Download UCSF Core Clerkships Objectives 2015-16

UCSF Core Clerkships Objectives 2015-16 (Source= Ilios)
Anesthesia (ANES 110) Objectives (15)
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Describe elements of the patient’s history, physical exam and planned procedure that
significantly influence the anesthetic plan and perioperative risk.
Using clinical reasoning, discuss various elements of a patient's perioperative care and
develop an anesthetic plan for the patient that optimizes the patient’s outcome and
addresses specific considerations for the preoperative, intraoperative and postoperative periods.
Perform a focused patient history and physical examination that includes all elements
pertinent to perioperative risk assessment and procedural considerations.
List appropriate equipment and medication for induction and maintenance of an
anesthetic case, and participate in the preparation and execution of a case at least
once.
List all critical elements of an IV catheter insertion, administration of IV medications,
effective airway management following induction, safe patient transport and
positioning; and demonstrate each of these skills at least once.
Anticipate, interpret and assist in management of a patient’s physiologic changes
noted during induction, maintenance, and emergence from anesthesia.
Establish appropriate rapport and demonstrate effective communication with patients
and staff in the perioperative setting.
Demonstrate respect, integrity and confidentiality towards patients, staff and faculty in
the perioperative setting.
Employ strategies to seek and incorporate feedback during the clerkship and critically
reflect on your performance and clinical experiences during both OR sessions and the
“Reflections” session.
Describe the contribution and limitations of anesthesiology to both patient care and
health care delivery system.
Preoperative evaluation: Review EMR. Confirm patient identity, procedure, site &
consent. Establish rapport with patient & family. Perform focused H&P
including confirmation of NPO status, allergies, and examination of airway, heart
& lungs. Assign MP class and ASA status. Discuss cardiac risk assessment.
Identify issues impacting anesthetic plan. Develop plan for monitoring, induction,
maintenance & post-op care. Present plan to team.
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Preparation for induction of general anesthesia: Properly prepare IV drugs. Check
suction, oxygen source, ventilator & airway equipment. Assemble an IV infusion
set. Insert an IV in the patient. Help transport patient to OR and place standard
monitors.
Airway Management: Preoxygenate. List sequence of drugs, dosing, and associated
physiologic changes for the induction. After induction, mask ventilate patient. Place
either an ET tube or LMA. Confirm appropriate placement. Initiate mechanical
ventilation.
Intraoperative anesthetic care including crisis management: Demonstrate proper hand
hygiene, glove use, and sharps management. Assist in patient positioning. Review
Time-Out elements. Interpret vital signs and communicate effectively to team. Monitor
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muscle relaxation. Administer drugs via stopcock. List common causes and treatment
for hypoxia, hypotension and hypertension.
Management of emergence from anesthesia and post- operative care: List criteria for
safe extubation. Develop a plan for pain management, nausea prevention & safe
emergence. Transfer to PACU. Participate in transfer of care report. List criteria for
patient discharge from PACU.
Family and Community Medicine (FCM 110) Objectives (18)
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History and Physical Exam- Demonstrates competence in performing and
documenting a complete yet focused primary care history and physical exam for the
following visit types: new patient visit, follow up of a chronic problem, health care
maintenance visit, and acute care visit.
Clinical Reasoning- Applies knowledge of fundamental and clinical sciences to
interpretation of clinical problems; uses clinical reasoning to independently generate an
assessment and plan for their patients’ problems; formulates differential diagnoses;
suggests and justifies appropriate diagnostic testing; generates problem lists; frames
clinical questions and independently uses resources for answering these questions.
Chronic Illness Care and Prevention- Demonstrates skill in performing outpatient visits
and follow up for patients with chronic illnesses including performing a targeted history
and physical exam for a patient with many chronic issues, working with the patient to
prioritize issues, promoting patient self-management, engaging family and health team
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members, applying clinical knowledge of chronic illnesses, applying national guidelines
of treatment goals and prevention and developing a longitudinal plan for the patient.
