2019-2020 M3/M4 Course Syllabi
Emergency Medicine
COURSE NUMBER:
24 01 03
TITLE:
ELECTIVE AI - EMERGENCY MEDICINE -ICE
Working one-on-one with faculty and senior residents, students will care for patients across the whole spectrum of acuity in the ED and simulation center and perform a variety of procedures. In this course, students learn how to approach the undifferentiated patient and build patient management skills by functioning as interns, formulating their own plans, placing orders, and documenting on all patient encounters.
PREREQUISITES:
26920371 (FAMILY MEDICINE CORE CLKSP), 26931373 (INTERNAL MEDICINE CORE CLKSP), 26940373 (NEUROSCIENCE CORE CLKSP), 26946374 (OBSTETRICS/GYN CORE CLKSP), 26961373 (PEDIATRICS CORE CLKSP), 26963371 (PSYCHIATRY CORE CLKSP), 26980373 (SURGERY CORE CLKSP)

Successful completion of Core Clerkships. 
expand all

GENERAL INFORMATION

COURSE YEAR:
M4
CREDIT HOURS:
8
CREDIT WEEKS:
4
DOMESTIC VISITING:
YES
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:
Robbie Paulsen
paulsere@ucmail.uc.edu
513-558-5281
MSB, 1654
ADMINISTRATIVE SUPPORT PERSON:
Kim Regan
Kimberle.Regan@uc.edu
513-558-8996
MSB, 1654
INSTRUCTOR:
Emergency Faculty
SITE(S):
UC Health Medical Center
MAX ENROLL:
10 
ROTATIONS:
Rotation Dates Max
1 07/08/2019 - 08/02/2019 10
2 08/05/2019 - 08/30/2019 10
3 09/03/2019 - 09/27/2019 10
4 09/30/2019 - 10/25/2019 10
5 10/28/2019 - 11/22/2019 0
6 11/25/2019 - 12/20/2019 0
7 01/06/2020 - 01/31/2020 0
8 02/03/2020 - 02/28/2020 4
9 03/02/2020 - 03/27/2020 4
10 03/30/2020 - 04/24/2020 4
11 04/27/2020 - 05/22/2020 4
12 05/25/2020 - 06/30/2020 8

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:
14 shifts total. 12 hour shifts (7am-7pm, 7pm-7am) in main ED, 5-8 hour shifts in Minor Care and Ult
REPORT 1ST DAY:
MSB 1452 8:00 am

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)
  • Patient Presentation--Faculty
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.

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:
Dr. Robbie Paulsen (Clerkship Director)
TEACHING:
80% Attending Physician
20% Senior Resident
FEEDBACK:
Elective director
ASSESSMENT:
FINAL GRADE:
60% Clinical work performance evaluations
10% External exam, e.g., NBME shelf exam; if so, specify source:
20% Topic presentation
10% Participation
GRADE ASSIGNED BY: Course director

OBJECTIVES

Attitudes :

1.   Learn to care for a very diverse group of patients with a wide spectrum of acute problems.

2.   Demonstrate teamwork necessary for effective care delivery in the emergency department.

3.   Experience a clinical schedule with significant day/night shift variation. 

Curricular Resources :
All reading is optional, though encouraged in order to succeed in the course. 

1.  Online National EM M4 Curriculum, which is curated by the Clerkship Directors in Emergency Medicine (CDEM): https://cdemcurriculum.com/m4/. This is the curriculum on which the SAEM National EM M4 Exam is based.

2.  Mahadevan SV and Garmel GM. "An Introduction to Clinical Emergency Medicine." 2nd edition. 2012. 

3.  Roberts JR. "Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care." 7th edition. 2018. 

4.  Wald DA. "Emergency Medicine Clerkship Primer: A Manual for Medical Students." 2008. 
Knowledge/Skills:

1.   Serve as the primary provider caring for acutely ill patients from admission to discharge from Emergency Department

2.   Evaluate and treat a broad variety of emergent and non-emergent diseases.

3.   Understand the basic operation and organization of a large urban Emergency Department.

4.   Perform routine literature searches and discuss literature reviewed with faculty.

5.   Discuss cost-effective issues involved in medical decision making, involving the entire spectrum of socio-economic factors seen in the patient population.

