ORSU-4017 - Orthopedic Research

ORSU-4017 - Orthopedic Research

Elective Title: Orthopedic Research
Course Number: ORSU-4017
Elective Type: research Duration/Weeks: 4 or 8 Max Enrollment: 2
Prerequisites: Successful completion of Year 2
Additional Requirements: An interview with one of the laboratory directors is required prior to enrollment. A R-form must be submitted 60 days in advance of all research electives.
Responsible Faculty Director: Zbigniew Gugala, MD, PhD Periods Offered: 1-13 including holiday period 8 
Coordinator: Bryanna Branch Other Faculty:
Location to Report on First Day:
2.316 Rebecca Sealy, Research director's office

To acquaint the student with modern quantitative methods of research in orthopedics. To acquaint the student with the current limits of knowledge in some aspects of a problem in orthopedics, and to demonstrate how laboratory research expands the knowledge-base.

At the completion of the electives the student should:
1. Be familiar with the current literature in some particular area related to orthopedics.
2. Become familiar with some particular laboratory testing methodology.
3. Be able to generate a research protocol and/or research report which includes a hypothesis, methodology, results and tests of the hypothesis.

Description of course activities
A variety of projects are ongoing in the Division's two laboratories. Depending upon the specific methodology used and the stage of the investigations, the student may become involved in any of the following activities:
Bone Physiology Laboratory - animal surgery, bone grafting, fluorescent labeling (tetracycline) and radioisotopic measurements of collagen and bone mineral formation, preparation of tissues for light microscopy and electron microscopy (TEM/SEM), microradiography, and histomorphometry; marrow cell culture.
Biomechanical Laboratory - mechanical testing of bone joints or soft tissues, joint contact pressure measurements, histomorphometric analysis, digital video scanning of images, mechanical instrumentation, computer-aided stress analysis, and computer simulation of the musculoskeletal system. The student will work under the supervision of the Director of the laboratories, as well as with a collaborating clinical faculty member.
Although not required, students with a background in research methods, statistics, computers, engineering, and cell biology would be useful.

Type of students who would benefit from the course
Students with career goals in orthopedics or plastic surgery, and those with a desire to continue in academic medicine.

Weekly Schedule
  Clinical Activities (estimated schedule)  
Day of Week   AM   PM

 Average number of patients seen per week:
 Call Schedule:

Research Activities (estimated schedule)
Activity Hours per Week
Faculty Contact-Time 5
Self-Directed Study 5
Data-Collection/Analysis 30

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?
    Research staff and research mentor
  B. Frequency / Duration of Presentation(s)?
    Weekly for 5-15 minutes
  C. Format - What guidelines are set for the student's presentation?
    Informal research environment
  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)?
    Variable in our research environment, but the student will at least have the experience of providing a written report that follows the typical research report guidelines.
  B. Format - What guidelines are set for the student's written work?
    Standard research report guidelines and editorial rules of individual journals.
  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?
    All students complete a literature review beginning with existing summaries using interactive computer resources such as medline/medlars and actual visits to the UTMB library.
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
    Depends upon current research activity and student interest.
  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)?
    The student takes part in all of the team related aspects of research during the time period. This includes weekly research meetings, reporting on research progress and results, and taking part in project related research meetings.

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.
    The laboratory director supervises the student's work and assigns a grade at the end of the elective period. The student is evaluated on experimental participation, teamwork, oral and written reports. All written material turned in by the students will be graded using editorial criteria for content and grammar typical of the Orthopaedic peer review journals.

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.