CEEU-4013 - Hybrid Addiction Medicine 2

CEEU-4013 - Hybrid Addiction Medicine 2

Elective Title: Hybrid Addiction Medicine 2
Course Number: CEEU-4013
Elective Type: career Duration/Weeks: 2 Max Enrollment: 2
Prerequisites: Successful completion of Year 1
Additional Requirements: Completion of Virtual Addiction Medicine 1, C-Form Required to ensure prerequisite met and clinic capacity during each period. Email CEE team at cee@utmb.edu for details.
Responsible Faculty Director: N. Miles Farr MD, MPH Periods Offered: 1-7, 9-13, A and B periods excluding holiday period 8 
Coordinator: CEE team at cee@utmb.edu Other Faculty: Carlos Dostal MD, PHD; Ernst Nicanord MD
Location to Report on First Day:
Will email location and schedule.

This rotation aims to provide a thorough understanding of addiction medicine, combining didactic learning with clinical practice. It focuses on preparing participants to deliver comprehensive care to individuals with addiction, emphasizing the integration of medical and psychosocial approaches. The course seeks to develop skills in evidence-based treatment, patient-centered communication, and an understanding of the broader impacts of substance use disorders.

1. Effectively screen, diagnose, and manage substance use disorders.
2. Employ patient-centered approaches in conducting addiction histories and physical examinations.
3. Identify and manage complications associated with substance use disorders.
4. Understand and apply treatment options for various substance use disorders, including tobacco, alcohol, opioids, club drugs, marijuana, and benzodiazepines.
5. Utilize urine drug testing in opioid prescribing and monitoring.

Description of course activities
• Didactic Curriculum – ~ 10 hours per week: Builds on previous knowledge with advanced topics in addiction medicine and includes a book assignment on the opiate crisis.
• Clinical and In-Person Experiences – ~ 20 hours per week: Includes outpatient clinics, telemedicine sessions, shadowing licensed counselors, attending community support groups, and Galveston Drug Court sessions. 2 clinics on Tu, Th morning plus support group and drug court times will vary depending on the week and opportunities chosen by student and leadership team.
• Reflection Assignment – ~ 2 hours per week: Designed to foster empathy and a deeper understanding of the challenges in addiction treatment.

Type of students who would benefit from the course
This elective is highly relevant for medical students across all specialties, given the universal challenge of managing pain and addiction in diverse patient populations. Its content is not only pertinent to future professional practice across the medical field but also offers valuable insights for supporting community members affected by addiction.

Weekly Schedule
  Clinical Activities (estimated schedule)  
Day of Week   AM   PM
Tuesday 8:00 12:30
Thursday 8:00 12:30

 Average number of patients seen per week: 10
 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?
    Twice a week
  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?
  B. Frequency / Duration of Presentation(s)?
  C. Format - What guidelines are set for the student's 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)?
    - H&Ps and progress notes in clinic twice a week. - Didactic completion verification certificates to be submitted online. - A reflection on Addiction Medicine and a book reflection will need to be completed by the end of the course. - The course will utilize Blackboard for assignment submissions.
  B. Format - What guidelines are set for the student's written work?
    - Standard clinical documentation expectations. - Will receive specific reflection prompts and guidance.
  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)?

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.