1. Objective: Assimilate the core knowledge base of Emergency Medicine using appropriate reference texts.
Method of Measurement: The teaching faculty directly observe the student's ability to answer questions during study guide and during the discussion of individual patient encounters. The student's performance is also reviewed.
Remediation: The medical student coordinator develops individualized, structured reading plans for the student, and mandates regular use of online quizes banks such as SAEM's online quizes.
2. Objective: Apply the core knowledge base of Emergency Medicine to solve clinical problems.
Method of Measurement: The teaching faculty directly observe the student's ability to form cohesive treatment plans during individual patient encounters. The student's performance on the Mock Oral Exam is also reviewed.
Remediation: The medical student coordinator develops structured reading plans for the student.
3. Objective: Select and interpret appropriate imaging, laboratory and other ancillary studies.
Method of Measurement: The teaching faculty directly observe the student's ability to employ appropriate diagnostic strategies, and to interpret diagnostic tests, during individual patient encounters. The student's performance on Mock Oral Boards is reviewed, with goal performance set at passing at least 4 of the 8 cases presented.
Remediation: The medical student coordinator develops individualized, structured reading plans for the student. The teaching faculty provides real-time feedback and instruction until the student can perform this task effectively.
4. Objective: Using findings from the focused evaluation of the patient to develop a differential diagnosis.
Method of Measurement: The teaching faculty directly observe the student's ability to develop a differential diagnosis during individual patient encounters. The student's performance is reviewed.
Remediation: The medical student coordinator develops individualized, structured reading plans for the student. The teaching faculty provides real-time feedback and instruction until the student can perform this task effectively.
Patient Care
1. Objective: Assume the role of a beginning EM student in a complex urban/suburban emergency department. Accept an appropriate level of graduated responsibility while functioning in the ED treatment room.
Method of measurement: The faculty directly observe student performance in the emergency department, and provide additional feedback in the form of written evaluations on a daily basis.
Remediation: The teaching faculty provide real-time feedback and instruction until the student can perform in a manner commensurate with the level of training.
2. Objective: Perform techniques required for conducting the primary assessment of a patient, and recognize pertinent physical findings. Develop a differential diagnosis using findings from this focused evaluation.
Method of Measurement: Teaching faculty directly observe student performance in the emergency department, and provide additional feedback in the form of written evaluations on a daily basis.
Remediation: The teaching faculty provides real-time feedback and instruction until the student can perform these tasks effectively.
3. Objective: Take appropriate steps to stabilize and treat patients. Evaluate the effectiveness of a patient's treatment or therapy, including addressing complications and potential errors.
Method of Measurement: Teaching faculty directly observe student performance in the emergency department, and provide additional feedback in the form of written evaluations on a daily basis.
Remediation: The teaching faculty provides real-time feedback and instruction until the student can perform these tasks effectively.
4. Objective: Accumulate experience with all clinical procedures in emergency medicine.
Method of Measurement: The medical student coordinator reviews the student's procedure log at at the end of the monthly rotation.s.
Remediation: The medical student coordinator provides feedback to the student, noting inadequate participation in specific clinical procedures. The medical student coordinator encourages the student to actively seek out opportunities to perform those procedures. The medical student coordinator also notifies ED teaching faculty and senior students of the student's need for further experience with a specific procedure so that they may seek out that student when there is the opportunity to perform the noted procedure.
5. Objective: Develop specific skills in both non-surgical and surgical airway techniques.
Method of Measurement: During Intern Airway Lab and Simulation Lab the teaching faculty directly observes the student performing bag-valve-mask ventilation and intubations on a High Fidelity Simulator. During the yearly Difficult Airway Lab, the teaching faculty directly observes the student performing non-surgical and surgical airway on a High Fidelity simulators as well as a bovine model. During clinical shifts in the ED, the teaching faculty directly observes the student performing these procedures on actual patients.
Remediation: The teaching faculty provides real-time feedback and instruction until the student can correctly perform the procedure.
6. Objective: Demonstrate mastery of current treatment algorithms for adult cardiac resuscitation and pediatric resuscitation.
Method of Measurement: The medical student coordinator notes the student's successful completion of ACLS and PALS courses.
Remediation: the student repeats the course until successful completion.
7. Objective: Examine the eye and remove an ocular foreign body using a slit lamp.
Method of Measurement: During Ophthalmology Lab, a teaching faculty directly observes the student's examination of the eye and removal of a metallic foreign body from a wax model using the slit lamp.
Remediation: The teaching faculty provides real-time feedback and instruction until the student can correctly perform the procedure.
8. Objective: Accurately measure intraocular pressure using applanation and indentation tonometry.
Method of Measurement: During Ophthalmology Lab, a teaching faculty directly observes the student measure the pressure of another student's closed eye using an electronic applanation device and a Shiotz tonometer.
Remediation: The teaching faculty provides real-time feedback and instruction until the student can correctly perform the procedure.
9. Objective: Visualize the ocular fundus using a panophthalmoscope.
Method of Measurement: During Ophthalmology Lab, a teaching faculty directly observes the student using a panopthalmoscope to visualize another student's fundus.
Remediation: The teaching faculty provides real-time feedback and instruction until the student can correctly perform the procedure.
10. Objective: Perform general eye care techniques such as pH measurement, fluorescein staining, and eye drop instillation in a manner comfortable for the patient.