6.   Discuss risk-benefit issues and ethical considerations integral to an Emergency Department.

7.   Address measures that ensure proper follow-up and further care for patients.

8.   Complete a self-guided written curriculum covering core content in Emergency Medicine and pass a written national examination.

Main Course Topics :

Airway Management

Advanced Cardiac Life Support

Resuscitation of Undifferentiated Patient

Approach to Trauma

Objectives:
1.  Develop clinical gestalt for "sick or not sick."

2.  Hone efficient bedside history and physical exam skills.

3.  Discuss the differential diagnosis and develop a management/disposition plan for each patient under your care, focusing on simultaneous diagnosis and treatment of life-threatening conditions in the undifferentiated patient.

4.  Be directly involved in patient care in the ED. You will serve as the patient's primary provider, performing appropriate procedures, documenting the patient's ED course in the electronic medical record, and discussing the patient with physicians and consultants from other services. 
Other Resources - Audiovisuals:
1.  Ultrasound online videos: Required training prior to ultrasound shift

2.  Tamingthesru.com: University of Cincinnati Emergency Medicine Residency Program's educational website, which contains patient care protocols, procedural videos, written and audio blog, and more. 
Other Resources - Computer resources:

Other Resources - Other :
1.  EKG: Lifeinthefastlane.com EKG Library
Procedures:
1.  Primarily perform basic procedures in the ED, including but not limited to laceration repair, incision and drainage, reduction and splinting, regional anesthesia, lumbar puncture, paracentesis, arthrocentesis, diagnostic ultrasound, ultrasound-guided vascular access, and interosseous access. 

2.  Observe, assist, or perform critical procedures including but not limited to intubation and airway management, central venous access, needle and tube thoracostomy, among others on simulated or real patients as appropriate. 

3.  Perform basic and advanced cardiac life support in the ED and in simulation. 

SAMPLE WEEK

Monday:
7:00AM 7:30AM Rounding in ED
7:30AM 8:00AM Morning Report
8:00AM 6:00PM Emergency Dept 8 am - 7 pm (12 hrs)
Tuesday:
7:00AM 7:30AM Rounding in ED
7:30AM 8:00AM Morning Report
8:00AM 10:00AM Didactic
10:00AM 6:00PM Emergency Depart 10 am - 7 pm (12 hr)
Wednesday:
8:00AM 1:00PM Grand Rounds
1:00PM 6:00PM Emergency Dept 1 pm - 7 pm (12 hr)
Friday:
10:00AM 4:00PM Emergency Dept Minor Care (6 hrs)
SCHEDULE NOTE:

14 Clinical Shifts in total:

10 12-hour shifts, divided among various pods in the ED, with one-on-one faculty or senior resident supervision. In general 4 of these shifts will be overnights, though this is variable. 

3 Minor Care shifts, 5-7 hours in length, with one-on-one faculty or senior resident supervision

1 Ultrasound shift, 6 hours in length, with Pattie Smith RDMS


In general, students can expect to have one weekend (Saturday-Sunday) off, one weekend in which you work one day (Saturday or Sunday), and one weekend in which you work both days. Students may request days off in advance for academic or personal reasons, but please allow at least 3 weeks notice and keep requests to a reasonable minimum. If necessary, students can swap shifts among each other once the clinical schedule is released, though all trades must be approved by the Clerkship Director to ensure shift distributions remain equal and duty hours are obeyed. 


Other Required Events (required unless post-overnight):

Didactic/Simulation: Tuesdays from 0800-1000

Grand Rounds: Wednesdays from 0800-1300

Morning Report: Every morning (except Wednesday) from 0730-0800 while working 7am day shift in ED


Other Optional Events:

Coffee Talk: Every other Wednesday from 0700-0800

Journal Club: Monthly on Wednesdays from 1800-2100, dates vary

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 Observance Policy that 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, Religious Observance Policy, Medical Student Handbook.




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