Assignments   Video Lectures   Video Lectures Evaluation   Checklist

Emergency Medicine Clerkship

Curriculum

The one-month required clerkship in a hospital Emergency Room setting gives fourth-year medical students direct involvement and experience in emergency medicine.

It is designed to further develop the concepts of diagnosis and management acquired during the OSU-COM pre-clinical course-work and to develop decision-making and cognitive skills related to patient care in an emergency setting.

In addition, this course may include experiences such as:

• Surgical assistance
• Labor and delivery
• Hospital staff and committee meetings
• Hospital emergency room calls
• Community and public health functions

Syllabus
CE 9255

General Description Course Title:  Osteopathic Emergency Medicine Clerkship Course Length:  One-month rotation Course Format:  Emergency Room - based Clerkship/Rotation Student Level:  Fourth Year Osteopathic Medical Students Course Coordinator:  William Pettit, D.O. The Emergency Medicine clerkship gives fourth year medical students direct involvement and experience in a hospital Emergency Room setting. This experience consists of a one-month rotation in an affiliated hospital emergency room designed to further develop the concepts of diagnosis and management acquired during the OSU-COM pre-clinical course-work and to develop decision-making and cognitive skills related to patient care in an emergency room. This course will also provide the student a chance to develop additional clinical psychomotor skills by performing routine basic procedures in a supervised setting. In addition, this course may include experiences such as surgical assistance, labor and delivery, hospital staff and committee meetings, hospital emergency room calls, community and public health functions. The student should be encouraged to observe, evaluate, and participate in the discussions and medical care of patients, at the discretion and under the immediate supervision of an assigned physician through the combined coordination and direction of the OSU-COM on-site supervising physician and the College's Course Coordinator, William Pettit, DO. William Pettit, D.O. will coordinate the course and will oversee student rotation assignments and course responsibilities in cooperation with the on-site supervising physician. The on-site supervising physician will coordinate daily supervision of the student, assign patient responsibilities, submit a final evaluation of the student's on-site clinical progress, and in coordination with the OSU-COM Clerkship Course Coordinator, will schedule academic presentations. It is further understood that an on-site physician must be in attendance at all times while the student is in the facility for training purposes. The on-site supervising physician may designate other physicians to meet this requirement. This practical clinical experience in primary care medicine is designed as an integral part of each OSU-COM clerkship program. The clerkship program is under the direction of the Oklahoma State University College of Osteopathic Medicine, and the courses (rotations) are conducted at affiliated primary care facilities. Successful completion of the course is an OSU-COM requirement for graduation. Student Responsibilities Pre-arrival Student Responsibilities and Information Contact Hospital: The student is required to contact the hospital contact prior to the beginning of the rotation to obtain hospital orientation and related information. Tulsa-OSU Medical Center Please report to the ER at 7:00 a.m. on the first day of the month in scrubs in case you are asked to stay and work that day. Someone will meet you there, make out a schedule for you and give you the reading list for the month. If you cannot be there on the first day, please notify our office at 584-4375.  Oklahoma City-Integris Southwest Medical Center Please email Joyce Harrison (Joyce.Harrison@integris-health.com) approximately two (2) weeks prior to starting your rotation to verify start date, time and location.  If you need housing, please notify Joyce as soon as possible.  Enid-Integris Bass Baptist Health Center Please contact C. Michael Ogle, D.O. (918-808-3264) approximately two (2) weeks prior to starting your rotation to verify start date, time and location.   Students are required to contact the housing contact as soon as possible if they will NOT be utilizing the housing for any reason. This decreases unnecessary costs to this site and helps maintain these benefits for future students. For more information about housing, see housing policy. Appropriate Dress: For students in the Emergency Room, appropriate dress is usually scrubs.  