Visiting Medical Student Electives

Electives by Department

 

ALHSAllied Health SciencesOBGYObstetrics and Gynecology
ANESAnesthesiologyORTHOrthopaedic Surgery
BINFBiomedical InformaticsPATHPathology
BIOMBiomedical SciencesPEDSPediatric and Adolescent Medicine
EMEREmergency MedicinePROFProfession of Medicine
FMEDFamily and Community MedicinePSYCPsychiatry
INDIndependent StudyRADRadiology
MEHLMedical Ethics, Humanities, and LawRESResearch
MEDMedicineSIMMedical Simulation
MEDEMedical EngineeringSURGSurgery
MEDUMedical Education  

 

All Electives

ANES 9410 Anesthesiology
Credits:
2,4
Directors:
George, Uggeri
Grading:
Pass/Fail
Description:

This is a comprehensive overview of anesthesia to include pre-, intra- and post-operative care and evaluation of surgical patients. Students will spend equal time in the pre-operative evaluation area; providing anesthesia during a case; and also post-operative evaluation. Student will develop familiarity with intubation techniques, the difficult airway, operative monitoring, regional anesthesia, and risk stratification.

Offered:  All weeks

Objectives:

Upon completion of this course, each student will be able to:

  • Describe the role and duties of an anesthesiologist.
  • Discuss the pharmacology of common anesthetic agents.
  • Manage the airway of an uncomplicated, unconscious apneic patient.
  • Describe the risks and benefits of regional, general and sedation anesthesia.
  • Understand and recognize the challenges in anesthetizing patients with difficult airways or other pre-existing conditions.
  • Preform a directed pre-anesthetic medical history and exam.
ANES 9420 Pain Management
Credits:
2
Directors:
Chafty
Grading:
Pass/Fail
Description:

Pain is prevalent in treatment of patients. The students will receive primarily acute pain management training while doing their anesthesia elective in the hospital. The pain management program is in an outpatient program done through the Kalamazoo Anesthesiology Pain Consultants. The student will be part of a team that includes physicians, physician's assistants, psychologists, nurses, occupational therapists, and physical therapists. There may be the occasional inpatient pain consult that the student will attend with the physician, but the vast majority of the training is done in an outpatient pain center and primarily deal with chronic, nonmalignant pain. By the end, the student should understand some common chronic pain issues and develop a considerate and thoughtful approach to management of these pain problems.

Offered: Only open to one student per block. Prior approval required.

Objectives:
  • Obtain an accurate and comprehensive history from the patient.
  • Perform a rational and thorough physical examination.
  • Try to focus as appropriate the history and physical to the patient's active pain issue.
  • Use the information gathered from the history and physical, as well as appropriate radiologic studies and labs, to create a problem list.
  • Try to generate a differential diagnosis from the active problem list.
  • Begin to develop a plan based on the problem list.
  • Present that problem list and differential diagnosis to the pain team.
  • Integrate learning based upon reading and experiences in the pain clinic to broaden the student's understanding of chronic pain management.
  • Begin to learn some block techniques that the student will apply as a resident and physician.
  • Understand the use of the multi-disciplinary approach to pain management.
EMER 9610 Emergency Medicine
Credits:
4
Directors:
Kothari
Description:

Emergency Medicine Selective provides experiences with a diverse set of patients spanning all ages and experiencing many pathological conditions that present to the emergency department. Students are expected to perform the initial patient assessment, formulate a differential diagnosis and problem list, present the patient to a senior resident or attending physician, write orders, interpret diagnostic studies, discuss patients with consultants, perform or assist with procedures under supervision, write discharge instructions, and facilitate admissions and transfers.

Offered:  Not offered in July

Objectives:
  • Perform a directed medical history and physical examination appropriate to the patient’s presentation.
  • Develop an appropriate differential diagnosis based on the patients’ complaint, history and physical exam.
  • Develop an appropriate management plan to evaluate & treat the patient’s condition.
FMED 9710 Advanced Hospital Family Medicine
Credits:
2,4
Directors:
VanDerKolk
Grading:
Pass/Fail
Description:

Advanced hospital clerkships provide the opportunity for students to assume greater responsibility for patient care of the hospitalized patient, with oversight from supervising residents and attending physicians. Students expand upon competencies they develop during the third year as they care for one to two patients at a time. Additional expectations include responsibility for developing management plans, writing orders, patient handovers and transfers of care, recognizing the policies that support patient safety, and developing competency in procedures that they will perform independently as residents. Fourth year students also assist in teaching third year students.

Advanced Hospital Family Medicine is an opportunity for students to participate in a busy, family medicine oriented, academic inpatient service at Bronson Methodist Hospital. Students will act as a sub-intern on the Family Medicine Service (FMS), comprised of and supervised by residents and attendings from the Department of Family and Community Medicine.

Participants will have the opportunity to work both days and nights on the service. While on days, students can expect to be responsible for the review, evaluation and management of 1-2 admitted patients under direct supervision. They will participate in regular daily rounds, presenting each patient under their care to the attending physician with their plan for the day. Students will be expected to present regularly on medical topics pertinent to the patients under their care. On nights, students will review and evaluate admitted patients and have the opportunity to admit patients from the emergency department.

This course can be taken as a required clerkship or an elective.

Offered:  All weeks

Objectives:
  • Identify patients requiring hospitalization for management of their conditions.
  • Obtain a complete History and Physical for a patient being admitted to the hospital.
  • Synthesize information from various sources to develop an assessment of the patient’s condition, culminating in a complete problem list with differential diagnoses.
  • Propose an initial management plan for each of the patients’ diagnoses.
  • Document adequately and completely the history, physical, and assessment and plan for the hospitalized patient.
  • Describe the presentation and initial management of several common inpatient conditions including COPD exacerbations, cellulitis, pancreatitis and others.

Advanced Clerkship Goals:

  1. Demonstrate clinical reasoning in gathering focused information relevant to a patient's care.
  2. Demonstrate patient-centered interview skills
  3. Demonstrate patient-centered examination techniques.
  4. Articulate a management plan based on the well-reasoned differential and working diagnoses.
  5. Provide complete and succinct documentation so that other providers have evidence of your clinical reasoning to ensure continuity of care and patient safety.
  6. Recommend reliable, cost-effective tests when indicated for screening or evaluating patients with common acute or chronic conditions.
  7. Routinely reflect on how the results of a test will influence clinical decision making and, conversely, on the potential consequences of not doing a test.
  8. Articulate the risks and benefits of what you are ordering (e.g., drugs, tests).
  9. Consistently discuss diagnostic plans with the patient, and provide evidence that patient preferences have been solicited and factored into decision making.
  10. Distinguish common, insignificant abnormalities from clinically important abnormalities.
  11. Provides documentation that is comprehensive and contains important information without unnecessary details or redundancies.
  12. Filter, synthesize, and prioritize information and recognize patterns, resulting in a concise, well organized, and accurate presentation.
  13. Adjust oral presentations for the receiver of information (e.g., faculty, patient/family, team members) and for the context of the presentation (e.g., emergent versus stable).
  14. Routinely identify the need to ask for help or seek new information in the context of the clinical setting, based on awareness of one's own knowledge gaps and patient needs.
  15. Provide key aspects of the ideal handover to the recipient, including verbalizing the patient's illness severity and/or providing action planning and/or contingency planning.
  16. Demonstrates awareness of known threats to handover communication (e.g., interruptions and distractions) by paying attention to the timing and location of the handover communication.
  17. Acts as an active and integrate member of the team who in most situations prioritizes team goals over one's own professional goals.
  18. Understands the roles of other team members, seek their counsel, actively listen to their recommendations, and incorporate them into practice.
  19. Interpret common test results to anticipate and respond to early clinical deterioration.
  20. Adhere to institutional procedures and protocols regarding escalation of patient care.
  21. Understand the importance of informed consent to rapport building and shared decision making.
  22. Demonstrate an understanding of the elements of informed consent generally (indications, contraindications, risks, benefits, alternatives) and the specifics of these elements for the procedures for which consent is being sought.
  23. Demonstrate patient-centered skills in performing procedures:
    • Avoid medical jargon such that patients are able to verbalize understanding of the procedure.
    • Participate in shared decision making with patients about procedures
    • Have confidence commensurate with level of knowledge and skill that puts patients at ease.
    • Simultaneously pay attention to both the procedure and the patient's emotional response.
  24. Identify real potential errors.
  25. Perform common safety behaviors (e.g., universal precautions, hand washing).
  26. Understand the importance of error prevention both to individual patients and to systems.
FMED 9720 Advanced Ambulatory Family Medicine
Credits:
2,4
Directors:
VanDerKolk
Grading:
Pass/Fail
Description:

Advanced ambulatory clerkships provide the opportunity for students to assume initial responsibility for the evaluation of patients in the ambulatory setting. Supervision will be provided by faculty preceptors in the academic setting as well as community private practices. Students expand upon competencies they developed during the third year as they team with residents and/or preceptors to provide preventive health services as well as acute and chronic illness management. The faster pace of ambulatory care provides an environment that strengthens patient and family communication skills, rapport development, and oral presentations. The use of evidence to inform treatment and counseling of patients and their caregivers are additional competencies that are highlighted in the outpatient setting.

Advanced Ambulatory Family Medicine is an opportunity for students to participate in a busy, resident-based family medicine outpatient clinic at the Family Health Center, a Federally Qualified Health Center. Students will act as entry level residents with direct supervision by senior Family and Community Medicine residents or attending physicians. Participants will perform the initial evaluation of patients, review patient records, and assimilate the information they have gathered into a complete assessment of the patient’s presenting problems. Finally, students will be expected to develop a plan for each problem identified.  Patients will be regularly presented to supervising physicians to finalize plans and follow-up. This course can be taken as a required ambulatory clerkship or an elective.

Offered:  All weeks

Objectives:
  • Identify a chief complaint for any patient presenting to the office.
  • Obtain an adequate history and physical exam for common outpatient complaints.
  • Synthesize history, physical exam findings and other patient data to complete an assessment of the patient’s condition.
  • Propose a plan for each problem identified in the visit.
  • Present patients with common outpatient conditions in a complete and concise manner, including the assessment and plan.
  • Integrate evidence-based medicine and preventive care into acute outpatient visits.
  • Begin to reconcile differences between preventive care guidelines from various organizations.

Advanced Clerkship Goals:

  1. Demonstrate clinical reasoning in gathering focused information relevant to a patient's care.
  2. Demonstrate patient-centered interview skills.
  3. Demonstrate patient-centered examination techniques.
  4. Articulate a management plan based on the well-reasoned differential and working diagnoses.
  5. Provide complete and succinct documentation so that other providers have evidence of your clinical reasoning to ensure continuity of care and patient safety.
  6. Recommend reliable, cost-effective tests when indicated for screening or evaluating patients with common acute or chronic conditions.
  7. Routinely reflect on how the results of a test will influence clinical decision making and, conversely, on the potential consequences of not doing a test.
  8. Articulate the risks and benefits of what you are ordering (e.g., drugs tests).
  9. Consistently discuss diagnostic plans with the patient, and provide evidence that patient preferences have been solicited and factored into decision making.
  10. Distinguish common, insignificant abnormalities from clinically important abnormalities.
  11. Provides documentation that is comprehensive and contains important information without unnecessary details or redundancies.
  12. Filter, synthesize, and prioritize information and recognize patterns, resulting in a concise, well organized, and accurate presentation.
  13. Adjust oral presentations for the receiver of information (e.g., faculty, patient/family, team members) and for the context of the presentation (e.g., emergent versus stable).
  14. Routinely identify the need to ask for help or seek new information in the context of the clinical setting, based on awareness of one's own knowledge gaps and patient needs.
  15. Act as an active and integrated member of the team who in most situations prioritizes team goals over one's own professional goals.
  16. understand the roles of other team members, seek their counsel, actively listen to their recommendations, and incorporate them into practice.
  17. Maintains a professional demeanor in all but the most trying of circumstances.
  18. Interpret common test results to anticipate and respond to early clinical deterioration.
  19. Understand the importance of informed consent to rapport building and shared decision making.
  20. Demonstrate an understanding of the elements of informed consent generally (indications, contraindications, risks, benefits, alternatives) and the specifics of these elements for the procedures for which consent is being sought.
  21. Provides complete information to patients and families.
  22. Avoids medical jargon in communicating with patients and families.
  23. Demonstrate patient-centered skills in performing procedures:
    • Avoid medical jargon such that patients are able to verbalize understanding of the procedure.
    • Participate in shared decision making with patients about procedures.
    • Have confidence commensurate with level of knowledge and skill that puts patients at ease.
    • Simultaneously pay attention to both the procedure and the patient's emotional response.
  24. Identify real and potential errors.
  25. Perform common safety behaviors (e.g., universal precautions, handwashing).
  26. Understand the importance of error prevention both to individual patients and to systems.
MED 9710 Advanced Hospital Medicine
Credits:
2,4
Directors:
Olken
Grading:
Pass/Fail
Description:

Advanced hospital clerkships provide the opportunity for students to assume greater responsibility for patient care of the hospitalized patient, with oversight from supervising residents and attending physicians. Students expand upon competencies they develop during the third year as they care for one to two patients at a time. Additional expectations include responsibility for developing management plans, writing orders, patient handovers and transfers of care, recognizing the policies that support patient safety, and developing competency in procedures that they will perform independently as residents. Fourth year students also assist in teaching third year students.

