Download Report

OUWB School of Medicine
EM Clerkship Orientation
Leadership
•
•
•
•
•
Clerkship Director
Troy Site Director
Clerkship Coordinator
EM residency director
Department Chair
Leadership
• Clerkship Director
– Amy Smark, MD
– [email protected]
– Cell: 586-260-6339
– Office: 248-898-0018
– Spectralink: 248-898-7932
Leadership
• Troy Site Director
– Shanna Jones, MD
– [email protected]
– Cell: 586-899-2311
Leadership
• Clerkship Coordinator
– Takesha Shelton
– [email protected]
– 248-898-8172
Leadership
• EM Residency Program
Director
– Ryan Fringer, MD
– ryan.fringer@beaumont.
edu
Leadership
• EM System Chair
– Terry Kowalenko
Orientation Folder
•
•
•
•
•
•
•
Clerkship Guidelines
Student didactic schedule
EM Resident Grand Rounds schedule
Student Clinical Shift Schedule
Patient/Procedure Log sheets
Troy Information
End of Rotation Forms
Medical Student Website
• Beaumontem.com
– Follow the EM clerkship link
– Policies
– Schedules
– Online lectures
– Contact information
– Useful links
GRADES
Grades
• Your overall grade is based on the following:
– Clinical evaluations
– End of Rotation exam
– OSCE
– Participation/Attendance
Grades
• Clinical Shift evaluations
– We use the OUWB clinical eval
– You are expected to have at least one eval for
every shift you work
– This also serves as attendance
– will be a composite of all evals
• End of Rotation Exam
Grades
• Exam
– NBME SHELF for OUWB clerkship students
• Administered at OU
– Departmental Exam for outside students, 2nd
rotation
• Must contact Takesha Shelton to take during the last
week of your rotation
Grades
• OSCE
– Administered at the Troy Clinical skills center
• Participation/attendance
– Completion of all clinical shifts
– Participation in student didactic, lab, and SIM
sessions
– Attendance at EM Resident didactics
Grades
• We follow the OUWB grading requirements
• Pass:
– Must earn “meets expectations” on composite
clinical evaluation
– Must pass the NBME (or departmental) exam
– Must pass the EM OSCE
– Must attend all required clerkship didactic/lab
activities
– Must complete all required shifts
Grades
• High Pass
– Complete everything for pass PLUS
– Earn either an “above expectations” on your
composite clinical eval OR
– Earn ≥80th percentile on the NBME exam or ≥85%
on the departmental exam
– Attend >50% of the optional resident grand
rounds
Grades
• Honors
– Fulfill all Pass requirements plus:
– Must earn Exceeds Expectations on Composite
Clinical evaluation
– Must achieve ≥80th %ile on the EM SHELF or ≥85%
on the departmental exam.
– Must have attended all the resident grand rounds
DIDACTICS
Didactics
•
•
•
•
•
•
On-line lectures
Discussion Sessions
Procedure Lab
SIM session (advanced students)
Are all REQUIRED to pass the rotation
If a scheduled session, take precedence over
clinical shifts
Online Lectures
•
•
•
•
Self-directed/asynchronous learning
Access on the student website
These are required for review
They will correlate with the discussion
sessions
Discussion Sessions
• Required Participation
• Case based review of online lectures
• Make sure to review lecture correlating with
discussion session Prior to attending
• Participation counts and is noted
Student Presentation
• You will need to prepare a short, 5-10 min
presentation on an interesting patient. Please
provide a handout on the case to your fellow
students
• This will take place after the discussion
sessions
• Please sign up for your presentation time
Procedure Lab
• REQUIRED for ALL students
• Surgical Learning Institute, 3rd Floor, South Tower
• Using Task Trainers
–
–
–
–
–
–
Lumbar Puncture
Central Venous Line
Airway/intubation
Suturing
Splinting
Ultrasound
SIM
• Simulation session in
SLC
• Required for advanced
students
• Review pre-scenario
information prior to
scheduled time
• Be PROMT. If you are
late, you will not be
allowed to participate.
EM Resident Grand Rounds
• Thursday mornings; 0900-1300
• ABW basement (location will vary, will be
noted on your schedule)
• Please sign in with chief resident
• These are optional
• Required for High Pass or Honors
CLINICAL SHIFTS
Clinical Shifts
• You will have 14-15 scheduled shifts
– Variety of modules:
• A, B, CD, Peds
– Variety of times
• Morning, afternoon, nights, weekends
– Procedure shift
• Will work with an EC tech to get IV starts, foley
catheters, EKGs and more.
Clinical Shifts
• You are required to complete all of your shifts
• Unexcused absences will NOT be tolerated
• If you have an unexcused absence, you will be
required to make up 2 shifts for every one you
miss
• If it is noted that you have missed multiple, you
will not pass the rotation
• Shifts are 10 hours
– 1st 8 hrs to pick up new patients, last 2 hours for dispo
Clinical Shifts
• Shift Swaps
– Must be mutually agreed upon
– Must still have 10 hours off between shifts
– Must be approved by Dr Smark
– Must be made at least 3 days ahead of scheduled
shift
– Keep in mind, not all “open” spots on the
schedule are open, they may be filled with other
learners
Clinical Shifts
• Sign in book-Module A
• Wear your white coat,
scrubs, name badge
• Bring your stethoscope!