Continuity Care- Demonstrates skill and reliability in providing continuity and follow up
care for patients including: (a) following up on patients' lab studies, test results,
specialty visits, required paperwork; (b) communicating with preceptor(s) and staff
about follow up results and generating ideas about how this affects the assessment
and plan for the patient; and (c) initiating and performing follow up with patients in the
office, by phone or in their home.
Medical Knowledge- Demonstrates appropriate fund of knowledge of common
outpatient acute illnesses, chronic illnesses and preventive health needs;
demonstrates knowledge of chronic care and preventive health national guidelines;
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applies and critically assesses national clinical guidelines relevant to individual patient
care and health promotion.
Reflection and self-improvement- Recognizes and acknowledges owns one’s
strengths and areas needing improvement; sets own learning goals in consultation with
preceptor and works with preceptor to achieve these goals; and solicits feedback on
performance and incorporates constructive suggestions.
Doctor-Patient Relationship and Communication- Demonstrates skill in establishing
rapport with patients and families, eliciting the patient’s agenda and developing a
shared agenda; clearly explains diagnosis and treatment plan to patients;
communicates clearly and effectively with the preceptor and the medical team;
identifies cultural, educational, psychosocial, linguistic, and other barriers impacting
patient care and uses effective communication, a team based-approach, and other
strategies to help address these barriers and optimize patient care.
Patient Education, Counseling, and Preventive Health- Demonstrates the ability to
effectively educate, counsel, and follow up with patients and families regarding the
following: (a) lifestyle change (diet, exercise); (b) addiction (nicotine, alcohol); (c)
education about a patient's illnesses (d) education about preventive health needs (e)
targeted recommendations for how an individual patient can optimize his/her health
based on risk factors, etc.
Professionalism- Demonstrates punctuality, reliability, preparedness, initiative, follow
through and honesty; creates accurate, timely notes, and prescriptions; acknowledges
gaps in skills, knowledge or patient information; asks for help when needed; works
collaboratively with team; approaches all actions with integrity, honesty and
authenticity.
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Community Health- Assesses and describes unique strengths and challenges of a
medically underserved community and some strategies which may be used to address
these needs; describes the roles of access to care and other systems issues in
improving the health of a community.
Participate in patient care through: a) performing history and physical exam and b)
participating in developing an assessment and plan
Participate in patient care through: a) performing history and physical exam and b)
assessing what preventive health is needed and c) counseling patient about preventive
health needs.
Participate in patient care through: a) assessing needs for behavioral change; b)
counseling patient about behavioral change using appropriate strategies such as
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action plans or motivational interviewing; and c) arranging follow up.
Participate in patient care through performing a targeted history and physical exam.
Performing a Musculoskeletal Exam and perform a Skin Exam
Perform an acute care visit and Perform a chronic care visit.
Participate in patient care through: a) following up with a patient for a return visit in
clinic or b) following up with a patient by phone or c) seeing a patient for a return visit
at home.
Participate in patient care through assessing medication adherence of a chronically ill
patient, reconciling medications, considering strategies to optimize adherence.
Medicine (MED 110) Objectives (10)
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By the end of the clerkship, students will be able to identify and interpret appropriate
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tests to rule in/out a given diagnosis.
By the end of the clerkship students will be able to apply knowledge of fundamental
sciences to interpretation of clinical problems; perform an appropriate history and
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physical exam; and use deductive reasoning to generate problem lists, from a
hypotheses, and to formulate differential diagnoses.