Hospital medicine is a growing professional track for internal medicine physicians. The Society for Hospital Medicine defines a hospitalist as a physician “who engages in clinical care, teaching, research, or leadership in the field of general hospital medicine. In addition to their core expertise managing the clinical problems of acutely ill, hospitalized patients, hospital medicine practitioners work to enhance the performance of hospitals and healthcare systems.” The M4 clerkship in hospital medicine exposes the student to the medical problems commonly seen in hospitalized adult patients and permits the student to have a greater role in the evaluation and management of these patients than they had during the M3 clerkship.

Offered: All weeks

Objectives:
  • Recognize, evaluate and manage the presentations of common acute medical problems encountered in inpatient general internal medicine.
    • Abdominal pain
    • Acute gastrointestinal bleeding
    • Acute pulmonary edema
    • Acute renal failure/kidney injury
    • Altered mental status
    • Arrhythmias
    • Chest pain
    • Drug withdrawal
    • Electrolyte disorders
    • Fever
    • Glycemic control
    • Hypertensive emergencies
    • Nausea and vomiting
    • Pain management
    • Respiratory distress
    • Seizures
    • Sepsis
  • Obtain a complete history and physical appropriate to the patient’s presentation.
  • Develop complete problem lists with appropriate assessment and plan, including differential diagnosis and selection of appropriate diagnostic studies and management plans.
  • Develop professional and caring relationships with patients and families, including timely discussions regarding the patient’s illness, recommended testing, prognosis, and treatment options.
  • Use consultants when indicated.
  • Develop appropriate discharge planning and outpatient follow-up care, including communication with outpatient physicians, discharge planners, and community resources essential for transition home.
  • Accurately assess and make judgments regarding acuity of illness for determining necessity for hospital admission and for determining need for intensive care admission.
  • Determine appropriate patient monitoring, including cardiac monitoring, diabetic monitoring, fluid management, neurological assessments and vital signs.
  • Function as both a responsible referring physician and as a consultant in appropriate settings.
  • Know the indications and be able to interpret and act upon the results, in the context of individual patients, for common lab and imaging studies.
  • Use the electronic health record to review test results, physician and non-physician notes, document patient care and progress as well as beginning proficiency in writing admission, discharge orders, and daily orders.

Advanced Clerkship Goals:

  1. Demonstrate clinical reasoning in gathering focused information relevant to a patient's care.
  2. Demonstrate patient-centered interview skills
  3. Demonstrate patient-centered examination techniques.
  4. Articulate a management plan based on the well-reasoned differential and working diagnoses.
  5. Provide complete and succinct documentation so that other providers have evidence of your clinical reasoning to ensure continuity of care and patient safety.
  6. Recommend reliable, cost-effective tests when indicated for screening or evaluating patients with common acute or chronic conditions.
  7. Routinely reflect on how the results of a test will influence clinical decision making and, conversely, on the potential consequences of not doing a test.
  8. Articulate the risks and benefits of what you are ordering (e.g., drugs, tests).
  9. Consistently discuss diagnostic plans with the patient, and provide evidence that patient preferences have been solicited and factored into decision making.
  10. Distinguish common, insignificant abnormalities from clinically important abnormalities.
  11. Provides documentation that is comprehensive and contains important information without unnecessary details or redundancies.
  12. Filter, synthesize, and prioritize information and recognize patterns, resulting in a concise, well organized, and accurate presentation.
  13. Adjust oral presentations for the receiver of information (e.g., faculty, patient/family, team members) and for the context of the presentation (e.g., emergent versus stable).
  14. Routinely identify the need to ask for help or seek new information in the context of the clinical setting, based on awareness of one's own knowledge gaps and patient needs.
  15. Provide key aspects of the ideal handover to the recipient, including verbalizing the patient's illness severity and/or providing action planning and/or contingency planning.
  16. Demonstrates awareness of known threats to handover communication (e.g., interruptions and distractions) by paying attention to the timing and location of the handover communication.
  17. Acts as an active and integrate member of the team who in most situations prioritizes team goals over one's own professional goals.
  18. Understands the roles of other team members, seek their counsel, actively listen to their recommendations, and incorporate them into practice.
  19. Interpret common test results to anticipate and respond to early clinical deterioration.
  20. Adhere to institutional procedures and protocols regarding escalation of patient care.
  21. Understand the importance of informed consent to rapport building and shared decision making.
  22. Demonstrate an understanding of the elements of informed consent generally (indications, contraindications, risks, benefits, alternatives) and the specifics of these elements for the procedures for which consent is being sought.
  23. Demonstrate patient-centered skills in performing procedures:
    • Avoid medical jargon such that patients are able to verbalize understanding of the procedure.
    • Participate in shared decision making with patients about procedures
    • Have confidence commensurate with level of knowledge and skill that puts patients at ease.
    • Simultaneously pay attention to both the procedure and the patient's emotional response.
  24. Identify real potential errors.
  25. Perform common safety behaviors (e.g., universal precautions, hand washing).
  26. Understand the importance of error prevention both to individual patients and to systems.
MED 9720 Advanced Ambulatory Medicine
Credits:
2,4
Directors:
Olken
Grading:
Pass/Fail
Description:

Advanced ambulatory clerkships provide the opportunity for students to assume initial responsibility for the evaluation of patients in the ambulatory setting. Supervision will be provided by faculty preceptors in the academic setting as well as community private practices. Students expand upon competencies they developed during the third year as they team with residents and/or preceptors to provide preventive health services as well as acute and chronic illness management. The faster pace of ambulatory care provides an environment that strengthens patient and family communication skills, rapport development, and oral presentations. The use of evidence to inform treatment and counseling of patients and their caregivers are additional competencies that are highlighted in the outpatient setting.

During this rotation, students will be assigned to a community internal medicine faculty preceptor at their practice site. Patients may be adults who have no health problems seeking care for acute, self-limited problems or may be wanting “a physical” or preventive health assessment. Or, patients may be adults with complex multiple medical problems, extensive medication lists who present with acute problems, follow-up care for chronic medical issues, and/or have preventive health tasks to be updated, as well. Thus, the entire spectrum of adult patients, aged 18+ may be encountered. Medical care that 20 years ago might have had to be delivered in the hospital setting is now managed and coordinated by a patient’s primary internist.

Offered: All weeks

Objectives:

M4 Medicine Subinternships and Electives: Global Clinical Competencies (borrowed and adapted from the CDIM Internal Medicine Subinternship Curriculum)

Communication learning objectives

  1. Knowledge. Subinterns and students on electives should demonstrate knowledge of:
    • Local and national ethical and legal guidelines governing patient confidentiality with specific attention to:
      • Written documentation in the EMR
      • Verbal communication with the patient’s family members and friends
    • Verbal and non-verbal clues of patient suicidality
    • Importance of cultural issues impacting health care decision making by patients
    • Identification of appropriate resources available in the inpatient and ambulatory (outpatient) setting for managing grief
  2. Skills. Subinterns should demonstrate the ability to:
    • Communicate effectively with patients and their family/friends (with whom the patient has given permission for the subintern to communicate with)
      • Utilize lay terms appropriate to the patient’s level of education, including explanation of scientific jargon
      • Recognize and manage denial and grief
      • Communicate abnormal results and “bad news” to patients in a sensitive manner
      • Discuss advanced directives and end of life issues with patients and their family members with attention to the patient’s wishes and needs
      • Provide concise daily updates for patients and families regarding hospital course and rationale for ongoing or new treatment plans (including new medications or discontinuation of previous medications), potential risks/benefits of proposed treatments, and discussion of anticipated discharge needs.
      • In the outpatient setting, discussing rationale and goals for monitoring/managing chronic disease conditions, including new medications and potential side effects, discontinuation of previous medications, and referrals to specialists for monitoring/managing and/or preventive health tasks appropriate for the patient’s age and health status.
    • Clearly summarize the patient’s reason for being brought into the hospital for observation status or inpatient admission status. AND the rationale for the clinical plan of care.
    • Assess suicidality in a depressed or psychotic patient
    • Be able to initiate a conversation with a patient about advanced directives
      • Inpatient setting, at time of admission, as well as on-going re-discussion as goals are defined and discussed during the hospital course
      • Outpatient setting when it is determined that the patient has not yet considered their end-of-life wishes or durable power of attorney for medical decision making
    • Demonstrate ability to clearly and concisely present oral and written summaries of patients to members of the health care team with attention to the inclusion of relevant information and synthesis of clinical information.
  3. Attitudes and professional behavior. Subinterns should demonstrate:
    • The ability to effectively communicate with physician and non-physician members of the health care team and consultants
    • Demonstrate an understanding of the importance of transitions of care by communication with the patient’s primary care physician (PCP) and the patient’s specialist physicians as they traverse their medical care between the inpatient and outpatient settings.
    • Seek to understand cultural sensitivities and patient wishes with regards to health care and incorporate this knowledge into discussions with the patient

Coordination of Care Learning Objectives

  1. Knowledge. Subinterns demonstrate knowledge of:
    • How to contact members of the health care team, consultants and other hospital personnel
    • How to properly transfer care throughout a patient’s hospitalization including end of day and end of service coverage using strategies such as I-PASS, EHR hand-off tools, and transfer notes.
  2. Skills. Subinterns should be able to:
    • Appropriately utilize consultants
      • Identify a consultant’s role and limits of participation in the care of a patient
      • Request a consultation by identifying a specific question(s) to be addressed
      • Discuss a consultant’s recommendations with members of the health care team
    • Effectively cooperate with physician and non-physician members of the health care team including:
      • Nursing staff (RN, RN Care Managers)
      • Patient care associates
      • Advanced practice providers: physician assistants (PAs) and nurse practitioners (NPs)
      • Medical social workers (MSW)
      • Therapists (occupational, physical and speech)
      • Pharmacists
      • Nutrition support staff
      • Discharge planners (MSW, RN Care Managers, outside liaisons from outside facilities/agencies such hospice care, skilled nursing facilities, long term acute care hospitals, and inpatient rehabilitation units)
    • Identify house staff on-call and cross-coverage schedules among house staff
    • Professionally and effectively request hospital operators to assist in making connections with other physicians/services potentially or currently involved in the care of the patient, as needed.
      • Recognize operators do not necessarily know the call schedules of individual physicians or practices
    • Communicate transfer of patient’s care responsibilities to other house staff. Depending on situation, this may involve verbal and/or written communication. Verbal may involve face-to-face vs via telephone conversation.
      • At end of shift (day or night)
      • Upon leaving service, at the direction of the preceptor/senior
      • Upon transfer of patient between services (such floor to ICU or ICU to floor)
    • Demonstrate proficiency in coordinating a comprehensive and longitudinal patient care plan
    • Communicate plan with PCP or specialist, arranging for follow-up when appropriate
    • Coordinate care plan utilizing community resources when necessary. This includes discussing community resources with patient at time of discharge for those resources which may not be “medical” (such as substance abuse programs, grief counseling, senior services, public library)

Information Management Learning Objectives

  1. Knowledge. Subinterns should demonstrate knowledge of:
    • How to access the clinical information system (EHR) in use at their hospital or ambulatory setting
    • How “panic” or “critical” values are communicated from the hospital laboratory to the responsible intern
    • The necessity for a systematic method to track clinical/laboratory/radiologic data
      • Relevant for an acute hospital encounter
      • Relevant for longitudinal tracking in the ambulatory setting
    • Patient confidentiality regulations governing medical records and clinical information
  2. Skills. Subinterns should demonstrate the ability to:
    • Prioritize and systematically organize tasks for daily patient care to efficiently manage time as well as optimize patient care
    • Document the following in an organized and efficient manner, and per the guidelines by preceptor within the individual clinical setting:
      • Admission notes (floor and ICU)
      • Daily progress notes (floor and ICU)
      • Transfer notes (e.g., floor to ICU; ICU to floor)
      • Floor calls/clinical events/emergencies
      • Discharge summaries
      • Outpatient encounters
    • Review, reconcile, and document medication lists.
      • Upon admission, document an accurate home medication list utilizing HER information (and verifying compliance with patient), pharmacy information from patient, outside facility list (such as nursing home). Include over-the-counter products patient may be using. It is extremely important to document what the patient is actually taking and not presume the way a prescription is written is the manner the patient is taking.
      • Review inpatient medication administration reconciliation (MAR) daily to ensure medications that have been prescribed have been able to be administered.
      • Document variances within daily progress note.
      • Discharge medication reconciliation
        • Compare with home medications for changes
        • Document patient education on new medications or changes in home medication dosage/frequency in daily progress note or discharge summary
      • Medications and compliance should be reviewed at each outpatient encounter
    • Use paper, mobile apps, or electronic references to access evidence based medicine to solve clinical problems
  3. Attitudes and professional behaviors. Subinterns should demonstrate:
    • Respect for patient’s rights to confidentiality