Please verify appropriate dress with your hospital contact. All students must wear College approved identification and a clean, pressed white clinical jacket. Men are expected to wear a shirt, tie, and dress trousers. Women are expected to wear slacks or a dress. Students are required to bring identification passwords for library resources (i.e. MD Consult), course syllabus, and current references for Family Medicine, Internal Medicine and Obstetrics/Gynecology with them. Student Responsibilities During the Clerkship First Week of Rotation: Attend required hospital orientation. Meet with your on-site supervising physician for an orientation. Be prepared to discuss your clinical strengths and weakness relative to the rotation objectives. We suggest you use the student performance evaluation form as a guide. During the Rotation: At all times dress appropriately (as defined above), utilize College approved identification, and identify self as a non-graduate medical student not as a medical graduate or a licensed physician. View video lectures and take corresponding evaluations. Video lectures are accessible through resource link on OSU-COM Center for Rural Health Emergency Medicine syllabus. Provide appropriate patient care under the supervision of the attending physician(s). Demonstrate appropriate indications and techniques in using O.M.M. Complete all outlined rotation objectives. Midpoint: Meet with your attending physician(s) and/or your on-site supervising physician for a verbal evaluation of your clinical performance, areas to improve, and a discussion of your progress on the assigned patient case. You are responsible for scheduling this meeting. Final Week: Meet with your attending physician(s) and your on-site supervising physician at the end of the rotation to review your clinical performance. Give the student performance evaluation form to the on-site supervising physician or direct him/her to the online evaluation form for completion of the preceptor’s section. You are responsible for scheduling these meetings. Tulsa-OSU Medical Center Michele Fowler, D.O. has requested that the OSUMC students bring a copy of the Performance Evaluation form to the ER on the last scheduled day of their rotation.  The evaluation will be discussed and completed at that time.  Dr. Fowler must sign the evaluation before you turn it in to our office.  Submit the checklist, site evaluation, and video lecture evaluations to Vicky Pace, OSU-COM Center for Rural Health. All forms are due within 7 days (postmarked by the 5th day) of the end of the rotation. A grade will not be issued until all the paperwork has been received. If forms are not received within 7 days of the end of the rotation, the student’s grade may decrease one letter grade. Clerkship Calendar The student's actual working days and hours shall fall within the clerkship calendar. The specific scheduling of days and hours shall be made by the on-site supervising physician, with approval by the OSU-COM Course Coordinator, and shall generally conform to the following: Rotation Period: This clerkship is one month in length. Date of Arrival: It is the student's responsibility to report to his or her official rotation site on the date specified. If there is a reasonable explanation for a delay in reporting (e.g., auto accident, illness, or similar reason), the student is to contact the preceptor, the regional AHEC coordinator and the OSU-COM clinical training coordinator immediately. Working Day: A typical working day (or night) is considered to be 12 hours in length; however, there may be instances when the working period may exceed 12 hours especially when accompanying the physician on "out of office" professional duties. During the one-month rotation, a students schedule will be arranged to provide at least 2 days off out of every fourteen (14) days, as in every other weekend. Holidays: Students receive one day off for the Thanksgiving holiday. Students receive two consecutive days off for the Christmas holiday. Students are to request approval for specific days off for Thanksgiving and Christmas holidays from their on-site supervising physician. Travel Time: Travel time may be taken for rotations requiring travel of more than 50 miles outside the greater Tulsa area as specified in the student clerkship handbook. Attendance: One hundred percent (100%) attendance is required on all clinical rotations. The student is required to inform the on-site supervising physician and clinical training coordinator of any absence in a timely manner. If a student needs time off the rotation, make up time may be required. A student is required to complete an Exception to the Rotation application with the preceptor, didactic coordinator and course coordinator signatures if he/she is absent for any reason (or multiple reasons) for a total of 3 or more days. Rotation Changes:  Under approved special circumstances only, students may trade rotation assignments