Surgery Clerkship

Director: Melissa Roelle, M.D., Clerkship Director, and Assistant Professor, Surgery

Clerkship Description: The Surgery clerkship goal is to ensure students acquire the skills and knowledge that all physicians need to know in order to manage patients with conditions commonly treated by surgeons.

Boonshoft SOM Educational Objectives/Competencies

Code	What competencies / milestones will this unit address?
*Foundational Knowledge – Medical Knowledge:* Master fundamental biomedical concepts, terms, processes, and system interactions
1.1A	Apply knowledge of the expected changes in organ function as well as normal physiologic changes across the lifespan into the care of patients with core medical problems
1.1B	Describe how the altered structure and function of the body and its major organ systems are manifest through major diseases and conditions
1.1C	Describe the scientific basis for the diagnostic tests used in medicine
*Foundational Knowledge – Medical Knowledge:* Describe the determinants of health
1.2A	Using available data, compare and describe the health status of the U.S. to the health status of other countries for key health indicators
1.2B	Identify determinants of health, risk factors and protective factors that influence the diagnosis of a specific patient with a health condition
*Foundational Knowledge – Medical Knowledge:* Utilize evidence in making clinical decisions
1.3A	Develop a clinical question, identify relevant research findings, critically evaluate the validity and reliability of that research, and apply the findings to the care of patients
1.3B	Incorporate pertinent biomedical information and research findings into clinical decision making and identify barriers to implementation
1.3C	Apply basic statistical approaches to clinical situations
*Application – Patient Care (Clinical Skills):* Conduct patient interviews and physical examinations
2.1A	Independently conduct an organized, comprehensive history and physical and recognize common abnormal findings
2.1B	Independently conduct a focused, prioritized history and physical
*Application – Patient Care (Clinical Skills):* Diagnose patient health problems
2.2A	Prioritize a differential diagnosis by applying knowledge of the basic sciences and pathophysiology
2.2B	Propose appropriate ancillary diagnostics and summarize diagnostic results
*Application – Patient Care (Clinical Skills):* Propose evidence-based health maintenance and therapeutic treatments
2.3A	Develop a cost-effective plan of care under supervision
2.3B	Identify and select relevant, evidence-based health promotion and education tools, as well as materials for common acute and chronic conditions encountered in the clinical setting
2.3C	Demonstrate the ability, under supervision, to perform basic medical procedures
*Integration – System-Based Practice:* Connect knowledge of patient populations and health delivery processes in making diagnoses and therapeutic recommendations
3.1A	Describe the reporting process for disease surveillance
3.1B	Describe the epidemiologic investigation process
3.1C	Identify available community resources to improve the health of individuals and populations
*Integration – System-Based Practice:* Advocate for the humane, just, safe and prudent care of persons
3.2A	Demonstrate behavior that conveys caring, honesty, genuine interest and tolerance when interacting with a diverse population of patients and families
3.2B	Recognize the impact of contextual factors on patient care
3.2C	Recognize the importance of effective communication in the prevention of medical errors
*Integration – System-Based Practice:* Adapt to the complex economic and social structure of health care delivery
3.3A	Recognize how the health care delivery system in which one works affects patient care
3.3B	Recognize the improvements in systems can enhance quality of care and identify strategies to improve systems of care
*Human Dimension – Personal and Interpersonal Professional Development Goals:* Reflect upon one’s personal strengths and weaknesses to make changes in one’s behavior
4.1A	Seek and integrate feedback from patients, peers and faculty to better understand one’s development as a physician and as a member of the health care team
*Human Dimension – Personal and Interpersonal Professional Development Goals:* Find one’s own meaning in medicine
4.2A	Develop the skill of self-reflection and apply the insights to one’s professional
*Human Dimension – Personal and Interpersonal Professional Development Goals:* Take care of oneself
4.3B	Engage in formal and informal self-awareness practices
4.3C	Demonstrate flexibility within the dynamic medical environment
*Human Dimension – Personal and Interpersonal Professional Development Goals:* Deliver effective patient presentations and document accurately in the medical record
4.4A	Present patient encounters accurately and succinctly
4.4B	Document patient encounters accurately in a timely, focused, and prioritized way
4.4C	Document supervised procedures accurately and succinctly in the medical record
*Human Dimension – Personal and Interpersonal Professional Development Goals:* Communicate and work effectively with others
4.5A	Seek feedback on one’s communication skills
4.5B	Effectively assimilate into the appropriate role and contribute to the health care team
4.5C	Communicate with patients and families in a timely, clear, empathetic, and humble manner
*Human Dimension – Personal and Interpersonal Professional Development Goals:* Demonstrate leadership skills in a variety of settings
4.6A	Meaningfully contribute to the clinical team
*Caring/Valuing – Professionalism Goals:* Value and behave in a manner consistent with the highest ethical standards of the profession
5.3A	Demonstrate the highest standards of individual and team-based ethical behavior that is patient centered, culturally sensitive, and socially just
5.3B	Apply knowledge of medical ethics to clinical situations
**Learning How to Learn – Practice-Based Learning:Appropriately utilize evidence-based resources to address uncertainty in medicine and gaps in knowledge/skills**
6.3A	Identify appropriate 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.	1.1abc, 2.1a
LO2	Explain disease specific treatment strategies and associated prognosis and complications.	1.1abc, 2.1b
LO3	Evaluate patients’ presenting clinical problems, including: abdominal pain, breast mass, colorectal disease, biliary tract disease, ventral/inguinal hernia, skin and soft tissue lesions, and traumatic injury.	1.1ab, 2.1a
LO4	Diagnose and manage surgical conditions in patients with acute and chronic conditions including: substance abuse, altered mental status, malignancy, DM, hypertension, and obesity. Participate in surgical procedures including, but not limited to: appendectomy, breast surgery, colon/small bowel surgery, cholecystectomy, hernia repair, tracheostomy, PEG tube placement, surgery of skin and/or soft tissue, and technical skills (Foley catheter placement, suturing and know typing, wound care).	1.1ab, 2.1ab, 2.2ab, 2.3c
LO5	Apply the fundamentals of surgical care to coordinate the care of acutely and chronically ill adults as well as traumatically injured patients.	1.1ab
LO6	Demonstrate systematic approach to adult patients utilizing sound skills in gathering components of the history and physical exam.	2.1ab, 4.4a
LO7	Demonstrate appropriate interpretation of labs and testing.	2.2b
LO8	Begin to formulate diagnostic reasoning, and justify therapeutic decision-making.	1.3abc, 2.2ab, 2.3ab
LO9	Demonstrate clear and concise oral presentations and written documentation reflecting a systematic approach to adult patients.	2.1ab, 4.4abc
LO10	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.	1.2ab, 31.abc, 3.2abc
LO11	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.	1.2b, 3.1bc, 3.2abc
LO12	Identify the role of each team member to the care of the patient, and call on interdisciplinary resources to provide optimal and comprehensive care.	3.3ab, 4.5bc, 4.6a
LO13	Establish professional relationships and effectively communicate with patients, their families, instructors, colleagues and staff.	4.1a, 4.3c, 4.5abc, 4.6a
LO14	Work effectively with the broad, interdisciplinary team in patient care and appropriately incorporate their unique care skills.	4.1a, 4.3c, 4.5b, 4.6a
LO15	Demonstrate the ability to act with honesty/integrity while maintaining ethical duties to patients and others.	5.3ab
LO16	Demonstrate the ability to act in a manner that is dependable, dedicated and punctual.	5.3a
LO17	Demonstrate the ability to act with patience, altruism and equanimity.	5.1a, 4.1a, 4.6c
LO18	Recognize when additional information is needed to care for the patient and demonstrate ongoing commitment to self-directed learning.	6.3a
LO19	Demonstrate effective skills in navigating the medical literature to answer clinical care questions.	6.3a
LO20	Demonstrate the ability to acquire and soundly manage knowledge, identify knowledge deficiencies and create a plan for knowledge gains	4.2a, 6.3a
LO21	Demonstrate the ability to seek out and listen to feedback on performance, accept it positively, and respond to it constructively by improving performance.	4.5a, 4.3bc, 4.1a