Procedures learning objectives

  1. Knowledge. Subinterns should be able to describe:
    • The indications, contraindications, risks and benefits of each of the following procedures:
      • Venipuncture
      • Intravenous catheter insertion: peripheral, central* (peripheral intravenous central catheter or PICC line; internal jugular central line; subclavian central line)
      • Arterial blood sampling
      • Nasogastric tube insertion
      • Lumbar puncture
      • Blood product transfusion
      • Urethral catheter insertion
      • [*Central line insertion competence is not expected of M4s, but indications, etc. should be known]
    • How the information obtained from these procedures will enhance the patient’s care
    • How to assess the patients’ competence to provide informed consent for a procedure
    • Potential procedure related risks to the operator and the need for universal precautions
  2. Skills. Subinterns should be able to:
    • Recognize clinical situations where one or more procedures are indicated
    • Effectively explain the rationale, risks and benefits for the procedure in language that is understandable by the patient or their representative
    • Obtain and document informed consent, if necessary
    • Recognize lack of skill or proficiency in performing one of the above procedures
    • Personally perform, with supervision, the above procedures
    • Write a procedure note
    • Ensure that samples obtained are properly prepared for laboratory processing (including orders on the EHR)
    • Teach procedures skills to third year medical students when appropriate
  3. Attitudes and professional behavior. Subinterns should demonstrate:
    • Respect for patient autonomy and the principles of informed consent
    • Concern for maximizing patient comfort
    • Commitment to learning how to perform procedures in an efficient and cost-effective manner
  4. Specific Hospital Internal Medicine Objectives
    • The student will be able to describe and define the following conditions frequently encountered in the adult outpatient setting. This includes the evidence-based guidelines for evaluation and management of common chronic problems, adult preventive health guidelines, and an awareness of the system issues inherent in coordinating patient care in the ambulatory environment.
      • Hypertension (blood pressure goals/control and monitoring for complications)
      • Diabetes (glycemic control and monitoring for complications)
      • Heart failure (evaluation of patient and evidence-based guideline adherence)
      • Hyperlipidemia
      • Skin cancers
      • Chronic pain management
      • Avoidance/evaluation of polypharmacy, particularly in elderly patients
      • Age-appropriate preventive health guidelines (cervical, breast and colon cancer screening, vaccinations, aortic aneurysm screening, tobacco cessation)

Advanced Clerkship Goals:

  1. Demonstrate clinical reasoning in gathering focused information relevant to a patient's care.
  2. Demonstrate patient-centered interview skills.
  3. Demonstrate patient-centered examination techniques.
  4. Articulate a management plan based on the well-reasoned differential and working diagnoses.
  5. Provide complete and succinct documentation so that other providers have evidence of your clinical reasoning to ensure continuity of care and patient safety.
  6. Recommend reliable, cost-effective tests when indicated for screening or evaluating patients with common acute or chronic conditions.
  7. Routinely reflect on how the results of a test will influence clinical decision making and, conversely, on the potential consequences of not doing a test.
  8. Articulate the risks and benefits of what you are ordering (e.g., drugs tests).
  9. Consistently discuss diagnostic plans with the patient, and provide evidence that patient preferences have been solicited and factored into decision making.
  10. Distinguish common, insignificant abnormalities from clinically important abnormalities.
  11. Provides documentation that is comprehensive and contains important information without unnecessary details or redundancies.
  12. Filter, synthesize, and prioritize information and recognize patterns, resulting in a concise, well organized, and accurate presentation.
  13. Adjust oral presentations for the receiver of information (e.g., faculty, patient/family, team members) and for the context of the presentation (e.g., emergent versus stable).
  14. Routinely identify the need to ask for help or seek new information in the context of the clinical setting, based on awareness of one's own knowledge gaps and patient needs.
  15. Act as an active and integrated member of the team who in most situations prioritizes team goals over one's own professional goals.
  16. understand the roles of other team members, seek their counsel, actively listen to their recommendations, and incorporate them into practice.
  17. Maintains a professional demeanor in all but the most trying of circumstances.
  18. Interpret common test results to anticipate and respond to early clinical deterioration.
  19. Understand the importance of informed consent to rapport building and shared decision making.
  20. Demonstrate an understanding of the elements of informed consent generally (indications, contraindications, risks, benefits, alternatives) and the specifics of these elements for the procedures for which consent is being sought.
  21. Provides complete information to patients and families.
  22. Avoids medical jargon in communicating with patients and families.
  23. Demonstrate patient-centered skills in performing procedures:
    • Avoid medical jargon such that patients are able to verbalize understanding of the procedure.
    • Participate in shared decision making with patients about procedures.
    • Have confidence commensurate with level of knowledge and skill that puts patients at ease.
    • Simultaneously pay attention to both the procedure and the patient's emotional response.
  24. Identify real and potential errors.
  25. Perform common safety behaviors (e.g., universal precautions, handwashing).
  26. Understand the importance of error prevention both to individual patients and to systems.
MEDU 9410 Medical Simulation
Credits:
2,4
Directors:
Lammers
Grading:
Pass/Fail
Description:

This elective is designed for medical students who are considering academic careers in medicine. Students will learn principles of experiential learning by developing simulation-based educational exercises. They will gain knowledge of and experience with simulation as an educational tool by reading selected textbook chapters and journal articles, assisting faculty in running simulation exercises, developing an immersive case simulation, observing and critiquing a debriefing session, and creating a procedure assessment tool. Students will observe simulations designed to teach or assess cognitive, technical, communication, and teamwork skills.

This two-week elective will be held primarily in the Simulation Centers at Western Michigan University School of Medicine and Borgess Medical Center. Students will work predominately with Dr. Lammers and the Simulation Center staff, but they will also interface with residents and faculty who are working on simulation projects.

Offered: must start by mid-October and end before mid-December

 

Objectives:

After completion of this elective, students will be able to:

  1. List six assumptions about adult learners that should guide curriculum development.
  2. List five advantages of medical simulation over bedside clinical teaching in the education of medical students and resident physicians.
  3. Describe simulation exercises that use the artificial representation of a person, a situation, an environment, and an event to provide learning experiences.
  4. Develop a simple, simulation-based exercise that incorporates the four stages of Kolb’s experiential learning model.
  5. Develop, program, and pilot-test a 5-10 minute case-based simulation that teaches one or more of the following: clinical reasoning, medical decision-making, communication, or teamwork skills.
  6. Explain how to use reflective practice techniques in post-scenario debriefing sessions.
  7. Create a performance checklist to assess a procedural (technical) skill.
OBGY 9420 Reproductive Endocrinology and Infertility
Credits:
2,4
Directors:
Dodds, Young, Shavell
Grading:
Pass/Fail
Description:

This elective is designed for 4th year medical students interested in pursuing Obstetrics and Gynecology. It is particularly relevant for students who may wish to consider subspecialty training in Reproductive Endocrinology and Infertility (REI). This elective will allow the student to focus on REI problems exploring in depth the diagnostic evaluation and treatment approaches to those problems. The course will involve one-on-one patient care with our Reproductive Endocrinologists. In addition, the student will spend a brief time in the andrology, endocrine, and in vitro fertilization laboratories to provide a better understanding of laboratory contribution to diagnosis and treatment. Students will also participate in pelvic ultrasound and surgical care of patients. Didactic training from the Reproductive Endocrinologists will be given. Students will prepare a presentation on a clinical topic or an interesting case and present it at the end of the elective.

Offered:  Not offered week of Christmas

Objectives:

After completion of this elective, each student will be able to:

  • Knowledge of menstrual cycle physiology to understand the basis of ovulation, abnormal bleeding, polycystic ovary disease, and an ovulatory infertility issues.
  • Demonstrate an understanding of the common causes of infertility and how to use evidence based medicine to develop a plan for further evaluation and treatment.
  • Understand and discuss the risks and benefits of advanced reproductive technologies including in vitro fertilization, preimplantation genetic testing, donor oocyte, donor embryo, gestational carrier, and gamete and embryo cryopreservation for fertility preservation.
  • Improve patient history & physical presentation skills.
OBGY 9460 Labor and Delivery
Credits:
2,4
Directors:
McGhee
Grading:
Pass/Fail
Description:

This elective is designed for 4th year medical students interested in pursuing Obstetrics and Gynecology. This elective will allow the student to explore the ins and outs of labor and delivery and give them the opportunity to manage patients in labor. The course will involve one-on-one patient care with Certified Nurse midwives as well as OBGYN physicians. In addition, the student will spend time in triage. Students will also be part of the surgical team for patients who required surgery. Didactic training from the attending physicians in labor and delivery will be given. Students will prepare a presentation on a clinical topic or an interesting case and present it at the end of the elective.

Offered: All weeks

Objectives:

After completion of this elective, each student will be able to:

  1. Have knowledge of normal pregnancy, labor and management of labor, delivery and immediate postpartum complications.
  2. Demonstrate an understanding of the most common antepartum conditions: Diabetes (gestational and pre-gestational), hypertension (pre-existent and pregnancy induced hypertension).
  3. Have basic knowledge of multiple pregnancies specially twin pregnancies.
  4. Understand and discuss the risks and benefits of antepartum and intra-partum fetal monitoring.
  5. Improve patient history & physical presentation skills and perform accurate cervical exams.
ORTH 9710 Advanced Orthopaedic Surgery
Credits:
4
Directors:
Lackey, Bovid
Grading:
Honors/Pass/Fail
Description:

Advanced hospital clerkships provide the opportunity for students to assume greater responsibility for patient care of the hospitalized patient, with oversight from supervising residents and attending physicians. Students expand upon competencies they develop during the third year as they care for one to two patients at a time. Additional expectations include responsibility for developing management plans, writing orders, patient handovers and transfers of care, recognizing the policies that support patient safety, and developing competency in procedures that they will perform independently as residents. Fourth year students also assist in teaching third year students.

Designed for the 4th year medical student with a potentially strong interest in pursuing orthopaedic surgery as a career. Patient care involvement will be both in the outpatient clinics and operating room. There will also be opportunities to be involved with emergency department and in-patient consultations.  Students will be required to take evening call and will be paired with a resident. Students will have opportunities to work with a variety of faculty that are fellowship trained in the different subspecialties of orthopaedic surgery. There will also be opportunities to work closely with orthopaedic residents. Students will learn musculoskeletal history taking skills, the details of a musculoskeletal physical examination, interpretation of radiographs and advanced imaging techniques, treatment options including both nonoperative and operative management, surgical approaches to include both soft tissue and bone handling techniques, and implant specifics. There will be a lectureship series for students given by the faculty. A fundamental knowledge of musculoskeletal anatomy will be important. 

Offered:  All weeks

Objectives:
  • Apply advanced fundamental knowledge in musculoskeletal gross anatomy to physical examination, surgical approaches and techniques.
  • Demonstrate understanding in the basic science of soft tissue healing, fracture healing, tendinopathies, arthropathies, meniscal, ligament and tendon injury, and joint biomechanics and apply this knowledge to patient care.
  • Develop advanced knowledge of common musculoskeletal complaints and diseases that present to the orthopaedic surgeon and use critical thinking to apply this in patient care.
  • Gather essential and accurate information in a thorough musculoskeletal-focused history
  • Perform an appropriate musculoskeletal physical examination to include the spine and extremities.
  • Interpret common plain film radiographs at a beginning level.
  • Participate in surgical care of patients including basic suturing and other skills as determined appropriate by the attending surgeon.
  • Demonstrate professionalism and effective communication skills in patient care and interactions with other members of the health care team.