by completing a Change of Rotation form. All forms must be forwarded to: Sherry Eastman OSU-CHS Center for Rural Health, Division of Rural Health 1111 West 17th Street Phoenix Building Tulsa, OK 74107 918-584-4375 918-582-8938 fax NOTICE: Emergency Medicine rotations begin on the first day of the month. If travel time is necessary or a holiday falls on the first day of the month, students are encouraged to contact the supervising physician at the new facility to verify date of arrival. Student Performance Evaluation Procedures The student's overall performance (grade) will be weighted using the following criteria: 90% = Student Performance Evaluation 10% = Video Lecture Post-tests All requirements must be passed with a 70 percent or above to pass this clerkship. Letter grades of A, B, C, or U will be assigned according to procedures outlined in the College Catalog. Student Performance Evaluation: At the completion of the Emergency Medicine rotation, the on-site supervising physician will evaluate the student's performance on clinical activities of the rotation on the student performance evaluation form. The final (overall) grade will be determined and issued by the Course Coordinator following the completion of the rotation. The grade is based on the Student Performance Evaluation, video-lecture post-tests, other required activities, all requirements passed with 70% or more, and the timely receipt (within 7 days) of all the paperwork. If all forms are not received within 7 days of the end of the month( rotation), the student’s grade may be decreased one letter grade. Performance Reviews: Students are responsible for scheduling "verbal reviews" and a written evaluation review with their on-site supervising physician. It is recommended that verbal reviews be conducted at various points throughout each rotation, allowing the on-site supervising physician and student to discuss the student's areas of weakness and plan of action for improvement. A “verbal review” conference should be scheduled at least once mid-way through each rotation and a written evaluation review on the final day of each rotation. Students are responsible for scheduling the meeting times. Paperwork: Students are responsible for ensuring that all paperwork (student performance evaluation, site evaluation, and video lecture evaluations) is completed and received by the OSU-COM Center for Rural Health by the 7th day following the end of each rotation (postmarked by the 5th day). In addition to an academic grade, all students are held accountable to the non-cognitive academic standards as the standard of professionalism for their conduct. A grade of S (Satisfactory) or N (Needs improvement) is determined by the Course Coordinator based upon evaluation of the student by the on-site supervising physician. A grade of "I" (Incomplete) will be assigned if: A student is unable to complete the course requirement of approved 100% attendance. The Course Coordinator recommends an extension of the student's clerkship, and sets forth reasoning for the recommended extension. The student fails to submit the required paperwork. Grievance Authority:  Grievance of a rotation, performance evaluation, or course grade should start with the Course Coordinator. The final grading authority will be with the Course Coordinator. Program Evaluation Students are required to complete a site evaluation form at the end of the rotation. This tool is used to evaluate the course curriculum, faculty (attending and on-site supervising physicians), and student experiences. Students are required to complete and return the form to the Center for Rural Health within 7 days of completing the rotation. The Course Coordinator reviews all site evaluations and is responsible for addressing any problems or issues, which are identified in the evaluations. Data will be collated annually. On-site supervising physicians will receive an aggregate report only. The individual site evaluations and responses will remain confidential. Rotation Objectives Provide the student practical clinical exposure, knowledge, and additional didactics in a Emergency Medicine setting. Accomplished through a basic structure developed to achieve proficiency in the following areas. Goals Supervised patient evaluation, diagnosis and management of general medical maladies. Application of didactic general medicine principles. Development & expansion of clinical psychomotor skills. Gain knowledge and skills in performing procedures commonly done in an Emergency Medicine setting. Subject/Method Learning Objectives Resources/Assignments Clinical Psychomotor Skills Development & expansion of clinical psychomotor skills Participate in daily patient rounds and conferences. Perform clinical workups of patients presenting in the Emergency Room (supervised/critiqued). Review