INTL-4042 - Medical Spanish Abroad

INTL-4042 - Medical Spanish Abroad

Elective Title: Medical Spanish Abroad
Course Number: INTL-4042
Elective Type: career Duration/Weeks: 4 Max Enrollment: no limit
Prerequisites: Successful completion of Year 2
Additional Requirements: International electives require both (1) course director approval on C-Form, AND (2) institution-level approval. Travel to areas in which a US Department of State Bureau of Consular Affairs Travel Warning is in effect will not be allowed.
Responsible Faculty Director: Matthew Dacso, MD, MSc Periods Offered: 1-7; 9-13 excluding holiday period 8 
Coordinator: Bradley Brock Other Faculty: Students should contact Dr. Matthew Dacso at mmdacso@utmb.edu for more information at least 3 months in advance of intended travel dates.
Location to Report on First Day:
teaching site abroad

Goals
1. To provide a language and cultural immersion program designed to give medical students an opportunity to study Spanish in an overseas location, and to develop oral proficiency in medical Spanish, including the ability to communicate in Spanish when interviewing a patient and doing physical examinations.
2. To provide, through home-stay and cultural activities in the overseas site, an opportunity for enhancing the students understanding of the culture of the Spanish-speaking people, and recognize the importance of communication in the primary language of patients in furthering the family physician-patient relationship.

Objectives
1. Demonstrate proficiency in basic verbal elements of Spanish pronunciation.
2. Utilize appropriate grammar in basic sentence patterns.
3. Communicate clearly and effectively in Spanish using simple and practical vocabulary as well as meaningful medical vocabulary.
4. Demonstrate understanding and appreciation of cultural differences in the health perception of Spanish-speaking patients.

Description of course activities
Several programs have been approved and are available to view by contacting Caley Satterfield at casatter@utmb.edu, Program Manager, Center for Global Health Education. Please contact at least 3 months prior to desired elective period to set up elective.
Students are financially responsible for the travel and program they choose to pursue. Students should be aware that the program may or may not include clinical activities.

Type of students who would benefit from the course
This course is particularly valuable for students interested in practicing in a Spanish speaking community, and are interested in a cultural immersion experience.

    Weekly Schedule
          Estimated Course Activities (Start-Time/Finish-Time):
Day of Week   AM   PM
Monday 4 hours class instruction self study, assignments, patient care
Tuesday 4 hours class instruction self study, assignments, patient care
Wednesday 4 hours class instruction self study, assignments, patient care
Thursday 4 hours class instruction self study, assignments, patient care
Friday 4 hours class instruction self study, assignments, patient care
Saturday off off
Sunday off off

 Average number of patients seen per week:
 Call Schedule:

Research / Other Course Activities
(estimated schedule)
Activity Hours per Week
Faculty Contact-Time 20
Self-Directed Study 20
Data-Collection/Analysis N/A
Other Home stay/other cultural activities


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?
    Usually daily but may vary depending on the site selected.
  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?
    peers, instructor, clinician
  B. Frequency / Duration of Presentation(s)?
    Daily conversation/presentations on selected topics
  C. Format - What guidelines are set for the student's presentation?
    Guidelines vary depending on topic presenting and site. Generally focused encounters with different specialty topics are discussed and presented.
  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)?
    Daily assignments
  B. Format - What guidelines are set for the student's written work?
    Varies according to content and program(site).
  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.?
    Varies according to content and program(site).
  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)?
    Students have classes daily and are required to attend and participate. Language study requires daily verbal conversation. Written assignments are usually reviewed in class.

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.
    Written pre and post tests will be administered to document student progress. In addition, student must pass a comprehensive Medical Spanish written and oral evaluation. Grades will be based on the on-site instructors evaluation and the final exam.

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.