MEDU-4096 - Caring for Patients with Disabilities

MEDU-4096 - Caring for Patients with Disabilities

Elective Title: Caring for Patients with Disabilities
Course Number: MEDU-4096
Elective Type: career Duration/Weeks: 4 Max Enrollment: 2
Prerequisites: Successful completion of Year 2
Additional Requirements: C-form required, these should be emailed directly to Dr. Szauter at kszauter@UTMB.EDU
Responsible Faculty Director: Karen Szauter, MD Periods Offered: 1-7; 9-13 excluding holiday period 8 
Coordinator: Kiki Baldwin Other Faculty: Joseph Ray, MD; Melissa Defilippis, MD; Christine Murphy, MD; William Mize, MD; Cynthia Peacock, MD (tentative); Robert Voight, MD (tentative);
Location to Report on First Day:
Virtual Orientation

1. Students will feel more comfortable working and interacting with people with disabilities
2. Students will explore the fields dedicated to working with people with disabilities
3. Students will learn how to communicate effectively with people with disabilities
4. Students will understand barriers to good health outcomes for people with disabilities
5. Students will understand socioeconomic implications of living with a disability

1. Students will have interactions and experiences volunteering with people with disabilities
2. Students will observe in several specialty clinics that treat patients with disabilities
3. Students will complete the American Academy of Developmental Medicine and Dentistry online webinar series

Description of course activities
Clinical Experience: 9 days of clinical experience with at least 3 different specialties/physicians chosen from a provided list. This list will consist of physicians who frequently treat patients with disabilities (Medical Genetics, Developmental Pediatrics, Complex Care, Pediatric Psychiatry, Transition Medicine, Specialty Clinics, etc.).
Community Experience: Students need to meet a minimum hourly requirement for volunteering with people with disabilities in the community. Students will be provided with a list of volunteer opportunities to choose from (Sunshine Center, Special Olympics, Galveston Schools, Easter Seals of Greater Houston, Galveston Families Exploring Down Syndrome, Camp CAMP, Camp for All, etc.), but they are also encouraged to find their own related volunteer opportunities. Volunteering at an overnight camp for any amount of time fulfills the minimum requirement, but students are still encouraged to volunteer locally in addition.
Disability Education: Certificate of completion of the American Academy of Developmental Medicine (AADMD) Physician Education in Developmental Disabilities (PEDD) Webinar. Some students will have already completed sections of this certification series in their POM 1 & 2 courses. (12 hours total)

The clinic hours consists of about 12-15 hours of faculty contact time, 5 hours of self-directed studies and 8-12 hours of community experience.

Type of students who would benefit from the course
This course is for students who want to get more comfortable working with people with disabilities. This course will offer students the ability to explore specialties that treat this population as well as opportunities directly interact with people with disabilities.

Weekly Schedule
  Clinical Activities (estimated schedule)  
Day of Week   AM   PM
Monday Medical Genetics, Dr. Ray Self Study/ Community Activity
Tuesday Ceramics/Garden volunteering at Sunshine Center Self Study/ Community Activity
Wednesday Medical Genetics, Dr. Ray Self Study/ Community Activity
Thursday Self Study/ Community Activity Evening Special Olympics tennis practice
Friday Pediatric Psych Development Clinic, Dr. Defilippis Self Study/ Community Activity
Saturday Camp (optional) Camp (optional)
Sunday Camp (optional) Camp (optional)

 Average number of patients seen per week: 5-15
 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?
    8-12 clinical experiences over the course of 3 weeks
  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?
    Attending Physician
  B. Frequency / Duration of Presentation(s)?
    1 per specialty
  C. Format - What guidelines are set for the student's presentation?
    Standard oral 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)?
    End of elective written reflection
  B. Format - What guidelines are set for the student's written work?
    Short reflective paper on experiences
  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)?
    Certificate of PEDD Webinar completion

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.
    Pre and post elective evaluation to assess attitude changes

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.