By the end of the clerkship, students can be entrusted, under supervision, to perform
the following for a medical inpatient from admission through discharge;complete
admission history and physical exam to generate a problem list and construct a
differential diagnosis using the information and relevant diagnostic test data.Follow
each assigned patient daily throughout the hospital stay, performing daily histories and
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physical exams targeted to patient problems and diagnoses, and documenting each
patient encounter. Participating in discharge planning taking into account each
patient's social situation
By the end of the clerkship, students will be able to explain findings, diagnoses and
treatment plan to patients and families; give complete oral presentations for each
admission; present patient information in SOAP format on daily rounds including
assessment and plan that reflects own clinical reasoning; discuss breaking bad news,
negotiating complex discharge plans, end-of-life care issues with patients under the
direction of the health care team; teach patients and families about illness, treatment
and prognosis; elicit patient concerns and agenda for care; identify and address
cultural forces and communication issues affecting patient care; communicate with
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consultants including initial consult and follow-up; and provide handover of clinical
information to next team/provider when leaving team.
Students will be able to demonstrate punctuality, reliability, preparedness, initiative,
follow through and honesty; create accurate, timely, legible notes, orders and
prescriptions; acknowledge gaps in skills, knowledge or patient information; ask for
help when needed; work collaboratively with team.
Students will ask for feedback on performance, receive and incorporate feedback
willingly; reflect on the impact of discharge planning on patient's transition from hsopital
to community and consider individual goal(s) for improvement in discharge planning.
Students will be able to use the medical record system to access and handle patient
data; incorporate the nature of health care delivery system into management of an
individual patient; participate in discharge planning that takes into account the patient's
social situation; work with interdisciplinary team members; learn to conduct a
medication reconciliation.
For each diagnosis, participate in patient care through: a) performing history and
physical exam and b) participating in developing an assessment and plan: ·Dyspnea;
Fever; Chest pain; Common arrhythmia; Acute non-surgical GI or liver symptoms;
Electrolyte abnormalities and/or acute or chronic kidney disease; Geriatric patient; Life
threatening or terminal illness.
Participate in patient care through: a) performing history and physical exam and b)
assessing what preventive health is needed and c) counseling patient about preventive
health needs.
Participate in patient care through: a) assessing needs for behavioral change; b)
counseling patient about behavioral change using appropriate strategies such as
action plans or motivational interviewing; and c) arranging follow up.
Neurology (NEURO 110) Objectives (31)
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Formulate an approach to the work-up and management of weakness, abnormal
movements (e.g., Parkinson Disease, tremor, chorea), headaches, dizziness, back
pain, neuropathy, seizure, stroke, and head trauma in adults and children.
Formulate an approach to the work-up and management of abnormal level of
consciousness (e.g., delirium, coma), abnormal cognition and information processing
(e.g., psychotic disorders, dementias, pseudodementia), and addiction (e.g., use vs
abuse vs dependence; substance induced psychiatric disorders).
Perform the complete neurologic examination (mental status, cranial nerves, motor
system, sensory system, reflexes, coordination, and gait).
Demonstrate anatomic localization of neurologic clinical findings.
Describe how to perform a lumbar puncture.
Demonstrate clinical assessment and reasoning through a complete new patient write
up.
Create documents (e.g., notes, orders and prescriptions) that are accurate, timely and
legible.
Write appropriate physician orders for your patients.
Perform a focused interval history and exam as appropriate for follow-up patients.
Apply skills learned on previous clerkships to the current clerkship (for example,
practice the neurological exam when evaluating patients on your psychiatry rotation or
the mental status exam on patients on your neurology rotation).
Demonstrate professional demeanor and behavior through punctuality, reliability,
preparedness, initiative, follow-through, and honesty.
Operate collaboratively within the team structure by being reliable and willing to help
where needed.
Use personal reflection and advice from mentor or supervisor to create and carry out
an ethically appropriate plan when witnessing someone else’s medical error or
professional misconduct.
Inform team members and staff in advance about expected conflicting clinical
responsibilities (e.g. conflicting clerkship and LCE schedules).
Identify and maintain appropriate boundaries between clinician and patient and
between team members.
Exemplify the commitment to put the needs of others before one's own needs.
Give oral presentations describing new patients and in the SOAP format on follow up
patients that demonstrate clinical assessment and reasoning.
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Explain diagnosis and treatment plan to patients and families under direction of the
health care team (early third year) or independently (late third year).
