Elective Title: Ambulatory Cardiology | |||
Course Number: MEDU-4093 | |||
Elective Type: career | Duration/Weeks: 4 | Max Enrollment: 2 | |
Prerequisites: Successful completion of Year 3 | |||
Additional Requirements: N/A | |||
Responsible Faculty Director: Ethan Podet, MD, FACC | Periods Offered: 1-13 including holiday period 8 | ||
Coordinator: Ethan Podet, MD, FACC | Other Faculty: | ||
Location to Report on First Day: Houston, Heart, 1200 Binz Street, Suite 540, Houston, TX 77004 Contact Dr. Podet at podet@sbcglobal.net. |
Goals |
1. Understand the principles and protocols for pre-operative cardiac assessment. 2. Develop a systematic approach to evaluating patients presenting with chest pain. 3. Gain expertise in the evaluation and management of patients experiencing palpitations. 4. Learn the approaches to diagnosing and managing dyspnea with a focus on cardiac causes. |
Objectives |
Identify patients at risk for perioperative cardiac complications.Learn how to perform and interpret pre-operative cardiac evaluations, including history taking, physical examination, and diagnostic testing (e.g., EKG, echocardiography, stress testing).Develop strategies for managing patients with significant cardiac conditions who require surgery.Differentiate between cardiac and non-cardiac causes of chest pain.Use appropriate diagnostic tools and tests (e.g., EKG, troponins, chest X-ray) to assess the severity and etiology of chest pain.Formulate management plans based on the underlying cause of chest pain, including both acute and chronic management strategies.Determine the potential cardiac and non-cardiac causes of palpitations through history, physical examination, and diagnostic testing (e.g., Holter monitoring, event monitors, EKG).Understand how to classify different types of arrhythmias and their clinical implications.Develop management strategies for patients with palpitations, including lifestyle modifications and pharmacologic treatments.Recognize the signs and symptoms of cardiac-related dyspnea versus dyspnea from other etiologies (e.g., pulmonary, musculoskeletal).Utilize diagnostic tests (e.g., BNP levels, echocardiography, chest imaging) to assess cardiac function and identify underlying conditions contributing to dyspnea.Create comprehensive management plans for patients with cardiac-related dyspnea, including pharmacologic and non-pharmacologic interventions. |
Description of course activities |
Students will practice understanding approaches to and evaluation of common cardiac clinical problems: pre-operative evaluation, chest pain, palpitations, dyspnea. This course in ambulatory cardiology is offered for students who seek to enhance their expertise in the evaluation and management of prevalent cardiac conditions encountered in outpatient settings. Emphasizing a patient-centered approach, the course identifies key aspects of pre-operative cardiac evaluation, chest pain, palpitations, and dyspnea, equipping students with the skills necessary to deliver high-quality care and make informed clinical decisions. Full participation in ambulatory patient care activities including histories and physical examinations, clinic note writing, and order entry. Rotations are 4 weeks in duration. Students will work Monday through Friday in an ambulatory setting with faculty supervision. Faculty will provide feedback on Oral Presentations and Clinic Notes whether working directly with faculty or residents. Feedback will include suggestions on how to improve verbal presentation skills, documentation in the electronic medical record (clinic notes), ability to enter orders and knowledge gaps in patient management. Students will have 12 hours of self-directed independent study per week to cover the assigned reading topics. Students will receive a list of essential readings, including textbooks, articles, and clinical guidelines, related to pre-operative evaluation, chest pain, palpitations, and dyspnea. Students are encouraged to reflect on their clinical experiences and relate them to the literature, enhancing retention and understanding of concepts. Self-directed study should complement the hands-on clinical experiences, helping students apply theoretical knowledge to practical scenarios. |
Type of students who would benefit from the course |
Those with interest in Internal Medicine or Cardiology |
Weekly Schedule | ||||
Estimated Course Activities (Start-Time/Finish-Time): | ||||
Day of Week | AM | PM | ||
Monday | 10 am | 2 pm | ||
Tuesday | 10 am | 2 pm | ||
Wednesday | 10 am | 2 pm | ||
Thursday | 10 am | 2 pm | ||
Friday | 8 am | 12pm | ||
Saturday | ||||
Sunday | ||||
Average number of patients seen per week: 30 |
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Call Schedule: No |
Research / Other Course Activities | |
(estimated schedule) | |
Activity | Hours per Week |
Faculty Contact-Time | 20 |
Self-Directed Study | 12 |
Data-Collection/Analysis | |
Other |
Method of Student Evaluation | ||
1. Clinical Observation | ||
A. | Where are students observed on this elective? | |
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B. | Frequency - How often are students observed clinically? | |
Daily | ||
C. | Format - What method(s) are used to document the student's clinical performance? | |
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2. Oral Presentation | ||
A. | Audience - To whom does the student present? | |
Dr. Ethan Podet - faculty on service | ||
B. | Frequency / Duration of Presentation(s)? | |
daily, 20-22 hours weekly | ||
C. | Format - What guidelines are set for the student's presentation? | |
Students will be expected to present historical and physical examination data as it relates to their patients. Students will be expected to have common medical knowledge and be able to effectively respond to instructor presentation assessments. | ||
D. | Assessment - Who assesses the student's presentation performance? | |
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E. | Method of content selection | |
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3. Written Assignment (H&P's, notes, papers, abstracts, etc.) | ||
A. | Frequency of written assignment(s)? | |
none | ||
B. | Format - What guidelines are set for the student's written work? | |
none | ||
C. | Length of written assignment(s)? | |
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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? | |
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4. Examination | ||
Format | ||
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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)? | ||
Student performance is evaluated by faculty and fellows based upon daily clinical performance. |
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". | ||
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.Specify how the student will be given formative feedback on their clinical skills. |
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B. |
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. |
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C. |
How specifically will this AI build on developing skills from the clerkship year to prepare students for internship? |
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D. |
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)? |
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E. |
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? |
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F. |
How is the student demonstrating drawing clinical conclusions and/or developing a management plan and documentation as an intern would do? |
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G. |
How and by whom will midpoint feedback be provided to the student? How will you remediate deficiencies identified at midpoint? |
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H. |
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. |
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