RADU-4003 - Diagnostic Ultrasound/Computerized Tomography

RADU-4003 - Diagnostic Ultrasound/Computerized Tomography

Elective Type: clinical
    
Title
Diagnostic Ultrasound/Computerized Tomography
Course Number
RADU-4003
Duration/Weeks
4
Prerequisites: Successful completion of Year 2 
      Additional Requirements:
N/A
Responsible Faculty Director:
Peeyush Bhargava, M.D.
Other Faculty:
Location to Report on First Day
Shirvonne Pope (sapope@utmb.edu)
Periods Offered
1-13
including holiday period 8
Maximum Enrollment
2

Goals
The rotation is designed to acquaint the students with the applications, contributions, and limitations of diagnostic ultrasound, and CT body tomography as imaging modalities used in clinical medicine. Methodology, basic tomographic anatomy, image interpretation, and cost of radiographic studies are stressed.

Objectives
At the completion of a three-week elective, the students should be able to: 1. Describe the cross-sectional anatomy depicted on tomograms created by Ultrasound and body CT units. 2. Make a judgment as to which modality, CT versus ultrasound, is the more prudent diagnostic study to order in a given clinical situation. 3. Select the appropriate protocol for the clinical situation. 4. Have some ability in the interpretation of ultrasound, and CT images that depict common chest, abdominal, retroperitoneal and pelvic disorders. 5. Appreciate the diagnostic and economic value of conventional radiographic studies in the prelimary workup of patients.

Description of course activities
Approximately 40 diagnostic studies are performed in the CT/US Sections daily. Two-thirds of these are ultrasound examinations including abdominal, vascular, and gynecological. The remaining cases consist of 20-25 body CT studies. The student has the opportunity to work closely with the technician, radiology resident and faculty on a day-to-day basis as the images are created and interpreted.

Type of students who would benefit from the course
This course is particularly valuable for students who are interested radiology, internal medicine, family practice, and surgery. All students can benefit by the experience however.

Weekly Schedule
  Clinical Activities (estimated schedule)
  Day of Week AM PM
  Monday 8:00 5:00
  Tuesday 8:00 5:00
  Wednesday 8:00 5:00
  Thursday 8:00 5:00
  Friday 8:00 5:00
  Saturday
  Sunday
   Average number of patients seen per week: 200  
   Call Schedule:   None  

Research 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?
    Daily
  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?
    Students are not required to give oral presentations.
  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)?
    Written assignments are not required. History and physicals are presented by the referring physician.
  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?
    N/A
  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)?
    All aspects of Radiology are covered during noon lectures presented daily for Radiology Residents. Students are encouraged to attend as many as possible and are required to attend three per week during their three week elective.

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.
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.