2024-2025 M3/M4 Course Syllabi
Neurology
COURSE NUMBER:
10 01 64
TITLE:
CHILD NEUROLOGY -ICE
Fourth year medical students will partcipate in a four week elective rotation at CCHMC Burnet site admitting and helping to manage patients on the neuology service. Students may also participate in neurology clinics both on the Burnet campus as well as at satellite clinics.
PREREQUISITES:
26961373 (PEDIATRICS CORE CLKSP)

The student must have a CCHMC Non-employee badge and complete the four prerequisite online courses before the start date of the rotation.  Below are the details regarding obtaining a badge and completing the courses.

1.  The CCHMC Administrative assistant, Marinda Shell, sends medical students an email with an attachment, Initial Badging Paperwork, which contains several forms that are required for the badging process. 
2.  The students must complete all forms and obtain necessary documentation (i.e. immunization status documents) and send all forms back to Marinda.
3.  Marinda Shell will provide students information regarding completing the courses.
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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: NO
COURSE LENGTH:
4 WKS
DIRECTOR:
Alexander Zygmunt
alexander.zygmunt@cchmc.org

Heather Wied
heather.wied@cchmc.org

ADMINISTRATIVE SUPPORT PERSON:
Angela Bustamante
bustamam@uc.edu
513-558-1754
MSB, 7103A
SITE(S):
CCHMC - Burnet Campus
CCHMC - Cincinnati Children's Hospital
MAX ENROLL:
1 
ROTATIONS:
Rotation Dates Max
1 05/06/2024 - 05/31/2024 1
2 06/03/2024 - 06/28/2024 1
3 07/01/2024 - 07/26/2024 2
4 07/29/2024 - 08/23/2024 1
5 08/26/2024 - 09/20/2024 1
6 09/23/2024 - 10/18/2024 1
7 10/21/2024 - 11/15/2024 1
8 11/18/2024 - 12/13/2024 1
9 12/16/2024 - 01/10/2025 0
10 01/13/2025 - 02/07/2025 1
11 02/10/2025 - 03/07/2025 1
12 03/10/2025 - 04/04/2025 1
13 04/07/2025 - 05/02/2025 0

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:
Monday-Friday, 07:00-17:00
REPORT 1ST DAY:
You will receive an email with detailed information prior to the elective

INSTRUCTION

LEARNING ACTIVITIES:
  • Case-Based Instruction/Learning
  • Clinical Experience - Ambulatory
  • Clinical Experience - Inpatient
  • Conference
  • Demonstration (description, performance, or explanation of a process, illustrated by examples, observable action, specimens, etc)
  • Discussion- Large Group (>12)
  • Discussion-Small Group (Small Group (=12)
  • Independent Learning (Instructor-guided learning activities to be performed by the learner outside of formal educational settings.)
  • Lecture
  • Patient Presentation--Faculty
  • Patient Presentation--Learner
  • Peer Teaching
  • Reflection
  • Research
  • Self-Directed Learning (Learners take initiative for their own learning; diagnosing needs; formulating goals; identifying resources; implementing appropriate activities; and evaluating outcomes.)
  • Ward Rounds
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:
60% Attending Physician
40% Senior Resident
FEEDBACK:
ASSESSMENT:
 
  1. While on clinical rounds, students present patients for analysis of differential diagnosis and management strategies. 
  2. A senior supervising resident will score the students’ performance of the neurological examination utilizing a standardized checklist.
  3. Attendings and senior residents assess the student’s follow-through on patient management plans, direct interactions with patients and teammates, work ethic and professionalism.
  4. Senior residents will score the student's self-directed clinical research question which will also be presented to the team.
  5. Formative assessments are ongoing during all contacts between students, and faculty and residents. More formal scheduled formative feedback occurs at the mid-point of the clerkship.

ASSESSMENT METHODS:
Clinical Performance Rating/Checklist
Oral Patient Presentation
Participation
Self-Assessment
FINAL GRADE:
GRADE ASSIGNED BY: Course director