Method of Measurement: During Ophthalmology Lab, the teaching faculty directly observes the student performing these techniques on another student.
Remediation: The teaching faculty provides real-time feedback and instruction until the student can correctly perform the procedure.
11. Objective: Apply a fiberglass posterior-mold splint to immobilize an extremity injury.
Method of Measurement: During Splint Lab, the teaching faculty directly observes the student applying splints to a fellow student. Splint types include: long/short arm splints, thumb spica splints, long/short leg splints, finger splint, boxer fracture splint, and sugar tong splint.
Remediation: The teaching faculty provides real-time feedback and instruction until the student can correctly perform the procedure
12. Objective: Master common skin-closure and suture techniques.
Method of Measurement: During Suture Lab, the teaching faculty directly observes the student performing skin-closure and suture techniques using a bovine model. Suture closure methods include simple interrupted, continuous, horizontal mattress, vertical mattress, half-buried horizontal mattress, and subcutaneous sutures. Other skin-closure techniques include stapling and tissue-adhesive application.
Remediation: The teaching faculty and/or a chief student provide real-time feedback and instruction until the student can correctly perform the procedure.
Professionalism
1. Objective: Attend and actively participate in weekly teaching conference.
Method of Measurement: The medical student coordinator maintains conference attendance sing-in logs, with a requirement of at least 75% of conferences attended to remain in good standing. The medical student coordinator observes the student's participation during didactic lectures.
Remediation: The medical student coordinator provides strong encouragement to participate. In recalcitrant cases of poor attendance, the PD may impose negative consequences (extra shifts, presentations, etc.), student probation or suspension.
2. Objective: Complete medical charts accurately and in a timely fashion.
Method of Measurement: Chart completion is monitored by the hospital's medical record department and by the department's medical billing and coding company.
Remediation: The medical student coordinator and teaching faculty provide strong encouragement and strategies for effective documentation. In recalcitrant cases of poor chart completion the medical student coordinator may impose student negative consequences, probation, or suspension.
3. Objective: Demonstrate a habit of timely arrival for clinical shifts.
Method of Measurement: The teaching faculty and fellow students directly observe the student's arrival for clinical shifts.
Remediation: Strong encouragement by the medical student coordinator and chief students.
4. Objective: Pursue opportunities to deliver patient care in an honest, respectful and mature manner. Take responsibility for errors in patient care.
Method of Measurement: Teaching faculty, chief students, and ancillary staff directly observe the student's interactions with patients and staff during clinical shifts.
Remediation: The medical student coordinator and chief students provide guidance and strong encouragement. Outside professional counseling may be used for students with continued or serious deficits.
Interpersonal skills/Communication
1. Objective: Communicate effectively with the patient and/or family to gain information regarding the patient's history, symptoms, and risk factors.
Method of Measurement: The teaching faculty directly observe the student's interactions with patients and family in the emergency department.
Remediation: The teaching faculty provides the student with real-time feedback and instruction.
2. Objective: Develop and present a student lecture.
Method of Measurement: The teaching faculty and/or the medical student coordinator attend the student's lecture during weekly teaching conference.
Remediation: The teaching faculty and fellow students provides the student with real-time feedback.
3. Objective: Develop telephone communication skills that facilitate accurate, professional and collegial exchange of information with primary care physicians, specialty consultants, and off-service students.
Method of Measurement: The teaching faculty directly observe the student's phone communications with attending and student house staff.
Remediation: The teaching faculty provides the student with real-time feedback as well as strategies for effective communication.
4. Objective: Presenting patient cases to emergency medicine faculty in a concise, organized and accurate manner.
Method of Measurement: The teaching faculty directly observe the student's case presentations during individual patient encounters.
Remediation: The teaching faculty provides the student with real-time feedback as well as strategies for effective case presentation.
System Based Practice
1. Objective: Communicate effectively with pre-hospital care providers via telemetry radio and assimilate the information provided into patient assessment and management.
Method of Measurement: During the EMS Base Station Course the EMS Course Director directly observes the student's use of the telemetry radio. During clinical shifts the teaching faculty and nurses certified in the use of the telemetry radio directly observe the student's interaction with EMS personnel. EMS department leadership periodically reviews telemetry tapes.
Remediation: The teaching faculty or EMS Course Director provides real-time feedback and instruction.
2. Objective: Utilize standing order forms for DKA, CHF, ACS, sepsis, anticoagulation, AMI, etc.
Method of Measurement: The teaching faculty directly observe the student's utilization of these forms. The departmental Performance Improvement Committee also monitors usage.
Remediation: The teaching faculty provides real-time feedback and instruction. The Performance Improvement Committee also provides feedback and encouragement.
3. Objective: Know the appropriate indications for specialty consultation.
Method of Measurement: The teaching faculty directly observe the student's consultation with specialty services in the emergency department. Consultants provide feedback to the medical student coordinator regarding student performance on specialty rotations, as well as selected clinical cases.
Remediation: The teaching faculty provides real-time feedback and instruction.
Practice Based Learning and Improvement
Objective: Use experiences gained from clinical encounters to direct learning strategies that will favorably impact future clinical outcomes.
Method of Measurement: The medical student coordinator reviews the student's patients' logs at at the end of the monthly rotation. The teaching faculty directly observe the student's presentation of clinical follow-up cases at the student conferences.
Remediation: The medical student coordinator and teaching faculty provide real-time feedback regarding adequacy of follow-up.