Advanced Clerkship Goals:

  1. Demonstrate clinical reasoning in gathering focused information relevant to a patient's care.
  2. Demonstrate patient-centered interview skills
  3. Demonstrate patient-centered examination techniques.
  4. Articulate a management plan based on the well-reasoned differential and working diagnoses.
  5. Provide complete and succinct documentation so that other providers have evidence of your clinical reasoning to ensure continuity of care and patient safety.
  6. Recommend reliable, cost-effective tests when indicated for screening or evaluating patients with common acute or chronic conditions.
  7. Routinely reflect on how the results of a test will influence clinical decision making and, conversely, on the potential consequences of not doing a test.
  8. Articulate the risks and benefits of what you are ordering (e.g., drugs, tests).
  9. Consistently discuss diagnostic plans with the patient, and provide evidence that patient preferences have been solicited and factored into decision making.
  10. Distinguish common, insignificant abnormalities from clinically important abnormalities.
  11. Provides documentation that is comprehensive and contains important information without unnecessary details or redundancies.
  12. Filter, synthesize, and prioritize information and recognize patterns, resulting in a concise, well organized, and accurate presentation.
  13. Adjust oral presentations for the receiver of information (e.g., faculty, patient/family, team members) and for the context of the presentation (e.g., emergent versus stable).
  14. Routinely identify the need to ask for help or seek new information in the context of the clinical setting, based on awareness of one's own knowledge gaps and patient needs.
  15. Provide key aspects of the ideal handover to the recipient, including verbalizing the patient's illness severity and/or providing action planning and/or contingency planning.
  16. Demonstrates awareness of known threats to handover communication (e.g., interruptions and distractions) by paying attention to the timing and location of the handover communication.
  17. Acts as an active and integrate member of the team who in most situations prioritizes team goals over one's own professional goals.
  18. Understands the roles of other team members, seek their counsel, actively listen to their recommendations, and incorporate them into practice.
  19. Interpret common test results to anticipate and respond to early clinical deterioration.
  20. Adhere to institutional procedures and protocols regarding escalation of patient care.
  21. Understand the importance of informed consent to rapport building and shared decision making.
  22. Demonstrate an understanding of the elements of informed consent generally (indications, contraindications, risks, benefits, alternatives) and the specifics of these elements for the procedures for which consent is being sought.
  23. Demonstrate patient-centered skills in performing procedures:
    • Avoid medical jargon such that patients are able to verbalize understanding of the procedure.
    • Participate in shared decision making with patients about procedures
    • Have confidence commensurate with level of knowledge and skill that puts patients at ease.
    • Simultaneously pay attention to both the procedure and the patient's emotional response.
  24. Identify real potential errors.
  25. Perform common safety behaviors (e.g., universal precautions, hand washing).
  26. Understand the importance of error prevention both to individual patients and to systems.
PATH 9410 Anatomic Pathology
Credits:
2,4
Directors:
DeJong
Grading:
Pass/Fail
Description:

The Anatomic Pathology elective is intended for medical students in their fourth year and provides broad experience in general diagnostic techniques. Students will have opportunities to participate in autopsy pathology, cytopathology and surgical pathology. A daily diagnostic conference is scheduled for students. In addition to direct responsibilities in autopsy and surgical pathology areas, the student will have the opportunities to participate in electron microscopy, immunohistochemistry, molecular diagnostics and flow cytometry techniques.

Offered:  All weeks

Objectives:
  • Gather the important information that is needed for the evaluation of specimens in anatomic pathology.
  • Complete a gross examination and dissection of at least 5-10 specimens per week. The student should demonstrate the ability to perform this gross dissection while being observed by at least one attending or resident.
  • Know about common pathologic conditions seen on the relevant subspecialty service (for example, GI pathology).
  • Perform Gross Dissection for the common specimens seen on the relevant subspecialty rotation.
  • Demonstrate professional responsibility in working as a team member with other members of the subspecialty service team, technical and support staff.
  • Career/context Know the training/career pathway for Anatomic Pathology.
PATH 9420 Forensic Pathology
Credits:
2,4
Directors:
DeJong
Grading:
Pass/Fail
Description:

By familiarizing the students with autopsies, to include clinical history, gross and microscopic findings, the forensic pathology rotation will enhance students' ability to establish clinicopathologic correlations. Emphasis will be placed on the student's development and use of observational and deductive skills, and on self-directed independent study. This elective will also provide an orientation to basic forensic medicine through observation of and active participation in forensic autopsies, death scene investigation, assigned readings, didactic instruction, observation of courtroom testimony and self-directed writing assignments. The student will receive focused instruction on Michigan Compiled Law as it pertains to physicians and the Medical Examiner’s Office in addition to training in proper death certification. The student will be exposed to the related and overlapping fields of anthropology, entomology, law enforcement, odontology and toxicology. The student’s mastery of the material will be assessed through daily teaching rounds and an open-book examination.

Offered: All weeks

Objectives:
  • Formulate a differential diagnosis based on a clinical history
  • Observe and describe gross findings in organs
  • Differentiate normal and abnormal gross findings at autopsy
  • Formulate a cause of death based on history, scene investigation and autopsy findings
  • Correlate clinical manifestations of the patient with morphologic findings at autopsy
  • Recognize the microscopic characteristics of frequent diseases
  • Describe the clinical and pathologic characteristics of common diseases and injuries
  • Outline the procedure of obtaining family consent for autopsy in hospital deaths
  • Define criteria for medical examiner’s case and apply the criteria to a variety of scenarios.
  • Exhibit conduct consistent with accepted standards of ethical and professional behavior.
PEDS 9410 Pediatric Endocrinology
Credits:
2,4
Directors:
Draznin
Grading:
Pass/Fail
Description:

Pediatric Endocrinology is a primarily ambulatory 4th year elective based at the WMed Pediatric Subspecialty Clinic on Oakland Drive. Students will also have the opportunity to participate in consultations at the Bronson Children’s Hospital in downtown Kalamazoo, MI. Students may spend two or four weeks in our active academic pediatric endocrinology program. The site available is WMed Pediatric Subspecialty Clinic.

Offered: All weeks

Objectives:

After completion of this elective, each student will be able to:

  • Describe processes of growth and their differences in infants children and adolescents.
  • List common growth disorders in all pediatric age groups
  • Give a basic explanation of the evaluation and management of common growth disorders in pediatric patients.
  • Describe the pathophysiology, clinical manifestations, diagnostic evaluation, and basic management principles of diabetes mellitus (types 1 and 2) in children and adolescents.
  • Describe the Michigan Newborn Endocrine Screening Program, the treatment and long term care of infants identified to have congenital adrenal hyperplasia or congenital hypothyroidism in plain language that would inform parents and children.
  • Participate in a multidisciplinary diabetes clinic and be able to explain the need for the different disciplines involved.
PEDS 9420 Pediatric Hematology and Oncology
Credits:
2,4
Directors:
Elliott
Grading:
Pass/Fail
Description:

The student will join the Bronson Children’s Hospital Pediatric hematology-oncology unit that is the tertiary care center for blood disorders and cancer for children and adolescents in Southwest Michigan. As a member of the pediatric hematology-oncology team, the student participates in evaluating outpatients, rounding on the inpatient hematology-oncology service and performing inpatient consultations. Selected procedures may be performed (lumbar punctures and bone marrow aspirations). The pediatric hematology-oncology faculty will provide the student with a study outline and reading materials. Independent projects may be arranged. The sites available are WMed Pediatric Clinics.

Offered: All weeks

Objectives:

After completion of this elective, students will be able to:

  • Describe physiologic basis underlying age-specific hematologic and coagulation norms and be familiar with peripheral blood and bone marrow smears.
  • Describe the historical, physical and laboratory findings diagnostic of hematologic or oncologic abnormalities and recognize the hematologic findings in disorders of other organ systems.
  • List basic strategies of oncologic treatment, management of complications, and with toxicities associated with chemo radiotherapy.
  • List known chromosomal and molecular genetic abnormalities underlying hematologic/oncologic diseases, including the familial cancer syndrome.
  • Appreciate the hereditary, genetic, protein and laboratory abnormalities associated with congenital bleeding dyscrasias, and become familiar with long-term health issues in these patients.
  • Appreciate the psychological and emotional aspects of childhood cancer and chronic hematologic disorders, and be involved in family genetic counseling sessions.
PEDS 9440 Pediatric Pulmonary Medicine
Credits:
2,4
Directors:
Gregoire-Bottex
Grading:
Pass/Fail
Description:

Pediatric Pulmonary Medicine is primarily an outpatient experience, but student will participate in all Pediatric activities including Morning report and resident block conferences. The student will have ample opportunity to interview patients, perform physical examinations and discuss management of the most common pulmonary disorders. The student will participate in inpatient rounds and consults on patient admitted at Bronson hospital. They will have opportunity to observe a multidisciplinary team during the Cystic Fibrosis and Ventilation clinics. The student will observe bronchoscopy and spirometry or other pulmonary function testing. Emphasis is also placed on general pediatric issues: growth, immunization, risk of smoking or exposure to tobacco smoke, and infection control, patient education, safety and planning of care. The sites available are WMed Pediatric Subspecialty Clinics.

Offered: All weeks

Objectives:

After completion of this elective, all students will be able to:

  • Demonstrate progress in obtaining a pediatric pulmonary history.
  • Demonstrate age appropriate pediatric pulmonary examination.
  • Discuss the genetics, pathophysiology and management of cystic fibrosis, including most common complications and other impairment of airway clearance.
  • Describe two types of airway clearance techniques or devices in cystic fibrosis.
  • Discuss the pathophysiology and classify severity of asthma.
  • Explain the difference between controller and rescue medications for asthma. 
  • Discuss asthma management using the NIH / EPR guidelines based on asthma severity and degree of control.
  • Discuss the basic interpretation of spirometry and other test of pulmonary function.
  • Discuss the general approach to management of chronic cough and stridor.
  • Understand the care of a child with chronic lung disease: including prematurity, aspiration and immunodeficiency.
  • Understand the role of a multidisciplinary team in planning the care for a patient with chronic lung disease.
  • Participate in the quality improvement projects in the Clinic.
PEDS 9470 Developmental Behavioral Pediatrics
Credits:
2,4
Directors:
Soarse
Grading:
Pass/Fail
Description:

The purpose of this course is to provide students with an overview of Developmental-Behavioral Pediatrics through their participation in several outpatient clinics as well as attendance at some of our community sites.  Students will learn skills specific to interviewing parents, caregivers, and children as well as the common developmental assessments used in general pediatric clinics and assessments used to evaluate for more complex developmental and behavioral concerns.

Offered:  All weeks 

Objectives:

After completion of this elective, each student will be able to:

  • Recognize normal and abnormal child development and behavior from infancy through young adulthood; including cognitive, language, motor, social and emotional components.
  • Differentiate between problem behavior and intrinsic and extrinsic factors that influence those behaviors that warrant referrals to other specialists.
  • Describe the impact of family structure, adoption and foster care on growth and development.
  • Interview parents, care providers, and youth.
  • Identify psychosocial and developmental screening techniques.
  • Identify components of psychological evaluations.
  • Identify management strategies for children with developmental disabilities or special needs.
  • Recognize needs of children at risk from psychosocial adversity.
  • Recognize abuse and neglect.
  • Discuss the impact of chronic illness, terminal conditions and death on children and their families.
  • Discuss the impact of trauma (domestic violence, bullying, physical and sexual abuse) on youth growth and development (domestic violence, bullying, physical and sexual abuse).
  • Recognize and manage common mental health conditions (anxiety, depression).
  • Recognize and manage common childhood behavioral concerns.
  • Recognize and coordinate childhood and adolescent mental health problems that require referral for diagnosis and treatment.
PEDS 9480 Prenatal Exposure and Childhood Trauma
Credits:
2,4
Directors:
Sloane
Grading:
Pass/Fail
Description:

Prenatal Exposure and childhood trauma is an ambulatory 4th year elective based at the WMU Unified Clinics on 1000 Oakland Drive. Students will also have the opportunity to participate in new patient interdisciplinary consultations and interdisciplinary follow-up visits at Elizabeth Upjohn Community Healing Center (2615 Stadium Drive in Kalamazoo) as well as integrated trauma screening and assessments at the Bronson Lakeview Family Care Pediatrics in Paw Paw. Students may spend two or four weeks in our active interdisciplinary elective.

Offered: All weeks

Objectives:

After completion of this elective, each student will be able to:

  • Describe multiple types of child trauma and maltreatment.
  • Understand the brain and developmental impact of traumatic stress including the significant impact on adult health (ACES model).
  • Understand the basic principles of Fetal Alcohol Spectrum Disorder, including University of Washington FASD Diagnostic Criteria.
  • Understand the deleterious impact of prenatal exposure to toxic stress.
  • Understand the deleterious impact of prenatal exposure to drugs (opiates, stimulants, cannabis, nicotine, et al).
  • Understand the concept of resiliency and the central place of importance for this when constructing trauma-informed case / treatment plans.
  • Understand the concept of secondary traumatic stress and learn the importance of processing trauma cases with a trusted supervisor as well as practical examples of self-care.
  • Understand the essential nature of intergenerational trauma and the practical impact of this in daily pediatric primary care practice.
  • Understand the importance of trauma screening in the primary care setting.
  • Understand the need for comprehensive interdisciplinary integrated trauma assessment in multiple settings.
  • Participate in interdisciplinary trauma assessments in multiple settings (BLFCP, EUCHC, and WMU CTAC) and be able to explain the need for tiered trauma assessment (based on trauma screening results) and the different disciplines involved in each tier.
  • Participate in follow-up visits for children involved in the Early Intervention Program (EIP) at EUCHC, and understand the unique regulatory roles of trauma-informed / sensory-focused occupational therapy, trauma-informed music therapy, and trauma-informed medication treatment in the overall management of complex young children exposed to toxic stress and complex prenatal exposure.
PEDS 9490 Pediatric Cardiology
Credits:
2,4
Directors:
Fountain
Grading:
Pass/Fail
Description:

The student will be working with the Bronson Children's Hospital Pediatric Cardiology Faculty in both the inpatient, consultative, and ambulatory clinic settings. Bronson Children's Hospital serves as the tertiary care referral center for Southwest Michigan.

