EMD 845 - EMERGENCY MEDICINE/CRITICAL CARE | Department of Emergency Medicine

Clerkship Coordinator:

Sonya Martyna-Seaman / Emergency Medicine Program Manager

(520) 621-5300

EMD 845 - EMERGENCY MEDICINE/CRITICAL CARE

Special Note:

This is a REQUIRED Clerkship Rotation for 4th year UA Medical Students. UA Medical Students must use Oasis to register for this course.

As an elective for Out-of-State Students, you must apply through the VSAS application system: https://www.aamc.org/students/medstudents/vsas/

Eligibility: In order to be a visiting student at the University of Arizona/Emergency Department, you must:

be in your 4th year of medical school at an LCME or COCA accredited program.
attend a university that has an affiliation agreement with the College of Medicine – Tucson.
have either BLS or ACLS training that has not expired.
Pass on USMLE Step 1 or COMLEX Level 1 and then either have completed or scheduled a USMLE Step 2 exam in 2023.

Year:

Fourth-Year Only

Prerequisites:

Senior standing or consent of Departmental Electives Coordinator

Course Director:

Hans Bradshaw, MD

Contact Email:

hbradshaw@aemrc.arizona.edu

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Goals and Objectives

Goals/Objectives:

This clerkship is designed to provide students with an intensive patient care experience in the emergency department as well as the intensive care unit. Students will be given an overview of the principles and concepts of the specialty of Emergency Medicine, with emphasis on the common presenting complaints and procedures in the undifferentiated patient. Additionally, students will experience how treatment in the Emergency Department affects the patient's subsequent hospitalization. Critical care concepts, such as ventilation management, hemodynamic monitoring and pressor management, critical care pharmacology and social and behavioral concepts affecting patient management at this level will be addressed. When not working clinically (14 shifts), students will be required to attend a minimum of 2 Emergency Department’s teaching conferences, have reading assignments and complete Aquifer cases.

Attendance is required for the first day (orientation), Mid-Clerkship evaluation and the last Friday (exam day) of the rotation. The shift schedule during the rest of the month is flexible and will be developed by the Course Coordinator 2 weeks before the rotation begins. Please contact the Course Coordinator with any requests outside the mandatory dates at least 2 weeks before your rotation begins.

Click here for: Emergency Medicine Clerkship Curriculum: An Update and Revision. Published in 2010 by the Society for Academic Emergency Medicine.

Educational Objectives

During this course students will:

Experience EM medicine from the perspective of critical care management to patient resuscitation to staffing critically ill patients with residents and faculty.
Experience the complexities and challenges faced in the ICU.
Develop the skills to evaluate an undifferentiated patient.
Interpret the results of common diagnostic procedures and tests.

Patient care

Obtain an accurate history and physical examination focused on key problems
Recognize immediate life-threatening illnesses
Patient management skills:
- Develop an evaluation and treatment plan
- Monitor the response to therapeutic interventions
- Make proper disposition and follow-up plans for the patient
Procedural skills:
- Learn the indications and contraindications for basic procedural skills
- Perform basic procedural skills
Health promotion:
- Discuss preventable injuries and illnesses
- Educate patients and insure comprehension of their outpatient treatment plan

Medical knowledge

Develop the skills to evaluate an undifferentiated patient
Development of a differential diagnosis
- Hierarchy based on the initial patient presentation and acuity
- Be aware of worst-case diagnoses
Develop a diagnostic and management plan for the evaluation of the patient, based on differential diagnosis
Interpret the results of common diagnostic procedures and tests

Practice-based learning

Effectively use available information technology to solve patient care problems, improve knowledge base, and develop case presentations

Interpersonal and communication skills

Humanistic qualities:
- Effectively communicate with patients and family members
- Show compassion and a nonjudgmental approach to all patients
- Work in a collegial manner within a health care team
Presentation skills:
- Present cases in a complete, concise, and orderly pattern
- Clearly delineate primary problems and management plan
- Effectively communicate with consultants and admitting services
- Complete documentation that is accurate, well organized, and appropriate for the level of care provided

Professionalism

Be conscientious, on time, and responsible
Exhibit honesty and integrity in patient care
Practice ethical decision making
Exercise accountability
Maintain a professional appearance
Be sensitive to culture issues (age, sex, culture, disability, etc.)
Work in a collegial manner with other members of the healthcare team
Practice self-directed learning (i.e. reading/learning outside of scheduled clinical duties)

System-based practice

Make appropriate referrals from the ED
Understand the role of emergency medicine in the community, including emergency medical services
Understand how access to care impacts patient care

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Format

Format:

This course will consist of laboratory and didactic sessions, self-directed online learning modules, Emergency Department and Intensive Care Unit shifts, Aquifer cases and a final written exam.

Evaluation Methods

Evaluation Methods/Grades:

Integrated Emergency Medicine & Critical Care

Course Objectives

This elective is designed to provide students with an intensive patient care experience in the emergency department as well as the intensive care unit. During this course students will:

Experience EM medicine from the perspective of critical care management, to patient resuscitation to staffing critically ill patients with residents and faculty
Experience the complexities and challenges faced in the ICU
Develop the skills to evaluate an undifferentiated patient
Interpret the results of common diagnostic procedures and tests

Expected Learning Outcomes

Upon completion of this course students will be able to:

Recognize immediate life-threatening illnesses
Develop a sense of professionalism while working closely with residents and faculty
Obtain an accurate history and physical examination focused on key problems
Present critically ill patients on rounds in an efficient and clear manner
Educate patients and ensure comprehension of their outpatient treatment plan

Before attending your first day of orientation, it is strongly suggested that students view all lecture videos. The information provided in these videos is crucial to ones success in this course.

Grading Scale and Policies

Grades Components:

Attendance
Assessed performance during clinical shifts
WBA Evaluations
Aquifer cases
NBME Shelf exam score
Professionalism

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.

All aspects of this rotation, including didactic activities, ED shifts and critical care time, are 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. The final grade will be calculated based on your performance on clinical shifts, in didactic sessions, on the end of rotation EM exam and in the critical care workbook.

We anticipate that roughly 25% of students who complete the rotation will earn honors, 25% will earn a “high pass” and 50% will pass.

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.

UNIVERSITY OF ARIZONA/COLLEGE OF MEDICINE 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-c...

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 for upcoming AY 2023-2024
EMCC-001 3/27/2023 - 4/21/2023
EMCC-002 5/8/2023 - 6/2/2023
EMCC-003 6/5/2023 - 6/30/2023
EMCC-004 7/3/2023 - 7/28/2023
EMCC-005 7/31/2023 8/25/2023
EMCC-006 8/28/2023 - 9/22/2023
EMCC-007 9/25/2023 - 10/20/2023
EMCC-008 10/23/2023 - 11/17/2023
EMCC-009 11/20/2023 - 12/15/2023
EMCC-010 1/2/2024 - 1/26/2024
EMCC-011 2/26/2024 - 3/22/2024
EMCC-012 3/25/2024 - 4/19/2024

Days and times are subject to change.

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EMD 845 - EMERGENCY MEDICINE/CRITICAL CARE

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System-based practice

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