RADU-4008 - General Radiology

RADU-4008 - General Radiology

Elective Title: General Radiology
Course Number: RADU-4008
Elective Type: clinical Duration/Weeks: 4 Max Enrollment: 2
Prerequisites: Successful completion of Year 3
Additional Requirements: None
Responsible Faculty Director: Dr. Falamaki Periods Offered: 1-13 including holiday period 8 
Coordinator: Lycia Champagne-Buckley Other Faculty:
Location to Report on First Day:
Lycia Champagne-Buckley, lcchampa@utmb.edu

To produce an appreciation of the role of radiologic imaging in the work-up of patients. That includes discussions of indications and alternatives, when imaging is appropriate and when it is not, and what course of action should follow both positive and negative findings. The purpose is to develop in our student physicians the realization that radiologic imaging is only one of a number of means by which information is obtained and that the history is, by far, the most important source of information.

To describe and illustrate normal and abnormal findings on radiologic images, emphasizing the wide range of values that are within normal limits, depending on the circumstances. To encourage and assist students in exercising deductive reasoning in the solution of diagnostic problems. To emphasize the important role diagnostic imaging has in the work-ups of almost all patients, and to encourage sensible and thrifty decisions when tests of any kind are requested. To limit the differential diagnosis to a few likely entities, since the role of the radiologist is mostly to discover the abnormal finding, the diagnosis often being made by needle aspiration or biopsy.

Description of course activities
Students are rotated through several departmental divisions, spending about three days in each over the course of the month they are with us. An effort is made to select those rotations that are busiest, but consideration is given to the students' personal wishes and choices as well. Faculty people in each of the departmental divisions are responsible for organizing the activities of the elective students, activities that include image interpretation, observation of and assistance with certain special procedures, discussions of complicated cases, display of normal anatomy and common abnormalities, study of unknown images for later report, and assignment of subjects for review and report.

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

    Weekly Schedule
          Estimated Course Activities (Start-Time/Finish-Time):
Day of Week   AM   PM
Monday 8:00; clinical rotations 5:00; clinical rotations
Tuesday 8:00 5:00;
Wednesday 8:00 5:00;
Thursday 8:00 5:00;
Friday 8:00 5:00;
Saturday n/a n/a
Sunday n/a n/a

 Average number of patients seen per week: 100+
 Call Schedule: n/a

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

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?
    Their observations and reasoning are scrutinized each day on each of the services, where they are asked to interpret images and comment on our interpretations. All of this is done at our various workstations throughout the department. How often are students observed clinically? Several times each day in each of the sections to which they are assigned.
  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?
    Dr. Schreiber
  B. Frequency / Duration of Presentation(s)?
    Three cases on GI rotation.
  C. Format - What guidelines are set for the student's presentation?
    Detailed in handout and oral explanation.
  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)?
    Being present, showing interest and performing creditably.

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.
    Quizzing and assignment of problem cases to be presented at a subsequent time. Students are expected to discover the abnormality, describe the findings, make a diagnosis or give the differential diagnosis, explain the natural history of the condition, tell the treatment and the prognosis. No formal examination is given. The student is evaluated on attendance, interest, and performance and improvement during the elective. Also tested in daily encounters with the faculty, in which the student is challenged to interpret and understand images and their importance to the patient.

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.