OBJECTIVES

Curricular Resources :
1.  Fenichel’s Clinical Pediatric Neurology. J.Eric Pina-Garza. 
2. Aicardi’s Epilepsy in Children. Alexis Arzimanoglou, Renzo Guerrine, and Jean Aicardi.
3. UpToDate
4. AAN & CNS Published guidlines for patient care
5. Current Diagnosis and Treatment Pediatric Neurology, Andrew Hershey editor- link provided during orientation
Instructional Methods:
  • Case-Based Instruction/Learning 
  • Clinical Experience--Ambulatory 
  • Clinical Experience - Inpatient 
  • Demonstration 
  • Independent Learning 
  • Reflection
  • Research 
  • Self-Directed Learning 
  • Rounds
Knowledge/Skills:
Goal 1: Understand how to assess and manage pediatric patients with epilepsy including new onset to medically intractable seizures.
Objective 1: Provide direct patient care and co-management with regards to the diagnostic and therapeutic interventions.
Objective 2: Understand the indications and limitations of diagnostic testing including:

  - HCT
  - MRI brain
  - Specialized imaging such as PET scan
  - Electrophysiology studies: routine, video, prolonged
  - Therapeutic lab testing

Objective 3: Understand the psychological, cost, time, and financial impact of epilepsy management in pediatric patients.
Goal 2: Understand how to assess and manage pediatric patients with neurologic specific diseases.
Objective 1: Provide direct patient care and co-management of neurologic diseases such as:
  - Headaches
  - Migraines
  - Spells
  - Ataxia
  - Meningitis/encephalitis
  - Peripheral nervous system abnormalities

Objective 2: Understand the indications and limitations of diagnostic testing including but not limited to:
  - Head imaging
  - Spine imaging
  - Lumbar puncture
  - Blood, CSF studies

Objective 3: Understand the psychological, cost, time, and financial impact of neurological disease management in pediatric patients.
Goal 3: Develop decision-making and problem solving skills in the approach to hospitalized pediatric patients with neurologic disease
Objective 1: Apply principles of decision-making and problem solving to the care of neurologically complex patients.
Objective 2: Gain expertise in a deliberate problem or system-based approach to patients with neurologic disease.
Main Course Topics :
      1.  Seizures and epilepsy
      2.  General inpatient pediatric neurologic topics
      3.  Diagnostic approaches
      4.  Therapeutic approaches, especially epilepsy chronic and rescue management
      5.  Risk and benefits of neurologic interventions
Procedures:
Goal 1: To provide opportunity for the student to review neurologic diagnostic testing involved in patient care and become familiar with the interpretation and role in management.
Goal 2: To provide opportunity when available and appropriate for the student to either observe or actively partake in procedures such as:
  - Lumbar taps
  - EEG
  - EMG
Remediation Plan:
 Failure to acheive a passing grade will require student to repeat the clerkship.

SAMPLE WEEK

Monday:
7:30AM 12:00PM Patient Care
12:00PM 1:00PM Neurology Residents' Lecture
1:00PM 5:00PM Patient Care
Tuesday:
7:30AM 12:00PM Patient Care
12:00PM 1:00PM Neuroscience Reseach Mtg
1:00PM 5:00PM Patient Care
Wednesday:
8:00AM 9:00AM Grand Rounds
9:00AM 4:00PM Patient Care
4:00PM 5:00PM Neurology Case Conference
Thursday:
7:30AM 5:00PM Patient Care
Friday:
7:30AM 11:30AM Patient Care
11:30AM 12:30PM Neuroradiology Conference
12:30PM 5:00PM Patient Care
SCHEDULE NOTE:

See the included schedule for the weekly conferences.

 

Schedule will vary based on location:

Burnet inpatient neurology service: While in the presence of the neurology rounding team, the medical student will examine assigned patients, review recent diagnostic data, formulate plans, and pre-round with the team. Then, the medical student will partake in morning family-centered rounds with faculty, neurology residents, pediatric interns, and nursing staff from 9 am until completed (typically 11 am).  The medical student will be involved with notes, patient care, evaluation of new admissions with neurology attending presence until 1 pm and neurology rounding team until 4 pm. The medical student is expected to attend the scheduled conferences via Teams or In-Person and be motivated for independent study (up to 5 hours a week) regarding pertinent neurologic diseases (included).

 

Satellite outpatient clinics: The medical student will attend the outpatient neurology clinics according to the clinic schedule provided performing evaluations and co-management of neurology patients with 1:1 faculty support. The medical student is expected to attend the Grand rounds and Wednesday case conference presentations via Teams while at satellite neurology outpatient clinics.  When the medical student is at the Burnet neurology outpatient clinic, he/she is expected to attend the scheduled conferences (included).

 

Available elective schedule options:

Four weeks neurology inpatient rotation (perfered if the student wants letter of recomendation)

Two weeks neurology inpatient and two weeks neurology outpatient clinics

 

 

 

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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