REQUIRED EMERGENCY MEDICINE SUBINTERNSHIP

Objectives

Each student is expected to:

Patient Care

1. Obtain an accurate and problem focused history and perform a focused physical examination for each patient encounter. PC-1, 2, 6

2. Formulate an appropriate plan including therapeutic interventions, diagnostic tests, and management practices. PC-3, 4

3. Care for patients across a range of social backgrounds. PC-7

4. Collaborate within a health-care team in a mature and collegial manner. PC-8

5. Recognize and initiate management of life-threatening conditions. PC-10

6. Demonstrate an understanding of the indications, contraindications, equipment required, safety, and technique for a variety of commonly performed procedures. PC-11

Medical Knowledge

1. Apply a fund of medical knowledge and an understanding of the pathophysiologic principles of disease and apply this in an appropriate fashion to the patients they encounter. MK-3

2. Demonstrate a comprehension of the utilization of, and appropriately interpret, commonly performed interventions and diagnostic studies used in the emergency department. MK-6, 7

3. Develop and assist with the assessment of patients and implementation of management plans including reevaluation, following up on all diagnostic studies ordered, and disposition in a timely fashion. MK-7

4. Develop an appropriate case specific differential diagnoses for each patient they encounter. MK-8

Practice-Based Learning and Improvement

1. Identify strengths and weaknesses in knowledge and skills and demonstrates the ability to respond to constructive feedback. PBLI-1, 3

2. Demonstrate effective use of educational resources to optimize patient care. PBLI-2

Interpersonal and Communication Skills

1. Obtain an accurate and complaint-oriented history and perform a focused examination in a respectful manner that facilitates rapport with the patient. ICS-1

2. Present accurate and succinct case presentations in a clear, concise and organized fashion and document such as instructed by the course director. ICS-2, 4, 5, PC-1

3. Transition care to appropriate team members in a concise and safe manner. ICS-3

4. Communicate with consultant physicians, admission teams, and other health-care members in a clear, concise, organized and respectful fashion. ICS-4

5. Communicate effectively with patients and families regarding plan of care and appropriate lifestyle modifications. ICS-6, 7, 8

Professionalism

1. Conduct themselves in a professional manner while working in the emergency department.

a. Model behaviors of professionalism include, but are not limited to the following; treats all patients, families, and staff with respect, protects the patient’s confidentiality, adheres to appropriate dress code (no tee shirts, sweat shirts, blue jeans, etc.), arrives on time for work, demonstrates honesty, empathy, reliability, dependability, and provides compassionate care. PR-1, 2, 3, 4, 7, 8

Systems-Based Practice

1. Recognize the role of emergency medicine in the community at large including access to care and its impact on patient care. SBP-2

2. Advocate for quality patient-care and assist the patient in dealing with the complexities of the health care. SBP-3, 4

The clerkship directors of emergency medicine have identified the following conditions that students should be exposed to:

1. Abdominal pain

2. Altered mental status

3. Cardiac arrest

4. Chest pain

5. GI bleeding

6. Headache

7. Poisoning

8. Respiratory distress

9. Shock

10. Trauma

Required Diagnoses	Clinical Setting	Level of Student Responsibility	Alternative Experience/Requirement
Abdominal Pain (e.g. appendicitis, biliary disease, bowel obstruction, massive GI bleed, mesenteric ischemia, perforated viscous)	Outpatient	Actively participate in patient care	cdemcurriculum.com Abdominal pain module and SAEM test
Altered Mental Status (e.g. acute stroke, intracranial hemorrhage, meningitis, status epilepticus, headache, poisoning/ingestion)	Outpatient	Actively participate in patient care	cdemcurriculum.com altered mental status module and SAEM test
Chest Pain (e.g. abdominal aortic aneurysm, acute coronary syndrome, heart failure, aortic dissection, pulmonary embolism)	Outpatient	Actively participate in patient care	cdemcurriculum.com chest pain module and SAEM test
Sepsis/evaluation for sepsis	Outpatient	Actively participate in patient care	cdemcurriculum.com sepsis module and SAEM test
Pelvic Pain (e.g. ectopic pregnancy, PID/TOA , testicular/ovarian torsion)	Outpatient	Actively participate in patient care	cdemcurriculum.com pelvic pain module and SAEM test
Cardiac arrest	Simulation	Actively participate in simulated patient care	cdemcurriculum.com cardiac arrest module and SAEM test
Shock	Outpatient	Actively participate in patient care	cdemcurriculum.com shock module and SAEM test
Respiratory Distress	Outpatient	Actively participate in patient care	cdemcurriculum.com shortness of breath  module and SAEM test
Trauma	Outpatient	Actively participate in patient care	Cdemcurriculum.com trauma module and SAEM test

Required Procedures	Clinical Setting	Level of Student Responsibility	Alternative Experience/Requirement
Airway Management	Outpatient	Observe and discuss	Simulation
Interpret Cardiac Monitor	Outpatient	Perform Procedure	Simulation
Start IV / venipuncture x3	Outpatient	Perform Procedure	Simulation
Obtain 12-Lead EKG x3	Outpatient	Perform Procedure	Simulation
Place patient on Monitor	Outpatient	Perform Procedure	simulation
Start an Ultrasound-guided IV	Outpatient	Observe and discuss	simulation

Evaluation

Standard DUCOM clinical assessment tool

· Currently using electronic, daily shift cards

Grade

· Clinical via Shift Cards: 70%

· Exam: 30%

o SAEM - concern of students taking the exam more than once

o Must get greater than 2 SD above mean to be eligible for honors

20180524