EMD 840 - Acute Resuscitation in Emergency Medicine Subinternship (AREM)

Clerkship Coordinator:

Sonya Martyna-Seaman / Emergency Medicine Program Manager

EMD 840 - Acute Resuscitation in Emergency Medicine Subinternship (AREM)

Special Note:

Special Note:

*PREREQISITE REQUIRED: Emergency Medicine/Critical Care (EMD 845) course or equivalent course.

UA COM-T students may use Oasis to register for this course.

Out-of-State/visiting students must apply through the VSAS application system: https://www.aamc.org/students/medstudents/vsas/

See Out-of-State/visiting students link https://emergencymed.arizona.edu/ for requirements for application requirements.

Year:

Fourth-Year Only

Offered:

All year-round

Prerequisites:

Must have a Fourth-Year Emergency Medicine Rotation

Course Director:

Christopher G. Williams, MD

Contact Phone:

(520) 621-5300

Contact Email:

cdub@aemrc.arizona.edu

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Goals and Objectives

Goals/Objectives:

The AREM Subi elective is designed to provide students with an intensive patient care experience, serving in an intern like capacity in an emergency department. Students will become familiar with common emergent problems; gain skills and understanding in providing care for patients who enter the emergency medical system and hone their ability to apply these skills to the solution of complex problems in emergency care. Sub-interns will participate in patient care in a responsible role supervised by resident or attending faculty. Sub-interns will provide care for assigned patients in the emergency department, performing history and physical examinations, creating an assessment and management plan, writing orders (under direct supervision of a resident and attending), and determining disposition of the patient. Along with the residents, Sub-interns will attend and participate in conferences as assigned.

Educational Objectives

During this course students will:

1. Become familiar with common emergent problems.
2. Hone bedside history and physical examination skills.
3. Be directly involved in patient care in the ED. You will serve as the patient’s primary provider, performing appropriate procedures, documenting the patient’s ED course in Cerner, and discussing the patient with physicians and consultants from other services.

Upon completion of this course students will be able to:

1. Perform basic emergency medical procedures.
2. Interpret diagnostic tests germane to the acute care setting.
3. Develop a sense of professionalism while working closely with residents, faculty, and staff.
4. Respond to the patient’s concerns and needs and establish a trusting relationship while informing, educating, and enlisting the patient to participate in his or her health care decision.
5. Present clinical information, both in the verbal and written format, in a concise and coherent manner.

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Format

Format:

AREM Curriculum: The original CDEM curriculum was crafted with an audience for M4 students. It was meant to capture the most common conditions a fourth-year student would encounter while rotating in the ED. Manthey DE, Ander DS, Gordon DC, et al. Emergency medicine clerkship curriculum: an update and revision. Acad Emerg Med. 2010;17(6):638-643. LINK: https://www.saem.org/about-saem/academies-interest-groups-affiliates2/cd...

14 END of Clinical Shifts Survey/Assessment submittals.
Students will need to collect END of Clinical Shifts Survey/Assessment from EACH assigned shift.
Failure to collect will result in a 7 % deduction from the overall grade.

Faculty and/or departmental residents/fellows will evaluate the student's clinical performance by assessing:

Medical knowledge; Exhibits appropriate knowledge and understanding of basic pathophysiological processes; Demonstrates critical thinking and clinical decision making.
Patient Care; Conducts accurate history and physical exams: Demonstrates competence in performing exam procedures.
Practice-Based Learning: Shows progressive improvement throughout rotation; Learning from mistakes.
Interpersonal & Communication Skills: Presents concise, accurate and pertinent information; Provides patient/faculty/resident with clear instructions appropriate to their educational level.
Systems-Based Practice: Demonstrates knowledge of broader health care resources available in the community; Completes patient encounters in a timely manner.
Professionalism: Demonstrates punctuality, accountability & honesty; Arrives well-prepared, actively seeks responsibility beyond the scope of expectation.

Aquifer Cases – Complete cases when not on shift.

SAEM Exam – Last day of rotation.

Course Requirements

Course Requirements:

AREM Curriculum: The original CDEM curriculum was crafted with an audience for M4 students. It was meant to capture the most common conditions a fourth-year student would encounter while rotating in the ED. Manthey DE, Ander DS, Gordon DC, et al. Emergency medicine clerkship curriculum: an update and revision. Acad Emerg Med. 2010;17(6):638-643. LINK: https://www.saem.org/about-saem/academies-interest-groups-affiliates2/cd...

14 END of Clinical Shifts

Qualtrics Survey/Assessment submittals: Students will need to collect 14 END of Clinical Shifts Survey/Assessment from EACH assigned shift. Failure to collect will result in a 7 % deduction from the overall grade.

Types of shifts will include:

1 Pharmacology Shift
1 Ultrasound Shift
2 Faculty Shifts
5 Resus Shifts
5 Resident Shifts

Faculty and/or departmental residents/fellows will evaluate the student's clinical performance by assessing:

Medical knowledge; Exhibits appropriate knowledge and understanding of basic pathophysiological processes; Demonstrates critical thinking and clinical decision making.
Patient Care; Conducts accurate history and physical exams: Demonstrates competence in performing exam procedures.
Practice-Based Learning: Shows progressive improvement throughout rotation; Learning from mistakes.
Interpersonal & Communication Skills: Presents concise, accurate and pertinent information; Provides patient/faculty/resident with clear instructions appropriate to their educational level.
Systems-Based Practice: Demonstrates knowledge of broader health care resources available in the community; Completes patient encounters in a timely manner.
Professionalism: Demonstrates punctuality, accountability & honesty; Arrives well-prepared, actively seeks responsibility beyond the scope of expectation.

