PEDU-4108 - Pediatric Allergy and Immunology Elective

PEDU-4108 - Pediatric Allergy and Immunology Elective

Elective Title: Pediatric Allergy and Immunology Elective
Course Number: PEDU-4108
Elective Type: clinical Duration/Weeks: 4 Max Enrollment: 2
Prerequisites: Successful completion of Year 3
Additional Requirements: Completion of pediatric clerkship
Responsible Faculty Director: David Lindsay, MD Periods Offered: 1-7, 9-13 excluding holiday period 8 
Coordinator: Tiffany Swain Other Faculty: Cleavon Covington, MD Sarah Pham, MD
Location to Report on First Day:
UTMB Bay Colony Pediatrics Subspecialty clinic

1. To prepare students for post-graduate training in pediatrics and allergy/immunology.
2. To improve understanding of physical exam maneuvers for pediatric allergy and immunology patients.
3. To encourage proficiency in the diagnostic and treatment modalities for patients with allergic and immunologic disease.
4. To make patients proficient in their understanding of basic immunology.

To understand:
1. Clinical evaluation and diagnosis of patients with allergic and immunologic disease.
2. Basic science of immunology and it's application to patient care.
3. Physical, developmental, and psychological considerations for patients with allergic and immunologic disease.

Description of course activities
1. Clinical rotation with the expectation that students will rotate at the UTMB Pediatric Allergy and Immunology clinics from Monday - Friday.
2. Students will actively engage with both patients and staff to provide care for patients with allergic and immunologic disease.
3. Students will be encouraged to proficiently present patients to faculty and other clinical learners.
4. Students will provide an oral presentation at the end of the elective regarding a disease state in our field.

Type of students who would benefit from the course
1. Students who plan to pursue a career in Allergy and Immunology
2. Students who plan to pursue a career in General Pediatrics
3. Students who plan to pursue a career in Otolaryngology, Hematology/Oncology, or Rheumatology.

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

 Average number of patients seen per week: 20
 Call Schedule: No

Research 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?
  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, residents, and other medical students
  B. Frequency / Duration of Presentation(s)?
    Once, at the end of rotation
  C. Format - What guidelines are set for the student's presentation?
    PowerPoint format presenting a comprehensive over of a chose allergic/immunologic disease state with evidence-based guidelines regarding diagnosis and current treatments.
  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 notes regarding patients seen in clinic.
  B. Format - What guidelines are set for the student's written work?
    To follow parameters of allergy / immunology clinic notes used by faculty and other learners.
  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)?
    Thoughtful questions, reviewing the literature for best practice guidelines.

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.

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.