Elicit and begin to address your patients’ concerns and agenda for care, taking into
account cultural forces.
Demonstrate good bedside manner by communicating and interacting with patients
and their families with compassion, respect, honesty, cultural sensitivity and integrity.
Demonstrate effective and honest communication and collaboration skills with all
members of the health care team and with other health care teams (e.g. calling a
consult or acting as a consultant to a primary team).
Complete handover of clinical information to next team/provider at points of transition
(e.g., student leaving for LCE, or patient transfer between services).
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Identify a clinical question related to one of your patients and demonstrate the ability to
investigate it and communicate your findings to your team.
Identify institutional or national guidelines or scientific studies relevant to individual
patient care and disseminate this knowledge to your team.
Initiate and solicit feedback and demonstrate the ability to make changes in
performance based on that feedback.
Acknowledge and evaluate gaps in skills, knowledge, or patient information, and ask
for help when needed.
Formulate a discharge plan for your patients taking into consideration biological,
psychological and sociocultural factors.
Integrate recommendations from allied health care professionals (e.g., social work,
psychology, nursing, physical, occupational, and speech therapy) into the treatment
plan.
Develop a functional neuroanatomical approach to evaluating not only motor and
sensory problems but also cognitive, mood, and behavioral problems.
Demonstrate how awareness of personal reactions to clinical situations can affect the
assessment and management of patients by discussing these with your team.
Participate in patient care through: a) performing a history and physical exam and b)
participating in developing an assessment and plan for the following: Acute Neurologic
problem; Neurodegenerative disorder; Neuromuscular disease; Paroxysmal disorder;
performing a complete neurologic exam.
Obstetrics and Gynecology (OBGYN 110) Objectives (31)
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Describe the critical components of: prenatal care, labor, delivery, postpartum issues,
and lactation
Recognize and evaluate symptoms and signs of breast disease including masses,
pain, and galactorrhea
Differentiate lesbian health issues from heterosexual women’s health issues
Demonstrate several times to resident/attending/team ability to obtain gynecologic and
obstetric patient histories.
Demonstrate several times to resident/attending/team ability to independently write
notes (H&P, progress notes in SOAP format, and procedure notes) and
incorporate feedback.
Demonstrate ability to participate as a team member in discharge planning with several
patients.
Demonstrate gynecologic and obstetric clinical skills, and describe steps of procedures
including ability to: Measure fundal height in a pregnant woman who is greater than 20
weeks pregnant; Locate fetal heart beat with a Doppler in a woman who is greater than
13 weeks pregnant; Interpret fetal heart rate monitor strip; Sensitively insert the
speculum and identify the cervix; Tie a two-handed square knot; Delineate steps of
vaginal and cesarean deliveries
Demonstrate ability glove and gown using sterile technique, and use universal
precautions with body fluids
Demonstrate appropriate, respectful inter-professional communication skills with
administrative staff, and health care teams including nurses, midwives, physicians and
other health professionals
Demonstrate professionalism by being punctual, reliable, prepared, taking initiative,
following through, and maintaining patient confidentiality
Take responsibility for personal behavior, gaps in knowledge and errors, and ask for
and accept feedback willingly
Integrate knowledge from textbooks, medical literature, and national guidelines to
contribute to decisions about individual patient care.
Apply knowledge of study design and statistical methods to the appraisal of clinical
studies and be able to communicate findings with your team
Demonstrate ability to identify one’s own learning needs, incorporate feedback, and
critically reflect.
Describe the diagnosis and management of benign and cancerous gynecologic
conditions.
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Describe methods of screening for such conditions as cervical cancer, osteoporosis,
and intimate partner violence.
Recognize the impact of an unintended pregnancy and be able to counsel about all
options.
Be able to describe and compare contraceptive methods and counsel patients about
them.
Demonstrate several times to resident/attending/team ability to perform a
comprehensive physical exam (include breast and pelvic exams), incorporate relevant
lab results, formulate an assessment and plan.