Aquifer Cases: Complete cases when not on shift.

SAEM Final Exam: Last day of rotation.

Evaluation Methods

Evaluation Methods/Grades:

Completion of all 14 clinical shifts in this rotation is mandatory. There are a limited number of “open” shifts that will serve as back-up shifts if an emergency arises. If you are unexpectedly unable to work one of your shifts, please email the coordinator in order to schedule a make-up shift. If one is unable to work a shift, it is their responsibility to find another comparable shift to work within the rotation. Like shifts may be traded with your other students pending the coordinators approval. It is the student’s responsibility to make sure the master schedule accurately reflects one's individual schedule. The standard College of Medicine-Tucson form for Faculty Assessment of Student Performance in Patient Care Elective Courses will be used with the grades of Honors, High Pass, Pass, and Fail.

Grading Components:

Assessed performance during clinical shifts (70%)
Aquifer Cases (10%)
SAEM Final Exam (20%)

All aspects of this rotation mandatory and will impact the student’s final grade. If is student is unable to complete one of the activities a grade of Incomplete for the rotation will be issues until the student can make up that activity.

Grading Scale:

Honors 92% - 100%
High Pass 88% - 91.9%
Pass 70% - 87.9%
Fail 0% - 69.9%

The following list, while not exhaustive, should help to clarify what is included in the Professionalism throughout the elective. Students will:

Complete credentialing paperwork and site-specific requirements such as, but not limited to, fingerprinting and drug screening, by the stated deadline.
Respond to emails in a timely manner (within 1 business day)
Refrain from using smartphones during meetings/sessions/didactics
Be considerate to staff, faculty, residents, patients, and other learners
Be on time for required meetings/sessions, stay for your entire shift and do not leave without permission or until dismissed.
Obtain advance permission from the clerkship director/coordinator for absences from activities and/or wards; inform appropriate residents and/or attendings
Be punctual and comply with SAEM proctoring rules
Attend Mid-Clerkship Formative Feedback meeting and return signed form

University of Arizona Policies:

Absence and Class Participation Policy

The UA’s policy concerning Class Attendance and Participation is available at https://catalog.arizona.edu/policy/courses-credit/courses/class-attendan....

The UA policy regarding absences for any sincerely held religious belief, observance or practice will be accommodated where reasonable: http://policy.arizona.edu/human-resources/religious-accommodation-policy.

Classroom Behavior/Attendance Policy

To foster a positive learning environment, students and instructors have a shared responsibility. We want a safe, welcoming, and inclusive environment where all of us feel comfortable with each other and where we can challenge ourselves to succeed. To that end, our focus is on the tasks at hand and not on extraneous activities (e.g., texting, chatting, reading a newspaper, making phone calls, web surfing, etc.).

Students are asked to refrain from disruptive conversations with people sitting around them during lecture. Students observed engaging in disruptive activity will be asked to cease this behavior. Those who continue to disrupt the class will be asked to leave lecture or discussion and may be reported to the Dean of Students.

College of Medicine – Tucson Attendance Policy: https://medicine.arizona.edu/form/attendance-policies-medical-students-com

Threatening Behavior Policy

The UA Threatening Behavior by Students Policy prohibits threats of physical harm to any member of the University community, including to oneself. See http://policy.arizona.edu/education-and-student-affairs/threatening-beha....

Accessibility and Accommodations

At the University of Arizona, we strive to make learning experiences as accessible as possible. If you anticipate or experience barriers based on disability or pregnancy, please contact the Disability Resource Center (520-621-3268, https://drc.arizona.edu/) to establish reasonable accommodations.

Code of Academic Integrity

Students are encouraged to share intellectual views and discuss freely the principles and applications of course materials. However, graded work/exercises must be the product of independent effort unless otherwise instructed. Students are expected to adhere to the UA Code of Academic Integrity as described in the UA General Catalog. See: http://deanofstudents.arizona.edu/academic-integrity/students/academic-i....

The University Libraries have some excellent tips for avoiding plagiarism, available at http://new.library.arizona.edu/research/citing/plagiarism.

UA Nondiscrimination and Anti-harassment Policy

The University is committed to creating and maintaining an environment free of discrimination; see https://policy.arizona.edu/human-resources/nondiscrimination-and-anti-ha...

Our classroom is a place where everyone is encouraged to express well-formed opinions and their reasons for those opinions. We also want to create a tolerant and open environment where such opinions can be expressed without resorting to bullying or discrimination of others.

Confidentiality of Student Records https://registrar.arizona.edu/privacy-ferpa/about-ferpa

Professional Conduct Comment website: Professional Conduct Comment | College of Medicine - Tucson (arizona.edu) The Professional Conduct Comment Form provides a mechanism for faculty, residents, fellows, medical students, and staff to report to the Professionalism Program either exemplary professional behavior OR lapses in professional behavior.

Subject to Change Statement

Information contained in the course syllabus, other than the grade and absence policy, may be subject to change with advance notice, as deemed appropriate by the instructor.

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Rotation Schedule

Start dates AY 24-25

EMCC-03: 7/1 - 7/26/2024
EMCC-04: 7/29 - 8/23/2024
EMCC-05: 8/26 - 9/20/2024
EMCC-06: 9/23 - 10/18/2024
EMCC-07: 10/21 - 11/15/2024
EMCC-08: 11/18 - 12/13/2024
EMCC-09: 1/6 - 1/31/2025
Application of Clinical Medicine Required Course: 2/3 - 2/28/2025
EMCC-10: 3/3 - 3/28/2025
EMCC-11: 3/31 - 4/25/2025

Days and times are subject to change.

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EMD 840 - Acute Resuscitation in Emergency Medicine Subinternship (AREM)

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