INTL-4016 - Field Experience in One Health and Outbreak Investigation

INTL-4016 - Field Experience in One Health and Outbreak Investigation

Elective Title: Field Experience in One Health and Outbreak Investigation
Course Number: INTL-4016
Elective Type: clinical Duration/Weeks: 4 Max Enrollment: 15
Prerequisites: Successful completion of Year 3
Additional Requirements: Students must complete an application process and undergo selection to participate in this course. A C-form is required.
Responsible Faculty Director: Matthew Dacso, MD, MSc Periods Offered: 13 excluding holiday period 8 Offered 100% Online
Coordinator: Other Faculty: Dennis Bente, DVM, PhD
Location to Report on First Day:
Texas A&M - College Station

1) Employ a One Health approach to identify the social, economic, environmental, and cultural determinants of population health
2) Develop the necessary knowledge, attitudes, and skills to participate effectively in the evaluation of an outbreak
3) Expand knowledge of the roles, responsibilities, and ways of thinking for the various disciplines and professions involved in improving global public health
4) Work in teams to develop and practice the fundamental leadership skills involved in addressing emerging public health threats
5) Explore the evolution of an emerging public health problem from a variety of learning environments

1) Describe the "One Health" approach to emerging epidemic threats
2) Explore how various institutions, agencies, and actors approach an outbreak response
3) Enhance knowledge on pathogen and immune diagnostics and development.
4) Strengthen knowledge on disease epidemiology and public health response
5) Apply theoretical public health knowledge to real-life situations to solve problems.
6) Reflect upon the benefits and challenges of working in an interprofessional environment
7) Develop teamwork and critical thinking capabilities.

Description of course activities
One Health is defined as the collaborative effort of multiple disciplines, working locally, nationally, and globally, to attain optimal health for people, animals, and our environment. Implementing this approach requires breaking down professional silos and engaging medical and veterinary professionals, laboratory scientists, the public health community, policymakers, and experts from the biomedical, social, and environmental sciences. This 4 week course will take a One Health approach to the problem of emerging infectious diseases, from various points of view, including (but not limited to) veterinary, public health, laboratory, and clinical. Using innovative and highly inter-professional learning approaches and guided by experts in the field, students will travel between various universities to observe regional differences in the social, economic, cultural, and environmental determinants of population health. Topics that will be addressed include animal/veterinary health, vector dynamics, sample collection and processing, molecular diagnostics, countermeasure development, biocontainment/biosecurity, clinical management of potential infectious threats, communications skills, interprofessional teamwork, and public health system response. This course is an interprofessional rotation for DVM, MD, PhD, MPH, and other graduate-level students. It provides an opportunity for training in translational team science, from the field to the lab to the bedside. The course will use scenario-based learning (SBL) as an active learning strategy, thus optimizing the conditions for development of knowledge, attitudes, and skills.

Type of students who would benefit from the course
This course is open to 3rd and 4th year students. Students who can work well in interprofessional teams and are interested in global health, emerging epidemics, vector-borne diseases, public health/prevention, health policy, environment/climate change, and field work would benefit the most from this course.

Weekly Schedule
  Clinical Activities (estimated schedule)  
Day of Week   AM   PM

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

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?
    Once weekly
  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 other students
  B. Frequency / Duration of Presentation(s)?
  C. Format - What guidelines are set for the student's presentation?
    Format will vary according to the activity being presented, with guidance from site supervisors
  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?
    Format will vary according to the activity being presented, with guidance from site supervisors
  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?
    Literature search from up-to-date One Health materials
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
    Content will be student or faculty-selected, and will relate to the cases being discussed.
  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)?
    Students should expect to participate in a variety of experiences throughout the elective, including animal necropsy, lab work, vector collection from the field, patient interviews, clinical simulation, public speaking, and written communications

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.
    Grading (satisfactory/unsatisfactory) will be based on attendance and participation in assigned activities at each field site, completion of assigned task(s), evaluations/feedback from the course mentors, and submission of a final report to the course committee by the student summarizing their internship experience and outcomes.

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.