Demonstrate appropriate student doctor-patient communication skills, including
patient’s agenda and concerns, and boundaries, and sensitive issues such as pelvic
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exam, sexual history, intimate partner violence, abortion history and family planning
options.
Provide and discuss patient education information with patients and families of diverse
backgrounds, including the ability to identify and address socio-economic and
cultural issues affecting patient's care.
Describe how systems structures and costs affect health care delivery at your site.
Perform a pelvic exam and collect specimens as appropriate and receive FEEDBACK.
Assist in a cesarean section and receive FEEDBACK.
Participate in a vaginal delivery and receive FEEDBACK.
Demonstrate a two-handed square knot (does not need to be on a patient) and receive
FEEDBACK
Participate in care of: Pregnant woman in labor, delivery and postpartum
Participate in care of a Woman with pelvic pain
Participate in care of: Woman with abnormal vaginal bleeding.
Participate in care of a woman with contraceptive needs.
Participate in care of a woman with menopausal issues.
Psychiatry (PSYCH 110) Objectives (18)
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Neurology: Formulate an approach to the work-up and management of: Weakness
Abnormal movements Headaches Dizziness Back Pain Neuropathy Seizure Stroke
Neurology and Psychiatry: Formulate an approach to the work-up and management of:
Abnormal Level of Consciousness (e.g., delirium, coma) Abnormal Cognition and
Information Processing (e.g., psychotic disorders, dementias, pseudodementia)
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Addiction (e.g., use vs abuse vs dependence; substance induced psychiatric
disorders)
Psychiatry: Formulate an approach to the work-up and management of: Persistent
Abnormal Mood (e.g., affective disorders) Anxiety (e.g., GAD, panic, OCD, PTSD,
social and other phobias) Personality Dysfunction (e.g., Axis II disorders and traits)
Abnormal Illness Behavior (e.g., somatoform disorders & factitious disorder vs
malingering) Demonstrate understanding of the principles and application of
involuntary psychiatric commitments and involuntary treatment. Demonstrate basic
understanding of the appropriate use and principals of major forms of psychotherapy
(e.g., CBT, DBT, ITP, insight oriented, supportive).
Neurology: Perform the complete neurologic examination. Demonstrate anatomic
localization of neurologic clinical findings. Learn how to perform a lumbar puncture.
Neurology and Psychiatry: Demonstrate clinical assessment and reasoning through a
complete new patient write-up. Perform a focused interval history and exam as
appropriate for follow-up patients. Demonstrate the ability to write appropriate
physician orders for your patients. Integrate biological, psychological and sociocultural
factors into treatment and discharge planning for your patients. Apply skills learned on
previous clerkships to the current clerkship (for example, practice the neurological
exam when evaluating patients on your psychiatry rotation).
Psychiatry: Perform the complete mental status examination and have it observed at
least once during the rotation. Demonstrate the application of the bio-psycho-social
model in a psychiatric formulation through oral or written case presentations. Assess
level of suicidality and homicidality and create an appropriate management plan.
Perform a clinical assessment of a patient's capacity to make healthcare decisions.
Team-based Professionalism: Demonstrate punctuality, reliability, preparedness,
initiative, follow-through, honesty, and professional demeanor and behavior. Create
documents (e.g., notes, orders, and prescriptions) that are accurate, timely, and
legible. Operate collaboratively within the team structure by being reliable and willing to
help where needed. Complete handover of clinical information to next team/provider at
points of transition (e.g., student leaving for LCE, or patient transfer between services).
Demonstrate effective communication with other health care teams (e.g. calling a
consult or acting as a consultant to a primary team). Demonstrate good beside manner
by communicating and interacting with patients and their families with compassion,
respect, honesty, cultural sensitivity and integrity. Acknowledge and evaluate gaps in
skills, knowledge, or patient information, and ask for help when needed. Use personal
reflection and advice from mentor or supervisor to create and carry out an ethically
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appropriate plan when witnessing someone else's medical error or professional
misconduct. Arrange clinical responsibilities appropriately (e.g., conflicting clerkship
and LCE schedules). Identify and maintain appropriate boundaries between clinician
and patient and between team members.