 

 

 

Objectives:

Upon completion of this elective, students will be able to:

  • Demonstrate the ability to do a thorough history of patients with a cardiovascular complaint.
  • Demonstrate the ability to perform a thorough cardiovascular examination, including auscultation.
  • Discuss initial evaluation and management of common pediatric cardiovascular disorders.
  • Understand the rationale for using noninvasive/ invasive diagnostic techniques in the evaluation and treatment of pediatric patients with cardiovascular issues including: echocardiography, cardiac catheterization and electrophysiology, cardiothoracic surgery.
  • Understand the implications of congenital heart disease AND acquired heart disease on the long term growth and development of infants, children, and adolescents.
PEDS 9510 Newborn and Infant Nutrition
Credits:
2,4
Directors:
Gibson
Grading:
Pass/Fail
Description:

During this rotation, students will work clinically with Bronson Lactation Consultants, the Bronson NICU Dietitian and Bronson Pediatric Occupational Therapists. The focus of this clinical experience is to gain first hand experience in evaluating infants and counseling parents and caregivers regarding the normal nutritional needs of infants and troubleshooting feeding problems that may arise during infancy. 

Offered: May – August  

Objectives:

After completion of this elective, each student will be able to:

  • Demonstrate how to counsel parents and caregivers about normal nutritional needs of the newborn.
  • Evaluate mom/infant dyad regarding appropriate feeding techniques, whether bottle or breast fed.
  • Demonstrate the ability to support breast feeding when there isn’t adequate growth in the infant.
  • Recognize infant risk factors for poor feeding.
  • Recognize maternal factors that lead to breast feeding failure.
  • Describe the role of lactation consultant, dietitian and occupational therapist in supporting normal newborn/infant growth.
  • Describe community resources that help to support infant feeding.
PEDS 9710 Advanced Hospital Pediatrics
Credits:
2,4
Directors:
Lane-Davies, Corpus
Grading:
Pass/Fail
Description:

Advanced hospital clerkships provide the opportunity for students to assume greater responsibility for patient care of the hospitalized patient, with oversight from supervising residents and attending physicians. Students expand upon competencies they develop during the third year as they care for one to two patients at a time. Additional expectations include responsibility for developing management plans, writing orders, patient handovers and transfers of care, recognizing the policies that support patient safety, and developing competency in procedures that they will perform independently as residents. Fourth year students also assist in teaching third year students.

Advanced Hospital Pediatrics is a hospital based pediatric rotation that utilizes Bronson Children’s Hospital as its clinical site. This center is the tertiary care referral center for pediatric disorders in Southwest Michigan. Fourth year students who have successfully completed all Year 3 required clerkships are eligible to register for this course.  During this rotation, students will focus on the development of patient management skills as they assume primary responsibility for patient care.

Faculty for this rotation are the Bronson Children's Hospital Pediatric Referral Service.

Offered:  All weeks

Objectives:
  • Take primary responsibility for their patients.
  • Perform focused histories, physicals, and communicate orally and in writing appropriately.
  • Share information effectively with patients and families.
  • Prioritize and organize work effectively.
  • Anticipate what patients will need during the course of hospitalization (i.e. when they need to be re-examined, when a lab needs to be repeated, when additional therapy is necessary, when additional history needs to be obtained, discharge criteria) and communicating this information effectively in hand-overs.
  • Re-evaluate patients when taking on their care (i.e. the assessment and plan, as well as the clinical status and looking further when the clinical picture is not consistent with the expected course).
  • Coping with uncertainty in patient care issues (i.e. knowing what you know and what you do not know, accessing best resources, and knowing when and how to get help).
  • Function as a "team player" with families, residents, attendings, nurses, ancillary staff and all others involved in the care of the patient.
  • Coordinate the care of patients during hospitalization and in planning for discharge.

Advanced Clerkship Goals:

  1. Demonstrate clinical reasoning in gathering focused information relevant to a patient's care.
  2. Demonstrate patient-centered interview skills
  3. Demonstrate patient-centered examination techniques.
  4. Articulate a management plan based on the well-reasoned differential and working diagnoses.
  5. Provide complete and succinct documentation so that other providers have evidence of your clinical reasoning to ensure continuity of care and patient safety.
  6. Recommend reliable, cost-effective tests when indicated for screening or evaluating patients with common acute or chronic conditions.
  7. Routinely reflect on how the results of a test will influence clinical decision making and, conversely, on the potential consequences of not doing a test.
  8. Articulate the risks and benefits of what you are ordering (e.g., drugs, tests).
  9. Consistently discuss diagnostic plans with the patient, and provide evidence that patient preferences have been solicited and factored into decision making.
  10. Distinguish common, insignificant abnormalities from clinically important abnormalities.
  11. Provides documentation that is comprehensive and contains important information without unnecessary details or redundancies.
  12. Filter, synthesize, and prioritize information and recognize patterns, resulting in a concise, well organized, and accurate presentation.
  13. Adjust oral presentations for the receiver of information (e.g., faculty, patient/family, team members) and for the context of the presentation (e.g., emergent versus stable).
  14. Routinely identify the need to ask for help or seek new information in the context of the clinical setting, based on awareness of one's own knowledge gaps and patient needs.
  15. Provide key aspects of the ideal handover to the recipient, including verbalizing the patient's illness severity and/or providing action planning and/or contingency planning.
  16. Demonstrates awareness of known threats to handover communication (e.g., interruptions and distractions) by paying attention to the timing and location of the handover communication.
  17. Acts as an active and integrate member of the team who in most situations prioritizes team goals over one's own professional goals.
  18. Understands the roles of other team members, seek their counsel, actively listen to their recommendations, and incorporate them into practice.
  19. Interpret common test results to anticipate and respond to early clinical deterioration.
  20. Adhere to institutional procedures and protocols regarding escalation of patient care.
  21. Understand the importance of informed consent to rapport building and shared decision making.
  22. Demonstrate an understanding of the elements of informed consent generally (indications, contraindications, risks, benefits, alternatives) and the specifics of these elements for the procedures for which consent is being sought.
  23. Demonstrate patient-centered skills in performing procedures:
    • Avoid medical jargon such that patients are able to verbalize understanding of the procedure.
    • Participate in shared decision making with patients about procedures
    • Have confidence commensurate with level of knowledge and skill that puts patients at ease.
    • Simultaneously pay attention to both the procedure and the patient's emotional response.
  24. Identify real potential errors.
  25. Perform common safety behaviors (e.g., universal precautions, hand washing).
  26. Understand the importance of error prevention both to individual patients and to systems.
PEDS 9720 Advanced Ambulatory Pediatrics
Credits:
2,4
Directors:
Patel
Grading:
Pass/Fail
Description:

Advanced ambulatory clerkships provide the opportunity for students to assume initial responsibility for the evaluation of patients in the ambulatory setting. Supervision will be provided by faculty preceptors in the academic setting as well as community private practices. Students expand upon competencies they developed during the third year as they team with residents and/or preceptors to provide preventive health services as well as acute and chronic illness management. The faster pace of ambulatory care provides an environment that strengthens patient and family communication skills, rapport development, and oral presentations. The use of evidence to inform treatment and counseling of patients and their caregivers are additional competencies that are highlighted in the outpatient setting.

Advanced Ambulatory Pediatrics is a 4 week, outpatient pediatric rotation that utilizes the WMed Pediatric Clinic as well as a community pediatric office as potential clinical sites. Fourth year students who have successfully completed all Year 3 required clerkships are eligible to register for this course. During this rotation, students will focus on understanding the normal progression of growth and development from infancy through adolescence. Students will also develop their diagnostic and management skills of common acute pediatric complaints, with a focus on respiratory, abdominal and dermatologic problems, as well as common behavioral and mental health disorders. Faculty will all have appointments in the Department of Pediatric and Adolescent Medicine.

Offered:  All weeks

Objectives:
  • Assess normal and abnormal growth patterns in children and adolescents.
  • Understand Tanner staging in adolescents.
  • Recognize the normal developmental timeline from early infancy to adolescence with regard to the gross motor, fine motor, language, adaptive and personal-social domains.
  • Administer and interpret standardized developmental testing.
  • Discuss the referral patterns for children who present with concerns regarding growth and/or development.
  • Appreciate the importance of vision and hearing assessment.
  • Demonstrate an evaluation of the upper and lower respiratory system including but not limited to otologic examination with pneumatic otoscopy, and nasal passage examination.
  • Recognize, compare and contrast nasal obstruction, stridor, wheezing and alveolar congestion.
  • Demonstrate understanding of abdominal pain in children.Distinguish between benign abdominal pain and that requiring outside consultation.
  • Demonstrate knowledge of basic dermatologic problems in children, demonstrate the ability to describe skin lesions and develop a differential diagnosis based on history and physical findings.

Advanced Clerkship Goals:

  1. Demonstrate clinical reasoning in gathering focused information relevant to a patient's care.
  2. Demonstrate patient-centered interview skills.
  3. Demonstrate patient-centered examination techniques.
  4. Articulate a management plan based on the well-reasoned differential and working diagnoses.
  5. Provide complete and succinct documentation so that other providers have evidence of your clinical reasoning to ensure continuity of care and patient safety.
  6. Recommend reliable, cost-effective tests when indicated for screening or evaluating patients with common acute or chronic conditions.
  7. Routinely reflect on how the results of a test will influence clinical decision making and, conversely, on the potential consequences of not doing a test.
  8. Articulate the risks and benefits of what you are ordering (e.g., drugs tests).
  9. Consistently discuss diagnostic plans with the patient, and provide evidence that patient preferences have been solicited and factored into decision making.
  10. Distinguish common, insignificant abnormalities from clinically important abnormalities.
  11. Provides documentation that is comprehensive and contains important information without unnecessary details or redundancies.
  12. Filter, synthesize, and prioritize information and recognize patterns, resulting in a concise, well organized, and accurate presentation.
  13. Adjust oral presentations for the receiver of information (e.g., faculty, patient/family, team members) and for the context of the presentation (e.g., emergent versus stable).
  14. Routinely identify the need to ask for help or seek new information in the context of the clinical setting, based on awareness of one's own knowledge gaps and patient needs.
  15. Act as an active and integrated member of the team who in most situations prioritizes team goals over one's own professional goals.
  16. understand the roles of other team members, seek their counsel, actively listen to their recommendations, and incorporate them into practice.
  17. Maintains a professional demeanor in all but the most trying of circumstances.
  18. Interpret common test results to anticipate and respond to early clinical deterioration.
  19. Understand the importance of informed consent to rapport building and shared decision making.
  20. Demonstrate an understanding of the elements of informed consent generally (indications, contraindications, risks, benefits, alternatives) and the specifics of these elements for the procedures for which consent is being sought.
  21. Provides complete information to patients and families.
  22. Avoids medical jargon in communicating with patients and families.
  23. Demonstrate patient-centered skills in performing procedures:
    • Avoid medical jargon such that patients are able to verbalize understanding of the procedure.
    • Participate in shared decision making with patients about procedures.
    • Have confidence commensurate with level of knowledge and skill that puts patients at ease.
    • Simultaneously pay attention to both the procedure and the patient's emotional response.
  24. Identify real and potential errors.
  25. Perform common safety behaviors (e.g., universal precautions, handwashing).
  26. Understand the importance of error prevention both to individual patients and to systems.
PEDS 9810 Advanced Pediatric Critical Care
Credits:
2,4
Directors:
Robert Beck
Grading:
Pass/Fail
Description:

This rotation offers students the opportunity to accelerate their learning by spending a four week block in the intensive care unit.  The rotation provides the student the opportunity to diagnose and treat of a wide range of clinical conditions common among critically ill patients. Students will enhance their knowledge and skill in caring for the sickest patients in the hospital.  The Clinical site utilized for the Pediatric Advanced Critical Care Clerkship is the pediatric ICU at Bronson Children’s Hospital.  Students will be paired with interns and residents, and will participate in the ICU in a dedicated fashion; the intent is for students to function as a “subintern” and will result in a high level learning experience. 

