PATU-4012 - Clinical Chemistry

PATU-4012 - Clinical Chemistry

Elective Title: Clinical Chemistry
Course Number: PATU-4012
Elective Type: clinical Duration/Weeks: 4 Max Enrollment: 2
Prerequisites: Successful completion of Year 2
Additional Requirements: N/A
Responsible Faculty Director: Anthony O. Okorodudu, Ph.D., MBA Periods Offered: 1-13 including holiday period 8 
Coordinator: Tracy Wilkins Other Faculty: Peter McCaffrey, M.D.
Location to Report on First Day:
Clinical Chemistry Division 7.412 QA CSW (409)772-3197

1. To enhance the theoretical concepts regarding the pathogenesis, pathophysiology, and treatment of diseases learned in the Basic Science Core and aid in the development of skills needed for disease diagnosis.
2. To learn how to interpret laboratory data in the monitoring of the pathophysiology of the course of disease and convalescence.
3. To develop an understanding of the function and operation of the clinical chemistry laboratory towards the goal of patient diagnosis and management.

1. Understand the significance of appropriate specimen collection, transport, processing, and storage in clinical chemistry.
2. Understand quality assurance indicators by participation in the daily rounds on patient test results and hands-on experience using the quality control system.
3. Acquire an overall knowledge of the principles and limitations of various clinical chemistry laboratory assay techniques.
4. Develop enhanced skills necessary for laboratory investigation and correlation of laboratory findings with patients' clinical presentation.

Description of course activities
The student will rotate through each work station in the division under the supervision of the pathologist/clinical scientist with the assistance of medical technologists. This bench level rotation will expose him/her to the various subsections which will include specimen receiving, urinalysis, enzymology, immunochemistry, special chemistry (RIA), and toxicology/therapeutic drug monitoring. Special attention will be paid to tests performed, instrumentation and methodologies, quality control (internal and external), quality assurance, test cost analysis, computer applications, reading, and case studies. The student will participate in daily rounds on selected cases and selected lectures given by the laboratory directors.

Type of students who would benefit from the course
All students interested in clinical practice.

Weekly Schedule
  Clinical Activities (estimated schedule)  
Day of Week   AM   PM
Monday 8:00 - 12:00 1:00 - 5:00
Tuesday 8:00 - 12:00 1:00 - 5:00
Wednesday 8:00 - 12:00 1:00 - 5:00
Thursday 8:00 - 12:00 1:00 - 5:00
Friday 8:00 - 12:00 1:00 - 5:00

 Average number of patients seen per week: 1,300 specimens/day
 Call Schedule: None

Research Activities (estimated schedule)
Activity Hours per Week
Faculty Contact-Time
Self-Directed Study
Other Clinical Chemistry Laboratory

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?
    Focus on clinical chemistry test results during weekly case presentations
  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?
    Faculty, Fellows, Pathology Residents and Technologists
  B. Frequency / Duration of Presentation(s)?
    Daily review of 2-3 patients test results with the Director-on-Call (1-2 hours) and one oral case presentation per week (1 hour).
  C. Format - What guidelines are set for the student's presentation?
    Powerpoint 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)?
    Once per week (case reports)
  B. Format - What guidelines are set for the student's written work?
    case report format for publication
  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?
    Pubmed search and assigned clinical chemistry textbook
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
    Selection will be from test results obtained in the clinical laboratory.
  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)?
    Active participation in all scheduled conferences. Demonstrated preparedness for conferences.

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.
    Student's participation in daily case review and the scope of the clinicopathologic discussion during weekly case presentation by student. Readiness to present cases as assigned and active correlation of diagnostic data, clinical presentation, and physical examination findings.

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.