Curriculum

Emergency Medicine Clerkship

Director: Jay Bernstein, MD, MPH, Clerkship Director, Emergency Medicine; Assistant Professor, Emergency Medicine

Clerkship Description: The Emergency Medicine Clerkship provides the medical student with an in-depth exposure to Emergency Medicine as a specialty and career choice. They will interact with a wide variety of undifferentiated patients and problems, with a goal of improving the students’ skill in acute care decision-making, a beneficial skill for all physicians. In addition to clinical duties, there is a reading and didactic component. Simulation exercises and small-group discussions/didactics comprise the majority of the educational curriculum, while reading assignments from supplemental materials complete the educational experience. The rotation responsibilities include participation in 130 hours of clinical encounters during the four-week rotation, attendance at four teaching/simulation sessions, attendance at one Resident Didactic Conference, and completion of a written examination and feedback instrument.

Topics covered in the curriculum each month include but are not limited to:

  • Orientation
  • Introduction to Emergency Medicine, including the Approach to the Undifferentiated Patient Basic Airway techniques
  • Advanced airway techniques
  • Dysrhythmia recognition and management
  • Procedural instruction on thoracostomy, lumbar puncture, central line placement, and suturing.
  • Approach to a patient with Dyspnea, Chest Pain, Abdominal Pain, Altered Mental Status, Trauma, Shock, and Toxic Exposure. 

Students will also be exposed to topics of discussion that are within the core curriculum for emergency medicine residents. One-on-one preceptorship is provided by clinical faculty, emergency medicine residents and academic faculty, each uniquely suited to introduce the broad domain of emergency medicine. This guided activity provides experience with a wide variety of clinical problems and their management. There is active participation in patient care through preliminary workup and presentation to the preceptor, after the student has had the opportunity to formulate their provisional diagnosis and plan.

Boonshoft SOM Educational Objectives/Competencies

Code

What competencies will this unit address? 

Foundational Knowledge – Medical Knowledge

1.1

Master fundamental biomedical concepts, terms, processes, and system interactions

Foundational Knowledge – Medical Knowledge

1.2

Describe the determinants of health

Foundational Knowledge – Medical Knowledge

1.3

Utilize evidence in making clinical decisions

Application – Patient Care (Clinical Skills)

2.1

Conduct patient interviews and physical examinations

Application – Patient Care (Clinical Skills)

2.2

Diagnose patient health problems

Application – Patient Care (Clinical Skills)

2.3

Propose evidence-based health maintenance and therapeutic treatments

Integration – System-Based Practice

3.1

Connect knowledge of patient populations and health delivery processes in making diagnoses and therapeutic recommendations

Integration – System-Based Practice

3.2

Advocate for the humane, just, safe and prudent care of persons

Integration – System-Based Practice

3.3

Adapt to the complex economic and social structure of health care delivery

Human Dimension – Personal and Interpersonal Professional Development Goals

4.1

Reflect upon one’s personal strengths and weaknesses to make changes in one’s behavior

Human Dimension – Personal and Interpersonal Professional Development Goals

4.2

Find one’s own meaning in medicine

Human Dimension – Personal and Interpersonal Professional Development Goals

4.3

Take care of oneself

Human Dimension – Personal and Interpersonal Professional Development Goals

4.4

Deliver effective patient presentations and document accurately in the medical record

Human Dimension – Personal and Interpersonal Professional Development Goals

4.5

Communicate and work effectively with others

Human Dimension – Personal and Interpersonal Professional Development Goals

4.6

Demonstrate leadership skills in a variety of settings

Caring/Valuing – Professionalism Goals

5.3

Value and behave in a manner consistent with the highest ethical standards of the profession

Learning How to Learn – Practice-Based Learning

6.3

Appropriately utilize evidence-based resources to address uncertainty in medicine and gaps in knowledge/skills

Clerkship-Level Objectives

Code

What are the clerkship-level objectives for this course?  

Boonshoft SOM Objectives

LO1

Frame a patient encounter in an organized fashion, reinforcing etiology, pathophysiology, clinical manifestations, diagnostic strategies and therapeutic interventions.

1.1, 2.1

LO2

Explain disease specific treatment strategies and associated prognosis and complications.

1.1, 2.1

LO3

Evaluate and manage patients’ presenting clinical problems, including: (abdominal pain; altered mental Status; chest pain; neurologic complaints (e.g. dizziness, weakness); acute intoxication, overdose or withdrawal; dyspnea; extremity injury; gastrointestinal complaint; headache; obstetric or gynecologic complaint, or major trauma.

1.1, 2.1

LO4

Develop a hierarchy of differential diagnoses based on the initial patient presentation to include the most likely and most threatening. 

1.1, 2.1, 2.2

LO5

Recognize immediate life-threatening illnesses.

1.1, 2.1, 2.2

LO6

Apply the fundamentals of adult care to coordinate the care of acutely ill patients

1.1

LO7

Demonstrate a systematic, yet focused, approach to undifferentiated patients utilizing sound skills in gathering and synthesizing components of the history and physical exam.