Students will be expected to participate on rounds, will continue to perfect the gathering and synthesis of data, and expand on their ability to make diagnoses and develop care plans.  The student will be expected to gather a history based upon interview of patients/families, evaluate laboratory and radiographic material, and generate differential diagnoses and management plans.  They will also be expected to improve their documentation skills by writing patient notes in the electronic medical record.

This is a 4 week block rotation, and will correspond to the calendar set forth by the Western Michigan University School of Medicine. This varies on the time of year and the rotation site. The pediatric ICU consists of all aspects of pediatric critical care.

Offered: All weeks

Objectives:

After completion of this elective, each student will be able to:

    Hemodynamics/Cardiovascular System

    1. Understand the diagnosis, pathophysiology, and treatment of shock
    2. Understand the basics of hemodynamic monitoring and apply this to resuscitation medicine
    3. Understand the basics of fluid resuscitation
    4. Know indications for the use of vasoactive agents
    5. Recognize and treat dysrhythmias
    6. Understand the principles of managing cardiac arrest

    Pulmonary System

    1. Recognize basic patterns on chest radiograph evaluation (ie infiltrate, effusion, pneumothorax)
    2. Understand basic pulmonary physiology (shunt, V/Q mismatch, dead space)
    3. Interpret arterial blood gases, and apply A-a gradient, P/F ratio
    4. Understand the indications for intubation and mechanical ventilation
    5. Understand the basics of mechanical ventilation and management
    6. Understand spontaneous awakening trials and spontaneous breathing trials and apply these to liberation from mechanical ventilation
    7. Recognize and treat pulmonary complications including pneumothorax, ARDS (including permissive hypercapnea), pneumonia, atelectasis, pulmonary embolism

    Gastrointestinal System

    1. Diagnose and treat gastrointestinal hemorrhage
    2. Diagnose and treat clostridium difficile colitis and its complications
    3. Recognize and treat complication from congenital GI abnormalities
    4. Evaluate and treat pancreatitis

    Neurologic System

    1. Understand Cerebral Perfusion Pressure and its management
    2. Diagnosis and treat acute ischemic and hemorrhagic stroke
    3. Diagnose and treat subarachnoid hemorrhage
    4. Diagnose and treat seizures including status epilepticus
    5. Be familiar with brain death and its determination
    6. Be familiar with sedation and analgesia and its effect on the CNS in the ICU

    Renal System

    1. Understand, diagnose, and treat oliguria
    2. Define and treat acute kidney injury
    3. Know the indications for renal replacement therapy

    Metabolic System

    1. Be familiar with, understand, and treat electrolyte disturbances
    2. Manage hyperglycemia in the ICU
    3. Understand, diagnose, and treat acid base disorders

    Hematologic System

    1. Understand the indications for blood product transfusion in the ICU
    2. Evaluate and treat anemia
    3. Evaluate and treat abnormalities of coagulation
    4. Understand principles of anticoagulation

    Endocrine System

    1. Evaluate and treat abnormalities of the thyroid axis as it relates to critical illness
    2. Evaluate and treat abnormalities of the adrenal gland as it relates to critical illness
    3. Understand the principles of steroid replacement in the ICU

    Infectious Diseases and Sepsis

    1. Understand source identification and control of infections
    2. Understand the basics of antibiotic selection and subsequent stewardship
    3. Define and treat sepsis and septic shock, including early goal-directed therapy, and resuscitation and support

    Advanced Clerkship Goals:

    1. Recognize the severity of illness in patients with a variety critical illness.
    2. Provide an extensive and complete assessment of the patient, including a complete history and physical examination, evaluation of laboratory data and radiographic material, synthesis of patient information, and generation of a comprehensive care plan.
    3. Develop a rational evaluation and management plan for the stabilization and treatment of organ system dysfunction while evaluating and treating underlying etiologies.
    4. Demonstrate competent use of technologic procedures and devices in the intensive care setting for the purposes of evaluating, monitoring, and managing patients.
    5. Integrate imaging and other diagnostic studies in assessing the critically ill.
    6. Effectively engage consultants and other ancillary care services in a team approach to manage critically ill patients.
    7. Perform procedures necessary for the assessment and treatment of critically ill patients.
    8. When indicated, address end of life decision making and advanced directives, and provide counseling for patients and their families.
    9. Provide appropriate documentation of all patient interactions

     

    PSYC 9440 General Psychiatry
    Credits:
    2,4
    Directors:
    Longstreet
    Grading:
    Pass/Fail
    Description:

    Students work directly with a faculty psychiatrist and often with a psychiatry resident. Students perform psychiatric evaluations and appropriate follow-up of patients on hospital medical/surgical services who are referred for psychiatric consultation. The sites available are Borgess Medical Center and Bronson Hospital.

    Offered: All weeks

    Objectives:

    After completion of this elective, each student will be able to:

    • Discuss the role of psychological and behavioral processes that impact patients’ somatic presentations in the general medical setting.
    • Gain experience seeing patients with a variety of medical illnesses and psychiatric issues.
    • Demonstrate the ability to clarify the reason(s) for a psychiatric consultation.
    • Demonstrate the capacity to effectively assess patients with common psychiatric referral problems.
    • Discuss the role of drug interactions, adverse effects of medications, and poly-pharmacy in the patient's psychiatric presentation.
    • Develop the capacity to perform cognitive assessments on these patients with delirium and or dementia.
    • Demonstrate the ability to perform a neurological screening exam, and know when it is appropriate to order neurodiagnostic tests.
    • Demonstrate the ability to provide supportive therapy for patients in the general hospital setting.
    • Provide capacity evaluations
    • Become knowledgeable about those medical conditions that present with psychiatric symptoms.
    PSYC 9710 Advanced Adult Psychiatry
    Credits:
    2,4
    Directors:
    Longstreet
    Grading:
    Pass/Fail
    Description:

    Advanced hospital clerkships provide the opportunity for students to assume greater responsibility for patient care of the hospitalized patient, with oversight from supervising residents and attending physicians. Students expand upon competencies they develop during the third year as they care for one to two patients at a time. Additional expectations include responsibility for developing management plans, writing orders, patient handovers and transfers of care, recognizing the policies that support patient safety, and developing competency in procedures that they will perform independently as residents. Fourth year students also assist in teaching third year students.

    Students work directly with a faculty psychiatrist, usually a psychiatry resident, and a multi-disciplinary team in an inpatient setting with older adult patients. Students perform initial evaluations and help manage patients throughout their hospitalization (if desired, the student may participate in the ECT Service). The site available is Borgess Medical Center.

    Not offered July and August

    Objectives:

    After completion of this elective, each student will be able to:

    • Demonstrate capacity to conduct comprehensive intake evaluations of inpatients
    • Discuss the diagnosis of a basic formulation, and provide a practical treatment plan for patients with a wide variety of psychopathologies.
    • Discuss basic pharmacology of psychotropic medications.
    • Manage their own inpatients with relative autonomy.
    • Provide supportive and or motivational therapies for inpatients when indicated.

    Advanced Clerkship Goals:

    1. Demonstrate clinical reasoning in gathering focused information relevant to a patient's care.
    2. Demonstrate patient-centered interview skills
    3. Demonstrate patient-centered examination techniques.
    4. Articulate a management plan based on the well-reasoned differential and working diagnoses.
    5. Provide complete and succinct documentation so that other providers have evidence of your clinical reasoning to ensure continuity of care and patient safety.
    6. Recommend reliable, cost-effective tests when indicated for screening or evaluating patients with common acute or chronic conditions.
    7. Routinely reflect on how the results of a test will influence clinical decision making and, conversely, on the potential consequences of not doing a test.
    8. Articulate the risks and benefits of what you are ordering (e.g., drugs, tests).
    9. Consistently discuss diagnostic plans with the patient, and provide evidence that patient preferences have been solicited and factored into decision making.
    10. Distinguish common, insignificant abnormalities from clinically important abnormalities.
    11. Provides documentation that is comprehensive and contains important information without unnecessary details or redundancies.
    12. Filter, synthesize, and prioritize information and recognize patterns, resulting in a concise, well organized, and accurate presentation.
    13. Adjust oral presentations for the receiver of information (e.g., faculty, patient/family, team members) and for the context of the presentation (e.g., emergent versus stable).
    14. Routinely identify the need to ask for help or seek new information in the context of the clinical setting, based on awareness of one's own knowledge gaps and patient needs.
    15. Provide key aspects of the ideal handover to the recipient, including verbalizing the patient's illness severity and/or providing action planning and/or contingency planning.
    16. Demonstrates awareness of known threats to handover communication (e.g., interruptions and distractions) by paying attention to the timing and location of the handover communication.
    17. Acts as an active and integrate member of the team who in most situations prioritizes team goals over one's own professional goals.
    18. Understands the roles of other team members, seek their counsel, actively listen to their recommendations, and incorporate them into practice.
    19. Interpret common test results to anticipate and respond to early clinical deterioration.
    20. Adhere to institutional procedures and protocols regarding escalation of patient care.
    21. Understand the importance of informed consent to rapport building and shared decision making.
    22. Demonstrate an understanding of the elements of informed consent generally (indications, contraindications, risks, benefits, alternatives) and the specifics of these elements for the procedures for which consent is being sought.
    23. Demonstrate patient-centered skills in performing procedures:
      • Avoid medical jargon such that patients are able to verbalize understanding of the procedure.
      • Participate in shared decision making with patients about procedures
      • Have confidence commensurate with level of knowledge and skill that puts patients at ease.
      • Simultaneously pay attention to both the procedure and the patient's emotional response.
    24. Identify real potential errors.
    25. Perform common safety behaviors (e.g., universal precautions, hand washing).
    26. Understand the importance of error prevention both to individual patients and to systems.
    PSYC 9712 Advanced Adolescent Psychiatry
    Credits:
    2,4
    Directors:
    Longstreet
    Grading:
    Pass/Fail
    Description:

    Advanced hospital clerkships provide the opportunity for students to assume greater responsibility for patient care of the hospitalized patient, with oversight from supervising residents and attending physicians. Students expand upon competencies they develop during the third year as they care for one to two patients at a time. Additional expectations include responsibility for developing management plans, writing orders, patient handovers and transfers of care, recognizing the policies that support patient safety, and developing competency in procedures that they will perform independently as residents. Fourth year students also assist in teaching third year students.

    Advanced Adolescent Psychiatry is an experience during which time students work as part of a treatment team including an attending psychiatrist, resident, social worker and therapists. Students will engage with faculty and staff in the process of psychological testing, group therapy, individual therapy, family therapy, and activities therapy. The site available is Borgess Medical Center.

    Not offered July and August

    Objectives:

    After completion of this elective, each student will be able to:

    • Demonstrate the capacity to perform a comprehensive intake evaluation on adolescents.
    • Assess and utilize family and community resources to better understand and manage patients.
    • Assess and manage the common psychiatric disorders in children and adolescents.
    • Utilize common psychotherapeutic and psycho-pharmacological treatment approaches.
    • Conduct observed individual and family therapy sessions.
    • Obtain collateral information from as well as provide comfort for the families and patients.

    Advanced Clerkship Goals:

    1. Demonstrate clinical reasoning in gathering focused information relevant to a patient's care.
    2. Demonstrate patient-centered interview skills
    3. Demonstrate patient-centered examination techniques.
    4. Articulate a management plan based on the well-reasoned differential and working diagnoses.
    5. Provide complete and succinct documentation so that other providers have evidence of your clinical reasoning to ensure continuity of care and patient safety.
    6. Recommend reliable, cost-effective tests when indicated for screening or evaluating patients with common acute or chronic conditions.
    7. Routinely reflect on how the results of a test will influence clinical decision making and, conversely, on the potential consequences of not doing a test.
    8. Articulate the risks and benefits of what you are ordering (e.g., drugs, tests).
    9. Consistently discuss diagnostic plans with the patient, and provide evidence that patient preferences have been solicited and factored into decision making.
    10. Distinguish common, insignificant abnormalities from clinically important abnormalities.
    11. Provides documentation that is comprehensive and contains important information without unnecessary details or redundancies.
    12. Filter, synthesize, and prioritize information and recognize patterns, resulting in a concise, well organized, and accurate presentation.
    13. Adjust oral presentations for the receiver of information (e.g., faculty, patient/family, team members) and for the context of the presentation (e.g., emergent versus stable).
    14. Routinely identify the need to ask for help or seek new information in the context of the clinical setting, based on awareness of one's own knowledge gaps and patient needs.
    15. Provide key aspects of the ideal handover to the recipient, including verbalizing the patient's illness severity and/or providing action planning and/or contingency planning.
    16. Demonstrates awareness of known threats to handover communication (e.g., interruptions and distractions) by paying attention to the timing and location of the handover communication.
    17. Acts as an active and integrate member of the team who in most situations prioritizes team goals over one's own professional goals.
    18. Understands the roles of other team members, seek their counsel, actively listen to their recommendations, and incorporate them into practice.
    19. Interpret common test results to anticipate and respond to early clinical deterioration.
    20. Adhere to institutional procedures and protocols regarding escalation of patient care.
    21. Understand the importance of informed consent to rapport building and shared decision making.
    22. Demonstrate an understanding of the elements of informed consent generally (indications, contraindications, risks, benefits, alternatives) and the specifics of these elements for the procedures for which consent is being sought.
    23. Demonstrate patient-centered skills in performing procedures:
      • Avoid medical jargon such that patients are able to verbalize understanding of the procedure.
      • Participate in shared decision making with patients about procedures
      • Have confidence commensurate with level of knowledge and skill that puts patients at ease.
      • Simultaneously pay attention to both the procedure and the patient's emotional response.
    24. Identify real potential errors.
    25. Perform common safety behaviors (e.g., universal precautions, hand washing).
    26. Understand the importance of error prevention both to individual patients and to systems.
    PSYC 9714 Advanced Geriatric Psychiatry
    Credits:
    2,4
    Directors:
    Longstreet
    Grading:
    Pass/Fail
    Description:

    Advanced hospital clerkships provide the opportunity for students to assume greater responsibility for patient care of the hospitalized patient, with oversight from supervising residents and attending physicians. Students expand upon competencies they develop during the third year as they care for one to two patients at a time. Additional expectations include responsibility for developing management plans, writing orders, patient handovers and transfers of care, recognizing the policies that support patient safety, and developing competency in procedures that they will perform independently as residents. Fourth year students also assist in teaching third year students.

