2018-2019 M3/M4 Course Syllabi
Neurosurgery
COURSE NUMBER:
26 01 11
TITLE:
NEUROCRITICAL CARE (NCC) -ICE
This rotation will introduce the student to the medical management of life-threatening neurological and neurosurgical conditions in the Neuroscience ICU involving exposure to vascular neurology and neuroendovascualr therapies.
PREREQUISITES:
Recommend completing one Year III neuro-related rotation prior to taking this elective.
expand all

GENERAL INFORMATION

COURSE YEAR:
M4
CREDIT HOURS:
8
CREDIT WEEKS:
4
DOMESTIC VISITING:
NO
INTERNATIONAL VISITING:
NO
GRADED:
Honors/High Pass/Pass/Fail
COURSE QUALIFICATIONS:
ICE
COURSE TYPE:
Clinical
STATUS:
Full-Time   
OFFERED AS FULL-TIME AND PART-TIME: NO
ALLOWS OVERLAP: YES
COURSE LENGTH:
4 wks
DIRECTOR:
Moshe Mizrahi, MD
mizrahma@ucmail.uc.edu
513-558-1059
Medical Sciences Building, 7107
ADMINISTRATIVE SUPPORT PERSON:
Karen Burk
burkkl@ucmail.uc.edu
513-558-0434
MSB, 5205
INSTRUCTOR:
SimonaFerioli, MD
SITE(S):
UC Health Medical Center
MAX ENROLL:
2 
ROTATIONS:
Rotation Dates Max
1 07/02/2018 - 07/27/2018 0
2 07/30/2018 - 08/24/2018 2
3 08/27/2018 - 09/21/2018 2
4 09/24/2018 - 10/19/2018 2
5 10/22/2018 - 11/16/2018 2
6 11/26/2018 - 12/21/2018 2
7 01/02/2019 - 01/25/2019 2
8 01/28/2019 - 02/22/2019 2
9 02/25/2019 - 03/22/2019 2
10 03/25/2019 - 04/19/2019 2
11 04/22/2019 - 05/17/2019 2
12 05/20/2019 - 06/30/2019 2

NOTE: If a rotation is offered in both 2 and 4 week slots, the max capacity is limited to the actual spots offered for the 4 weeks. (ie: the 2 week rotations listed share the max of the 4 week rotation)
WORKING HOURS:
6:30 am - 4:30 pm Monday - Friday, plus one week of nights 6:30 pm to 6:30 am
REPORT 1ST DAY:
University Hospital NSICU, 4th fl 6:30 a.m. See fellow/resident/NP on duty

INSTRUCTION

LEARNING ACTIVITIES:
  • Case-Based Instruction/Learning
  • Clinical Experience - Inpatient
  • Conference
  • Demonstration (description, performance, or explanation of a process, illustrated by examples, observable action, specimens, etc)
  • 1
  • Patient Presentation--Faculty
  • Patient Presentation--Learner
  • Research
LEARNING ENVIRONMENT POLICIES:
UCCOM strives to provide medical students with a learning environment that is conducive to their professional growth. All UCCOM and visiting medical students are encouraged to review the Student Handbook with specific attention to the following policies and procedures pertaining to the learning environment:


The Office of Student Affairs and Admissions is available to all UCCOM and visiting medical students to discuss any concerns/questions related to the learning environment. Please call 558-6796 to access faculty/staff that can assist you.
ORIENTATION:
NCC Fellow or Elective Director
TEACHING:
20% Attending Physician
55% Senior Resident
20% Junior Resident
5% Other Allied Health Professional(s)
FEEDBACK:
Faculty
ASSESSMENT:

ASSESSMENT METHODS:
Exam, Institutionally Developed, Oral
FINAL GRADE:
60% Clinical work performance evaluations
30% Attitude, e.g., professionalism, motivation etc
5% Case management problem(s)
5% Topic presentation
GRADE ASSIGNED BY: Elective director

OBJECTIVES

Attitudes :

 

·         Demonstrate enthusiasm for patient care

·         Actively participate in clinical  discussions

·         Demonstrate collaborative interactions with team members

·          Show respect towards patients, families, colleagues and all members of the ICU multidisciplinary team

·         Display integrity and appropriate work ethics for an ICU environment

 

Curricular Resources :

 

  • Critical Care Neurology. Provencio et al. Am J Respir Crit Care Med. 2001, 164 (3), pgs. 341-345.