Team-based Interpersonal and Communication Skills: Demonstrate effective
communication with other health care teams (e.g. calling a consult or acting as a
consultant to a primary team). Give oral presentations in SOAP format on focused
interval histories and exams. Apply effective and honest communication and
collaboration skills with all members of the health care team.
Practice based learning and improvement of knowledge: Select a topic related to a
current patient to investigate and prepare a brief oral presentation with references and
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a handout in a conference or rounds setting. Access institutional or national guidelines
or scientific studies relevant to individual patient care and disseminate this knowledge
to your team.
Systems based practice: Formulate a discharge plan for your patients taking into
consideration biological, psychological and sociocultural factors. Integrate
recommendations from allied health care professionals (e.g., social work, psychology,
nursing, physical, occupational, and speech therapy) into the treatment plan.
Patient-Centered Professionalism: Exemplify the commitment to put the needs of
others before one's own needs. Treat patients and their families with compassion,
respect, honesty, cultural sensitivity and integrity.
Patient-Centered Interpersonal and Communication Skills: Explain diagnosis and
treatment plan to patients and families under direction of the health care team (early
third year) or independently (late third year). Elicit and begin to address your patients'
concerns and agenda for care, taking into account cultural forces.
Psychiatric Patient Presentation: Demonstrate clinical assessment and reasoning
through a complete new patient oral presentation.
Practice based learning and improvement of self-assessment: Acknowledge and
evaluate gaps in skills, knowledge, or patient information, and ask for help when
needed. Demonstrate how awareness of personal reactions to clinical situations can
affect the assessment and management of patients by discussing these with your
team. Arrange mid-point and end of rotation meetings with instructors to discuss
expectations and level of student performance. Adapt performance based on critical
feedback. Use personal reflection and advice from mentor or supervisor to create and
carry out an ethically appropriate plan when witnessing someone else's medical error
or professional misconduct.
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Participate in patient care through: a) performing history and mental status exam and
b) participating in developing an assessment and plan for various diagnoses including
Affective Disorders, Anxiety, Phobias, Somatoform disorders, Personality Dysfunction,
Abnormal level of consciousness, Abnormal cognition, Addition and Substance use.
Participate in a clinical discussion about the indications for psychotherapy for a shared
patient.
Participate in discussions of cross disciplinary diagnoses during neuro-psych report by
developing a functional neuroanatomical approach to evaluating not only motor and
sensory problems but also cognitive, mood, and behavioral problems.
Demonstrate understanding of the principles and application of involuntary psychiatric
commitments and involuntary treatment by participating in a clinical discussion about
the indications for and processing of an involuntary hold for a shared patient; if
possible, attend a court hearing for someone challenging a legal hold.
Surgery (SURG 110) Objectives (43)
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Medical knowledge and clinical reasoning: To learn the surgical approach to assessing
and managing the acute abdomen.
Patient care/Priority Patient Encounters: To perform complete initial admission history
and physical exams on patients.
Interpersonal and Communication Skills: Demonstrate appropriate doctor-patient
communication skills, including patient agenda and concerns.
Medical knowledge and clinical reasoning: To learn the surgical approach to assessing
and managing the patient with shock, including hypovolemic, septic, neurogenic and
cardiogenic shock
Medical knowledge and clinical reasoning: To learn the surgical evaluation of
pathologic conditions of the GI tract, including: esophagus, stomach, small intestines,
and colon, rectum and anus.
Medical knowledge and clinical reasoning: To learn the surgical approach to the
differential diagnosis and diagnostic evaluation of malignancy
Medical knowledge and clinical reasoning: To learn the surgical approach to wound
management, including the process of normal and abnormal wound healing
Medical knowledge and clinical reasoning: To learn the surgical approach to the
differential diagnosis and diagnostic evaluation of the vascular examination
Medical knowledge and clinical reasoning: To learn the surgical approach to the
differential diagnosis and management of biliary tract disease.
