Advanced Diabetes Care in Clinical Practice
Successful completion of Year 3
Additional Requirements: C-form required for holiday period 10 only
Responsible Faculty Director:
Maria Belalcazar, MD
to Report on First Day
Report to faculty via text by 8:30 AM on the first day
including holiday period 8
|To advance diabetes management skills to the resident level and take leadership in efforts to raise awareness on existing diabetes care gaps among clinicians.|
|1. To become familiar with diabetes care guidelines and apply them to patient care
2. To become comfortable in prescribing insulin and non-insulin therapy in the inpatient setting and in adjusting regimen to the home setting at discharge
3. To identify a deficiency in care or a gap in diabetes care knowledge that may be shared with the medical community
|Description of course activities|
|With faculty support:
1. Acting intern will join as member of UTMB’s Inpatient Diabetes team and participate in rounds four days a week.
2. Acting intern will fully manage at least two diabetes patients a day and follow them by phone at least once during their first week of post-hospital discharge, modifying care, if needed, with faculty input through our transitions of care program
3. Identify and discuss with the medical team a deficiency in diabetes care or knowledge observed during the clinical elective and present it in brief written form by the end of the elective in a format that could be shared with the medical community
|Type of students who would benefit from the course|
|1. Students interested in an adult medicine specialty
2. Students who would like to strengthen and improve the quality of care for people with diabetes
3. Students who would like to advance their medical career by strengthening skills in the care of a highly prevalent and complex medical condition
4. Students who enjoy team work and patient interaction
|Clinical Activities (estimated schedule)|
|Day of Week||AM||PM|
|Average number of patients seen per week: 8-12|
|Call Schedule: N/A|
|Research Activities (estimated schedule)|
|Activity||Hours per Week|
|1. Clinical Observation|
|A.||Where are students observed on this elective?|
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
|2. Oral Presentation|
|A.||Audience - To whom does the student present?|
|B.||Frequency / Duration of Presentation(s)?|
|C.||Format - What guidelines are set for the student's presentation?|
|• Diabetes-focused patient evaluation and presentation. Guide provided at start of elective • Interactive discussion during rounds and independently with faculty on work regarding deficiency in diabetes care or knowledge|
|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)?|
|• Written consult and or progress note on EPIC 4 days/week • One abstract summary on observed knowledge or diabetes care deficiency with faculty input, due by the end of the elective|
|B.||Format - What guidelines are set for the student's written work?|
|• Standardized EPIC note documenting evaluation and plan for diabetes patient (guide given first day) • Summary raising awareness of deficiency in knowledge gap should be limited to 300 words and should follow an abstract format that will be provided|
|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?|
|At least 2-3 pertinent references relating to the case|
|E.||Method of content selection - e.g. student-selected, relate to cases, etc.?|
|Patient case seen during elective|
|F.||Audience - Who assesses the student’s written performance?|
|Peer Assessment Faculty Assessment Other|
Written multiple choice
Written essay / short answer
|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)?|
|• If student is interested, they may use abstract relating to deficiency in knowledge or care for submission to a scientific meeting for presentation • Students interested in further advancing diabetes quality and safety efforts at the system level may sign up for research elective or work on their own time on an initiative of their choice|
|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.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.