DERU-4007 - Skin Diseases Depicted in Film

DERU-4007 - Skin Diseases Depicted in Film

Elective Title: Skin Diseases Depicted in Film
Course Number: DERU-4007
Elective Type: career Duration/Weeks: 4 Max Enrollment: 3
Prerequisites: Successful completion of Year 2
Additional Requirements: N/A
Responsible Faculty Director: Richard Wagner, MD Periods Offered: 1-3; 5-13 including holiday period 8 
Coordinator: Reynol Lopez Other Faculty:
Location to Report on First Day:
Virtual Call Meeting

Goals
Elective students will be joined with senior UTMB medical students taking this course to meet their BSHS Selective graduation requirement. In this class, the impact of skin diseases on individuals and societal perceptions of those with skin diseases will be studied by viewing the required films. Students will view the assigned films weekly. On the last Thursday of the period, students must each submit an original essay about one of the three following topics: 1) the impact of a specific skin disease faced by someone they know; 2) the impact of a specific skin disease on a historical figure taken from politics, science or the arts; or 3) a critique for a movie that has not been discussed in the course (available from dermatology film library)or another film with skin disease content.

Objectives
The first class session will address critical constructs used to analyze film through an orientation lecture and class discussion. Additional references and resources for further reading on this topic will be provided in the course syllabus. Special emphasis in this course will be consideration of the following 3 dermatology issues: 1) How accurately was the skin disease portrayed, in terms of cinematic appearance and clinical course; 2) What specific social interactions related to the skin disease were portrayed in the film; and 3) What choices did the character make that were related to his/her skin disease? The Dermatology Department will maintain a course film library for students.

Examples of the 17 films currently covered in the course (subject to change) are:

Dallas Buyers Club (2013): Role of Kaposi's Sarcoma as part of the historical epidemiology of AIDS/HIV.

Kingdom of Heaven (2005): Historical importance of Hanson's Disease (leprosy).

Death Becomes Her (1992): The cultural fixation with maintaining a perpetual youthful appearance is the comedic theme of this film. The impact of natural aging and society's response will be studied.


Description of course activities
This course is offered both as an elective (DERU 4007) and as a Selective (DERU 4051). It is not possible to switch from DERU 4007 into DERU 4051 or from DERU 4051 to DERU 4007 once the Period has started. Students are not permitted to receive academic credit for both of these courses. In addition, students taking either DERU 4007 or DERU 4051 for credit may not receive credit in elective DERU 4017 or in Selective DERU 4402 due to the overlapping nature of these classes.

1. Virtual student excused absences require a written make-up assignment. There will be attendance taken for each class. Students should view the films and read the assigned articles scheduled for discussion prior to each class, take notes on the films, and be prepared to discuss them with special attention to the skin disease(s) depicted.
2. Write an original 5-10 page essay about the impact of skin disease on an unidentified person/patient the student has seen, about a historical figure with skin disease, or critically review another film that was not discussed in class from the dermatology department film library about the skin disease depicted. The Department of Dermatology makes an annual graduation award for the best MS4 student essay submitted during each academic year.
3. Please complete the course evaluation! Your comments are of value to the course director, future students, and the UTMB Elective Course Committee.

Class will meet twice weekly for two hours under dermatology faculty supervision for discussion of the assigned films. Since 40 hours are expected to be devoted weekly to this class, and 25 hours are "self study" time, this time should be spent in the following course activities: 1) View the films scheduled for each class at least 3 times. It is necessary for you to be extremely familiar with the film being discussed because of the film/media deconstruction methods that we will employ during our class meetings. One viewing is too superficial to accomplish these goals; 2) The text, Fitzpatrick''''s Color Atlas and Synopsis of Clinical Dermatology (available online through STAT!-Ref from the UTMB Moody Medical Library) should be carefully studied in relationship to the specific skin diseases depicted in film for the next class, with particular emphasis on the differential diagnosis of skin diseases with similar morphology to the skin disease depicted in the film studied and key differences of clinical diagnosis based on the photographs available in the Fitzpatrick text and internet resources. By the end of the course, students should be able to recognize the skin diseases studied by their morphology, presentation and skin distribution; 3)Prior to the class meeting, students are required to study aspects of film origination, including original text or screenplay, changes between the original work and the film (if any), previous or subsequent books or films by the writer/producer/director (is there any nexus between earlier and later works to the themes present in the movie currently being studied for class?).


Type of students who would benefit from the course
Students with an interest in skin diseases will benefit from this course. Visiting students may be particularly interested in this course because a similar course may not be offered at their school. UTMB medical students interested in this course may take it to satisfy their senior year BSHS selective requirement (but they need to be in the DERU-4051 section) or take it for elective credit (DERU-4007) but not both. Some previous students have been able to develop their required essays into peer-reviewed publications about skin disease portrayals in media.

    Weekly Schedule
          Estimated Course Activities (Start-Time/Finish-Time):
Day of Week   AM   PM
Monday 10-noon self-study
Tuesday self-study self-study
Wednesday self-study self-study
Thursday 10-noon self-study
Friday self-study self-study
Saturday no class no class
Sunday no class no class

 Average number of patients seen per week: didactic elective without clinical patient compone
 Call Schedule: none

Research / Other Course Activities
(estimated schedule)
Activity Hours per Week
Faculty Contact-Time
Self-Directed Study
Data-Collection/Analysis
Other


Method of Student Evaluation
1.  Clinical Observation
  A. Where are students observed on this elective?
    Inpatient Service   Ambulatory   Surgery   Standardized patients
Patients simulators   Other
  B. Frequency - How often are students observed clinically?
    The class meets with faculty twice a week for two hours each time (Monday mornings from 10 am to noon and on Thursday mornings from 10-noon in the Dermatology Conference Room, 4.130 McCullough Building. Off campus students may teleconference with the class. Missed classes require a written make-up assignment.
  C. Format - What method(s) are used to document the student's clinical performance?
    Daily oral feedback   End of period oral feedback   Written feedback
Other

