MEDU-4163 - Physical Examination Training for Senior Medical Student Tutors

MEDU-4163 - Physical Examination Training for Senior Medical Student Tutors

Elective Title: Physical Examination Training for Senior Medical Student Tutors
Course Number: MEDU-4163
Elective Type: career Duration/Weeks: 2 Max Enrollment: 8
Prerequisites: Successful completion of Year 3
Additional Requirements: Successful completion of the pre-clerkship and clerkship phase of medical school (Years 1,2, and 3)
Responsible Faculty Director: Karen Szauter, MD Periods Offered: 4B, 5A excluding holiday period 8 
Coordinator: Kiki Baldwin Other Faculty:
Location to Report on First Day:
email C-form directly to Karen Szauter kszauter@utmb.edu

Goals
Train senior medical students to serve as physical exam tutors for pre-clerkship medical students.

Objectives
1. Review the physical examination (PE) of the adult by system
2. Demonstrate competence in teaching the physical examination to early medical students using self as a model.
3. Demonstrate effective communication skills to provide feedback to early medical students on PE skills.

Description of course activities
This course will prepare senior medical students to serve as tutors to pre-clerkship students on physical examination skills.
Each student will review the appropriate chapters in Bates Guide to the Physical Examination and the associated materials used by the DoCS course in training students. (lung/respiratory, cardiovascular, abdomen, musculoskeletal, neurological, head-eyes-ears-nose throat exams.)
Students will allow peer students to practice physical exam techniques on themselves and will demonstrate skill in offering supportive and corrective feedback on PE maneuvers.
Each student will be assessed on their PE teaching skills and if correctly demonstrating skills and feedback will be added to the pool of PE tutors for the School of Medicine.
As time allows, more advanced PE skills will be practiced with the group. This is for benefit of the students enrolled in the course, to assist in preparation for internship. Specific resources including articles on the PE and Evidence Based PE book will be used during this course (all available through the UTMB library)

Type of students who would benefit from the course
1. Students interested in medical education.
2. Students entering primary care specialties (IM, FM) with a focus on adult care.

    Weekly Schedule
          Estimated Course Activities (Start-Time/Finish-Time):
Day of Week   AM   PM
Monday assigned readings assigned readings
Tuesday seminar and PE practice seminar and PE practice
Wednesday seminar and PE practice seminar and PE practice
Thursday seminar and PE practice assigned readings
Friday seminar and PE practice assigned readings
Saturday
Sunday

 Average number of patients seen per week: 0
 Call Schedule: N/A

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


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?
    Students will work together to demonstrate, practice, and instruct each other on the physical examination in preparation for teaching pre-clerkship students.
  C. Format - What method(s) are used to document the student's clinical performance?
    Daily oral feedback   End of period oral feedback   Written feedback
Other

2.  Oral Presentation
  A. Audience - To whom does the student present?
    N/A
  B. Frequency / Duration of Presentation(s)?
    N/A
  C. Format - What guidelines are set for the student's presentation?
    N/A
  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)?
    none
  B. Format - What guidelines are set for the student's written work?
    N/A
  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.?
    N/A
  F. Audience - Who assesses the student's written performance?
    Peer Assessment     Faculty Assessment     Other

4.  Examination
  Format
    Oral   Written multiple choice   Written essay / short answer   OSCE
Other

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".
    None

7.  Other Modes of Evaluation
  Please explain below.
    Students will be required to demonstrate skill in instruction of the physical examination. This will be done in small groups, and each student will be assessed by the course director and peers based on physical exam techniques.

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.
   
 
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.
   
 
C.
How specifically will this AI build on developing skills from the clerkship year to prepare students for internship?
   
 
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)?
   
 
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?
   
 
F.
How is the student demonstrating drawing clinical conclusions and/or developing a management plan and documentation as an intern would do?
   
 
G.
How and by whom will midpoint feedback be provided to the student? How will you remediate deficiencies identified at midpoint?
   
 
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.