 

  • Management of Blood Flow in the NeuroIntensive Care Unit. Provencio

 

  • Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest, Holzer et al. NE Journal of Medicine, 2002, 346 (8), 549-556.

 

  • Primer on medical management of severe brain injury. Vincent, Berre'. Crit Care Med, 2005, 33(4), pgs. 1392-99.

 

  • Predicting Outcome from Hypoxic-Ischemic Coma. Levy et al. JAMA, 253 (10), pgs. 1420-26.

 

  • Practice Parameter : Prediction of outcome in comatose survivors after cardiopulmonary resuscitation (an evidence-based review). Neurology, July 2002, pgs. 203-10.

 

  • Guidelines for the Management of Spontaneous Intracerebral Hemorrhage in Adults. Stroke, 38 (6) 2001, pgs. 1-23.

 

  • Intensive Insulin Therapy in Critically Ill Patients, van der Berghe et al. N Engl J Med, 345 (19), 11/8/01, pgs1359 – 1367.

 

  • The Acute Respiratory Distress Syndrome, Ware, Matthay. New Engl J Med, 5/4/00, pgs 1334 – 1349.

 

  • Recommendations for end of life care in the intensive care unit: The Ethics Committee of the Society of Critical Care Medicine, Truog et al. Crit Care Med, 2001, 29 (12), pgs. 2332-2348.

 

  • Large hemispheric infarction, deterioration, & intracranial pressure, Frank, Neurology, 1995, 45 (7), pgs. 1286-1290.

 

TEXT:

  • Critical Care Neurology & Neurosurgery, Humana Press Inc., 2004, Editor: Jose Suarez, M.D.

 

 

Knowledge/Skills:

         Gain / Display knowledge in:

·         Acute management of neurological emergencies

·         Indications for neurosurgical procedures

·         Indications for thrombolytic therapy

·         Identification of complications from life threatening neurological conditions

·         General management of the critically ill patient

·         Discuss ethical and end-of-life issues involving neurological conditions

·          Medical decision-making relative to neurological conditions, including cost  effectiveness of diagnostic studies and procedures

 

Main Course Topics :

·         Ischemic stroke

·         Hemorrhagic stroke

·         Subarachnoid hemorrhage

·         Intracranial pressure

·         Status epilepticus

·         ICU ethics

·         End-of-life issues

      Traumatic Brain Injury

      General critical care

 

Objectives:

Other Resources - Audiovisuals:

Available upon request

 

Other Resources - Computer resources:
Multiple computers are available on the NSICU with internet access

 

 

Other Resources - Other :

Full access to MacKesson PACS system to review any imaging studies

Procedures:

·         Place an external feeding tube

·         Assist with arterial and central venous line placement

 

