INTL-4024 - Policy / Public Health

INTL-4024 - Policy / Public Health

Elective Title: Policy / Public Health
Course Number: INTL-4024
Elective Type: career Duration/Weeks: 4 Max Enrollment: 5
Prerequisites: Successful completion of Year 2
Additional Requirements: Completion of pre-approval interview with course director or course faculty. Call 409.772.7884 to schedule the interview. C-Form is required to register.
Responsible Faculty Director: Ben Raimer, MD ??? Periods Offered: 12 & 13 excluding holiday period 8 
Coordinator: Other Faculty:
Location to Report on First Day:
Austin office of Dr. Ben Raimer, 8:00 AM first day of assignment. Arrangements made by appointment via 409-772-5304; or other alternative location to be provided.

Participants will understand the formulation of health policy through legislative action enacting law, agency regulation establishing rules and guidelines, and the public’s interpretation and action. This course is offered only on odd numbered calendar years when the Texas Legislature is in session.

1. Participate as a member of a team in the Texas legislative process. 2. Observe committee hearings on issues and draft legislation; 3. Prepare legislative bill analysis on selected health issue. 4. Describe how health policy is formulated and translated into law and regulation. 5. Explain how health policy impacts the health care professions and the health of individuals and communities. 6. Differentiate public health policy issues from other health policy. 7. Identify potential roles of healthcare professionals in health policy development and implementation.

Description of course activities
This is a non-clinical elective. Students approved for this course offering have one of four options to pursue. This four week experience may occur with one of the following placements, on a space available basis: a) with a Legislative or Senate member’s staff or in a Committee staff, b) with Dr. Raimer and his team supporting UTMB legislative affairs, or another health-related state agency’s legislative relations staff, c) with a health professional constituency organization such as Texas Medical Association’s legislative affairs team, or d) and health issue advocacy organization, such as American Heart Association – Texas Affiliate. Specific placements can't be guaranteed prior to the start of the course block. Students will be supervised by a policy and advocacy staff member at their assignment, who will report to the course director regarding professionalism, timeliness (attendance and punctuality), attention to detail, insightfulness, and willingness to be engaged and learn from the experience. Activities in this course include meeting and interacting with elected leaders, resource experts, and key stakeholders. Students will attend both committee hearings and Floor discussion and debate. Students will witness a dynamic policy development process, often charged with strong opinions regarding an issue, and the political intrigue accompanying the process. The student should not be drawn into this dynamic, but rather be an observer keen on synthesis of the key concepts, drivers and influences, and be alert to unintended consequences of potential new policy. Students on this assignment will meet with AHEC staff periodically for updates in person or by phone. Students will complete the course requirements by selecting a health issue and preparing an essay that summarizes their experiences observing movement of the issue through the legislative process. The essay should be 5- 10 pages in length, properly cited (APA), and submitted at the end of the course block to the course director and coordinator. Students approved for this course will be a reflection of, and on UTMB as an institution, and as such will be expected to fully participate in the Capitol assignment experience. Professional attire consistent with that of the Capitol staff is required. Work hours for the assignment will be the same as for Capitol staff, which during Legislative Session are often long, irregular, and unpredictable. Well-thought-out ideas should be the norm for the student's contribution to dialog in which the student participates.

Type of students who would benefit from the course
Health professions students who, in their future, may choose to advocate for their profession and for health issues affecting individuals and communities. Those who desire to be proactive in health policy through individual and leadership roles will be interested in this course opportunity.

    Weekly Schedule
          Estimated Course Activities (Start-Time/Finish-Time):
Day of Week   AM   PM
Monday 8:00 6:00
Tuesday 8:00 6:00
Wednesday 8:00 6:00
Thursday 8:00 6:00
Friday 8:00 6:00

 Average number of patients seen per week: 0
 Call Schedule: Not a clinical schedule; Schedule is is for work at the Capitol and is variable depending on hearing schedule, team meetings, or other special meetings. After-hours work may be expected, depending on circumstances.

Research / Other Course Activities
(estimated schedule)
Activity Hours per Week
Faculty Contact-Time 32
Self-Directed Study 8
Other Self-directed study will vary, depending on bill or issue research need to stay current with discussion.

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?
    a. Students are observed and evaluated by policy staff in the team where they are assigned, who will report to the course director as indicated above. b. Frequency – constantly
  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?
    Team members at placement site, may also include elected officials.
  B. Frequency / Duration of Presentation(s)?
    Ad hoc.
  C. Format - What guidelines are set for the student's presentation?
    Dependent upon team leader “preceptor”.
  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)?
    As requested by team leader (typically once per week), and completion of summative essay for course director.
  B. Format - What guidelines are set for the student's written work?
    Issue analysis; bill analysis; typically in narrative form.
  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?
    Not generally
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
    Assigned and/or student selected
  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)?
    May include attending receptions, press conferences, and other functions as part of policy team.

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.
    None, however, if standards of conduct described above are not maintained, prompt withdrawal from placement will occur without notice and an alternate placement for completion of the course will not be available.

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.