MEDU-4077 - Cardiac Electrophysiology Clinical Elective

MEDU-4077 - Cardiac Electrophysiology Clinical Elective

Elective Title: Cardiac Electrophysiology Clinical Elective
Course Number: MEDU-4077
Elective Type: clinical Duration/Weeks: 4 Max Enrollment: 1
Prerequisites: Successful completion of Year 2
Additional Requirements: Successful completion of either Surgery or Internal Medicine rotation
Responsible Faculty Director: Asif Sewani, MD Periods Offered: 4-7,9-13 excluding holiday period 8 
Coordinator: Other Faculty:
Location to Report on First Day:
JSA 5.106, contact Alexandria "Allie" Cornell at 8:15am

To develop skills in the diagnosis and management of cardiovascular and cardiac electrophysiological conditions.

The student should be able to: -obtain a comprehensive but focused medical history. -perform a comprehensive but focused physical exam. -identify key abnormalities to generate a differential diagnosis. -devise a diagnostic testing strategy to narrow down a diagnosis. -understand basic concepts in management of electrophysiologic disorders. -write and verbalize an efficient assessment and plan in management of electrophysiologic disorders. -describe common procedures performed in the electrophysiology lab. -increase ability to read and interpret specific diagnostic studies including ECG and device interrogations.

Description of course activities
-See inpatient electrophysiology consultations. -See outpatient electrophysiology consultations. -Complete written notes and present patients to faculty and fellows. -Discuss patient cases with faculty and fellows to bolster knowledge and skills. -Observe procedures in the electrophysiology lab. -Engage in interactive learning with faculty and fellows.

Type of students who would benefit from the course
Students with high self-motivation who have an interest in cardiology and/or electrophysiology, who want to learn more in-depth content of electrophysiology as well as gain insight into potential procedural-based internal medicine careers. Content understanding requires steep learning curve.

    Weekly Schedule
          Estimated Course Activities (Start-Time/Finish-Time):
Day of Week   AM   PM
Monday 8-12 1-6
Tuesday 8-12 1-6
Wednesday 8-12 1-6
Thursday 8-12 1-6
Friday 8-12 1-6

 Average number of patients seen per week: 10 (mix of inpatient/outpatient)
 Call Schedule:

Research / Other Course Activities
(estimated schedule)
Activity Hours per Week
Faculty Contact-Time 22
Self-Directed Study 8
Data-Collection/Analysis 10

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?
    Multiple times daily in a variety of settings
  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 & Fellows
  B. Frequency / Duration of Presentation(s)?
    Daily presentations of patient cases and two oral presentations on student-selected topics (20 min each)
  C. Format - What guidelines are set for the student's presentation?
    Daily presentations to be given continuous feedback. Oral presentations to be efficient, evidence-based presentations, focused on a clinical problem seen by the student.
  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)?
    Notes to be written for every patient encounter, but 4 H&Ps to be assessed formally (2 per each faculty).
  B. Format - What guidelines are set for the student's written work?
    Parameters for good notes to be discussed/taught throughout the elective.
  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)?
    EKG interpretation will be emphasized throughout the course and basic proficiency should be demonstrated by completion of the 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".

7.  Other Modes of Evaluation
  Please explain below.
    Overall evaluation to be based on: 1. H&Ps, for content, quality, and clarity. 2. Oral presentations, for content, quality, and clarity. 3. EKG interpretation, for basic proficiency.

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.