SAMPLE WEEK

Monday:
6:30AM 8:00AM Patient Data Collection Student Pre-rounding
8:00AM 10:30AM Patient rounds with team
10:30AM 11:30AM NCC Education Series
11:30AM 12:30PM Lunch
12:30PM 4:00PM Independent Reading/Patient Care
4:00PM 4:30PM PM Checkout
Tuesday:
6:30AM 8:00AM Patient Data Collection Student Pre-rounding
8:00AM 10:30AM Patient rounds with team
10:30AM 11:30AM NCC Education Series
11:30AM 12:30PM Lunch
12:30PM 4:00PM Indepedent Reading/Patient Care
4:00PM 4:30PM PM Checkout
4:30PM 5:30PM Optional:Neuroimaging Conference
Wednesday:
6:30AM 8:00AM Patient Data Collection Student Pre-rounding
8:00AM 9:00AM Neurology Grand Rounds
9:00AM 9:30AM Student Pre-rounds
9:30AM 11:30AM Patient rounds with team
11:30AM 12:30PM Lunch
1:00PM 2:00PM Critical Care Lecture Series
2:00PM 3:30PM Independent Reading/Patient Care
3:30PM 4:00PM PM Checkout
Thursday:
6:30AM 7:30AM Patient Data Collection Student Pre-rounding
7:30AM 8:00AM Neurovascular Conference
8:00AM 10:30AM Patient rounds with team
10:30AM 11:30AM NCC Education Series
11:30AM 12:30PM Lunch
12:30PM 4:00PM Independent Reading/Patient Care
4:00PM 4:30PM PM Checkout
Friday:
6:30AM 8:00AM Patient Data Collection Student Pre-rounding
8:00AM 10:30AM Patient rounds with team
10:30AM 11:30AM NCC Education Series
11:30AM 12:30PM Lunch
12:30PM 4:00PM Independent Reading/Patient Care
4:00PM 4:30PM PM Checkout
SCHEDULE NOTE:

-   Report first day to the NSICU South at 7 AM.  Ask for the NSICU/NCC Fellow/Resident/NP.

-   Attend:

     - NCC Journal Club (second Tuesday at 3:00 PM)

     - NSICU M&M (fourth Tuesday at 2:30 PM)

-  Various meetings with the Course Director.


ATTENDANCE AND ABSENCE POLICY

 

Session Attendance for M4 Students

  • Students may miss no more than two days of planned excused absences on a four week rotation without being required to make-up the work, at the discretion of the clerkship/elective/course director or his/her designee.
  • Non-AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the clerkship director to best align with the site schedule. Students may request to schedule 1 or more of these 4 days for planned absences that fall under 1 of the categories listed below for excused absences during non-AI rotations, in consultation with the course/elective director, who may or may not approve such planned absences.
  • AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the course director to best align with the site schedule. Students may request to schedule 1 or 2 of these days for planned absences that fall under 1 of the categories listed below for excused absences during AI rotations, in consultation with the course director, who may or may not approve such planned absences. Students must avoid scheduling Step 2 examinations during an Acting Internship.
  • Excused Absences - The following will be considered excused absences:
    • Diagnostic, preventative, and therapeutic health services (e.g. doctor appointments, physical therapy, counselling, etc).
    • Personal illness, accident or a major catastrophic event
    • Death or serious illness of immediate family members. Immediate family members, as defined by UC, are Grandparents, Brother, Sister, Brother-in law, Sister-in-law, Daughter-in-law, Son-in-law, Father, Mother, Mother-in-law, Father-in-law, Step-sister, Step-brother, Step-mother, Step-father, Spouse or domestic partner, Child, Grandchild, legal Guardian or other person who stands in place of parent (in Loco Parentis)
  • Whenever possible, planned absences should be requested a minimum of six weeks in advance of the start of the clerkship/elective/course in which the absence will occur; this enables the clerkship/course/elective to help plan for educational event scheduling (e.g. a known appointment could be scheduled around with enough notice and the student might not have any required coursework to make up). Absences requested less than 1 week prior to the planned absence may not be considered for a possible excused absence unless extenuating circumstances prevented the student from providing timely notification per the policy. Students should first submit their request for a planned absence to the clerkship/elective/course director using the online MSSF. All planned/excused absences for any reason should be documented on the MSSF.
  • The COM abides by the UC Religious Observances and Class Attendance Policythat respects the religious diversity of its students by providing opportunities, where possible, for accommodation in cases where conflicts exist between students’ religious beliefs/practices and educational activities. In clinical settings, such accommodations must honor the primacy of a commitment to patient care and avoid unduly burdening faculty, staff and the general student population involved in the affected educational and/or patient care activity.
  • The following items are explained in detail in the Medical Student Handbook:
    • Excused/unexcused/unplanned absence, religious holidays, jury duty, and make-up work

See Attendance and Absences Policy, Accommodation for Religious Purposes, Medical Student Handbook.




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