2022-2023 M3/M4 Course Syllabi
Emergency Medicine
COURSE NUMBER:
24 01 21
TITLE:
PRIM CARE ER MED -ICE
This elective gives the student an opportunity to participate directly in the care of undifferentiated patients in a rural emergency department. All shifts will be at Adams County Regional Medical Center in Seaman, OH. Students will be the only learners on site and benefit from one-on-one attending supervision. On shift experiences, in coordination with outside reading, gives each student an excellent chance to evaluate a wide variety of ED patients in a lower-resource community setting.
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:
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: NO
COURSE LENGTH:
4 wks
DIRECTOR:
Jason Nagle, MD, MPH
naglejn@ucmail.uc.edu
513-558-5281
MSB, 1553A
ADMINISTRATIVE SUPPORT PERSON:
Kim Regan
Kimberle.Regan@uc.edu
513-558-8996
MSB, 1654
SITE(S):
Adams Cnty Hospital
MAX ENROLL:
2 
ROTATIONS:
Rotation Dates Max
1 06/06/2022 - 07/01/2022 2
2 07/04/2022 - 07/29/2022 2
3 08/01/2022 - 08/26/2022 2
4 08/29/2022 - 09/23/2022 2
5 09/26/2022 - 10/21/2022 2
6 10/24/2022 - 11/18/2022 2
7 11/21/2022 - 12/16/2022 2
8 01/02/2023 - 01/27/2023 2
9 01/30/2023 - 02/24/2023 2
10 02/27/2023 - 03/24/2023 2
11 03/27/2023 - 04/21/2023 2
12 04/24/2023 - 05/19/2023 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:
Ten 12-hour clinical shifts: 5 days and 5 nights
REPORT 1ST DAY:
You will receive an email with information on your clinical schedule and where to report prior to the elective.

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--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.

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.
TEACHING:
100% Attending Physician
FEEDBACK:
Faculty
ASSESSMENT:
FINAL GRADE:
GRADE ASSIGNED BY: Principle instructor

OBJECTIVES

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/. 

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

3.  Toy EC et al. "Case Files: Emergency Medicine." 4th edition. 2017.
Instructional Methods:
·         Didactic: Students are required to attend Emergency Medicine Grand Rounds at the University of Cincinnati Medical Center campus every Wednesday

·         Experiential on-shift learning

·         Independent reading and self-instruction on relevant patient cases at home
Knowledge/Skills:
·         Develop your clinical gestalt for “sick” or “not sick.”

·         Hone bedside history and physical examination skills.

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

·         Serve as your patients’ primary provider, performing appropriate procedures and discussing the patient with physicians and consultants from other services. 

·         Concurrently manage multiple patients across variable levels of acuity and stages of patient progression.  

·         Understand the basic operation and organization of a small suburban/rural emergency department.

·         Self-educate on core emergency medicine topics and use evidence to guide your management decisions in the emergency department. 

·         Discuss cost-effective issues involved in medical decision making, involving the entire spectrum of socioeconomic factors seen in a community patient population. 

·         Analyze risk-benefit issues and ethical considerations integral to the management of ED patients. 

Main Course Topics :
Initial evaluation of undifferentiated patient

Initial stabilization of critically ill, undifferentiated patient

Approach to traumatically injured patients at a non-trauma center

Resource management and decisions to transfer to a higher level of care
Procedures:
1.  Perform basic procedures including but not limited to laceration repair, incision and drainage, reduction and splinting, regional anesthesia, ultrasound, lumbar puncture, paracentesis, and basic cardiac life support.

2.  Observe or assist with complex procedures including but not limited to airway management and intubation, needle and tube thoracostomy, central venous and arterial access, and advanced cardiac life support.

SAMPLE WEEK

Monday:
7:00AM 5:00PM Emergency Dept (12 hours)
Tuesday:
7:00AM 5:00PM Emergency Dept (12 hours)
Wednesday:
8:00AM 1:00PM Grand Rounds
Thursday:
7:00AM 5:00PM Emergency Dept (12 hours)
SCHEDULE NOTE:
Students work 10 12-hour shifts throughout the 4 week rotation. Schedules will be variable and students must work a mix of days and nights, though both the dates and day-night variation can be modified somewhat to meet your needs. You will be paired one-on-one with a faculty preceptor for each shift and will work directly with the Adams County Site Coordinator, Michelle Armstrong, to set your schedule. 

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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