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Patient Care/Priority Patient Encounters: To perform symptom-focused history and
physical exam on patients.
Patient Care/Priority Patient Encounters: To demonstrate a thorough, diagnostic
abdominal exam in a patient with an acute abdomen.
Patient Care/Priority Patient Encounters: To learn about the surgery-radiology
interface.
Patient Care/Clinical Skills: To perform a thorough, diagnostic vascular exam.
Patient Care/Clinical Skills: Participate in an encounter with a patient who sustained
traumatic injury.
Patient Care/Clinical Skills: Participate in the care of the patients with breast cancer,
including history & Physical exam.
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Patient Care/Clinical Skills: Perform a rectal exam.
Patient Care/Clinical Skills: Examine a patient with acute abdominal pain.
Interpersonal and Communication Skills: Appropriately share information with patients
and families of diverse backgrounds and cultures.
Interpersonal and Communication Skills: Identify and address cultural forces and
communication issues affecting patient care.
Professionalism: Treat patients with compassion, respect, with sensitivity to their
individuality and maintain appropriate boundaries.
Professionalism: Demonstrate punctuality, reliability, preparedness, initiative and follow
through.
Professionalism: Maintain patient confidentiality and respect for patient privacy.
Professionalism: Recognize professional misconduct in others and use personal
reflection and advice from mentor or supervisor to create and carry out ethically
appropriate plan.
Professionalism: Contribute to patient-centered care while balancing your educational
needs.
Professionalism: Take responsibility for personal behavior, gaps in knowledge and
errors.
Professionalism: Ask for and accept feedback willingly.
Professionalism: Recognize and maintain appropriate boundaries between clinician
and patient (e.g., disclosure, time, intimacy, gifts).
Professionalism: Recognize and maintain appropriate boundaries with HCT (e.g.,
disclosure, dating, “brown-nosing”).
Professionalism: Displays professional dress, hygiene, language, demeanor and
behavior during work hours.
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Professionalism: Displays awareness of intended and unintended representation of the
medical profession in public, non-professional settings.
Practice based learning and improvement - Institutional, regulatory and professional
society standards: Adheres to institutional, regulatory and professional society
standards such as handling patient information; personal, patient and public safety;
and professional identification (e.g., HIPAA, infection control, reporting requirements,
name tags).
Practice based learning and improvement - Evidence Based Medicine: Research and
present related to patients cared for on the service and in the clinic. Using Evidence
Based Medicine to help guide the review of the literature in detail.
Practice based learning and improvement - Evidence Based Medicine: Effective use
the literature to guide the care of the patient.
Systems based practice: Participate in discharge planning and advocate for follow-up
for specific care needs.
Systems based practice: Advocate for resources for the patients.
Systems based practice: Understand how to use surgical outcomes to help guide the
practice of surgery in different environments.
Systems based practice: Understand the national patient safety goals.
The student is to perform a focused abdominal examination on a patient who is in the
hospital. as well as: Perform an abdominal exam on a surgical patient; Perform a
breast exam on a patient with breast cancer; Perform a vascular exam to assess the
pulses of a patient.
Do a history and physical exam on the following patients: with an acute abdominal
process; on a patient who has been injured in the emergency department, OR, on the
ward; with a GI malignancy; of a female patient who has been diagnosed with breast
cancer; on a patient with an abdominal wall hernia; on a patient with biliary tract
pathology; on a patient with wound healing issues; on a patient with shock.
The student will perform an history and physical examination on a patient with vascular
disease or injury.
Demonstrate a two-handed square knot during a surgical procedure or outside of a
surgical procedure to the resident or to the attending Physician.
Scrub in for surgical procedure, hold retractors, and cut sutures as requested. If an
opportunity arises, tie knots for subcutaneous sutures, place subcutaneous sutures,
place staples on skin.
The student will perform a rectal exam during the course of the rotation.