year3surgeryclerkship% reviewedbythomas% … · 3.clinicaleducation–surgery(aamcgs2010)% ......
TRANSCRIPT
Year 3 Surgery Clerkship Reviewed by Thomas Frandsen (MEC)
Additional material prepared by David Nierenberg, MD
December 21, 2010
Organiza(on of Clerkship Review 1. Description of clerkship (Tom Frandsen) 2. Student evaluations end-‐of-‐clerkship AY 2009-‐10
(Tom Frandsen) 3. Student evaluations on AAMC Graduate Survey 2010 4. Shelf exam AY 2009-‐10 5. USMLE Step 2 CK results AY 2009-‐10 6. Career choice in Surgery (past 3 years) 7. Required clinical skills 8. Required conditions and diagnoses
1. Descrip(on of Clerkship Provided by Thomas Frandsen
2.Student evalua(ons (end of clerkship)
5
3. Clinical Educa(on – Quality (AAMC GS 2010)
1=Poor 2=Fair 3=Good 4=Excellent
Rate the quality of your educational experience in the following clerkships:
6
3. Clinical Educa(on – Quality (AAMC GS 2010)
1=Poor 2=Fair 3=Good 4=Excellent
Rate the quality of your educational experience in the following clerkships:
7
I received clear learning objectives for the clerkship.
My performance was assessed against the learning objectives.
I had an opportunity to follow a variety of patients (with different medical conditions).
Faculty members provided me with sufficient feedback on my performance.
3. Clinical Education – Surgery (AAMC GS 2010) 1=Strongly Disagree Agree 2=Disagree 3=Neutral 4=Agree 5=Strongly Agree
8
A faculty member personally observed me taking a patient history during the clerkship.
A faculty member personally observed me performing physical examinations during the clerkship.
3. Clinical Education – Surgery (AAMC GS 2010) 1=Strongly Disagree Agree 2=Disagree 3=Neutral 4=Agree 5=Strongly Agree
4. Shelf exam results AY 2009-‐10
5. USMLE STEP 2 CK RESULTS (AY 2009-‐10)
Students choosing General Surgery Residencies as career choice, 2008-‐2010 3-‐year rolling average, DMS seniors= 7.6% 3-‐year rolling average, National seniors = 5.5%
6. Required Clinical Skills (AY 09-‐10)
6. New Recommenda(ons for Clinical Skills Essential clinical skills (e.g. simple suturing, n=2)
Will be highlighted in DMEDS for emphasis An essential part of the clerkship experience Will be formally assessed for competency at end of clerkship Meeting the learning target is expected of each student Clinical grade will be based in part on meeting these learning targets
Recommended skills (e.g. incise and drain abscess, n=1) Have learning targets attached, but meeting target is not expected for
each one Learning these skills will provide greater breadth to your clerkship
experience Additional useful skills (e.g. insert feeding tube, n=0)
Can be checked off in DMEDS, but no learning targets have been attached
Will be useful to you when you begin your internship
6. New Essen(al Clinical Skills (proposed) (with input from Drs. Freeman, Burchard, and Henriques) # Area Skill N=
1 Interpret Dx Test CT of Abd, pelvis, or chest 10 (aggregated from 2 current items)
2 US of Abdomen 3
3 X-‐ray of Abdomen (KUB) 3
4 OR procedure Participate in any type of intra-‐abdominal surgery
5 (aggregated from 4 current items)
5 Procedure, complex Trauma resuscitation in ER 3
6 Procedure, simple Foley catheter (insert) 3
7 Local anesthetic (inject) 3
8 NG tube (place) 2
9 Suture removal 2
10 Suturing (simple, skin) 2
11 Interviewing HPI relevant to clerkship 10
12 PE Abdominal exam 15
13 Trauma emergency evaluation 2
14 Wound exam (post op) 5
15 Notes and presentations Oral presentation, inpatient admission 5
16 Written note, inpatient admission 5
Welcome to your Y3 Surgery Clerkship: The goal of this clerkship is to introduce you to the though`ul surgical approach to common condi(ons and diseases which can benefit from appropriate diagnosis, surgical management, and post-‐opera(ve management.
