OPHU-4404 - Ophthalmology Sr. Elective

OPHU-4404 - Ophthalmology Sr. Elective

Elective Title: Ophthalmology Sr. Elective
Course Number: OPHU-4404
Elective Type: clinical Duration/Weeks: 4 Max Enrollment: 1
Prerequisites: Successful completion of Year 3
Additional Requirements: C-form required & OPHU-4001, Fam Med, Int Med, & Surgery Clerkships should be completed prior to this course. Visiting Students should submit a CV, USMLE scores & transcripts to the course director to be considered for this elective.
Responsible Faculty Director: Aishat Adebayo, MD Periods Offered: 1-13 including holiday period 8 
Coordinator: Clarissa Mora & Rene Vela III Other Faculty: All Ophthalmology faculty who staff the TDC clinic and consults will be involved.
Location to Report on First Day:
Shayna Bell, University Eye Center, 2nd floor, Rm 2.220 409-747-5434

1. Learn a more in-depth history and examination for the Ophthalmology patient in both an inpatient and outpatient setting
2. Gain hands-on skills in examination techniques
3. Broaden one's knowledge base in Ophthalmology
4. To present at least one interesting case seen during the rotation at the departmental Grand Rounds

1. Evaluate patients independently in the TDC Clinic, present the patients to Ophthalmology residents and/or faculty in a concise, thorough manner.
2. Work with the Consult resident during the day to see at least 2-3 consult patients during the month and evaluate them with the resident at bedside.
3. Plan on taking "shadow call" from home at least one day a week. Student will be contacted by resident if a consult comes in (after hours/weekend) with the on-call resident team.

Description of course activities
Student will work with Ophthalmology residents at the TDC Ophthalmology Clinic M-F during subspecialty clinics. The student can also choose to work with the Ophthalmology Consult resident during this time, seeing inpatients/ER patients for consultation. The student will be expected to take "shadow call" at least one day a week with the on-call resident team.

Type of students who would benefit from the course
Students with a desire to enter the field of Ophthalmology and who have already completed the pre-requisite rotation.

Weekly Schedule
  Clinical Activities (estimated schedule)  
Day of Week   AM   PM
Monday 8:00 TDC/Consults 5:00 TDC/Consults
Tuesday 8:00 TDC/Consults 5:00 TDC/Consults
Wednesday 8:00 TDC/Consults 5:00 TDC/Consults
Thursday 8:00 TDC/Consults 5:00 TDC/Consults
Friday 8:00 TDC/Consults 5:00 TDC/Consults
Saturday on call if student chooses
Sunday on call if student chooses

 Average number of patients seen per week: 100
 Call Schedule: one day per week

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, residents and medical students
  B. Frequency / Duration of Presentation(s)?
    At least one Grand Rounds presentation during rotation; daily patient review
  C. Format - What guidelines are set for the student's presentation?
    Grand Rounds presentation information and template will be provided during orientation on first day of elective. The Chief resident will work with the student to refine case presentation details.
  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)?
  B. Format - What guidelines are set for the student's written work?
  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)?
    The student should attend Grand Round sessions on Wednesdays. The student is encouraged to attend additional weekly conferences assigned to residents. Schedule provided during orientation.

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.
    Patients will be presented to the residents/faculty at TDC clinic after evaluation by the student. Case discussion will also occur regularly. A case presentation will be given at our Grand Rounds once during the rotation regarding an interesting case seen on the rotation.

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.