2.1, 4.4

LO8

Demonstrate appropriate ordering and interpretation of common diagnostic tests and procedures as part of an evaluation and management plan.

2.2

LO9

Formulate diagnostic reasoning, and justify therapeutic decision-making.

1.3, 2.2, 2.3

LO10

Monitor the response to therapeutic interventions with frequent reassessment of patients.

2.3

LO11

Develop a disposition plan for patients to include education and ensured comprehension of an outpatient treatment plan.

2.3

LO12

Demonstrate clear and concise oral presentations and written documentation reflecting a systematic approach to adult patients.

2.1, 4.4

LO13

Apply the indications and contraindications for basic procedural skills.

2.3

LO14

Perform basic procedural skills (e.g. attach a cardiac monitor and pulse oximeter; obtain a 12-lead ECG; basic airway maneuvers; place intravenous line and start IV fluid infusion; suture placement).

2.3

LO15

Identify the social determinants of health for a specific patient, and develop a plan to coordinate care to include community resources to try to improve the health of the individual.

1.2, 3.1, 3.2

LO16

Consider patient, physician, and system barriers to successfully negotiate treatment plans and patient adherence; and identify strategies that may be used to overcome these barriers.

1.2, 3.1, 3.2

LO17

Identify the role of each team member to the care of the patient, and call on interdisciplinary resources to provide optimal and comprehensive care.

3.3a 4.5, 4.6

LO18

Establish professional relationships and effectively communicate with patients, their families, instructors, colleagues and staff.

4.1, 4.3, 4.5, 4.6

LO19

Work effectively with the broad, interdisciplinary team in patient care and appropriately incorporate their unique care skills.

4.1, 4.3, 4.5, 4.6

LO20

Demonstrate the ability to act with honesty/integrity and compassion while maintaining ethical duties and a nonjudgmental approach to patients and others.

5.3

LO21

Demonstrate the ability to act in a manner that is dependable, dedicated and punctual, while maintaining a professional appearance.

5.3

LO22

Demonstrate the ability to act with patience, altruism and equanimity, with sensitivity to cultural issues.

4.1, 4.6

LO23

Recognize when additional information is needed to care for the patient and demonstrate ongoing commitment to self-directed learning.

6.3

LO24

Demonstrate effective skills in navigating the medical literature and available information technology to answer clinical care questions.

6.3

LO25

Demonstrate the ability to acquire and soundly manage knowledge, identify knowledge deficiencies and create a plan for knowledge gains

4.2, 6.3

LO26

Demonstrate the ability to seek out and listen to feedback on performance, accept it positively, and respond to it constructively by improving performance.

4.5, 4.3, 4.1

Required Clinical Experiences

Clerkship/Clinical discipline

Patient type/Clinical condition

Procedures/Skills

Clinical setting

Level of student responsibility

Emergency Medicine

Neurocognitive Disorders

 

Emergency Dept.

Full Participation

Emergency Medicine

Chronic Respiratory Illness

 

Emergency Dept.

Full

Emergency Medicine

Psychiatric Condition

 

Emergency Dept.

Full

Emergency Medicine

Diabetes

 

Emergency Dept.

Full

Emergency Medicine

Cardiovascular disease

 

Emergency Dept.

Full

Emergency Medicine

Infection

 

Emergency Dept.

Full

Emergency Medicine

Toxicological Condition (e.g. intentional or unintentional overdose)

 

Emergency Dept.

Full

Emergency Medicine

Abdominal pain

 

Emergency Dept.

Full

Emergency Medicine

Acute Neurologic condition

 

Emergency Dept.

Full

Emergency Medicine

Major Trauma Resuscitation

 

Emergency Dept.

Moderate Participation

Emergency Medicine

Headache

 

Emergency Dept.

Full

Emergency Medicine

Obstetrical or gynecologic condition

 

Emergency Dept.

Full

Emergency Medicine

Geriatric

 

Emergency Dept.

Full

Emergency Medicine

Pediatric

 

Emergency Dept.

Full

Emergency Medicine

Extremity Injury

 

Emergency Dept.

Full

Emergency Medicine

Critical Care

 

Emergency Dept.

Moderate

Emergency Medicine

 

Attach cardiac monitor/pulse oximeter

Emergency Dept.

Fully performed the procedure

Emergency Medicine

 

Obtain 12 lead ECG

Emergency Dept.

Fully performed

Emergency Medicine

 

Perform basic airway maneuvers

Emergency Dept.

Fully performed

Emergency Medicine

 

Peripheral IV line placement

Emergency Dept.

Fully performed

Emergency Medicine

 

Suture placement

Emergency Dept.

Fully performed

Observation: Student is observing encounter

Moderate Participation: Student completes the History and Physical (either complete or focused) and participates in the differential diagnosis. (*Student directly interacts with the patient)

Full Participation: Student completes History and Physical (either complete or focused), participates in the differential diagnosis, and then completes a therapeutic treatment plan, which can include documentation.

For Procedures:

            Observation
            Assisted in the procedure
            Fully performed the procedure

 

Last edited on 06/22/2020.