• This clerkship has selected 16 “essential” clinical skills that you must practice during the clerkship, and then demonstrate your competence to perform the skill prior to completion of the clerkship. Your final grade will be based in part on how well you meet these learning targets. These core clinical skills, and the learning targets for each one, are:
• (Dx) Interpret a CT scan of the abd/pelvis or chest (target = 10) • (Dx) Interpret an Ultrasound of the abdomen (target = 3) • (Dx) Interpret an X-‐ray (KUB) of the abdomen (target = 3) • (OR) Participate in the OR in an intra-‐abdominal surgical procedure (n=5) • (Procedure, complex) Participate in a trauma resuscitation in the ER (target = 3) • (Procedure, simple) Insert a foley catheter (target = 3) • (Procedure, simple) Inject a local anesthetic (target = 3) • (Procedure, simple) Place an NG tube (target = 2) • (Procedure, simple) Remove sutures (target = 2) • (Interview) Perform an HPI relevant to this clerkship (target = 10) • (PE) Perform an abdominal exam (target = 15) • (PE) Perform a trauma exam and evaluation (target = 2) • (PE) Perform a wound exam (post-‐op) (target = 5) • (Notes/presentions): Oral present a hospital admission (target = 5) • (Notes/presentations): Write an admission note (target = 5)
6. New Recommenda(ons for Diagnoses and Condi(ons Core, essential conditions (e.g. fever, post-‐op, n=2)
Will be highlighted in DMEDS for emphasis An essential part of the clerkship experience Meeting the learning target is expected of each student Clinical grade will be based in part on meeting these learning targets
Recommended conditions (e.g. bacteremia/sepsis, n=3) Have learning targets attached, but meeting target is not expected for
each one These will provide greater breadth to your clerkship experience
Additional useful conditions (e.g. hemorrhage, n=0) Can be checked off in DMEDS, but no learning targets have been
attached Will be helpful to you to see this and be familiar with it when you
begin your internship
7. New Essen(al Diagnoses and Condi(ons (proposed) (with input from Drs. Freeman, Burchard, and Henriques)
# Area Skill N= 1 Systemic Shock or SIRS 5 (aggregated from 2
current items)
2 Fever (post op) 2
3 Pain management 5
4 Cancer (any site) requiring surgery
2
5 Routine health, prevention Post-‐op care 10
6 GI system Abdominal pain 7
7 Abdominal trauma 4
8 Peritonitis or intra-‐abd abscess 3 (aggregated from 2 current items)
9 Bowel obstruction (large or small)
3(aggregated from 2 current items)
10 Respiratory system Acute resp failure 2
11 CT and musculoskeletal Complex infected wound 2
Welcome to your Y3 Surgery Clerkship: The goal of this clerkship is to introduce you to the though`ul surgical approach to common condi(ons and diseases which can benefit from appropriate diagnosis, surgical management, and post-‐opera(ve management.
• This clerkship has selected 11 “essential” conditions or diagnoses that you must see, learn about, and manage during the clerkship. Your final exams will test your knowledge about these conditions at the end of the clerkship. Your final grade will be based in part on how well you meet these learning targets. These essential conditions and diagnoses, and the learning targets for each one, are:
• (Systemic) Shock or SIRS (see and manage 5 patients) • (Systemic) Fever, post-‐op (see and manage 2 patients) • (Systemic) Pain management (see and manage 5 patients) • (Systemic) Cancer requiring surgery (see and manage 2 patients) • (Prevention) Post-‐perative care (see and manage 10 patients) • (GI system) Abdominal pain (see and manage 7 patients) • (GI system) Abdominal trauma (see and manage 4 patients) • (GI system) Peritonitis or intra-‐abdominal abscess (see and manage 3 patients) • (GI system) Bowel obstruction, large or small bowel (see and manage 3 patients) • (Respiratory system) Acute respiratory failure (see and manage 2 patients) ª (CT and MS system) Complex infected wound (see and manage 2 patients)