically triage a trauma patient and perform primary and secondary surveys.
2. Based on the mechanism of injury and initial assessment, formulate a diagnostic plan for the trauma patient: order appropriate lab studies, imaging, and engage consultant services.
3. Scrub in to assist and learn the basic principles of trauma and damage control surgery.
4. Gain exposure to critical care management of the traumatic patient.
5. Develop own skill set in writing orders, notes, presenting patients to faculty, and basic surgical skills like suturing and knot tying.


Description of course activities
Students will learn how to assess trauma patients in multiple settings: initial presentation in emergency room, operating room, intensive care unit, the ward, and biweekly outpatient clinic. As part of the care team, students will attend morning report, participate in patient rounds, scrub operative cases, help the care team triage active traumas and carry out care plans. They will have exposure to care coordination amongst multiple subspecialities and disposition planning.
Clinic 1:30pm-5:30 Tuesdays and Thursday, UHC 5th Floor
M7M and Grand Rounds 7am-9am Wednesdays, McCullough 6.106
Service checkout 5:30pm ER 1.328
Weekend approximately 6am-10am either Saturday or Sunday

Type of students who would benefit from the course
This course will be particularly useful for those students who have a strong interest in or plan a career in Emergency Medicine or Trauma Surgery.

    Weekly Schedule
          Estimated Course Activities (Start-Time/Finish-Time):
Day of Week   AM   PM
Monday 6:00 6:00
Tuesday 6:00 6:00
Wednesday 6:00 6:00
Thursday 6:00 6:00
Friday 6:00 6:00
Saturday 6:00 noon
Sunday 6:00 noon

 Average number of patients seen per week: 40
 Call Schedule: 1/week

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


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?
    Faculty & residents
  B. Frequency / Duration of Presentation(s)?
    Daily
  C. Format - What guidelines are set for the student's presentation?
    Standard case presentation format
  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&P's and progress notes
  B. Format - What guidelines are set for the student's written work?
    Standard note format; (3C)no written assignments
  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.?
    Based on cases
  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)?
    n/a

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.
    Clinical evaluation completed by faculty.

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.