    Students work directly with a faculty psychiatrist, usually a psychiatry resident, and a multi-disciplinary team in an inpatient setting with older adult patients. Students perform initial evaluations and help manage patients throughout their hospitalization (if desired, the student may participate in the ECT Service). The site available is Borgess Medical Center.

    Not offered July and August

    Objectives:

    After completion of this elective, each student will be able to:

    • Demonstrate the capacity to provide psychiatric evaluations on older adult patients.
    • Discuss the effects of medical illnesses and medications on the presentation of psychiatric illness.
    • Demonstrate the ability to appropriately use and interpret the results of various psychometric screening instruments.
    • Demonstrate the ability to assess and utilize family and community resources to better understand and manage patients.
    • Identify and assess common neuropsychiatric disorders.
    • Discuss pharmacologic and non-pharmacologic including treatment approaches to manage behavioral problems.
    • Explain the unique biomedical processes involved in the presentation of psychiatric symptoms in some medical conditions as well as the effect of medical illnesses on psychiatric disorders.

    Advanced Clerkship Goals:

    1. Demonstrate clinical reasoning in gathering focused information relevant to a patient's care.
    2. Demonstrate patient-centered interview skills
    3. Demonstrate patient-centered examination techniques.
    4. Articulate a management plan based on the well-reasoned differential and working diagnoses.
    5. Provide complete and succinct documentation so that other providers have evidence of your clinical reasoning to ensure continuity of care and patient safety.
    6. Recommend reliable, cost-effective tests when indicated for screening or evaluating patients with common acute or chronic conditions.
    7. Routinely reflect on how the results of a test will influence clinical decision making and, conversely, on the potential consequences of not doing a test.
    8. Articulate the risks and benefits of what you are ordering (e.g., drugs, tests).
    9. Consistently discuss diagnostic plans with the patient, and provide evidence that patient preferences have been solicited and factored into decision making.
    10. Distinguish common, insignificant abnormalities from clinically important abnormalities.
    11. Provides documentation that is comprehensive and contains important information without unnecessary details or redundancies.
    12. Filter, synthesize, and prioritize information and recognize patterns, resulting in a concise, well organized, and accurate presentation.
    13. Adjust oral presentations for the receiver of information (e.g., faculty, patient/family, team members) and for the context of the presentation (e.g., emergent versus stable).
    14. Routinely identify the need to ask for help or seek new information in the context of the clinical setting, based on awareness of one's own knowledge gaps and patient needs.
    15. Provide key aspects of the ideal handover to the recipient, including verbalizing the patient's illness severity and/or providing action planning and/or contingency planning.
    16. Demonstrates awareness of known threats to handover communication (e.g., interruptions and distractions) by paying attention to the timing and location of the handover communication.
    17. Acts as an active and integrate member of the team who in most situations prioritizes team goals over one's own professional goals.
    18. Understands the roles of other team members, seek their counsel, actively listen to their recommendations, and incorporate them into practice.
    19. Interpret common test results to anticipate and respond to early clinical deterioration.
    20. Adhere to institutional procedures and protocols regarding escalation of patient care.
    21. Understand the importance of informed consent to rapport building and shared decision making.
    22. Demonstrate an understanding of the elements of informed consent generally (indications, contraindications, risks, benefits, alternatives) and the specifics of these elements for the procedures for which consent is being sought.
    23. Demonstrate patient-centered skills in performing procedures:
      • Avoid medical jargon such that patients are able to verbalize understanding of the procedure.
      • Participate in shared decision making with patients about procedures
      • Have confidence commensurate with level of knowledge and skill that puts patients at ease.
      • Simultaneously pay attention to both the procedure and the patient's emotional response.
    24. Identify real potential errors.
    25. Perform common safety behaviors (e.g., universal precautions, hand washing).
    26. Understand the importance of error prevention both to individual patients and to systems.
    RAD 9410 Diagnostic Radiology
    Credits:
    2,4
    Directors:
    Tominna, Smullens
    Grading:
    Pass/Fail
    Description:

    This is an overview of diagnostic radiology. Students will rotate through general radiology and the different subspecialties (gastrointestinal, neuroradiology, mammography, interventional radiology, musculoskeletal, and emergency radiology). Students will participate in the daily reading of images and in the performance of procedures. They will operate during the rotation as part of a team consisting of physicians, physician assistants, radiology physician assistants, nurses, and technologists.

    During the elective, the students will choose what rotations they would like to participate in. They will participate in interpretation of images and performing procedures with the staff radiologist. Students will be on the rotation for approximate ten hours per day, some of which may be night shifts. Students will be expected to present an interesting case at the end of the elective. Students will attend all departmental conferences.

    Offered: All weeks

    Objectives:

    After completion of this elective, each student will be able to:

    • Develop and demonstrate an understanding of the imaging modalities of radiology (X-ray, Ultrasound, CT, MRI, Fluoroscopy, Nuclear Medicine, and Interventional Radiology).
    • Develop and demonstrate an understanding of the indications for imaging.
    • Develop and demonstrate an understanding of the anatomy on imaging
    • Develop an understanding of the pathology seen on imaging.
    • Maintain a professional and positive relationship with the radiology staff and referring clinicians (professional, interpersonal and communication skills).
    • Develop an understanding of the limitations of imaging.
    • Develop an understanding of the risks of radiation and contrast.
    • Develop an understanding of the terminology used in radiology.
    RAD 9460 Interventional Radiology
    Credits:
    2,4
    Directors:
    Tominna, Smullens
    Grading:
    Pass/Fail
    Description:

    This is a 2 or 4-week elective in interventional radiology. Students will be expected to be involved in the initial work up of patients, participate in procedures, and in the follow-up care of patients. Students will be expected to understand the risks, benefits and alternatives to procedures. The will be expected to perform basic procedure (line placement, paracetesis and thoracetesis) by the end of the rotation. Students will also be expected to participate in ward rounds. They will operate during the rotation as part of a team consisting of physicians, physician assistants, radiology physician assistants, nurses, and technologists. Students will not be required to take call. Students will be expected to present an interesting case at the end of the elective. Students will attend all departmental conferences.

    Offered: All weeks

    Objectives:

    After completion of this elective, each student will be able to:

    • Develop and demonstrate an understanding of the different imaging modalities used in interventional radiology (X-ray, Ultrasound, CT, MRI, and Fluoroscopy).
    • Develop and demonstrate an understanding of the indications, alternatives, and risks for intervention.
    • Develop and demonstrate an understanding of the anatomy on imaging.
    • Develop the skill to be able to perform basic procedures (image guided line placement, paracentesis and thoracentesis).
    • Participate in more complex procedures and understand the equipment used.
    • Maintain professional and positive relationships with interventional radiology staff and referral clinicians (Professionalism, Interpersonal and Communication Skills).
    • Attend clinic once a week with the interventional radiologist.
    • Develop an understanding of the risks of radiation and contrast.
    • Develop an understanding of the terminology used in interventional radiology.
    SURG 9430 Ophthalmology
    Credits:
    2,4
    Directors:
    Miller
    Grading:
    Pass/Fail
    Description:

    The ophthalmology rotation is designed for students who are interested in an ophthalmology or primary care residency. They will manage patients as independently as possible with oversight from an attending surgeon. They will be assigned to the general surgery service at either Borgess or Bronson. They will gain operative experience as well as have increased responsibilities managing patients in the inpatient and outpatient setting. They will be assigned a faculty mentor/preceptor at their assigned hospital.

    Offered: All weeks

    Objectives:
    • Obtain a complete and accurate history in an organized fashion
      • Demonstrate patient-centered interview skills (attentive to patient verbal and nonverbal cues, patient/family culture, need for interpretive services, demonstrates active listening skills)
      • Identify pertinent history elements in common presenting situations
      • Obtain focused, pertinent histories in urgent, emergent and consultative setting
      • Demonstrate clinical reasoning in gathering focused information relevant to patient’s care
    • Perform a complete and accurate physical exam in logical and fluid sequence
      • Perform a clinically relevant, focused ophthalmologic exam pertinent to the setting and purpose of patient visit
      • Identify, describe and document abnormal physical exam findings
      • Demonstrate patient-centered examination techniques that reflect respect for patient privacy, comfort and safety
    • Prioritize a differential diagnosis following a clinical encounter
      • Synthesize essential information from the previous records, history, physical exam and initial diagnostic evaluations
      • Integrate information as it emerges to continuously update differential diagnosis
      • Integrate the scientific foundations of medicine with clinical reasoning skills to develop a differential diagnosis and a working diagnosis
      • Engage with supervisors and team members for endorsement and verification of the working diagnosis in developing a management plan
    • Recommend and interpret common diagnostic and screening tests
      • Recommend first-line, cost-effective diagnostic evaluation for a patient with an acute or chronic common disorder
      • Provide rationale for decision to order the test
      • Interpret the results of basic diagnostic studies (both lab and imaging); know common lab values
    • Enter and discuss orders and prescriptions of eye drops
      • Demonstrate an understanding of the patient’s current condition and preferences that will underpin the orders being provided
      • Demonstrate working knowledge of the protocol by which orders will be processed in the environment in which they are placing the orders
      • Compose orders efficiently and effectively, such as by identifying the correct admission order set, selecting the correct fluid and electrolyte replacement orders, and recognizing the needs for deviations from standard order sets
    • Document a clinical encounter in the patient record
      • Filter, organize, and prioritize information
      • ynthesize information into a cogent narrative
      • Record a problem list, working and differential diagnosis and plan
      • Verify the authenticity and origin of the information recorded in the documentation (e.g., avoids blind copying and pasting)
    • Provide an oral presentation of a clinical encounter
      • Present information that has been personally gathered or verified, acknowledging any areas of uncertainty
      • Provide an accurate, concise, and well-organized oral presentation
    • Recognize a patient requiring urgent or emergent care and initiate evaluation and management
      • Recognize normal vital signs and variations that might be expected based on patient- and disease-specific factors
      • Recognize severity of a patient’s illness and indications for escalating care
      • Identify potential underlying etiologies of the patient’s decompensation
      • Communicate the situation to responding team members
    • Obtain informed consent for tests and/or procedures such as cataract extraction,
      • Describes the indications, risks, benefits, alternatives and potential complications of basic procedures
    • Perform basic procedures such as assisting in surgery and ophthalmologic examination
      • Demonstrate the technical (motor) skills required for the procedure
      • Understand and explain the anatomy, physiology, indications, risks, contraindications, benefits, alternatives, and potential complications of the procedure
    SURG 9710 Advanced General Surgery
    Credits:
    2,4
    Directors:
    Miller
    Grading:
    Pass/Fail
    Description:

    Advanced hospital clerkships provide the opportunity for students to assume greater responsibility for patient care of the hospitalized patient, with oversight from supervising residents and attending physicians. Students expand upon competencies they develop during the third year as they care for one to two patients at a time. Additional expectations include responsibility for developing management plans, writing orders, patient handovers and transfers of care, recognizing the policies that support patient safety, and developing competency in procedures that they will perform independently as residents. Fourth year students also assist in teaching third year students.