• Be interested
• Stay busy
• Track your patients
progress
• Follow up on studies,
results
• Understand the plan
Beaumont Hospital-Royal Oak
EC MODULES
Module A
• Critical Care Module
–
–
–
–
9 Cat 1 Beds
Sickest patients
Get Involved!
Additional Cat 2 beds
Module B
• 23 Category 2 beds
• All capable of cardiac
monitoring
• (+) hallway beds;
marked as “x” bed
Modules C/D
• Cover modules C and D
• Common work area in the walk-through of C
• All charts come to the area C rack
Pediatric EC
• Staffed by general EM
docs as well as
fellowship trained Peds
EM docs
• 2 pediatric critical care
beds
• Significant pediatric
trauma starts in the
Trauma room, bed 3
PATIENT CARE
Patient Care
• Grab a chart from the
Available for Provider
rack
• Eventually will be
chartless and new
patients will only be
denoted by
on the
EPIC dashboard
– Currently in place in the
PEDS EC
Patient Care
• Chart
– Cover sheet with CC and
vitals
– Have patient stickers
– EKG/EMS sheets
– ECF info
Patient Care
• Orange Bin Charts
– PRIORITY pts
– Let resident/attending
know you are seeing
them
– Significantly abn vital
signs
– Abn EKG
– Time dependant CC
Presentations
• Make sure to staff at least 2 patients directly
with attending physicians
• Remaining cases may be with resident or
attending
Presentations
•
•
•
•
Concise
Organized
Include your differential diagnosis
Present your assessment/plan
Documentation
• You will complete a medical student note in
EPIC
• You will be expected to enter your orders for
cosign by the resident or attending on the
case
Follow up and Disposition
• Make sure to follow up on all studies and
results
• Re-evaluate your patients!!
• Make sure to update the staff with results and
discuss progression of/change in plan
• Be a part of the disposition
• Call consultants
Procedures
• IVs, foleys, EKGs, will be
supervised by RNs or
techs
• Remaining procedures
will be supervised by the
EM residents/Attendings
• Be Assertive/Proactive in
doing procedures
• SIM/Procedure Lab
counts towards required
• Required Procedure list
–
–
–
–
–
–
–
–
–
Foley
IV start
ABG
Intubation
Central line
LP
Lac repair
EKG
FAST exam
Clinical Shift evaluations
• It is your responsibility to hand out on every
shift!
• This gives us a well-rounded evaluation of
your clinical performance as well as proves
attendance
WBH-TROY
WBH-Troy
•
•
•
•
You will have at least 3 shifts at the Troy site
You will work directly with EM attendings
Troy Site Director is Dr Shanna Jones
Map/instructions are included in your
orientation packet
Computer Access
• You MUST have EPIC access prior to your first
shift
• If you have problems with access, please
contact Monica Demres or Lori Kurkowski in
UGME
Kaizen
• For OUWB clerkship students only
• During your EM clerkship, you will be completing
a day with the Kaizen team.
• This is a part of your OUWB Curriculum, not part
of the EM curruiculum.
• It is not evaluated under EM
• This is REQUIRED and only occurs 2 days of the
month. You will be assigned one of these dates
and MUST attend. There is no make-up for this
requirement.
MIDCLERKSHIP EVAL
Midclerkship Eval
• Students are required to meet with Dr Smark
for their mid-clerkship evaluation
• We will discuss your performance to date as
well as any concerns
Advanced Rotations
• Advanced EM
• Advanced Peds EM
• Must have 1st completed a core EM rotation
Advanced EM
• Your month will focus more in the critical care
areas
• Will have additional U/S time
– Will scan with residents on U/S rotation
– Will attend an u/s review session with u/s staff
• Can do an EMS ride along shift
– Will take place of one of your regular shifts of your
choosing. Must let Dr Smark know which shift you are
dropping.
– Give EMS providers eval to sign for attendance
• You will complete the departmental exam
Advanced Peds EM
•
•
•
•
You will rotate exclusively in our Peds EC
Will work with our Peds EM staff, fellows
Will attend the Peds EM grand rounds
Will take an end of rotation written exam
ROTATION PEARLS
Rotation Pearls
• Be assertive!
• Focus on areas that may be different from your
intended speciality
• Be sure to follow up/re-eval your patients
• Know the results
• Be involved in the plan
• Be efficient-do not spend more than 20 minutes
in a room
• Do not disappear on shift
ORIENTATION COMPLETION
Orientation Completion
• Please sign and turn in the orientation
completion form
• By signing this, you understand the rotation
expectations, grading and required activities
• Please contact Dr Smark for any questions
THE END