SURU-4043 - Advanced Clinical Urology

SURU-4043 - Advanced Clinical Urology

Elective Title: Advanced Clinical Urology
Course Number: SURU-4043
Elective Type: clinical Duration/Weeks: 4 Max Enrollment: 3
Prerequisites: Successful completion of Year 3
Additional Requirements: Completion of Urology AI rotation (SURU 4010) before being eligible to take this elective.
Responsible Faculty Director: J. Nicholas Sreshta, MD Periods Offered: 1-13 including holiday period 8 
Coordinator: Amy White Other Faculty: Joseph Sonstein, MD Stephen Williams, MD Dr. Farhan, Dr. Alzweri, Dr. Gerber
Location to Report on First Day:
Urology Office - JSA 6.310

Provide a comprehensive outpatient/inpatient experience specifically for 4th year medical students who intend to participate in the upcoming urology match. Student goals for each week include seeing 10 clinic patients and participate in at least 5 cases.

Rotation is designed to help further educate prospective urology applicants in the field of urology in a comprehensive outpatient/inpatient model that goes beyond the level of participation provided in the current surgery clerkship and AI experiences.

Description of course activities
1. One-on-one preceptorship models with different urology faculty.
2. Outpatient clinical and procedural experience
3. Inpatient OR and direct patient care experience
4. Simulation lab training.
5. Involvement in ongoing research activities

Type of students who would benefit from the course
Course is specifically designed only for those 4th year students who have fully decided on participating in the urology match. These students would have already been expected to complete their surgery clerkship as well as AI rotation. This rotation is not a requirement for all prospective urology applicants, but does serve as an opportunity to spend an additional month in a more dedicated fashion. This would especially be useful to those students who did not get to rotate in urology as part of their 3rd year clerkship, and may have already completed their AI as a 3rd year student.

Weekly Schedule
  Clinical Activities (estimated schedule)  
Day of Week   AM   PM
Monday 7:00 am 6:00 pm
Tuesday 7:00 am 6:00 pm
Wednesday 7:00 am 6:00 pm
Thursday 7:00 am 6:00pm
Friday 7:00 am 6:00 pm
Saturday optional
Sunday optional

 Average number of patients seen per week: 120+
 Call Schedule: no required call

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?
    Students will be observed clinically throughout the rotation.
  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 and residents
  B. Frequency / Duration of Presentation(s)?
    One presentation given at the weekly urology education conference on a topic of the student's choice
  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)?
    weekly at education conference
  B. Format - What guidelines are set for the student's written work?
    15-20 minute PowerPoint Presentation
  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.?
    interesting case, a core curriculum topic, or an ongoing research.
  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)?
    In addition to a presentation, the students will also participate in all urology education activities including tumor board, journal club. Additionally, the students will spend time in the LSTAR simulation lab.

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.