    The advanced general surgery rotation is designed for students who are interested in a general surgery residency. They will manage patients as independently as possible with oversight from the general surgery chief resident and an attending surgeon. They will be assigned to the general surgery service at either Borgess or Bronson. Assistance with teaching 3rd year students will also be expected. They will gain operative experience as well as have increased responsibilities managing patients in the inpatient and outpatient setting. They will be assigned a faculty mentor/preceptor at their assigned hospital.

    Offered:  Not offered in July

    Objectives:

    Upon completion of this course, each student will be able to:

    • Obtain a complete and accurate history in an organized fashion.
      • Demonstrate patient-centered interview skills (attentive to patient verbal and nonverbal cues, patient/family culture, need for interpretive services, demonstrates active listening skills).
      • Identify pertinent history elements in common presenting situations.
      • Obtain focused, pertinent histories in urgent, emergent and consultative setting.
      • Demonstrate clinical reasoning in gathering focused information relevant to patient’s care.
    • Perform a complete and accurate physical exam in logical and fluid sequence.
      • Perform a clinically relevant, focused physical exam pertinent to the setting and purpose of patient visit.
      • Identify, describe and document abnormal physical exam findings.
      • Demonstrate patient-centered examination techniques that reflect respect for patient privacy, comfort and safety.
    • Prioritize a differential diagnosis following a clinical encounter.
      • Synthesize essential information from the previous records, history, physical exam and initial diagnostic evaluations.
      • Integrate
      • Integrate the scientific foundations of medicine with clinical reasoning skills to develop a differential diagnosis and a working diagnosis.
      • Engage with supervisors and team members for endorsement and verification of the working diagnosis in developing a management plan.
    • Recommend and interpret common diagnostic and screening tests.
      • Recommend first-line, cost-effective diagnostic evaluation for a patient with an acute or chronic common disorder.
      • Provide rationale for decision to order the test.
      • Interpret the results of basic diagnostic studies (both lab and imaging); know common lab values.
    • Enter and discuss orders and prescriptions.
      • Demonstrate
      • Demonstrate working knowledge of the protocol by which orders will be processed in the environment in which they are placing the orders.
      • Compose orders efficiently and effectively, such as by identifying the correct admission order set, selecting the correct fluid and electrolyte replacement orders, and recognizing the needs for deviations from standard order sets.
    • Document a clinical encounter in the patient record.
      • Filter, organize, and prioritize information.
      • Synthesize information into a cogent narrative.
      • Record a problem list, working and differential diagnosis and plan.
      • Verify the authenticity and origin of the information recorded in the documentation (e.g., avoids blind copying and pasting).
    • Provide an oral presentation of a clinical encounter.
      • Present information that has been personally gathered or verified, acknowledging any areas of uncertainty.
      • Provide an accurate, concise, and well-organized oral presentation.
    • Give or receive a patient handover to transition care responsibly.
      • Conduct handover communication that minimizes known threats to transitions of care (e.g., by ensuring you engage the listener, avoiding distractions).
      • Document—and update—an electronic handover tool.
      • Provide succinct verbal communication that conveys, at a minimum, illness severity, situation awareness, action planning, and contingency planning.
    • Recognize a patient requiring urgent or emergent care and initiate evaluation and management.
      • Recognize normal vital signs and variations that might be expected based on patient- and disease-specific factors.
      • Recognize severity of a patient’s illness and indications for escalating care.
      • Identify potential underlying etiologies of the patient’s decompensation.
      • Communicate the situation to responding team members.
    • Obtain informed consent for tests and/or procedures.
      • Describes the indications, risks, benefits, alternatives and potential complications of basic procedures.
    • Perform basic procedures such as assisting in surgery, suturing wounds, debridements, wound VAC changes, incision and drainage of abscesses.
      • Demonstrate the technical (motor) skills required for the procedure.
      • Understand and explain the anatomy, physiology, indications, risks, contraindications, benefits, alternatives, and potential complications of the procedure.

    Advanced Clerkship Goals:

    1. Demonstrate clinical reasoning in gathering focused information relevant to a patient's care.
    2. Demonstrate patient-centered interview skills
    3. Demonstrate patient-centered examination techniques.
    4. Articulate a management plan based on the well-reasoned differential and working diagnoses.
    5. Provide complete and succinct documentation so that other providers have evidence of your clinical reasoning to ensure continuity of care and patient safety.
    6. Recommend reliable, cost-effective tests when indicated for screening or evaluating patients with common acute or chronic conditions.
    7. Routinely reflect on how the results of a test will influence clinical decision making and, conversely, on the potential consequences of not doing a test.
    8. Articulate the risks and benefits of what you are ordering (e.g., drugs, tests).
    9. Consistently discuss diagnostic plans with the patient, and provide evidence that patient preferences have been solicited and factored into decision making.
    10. Distinguish common, insignificant abnormalities from clinically important abnormalities.
    11. Provides documentation that is comprehensive and contains important information without unnecessary details or redundancies.
    12. Filter, synthesize, and prioritize information and recognize patterns, resulting in a concise, well organized, and accurate presentation.
    13. Adjust oral presentations for the receiver of information (e.g., faculty, patient/family, team members) and for the context of the presentation (e.g., emergent versus stable).
    14. Routinely identify the need to ask for help or seek new information in the context of the clinical setting, based on awareness of one's own knowledge gaps and patient needs.
    15. Provide key aspects of the ideal handover to the recipient, including verbalizing the patient's illness severity and/or providing action planning and/or contingency planning.
    16. Demonstrates awareness of known threats to handover communication (e.g., interruptions and distractions) by paying attention to the timing and location of the handover communication.
    17. Acts as an active and integrate member of the team who in most situations prioritizes team goals over one's own professional goals.
    18. Understands the roles of other team members, seek their counsel, actively listen to their recommendations, and incorporate them into practice.
    19. Interpret common test results to anticipate and respond to early clinical deterioration.
    20. Adhere to institutional procedures and protocols regarding escalation of patient care.
    21. Understand the importance of informed consent to rapport building and shared decision making.
    22. Demonstrate an understanding of the elements of informed consent generally (indications, contraindications, risks, benefits, alternatives) and the specifics of these elements for the procedures for which consent is being sought.
    23. Demonstrate patient-centered skills in performing procedures:
      • Avoid medical jargon such that patients are able to verbalize understanding of the procedure.
      • Participate in shared decision making with patients about procedures
      • Have confidence commensurate with level of knowledge and skill that puts patients at ease.
      • Simultaneously pay attention to both the procedure and the patient's emotional response.
    24. Identify real potential errors.
    25. Perform common safety behaviors (e.g., universal precautions, hand washing).
    26. Understand the importance of error prevention both to individual patients and to systems.
    SURG 9810 Advanced Trauma and Surgery Critical Care
    Credits:
    2,4
    Directors:
    Curtiss, Maltz
    Grading:
    Pass/Fail
    Description:

    This rotation offers students the opportunity to accelerate their learning by spending a four week block in the intensive care unit.  The rotation provides the student the opportunity to diagnose and treat of a wide range of clinical conditions common among critically ill patients. Students will enhance their knowledge and skill in caring for the sickest patients in the hospital.  The Clinical site utilized for the Pediatric Advanced Critical Care Clerkship is the pediatric ICU at Bronson Children’s Hospital.  Students will be paired with interns and residents, and will participate in the ICU in a dedicated fashion; the intent is for students to function as a “subintern” and will result in a high level learning experience. 

    Students will be expected to participate on rounds, will continue to perfect the gathering and synthesis of data, and expand on their ability to make diagnoses and develop care plans.  The student will be expected to gather a history based upon interview of patients/families, evaluate laboratory and radiographic material, and generate differential diagnoses and management plans.  They will also be expected to improve their documentation skills by writing patient notes in the electronic medical record.

    The advanced trauma and critical care surgery rotation is designed for students who are interested in a general surgery or other surgery subspecialty residency. They will manage patients as independently as possible with oversight from the general surgery senior resident on service and an attending surgeon. They will be assigned to the trauma/critical care surgery service at either Borgess or Bronson. Assistance with teaching 3rd year students will also be expected. They will gain operative experience as well as have increased responsibilities managing patients in the inpatient critical care and trauma bay settings. They will be assigned a faculty mentor/preceptor at their assigned hospital.

    This is a 4 week block rotation, and will correspond to the calendar set forth by the Western Michigan University School of Medicine. This varies on the time of year and the rotation site. The trauma/surgical ICU consists of primarily surgical-related problemd.

    Offered:  Not offered in July

    Objectives:

    Upon completion of this course, students will be able to:

    • Obtain a complete and accurate history in an organized fashion
      • Demonstrate patient-centered interview skills (attentive to patient verbal and nonverbal cues, patient/family culture, need for interpretive services, demonstrates active listening skills)
      • Identify pertinent history elements in common presenting situations
      • Obtain focused, pertinent histories in urgent, emergent and consultative setting
      • Demonstrate clinical reasoning in gathering focused information relevant to patient’s care
    • Perform a complete and accurate physical exam in logical and fluid sequence
      • Perform a clinically relevant, focused physical exam pertinent to the trauma or critically ill patient
      • Identify, describe and document abnormal physical exam findings with specific focus on the ABCs of trauma
      • Demonstrate patient-centered examination techniques that reflect respect for patient privacy, comfort and safety
    • Prioritize a differential diagnosis following a clinical encounter
      • Synthesize essential information from the previous records, history, physical exam and initial diagnostic evaluations with specific focus on the ABCs of trauma
      • Integrate information as it emerges to continuously update differential diagnosis
      • Integrate the scientific foundations of medicine with clinical reasoning skills to develop a differential diagnosis and a working diagnosis
      • Engage with supervisors and team members for endorsement and verification of the working diagnosis in developing a management plan
    • Recommend and interpret common diagnostic and screening tests
      • Recommend first-line, cost-effective diagnostic evaluation for a patient with an acute or chronic common disorder
      • Provide rationale for decision to order the test
      • Interpret the results of basic diagnostic studies (both lab and imaging); know common lab values
    • Enter and discuss orders and prescriptions
      • Demonstrate an understanding of the patient’s current condition and preferences that will underpin the orders being provided
      • Demonstrate working knowledge of the protocol by which orders will be processed in the environment in which they are placing the orders
      • Compose orders efficiently and effectively, such as by identifying the correct admission order set, selecting the correct fluid and electrolyte replacement orders, and recognizing the needs for deviations from standard order sets
    • Document a clinical encounter in the patient record
      • Filter, organize, and prioritize information
      • Synthesize information into a cogent narrative
      • Record a problem list, working and differential diagnosis and plan
      • Verify the authenticity and origin of the information recorded in the documentation (e.g., avoids blind copying and pasting)
    • Provide an oral presentation of a clinical encounter
      • Present information that has been personally gathered or verified, acknowledging any areas of uncertainty
      • Provide an accurate, concise, and well-organized oral presentation
    • Give or receive a patient handover to transition care responsibly
      • Conduct handover communication that minimizes known threats to transitions of care (e.g., by ensuring you engage the listener, avoiding distractions)
      • Document—and update—an electronic handover tool
      • Provide succinct verbal communication that conveys, at a minimum, illness severity, situation awareness, action planning, and contingency planning
    • Recognize a patient requiring urgent or emergent care and initiate evaluation and management
      • Recognize normal vital signs and variations that might be expected based on patient- and disease-specific factors
      • Recognize severity of a patient’s illness and indications for escalating care
      • Identify potential underlying etiologies of the patient’s decompensation
      • Communicate the situation to responding team members
    • Obtain informed consent for tests and/or procedures
      • Describes the indications, risks, benefits, alternatives and potential complications of basic procedures
    • Perform basic procedures such as assisting in surgery, suturing wounds, debridements, wound VAC changes, intubation, central venous and arterial line placement, chest tube placement, foley catheterization, C spine stabilization
      • Demonstrate the technical (motor) skills required for the procedure
      • Understand and explain the anatomy, physiology, indications, risks, contraindications, benefits, alternatives, and potential complications of the procedure

    Advanced Clerkship Goals:

    1. Recognize the severity of illness in patients with a variety critical illness.
    2. Provide an extensive and complete assessment of the patient, including a complete history and physical examination, evaluation of laboratory data and radiographic material, synthesis of patient information, and generation of a comprehensive care plan.
    3. Develop a rational evaluation and management plan for the stabilization and treatment of organ system dysfunction while evaluating and treating underlying etiologies.
    4. Demonstrate competent use of technologic procedures and devices in the intensive care setting for the purposes of evaluating, monitoring, and managing patients.
    5. Integrate imaging and other diagnostic studies in assessing the critically ill.
    6. Effectively engage consultants and other ancillary care services in a team approach to manage critically ill patients.
    7. Perform procedures necessary for the assessment and treatment of critically ill patients.
    8. When indicated, address end of life decision making and advanced directives, and provide counseling for patients and their families.
    9. Provide appropriate documentation of all patient interactions.