To review all Boonshoft SOM Educational Milestones please visit the Educational Milestones page.

Required Clinical Experiences

Clerkship/Clinical discipline	Patient type/Clinical condition	Procedures/Skills	Clinical setting	Level of student responsibility
Surgery	Neurocognitive Disorders		Ambulatory/inpatient	Moderate
Surgery	Cardiovascular Disease		Ambulatory/inpatient	Moderate
Surgery	Substance abuse		Ambulatory/inpatient	Moderate
Surgery	Cancer		Ambulatory/inpatient	Moderate
Surgery	Diabetes		Ambulatory/inpatient	Moderate
Surgery	Hypertension		Ambulatory/inpatient	Moderate
Surgery	Infection		Ambulatory/inpatient	Moderate
Surgery	Obesity		Ambulatory/inpatient	Moderate
Surgery	Abdominal pain – evaluation and workup		Ambulatory/inpatient	Moderate
Surgery	Breast mass – evaluation and workup. Benign or malignant.		Ambulatory/inpatient	Moderate
Surgery	Colorectal disease – evaluation and workup. Benign or malignant.		Ambulatory/inpatient	Moderate
Surgery	Biliary tract disease – evaluation and workup		Ambulatory/inpatient	Moderate
Surgery	Hernia (ventral, incisional, or inguinal) – evaluation and workup.		Ambulatory/inpatient	Moderate
Surgery	Skin and soft tissue –evaluation and workup. Benign or malignant.		Ambulatory/inpatient	Moderate
Surgery	Traumatic injury – evaluation and workup.		Ambulatory/inpatient	Moderate
Surgery		Appendectomy	Ambulatory/inpatient	Assisted in procedure
Surgery		Breast surgery or procedure	Ambulatory/inpatient	Assisted
Surgery		Colon or small bowel surgery	Ambulatory/inpatient	Assisted
Surgery		Cholecystectomy	Ambulatory/inpatient	Assisted
Surgery		Hernia repair: ventral	Ambulatory/inpatient	Assisted
Surgery		Hernia repair: inguinal	Ambulatory/inpatient	Assisted
Surgery		Abdominal washout	Ambulatory/inpatient	Assisted
Surgery		Tracheostomy	Ambulatory/inpatient	Assisted
Surgery		Percutaneous endoscopic gastrostomy tube placement (PEG tube)	Ambulatory/inpatient	Assisted
Surgery		Skin or tissue surgery OR drainage of abscess	Ambulatory/inpatient	Assisted
Surgery		Technical skills: wound care	Ambulatory/inpatient	Fully performed the procedure
Surgery		Technical skills: insert Foley catheter (male)	Ambulatory/inpatient	Fully performed
Surgery		Technical skills: insert Foley catheter (female)	Ambulatory/inpatient	Fully performed
Surgery		Technical skills: suture	Ambulatory/inpatient	Fully performed
Surgery		Technical skills: knot tying	Ambulatory/inpatient	Fully performed
Surgery		Other surgery	Ambulatory/inpatient	Assisted

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 07/12/2018.

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Surgery Clerkship

Boonshoft SOM Educational Objectives/Competencies

Clerkship-Level Objectives

Required Clinical Experiences

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