2.  Oral Presentation
  A. Audience - To whom does the student present?
    Students present movie plot summaries or articles to the class and faculty during each class. These presentations are followed by class discussions with the class and faculty.
  B. Frequency / Duration of Presentation(s)?
    Each class meeting.
  C. Format - What guidelines are set for the student's presentation?
    The student should focus on the diagnosis of disease depicted in the assigned movie, epidemiology of disease, brief pathophophysiology of the disease, historic importance of the skin disease (if applicable), impact of the skin disease on life functions, diagnostic tests/criteria, differential diagnosis, treatment and prognosis
  D. Assessment - Who assesses the student's presentation performance?
    Self-assessment   Peer assessment   Faculty assessment
  E. Method of content selection
    Current cases  Student-selected topic   Assigned topic

3.  Written Assignment (H&P's, notes, papers, abstracts, etc.)
  A. Frequency of written assignment(s)?
    One required 5-10 page electronically submitted original essay to rfwagner@utmb.edu due on the last day of class by 5 pm cst.
  B. Format - What guidelines are set for the student's written work?
    5-10 page original essay (double-spaced).
  C. Length of written assignment(s)?
    Abstract   Annotated bibliography   1 - 2 page paper   3+ page paper
  D. Are recent references required?   No    If yes, how are they selected?
    If references are included, they should be selected by the student.
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
    student-selected
  F. Audience - Who assesses the student's written performance?
    Peer Assessment     Faculty Assessment     Other

4.  Examination
  Format
    Oral   Written multiple choice   Written essay / short answer   OSCE
Other

5.  Extra Course Activities
  What expectations do you have for the student to demonstrate participation in the elective (e.g. small group activities, seminars, thoughtful questions, providing resources, journal club, resident lecture attendance)?
    Students taking this elective are encouraged but not required to participate in the dermatology clinics and dermatology conferences. Many students have been able to publish their essays (with additional research and writing) in peer-reviewed medical journals.

6.  Additional Costs
  Please list any additional costs and/or purchases (books, materials, movies to watch, etc.) that are required for this course. Include an estimated total cost. If there are no additional costs, please enter "None".
    None

7.  Other Modes of Evaluation
  Please explain below.
    1. Students are required to attend or teleconference to all 8 scheduled classes or submit their written make-up class work in order to receive course credit. Attendance will be taken for each class. Students must view each film to be discussed prior to class (films may be borrowed from the dermatology department film library), take notes on each film to be discussed, and be prepared to critically discuss each film, with focus on the skin disease depicted.

2. An original 5-10 page essay about the impact of skin disease on an unidentified real person, historical figure, or an original critical review on another movie that depicts skin disease (students may borrow these films maintained by the dermatology department film library) must be electronically received by the Course Director, Dr. Wagner (rfwagner@utmb.edu) by 5 pm on the last Thursday of of the Period in order to receive course credit.

8.  If this course is an Acting Internship, please complete the following:
  A. Objectives for the AI should relate directly to the Entrustable Professional Activities (EPAs). Each AI should describe how the four key Year-4 EPAs that our school has identified as being Year-4 skills are assessed. The Year-4 objectives are:
1. Entering and discussing orders/prescriptions.
2. Give or receive patient handover to transition care responsibility.
3. Recognizing a patient requiring urgent or emergent care and initiating management.
4. Obtaining informed consent for tests and procedures.
Specify how the student will be given formative feedback on their clinical skills.
   
 
B.
Year-4 students should demonstrate mastery of EPAs they developed in the clerkship year, including recommending and interpreting common diagnostic and screening tests, and performing general procedures of a physician. They should be able to demonstrate masterfully and independently skills they mastered in Years 2-3, including efficiently performing comprehensive admission-notes and succinct daily progress notes and perform accurate, concise, and hypothesis-driven clinical presentations, form clinical questions and retrieve evidence to advance patient care. They should be able to demonstrate basic understanding of and beginning mastery of collaborate as a member of the interprofessional team and identify system failures and contribute to a culture of safety improvement.

List advanced clinical skills that a student will be assured an opportunity to practice.
   
 
C.
How specifically will this AI build on developing skills from the clerkship year to prepare students for internship?
   
 
D.
What opportunities will typically be available to all students who take this AI (procedures, required presentations, etc.)? What opportunities may be available based on patient load/presentation or student initiative (ie. Writing a case report)?
   
 
E.
An AI should have expectation of a minimum of 32 hours per week of clinical responsibilities. Duty hours should be capped at ACGME limits for an intern, thus up to 24 hours followed by 4 hours of activities related to patient safety, education, and handoff. Students cannot work more than 80 hours per week averaged over 4 weeks. They can only have 1 day off in a 7-day work week with 8 hours off between shifts.

Clinical responsibilities will vary depending on specialty, but how is the student functioning with work commensurate to a PGY1 with an appropriate level of training?
   
 
F.
How is the student demonstrating drawing clinical conclusions and/or developing a management plan and documentation as an intern would do?
   
 
G.
How and by whom will midpoint feedback be provided to the student? How will you remediate deficiencies identified at midpoint?
   
 
H.
Acting Internship students often seek letters of recommendation following their experience. How many different Faculty will work directly with the student and have knowledge of the student's abilities to detail in a written evaluation? Describe the degree of supervision and interaction with faculty vs. residents or other providers and how feedback will be obtained if more direct work is with residents or other providers.