reading/case presentations related to cases in the Emergency Room. Review required video lectures and complete evaluations. Attend/participate in formal clinical presentations by hospital staff and guest presenters. Receive performance feedback from on-site supervising physician and attending physicians. Required Internet video lectures: Must review required video-lectures and submit evaluations during rotation. Video-lectures are available via streaming through a resource link on this online syllabus. For Technical Assistance contact Jon Barnaby (607-4081) Required readings and case presentations are determined by on-site supervising physician Emergency Room Skills Demonstrate and discuss the principles of clean and sterile technique. Demonstrate and discuss proper isolation technique. Demonstrate ability to scrub, gown, glove alone and with assistance, and to maintain proper sterile techniques in an emergency room setting. Demonstrate knowledge of and proper usage of commonly used instruments.   Emergency Room Procedures Supervised patient evaluation, diagnosis & management of general medical maladies Perform specific, assigned medical/surgical case responsibilities. Perform general medicine assignments. Obtain a complete and accurate history and physical examination. Keep adequate and up-to-date medical records. Identify patient problems utilizing the SOAP format. Provide patient case presentation to attending physician with appropriate management strategy. Perform simple procedures (supervised), including but not limited to: Suturing lacerations and surgical wounds Removal of sutures and skin staples Steristrip use in lacerations and surgical wounds Drainage of abscesses Surgical dressings Propose a plan for management of patient, for review by the attending. Properly indicate the need to perform laboratory or radiographic tests. Determine appropriate physical activity to be permitted by patient. Determine type & caloric content of patient's diet. Determine and recommend appropriate therapeutic measures. Determine requirement for special precautions or consultation. Determine appropriate time of patient discharge or release from hospital. Propose a method for patient follow-up. Maintain a humane approach, recognizing fears and anxieties of patient and family - understand the impact of patient's background and environmental relationships to his/her illness or trauma. Apply appropriate Osteopathic Principles and Practice for diagnosis and treatment of patient.   Application of Didactic General Medicine Principles in Emergency Room Cases Application of didactic general medicine principles in the following areas: Cardiovascular Myocardial infraction Acute dysarrhythmias Cardiac arrest Cardiac tamponade Penetrating and non-penetrating cardiac injuries Hypertensive emergencies Thoracic-abdominal aneurysm Basic life support techniques Principles of advanced life support Recognition and treatment of different types of shock Tracheal foreign bodies Acute injuries Simple-compound fractures Pneumothorax Burns Head and neck injuries Psychiatric emergencies Acute psychosis Depression – suicide Paranoia Delirium tremens Medical emergencies Pulmonary edema Heart blocks Intractable angina/MI Hypoglycemia Status epilepticus Overdose patient Anaphylactic shock Acute endocrine emergencies Thyroid storm Hypertensive emergency Insulin shock Acute Adrenal insufficiency CVA Acute emergencies of hematology Hemophiliac conditions Sickle cell crisis ITP Urological emergencies Renal trauma (penetrating and non-penetrating) Acute urinary tract infections Testicular torsion Urethral, ureteral, bladder injuries Care of acute infections and prevention Meningitis – encephalitis Tetanus Endocarditis Fulminating pneumonia Abdominal emergencies Blunt – penetrating injuries Upper GI hemorrhage Upper – lower GI foreign body Perforated viscus Intestinal obstruction Acute appendicitis Acute pancreatitis Diverticulitis Incarcerated hernia Acute cholecystitis Acute electrolyte imbalances Hyponatremia – hypernatremia Hypokolemia – hyperkolemia Hypocalcemia - hypercalcemia Eye emergencies Penetrating – blunt eye trauma Acute glaucoma Corneal injuries Chemical injuries Intraocular foreign bodies Hyphema Acute iritis Acute conjunctivitis Pediatric emergencies Cardiac Pulmonary Endocrine Overdoses Trauma Dental emergencies Post extraction hemorrhage Root abscess Tooth fracture/avulsion Gynecological emergencies PID Ectopic pregnancy Ovarian torsion Ruptured ovarian cyst ENT emergencies Epitaxis Foreign body removal from ear canal Foreign body removal from nose Ruptured TM Labrinthitis Wound care Proper wound preparation Hemostasis Suture techniques Environmental emergencies Insect bites   OMM Hans-on Demonstrate appropriate techniques and indications in the use of OMT, as applicable to patient care.