ANEU-4021 - Anesthesiology Quality Improvement and Patient Safety

ANEU-4021 - Anesthesiology Quality Improvement and Patient Safety

Elective Title: Anesthesiology Quality Improvement and Patient Safety
Course Number: ANEU-4021
Elective Type: research Duration/Weeks: 4 Max Enrollment: 5
Prerequisites: Successful completion of Year 2
Additional Requirements: Must have approval by a ANEU faculty prior to enrollment. An R form & CITI Basic Training & CITI Best Clinical Practice Training must be submitted at least 60 days in advance of the start of the elective.
Responsible Faculty Director: Dr. Rovnat Babazade Periods Offered: 1-13 including holiday period 8 
Coordinator: Lyndsey Phillips Other Faculty: Any ANEU faculty approved by Dr. Babazade.
Location to Report on First Day:
This will be arranged with the faculty you have been assigned to. for any questions, please contact Lyndsey Phillips @ lnphilli@utmb.edu

Goals
The goal of this elective is to provide the third and fourth year medical student with research experience through collaboration with an exemplary faculty to design a Quality Improvement project, a medical device, a protocol, tool, simulation case design or medical education program for improving the safety and quality of the services provided by anesthesiologists and the implications for patient care of public health.

Objectives
Discuss the scientific/theoretical basis of the project in which he or she participates, the ethical and regulatory issues, and the processes that lead to a research project that has translational implications to enhance clinical care of public health.

Identify and attend/participate in relevant research-related meetings, trainings and seminars.

Description of course activities
Research-centered experiences during a 4-week period. Research activities will depend on the interests of the student and the mentor; options for activities must be described in the written plan and approved by mentor before submission. Activities may include product design, reverse engineering, study design, preparation of review committee documents to meet federal regulations, training and performing human subject consents, training and using laboratory equipment, assisting in research procedures, developing evidence based patient care protocols that contribute to patient safety, and collection and/or analysis of data for research/Quality Improvement projects.

Following are the study courses you will need to complete and provide training certificates:

1. CITI-Basic,
2. Good Clinical Practice,
3. Biomedical Research
4. Human Subject Research course provided on the CITI website. (Click Research, IRB, CITI Mandatory Training, log in with UTMB Log in, select and complete courses).
5. R form
6. Conflict of Interest (COI) (In your UTMB my training) Part 1 - Conflict of Interest Training - Required Every 4 Years
Go to the iUTMB homepage and click the top left tab "Annual Online Training";
Logon with your UTMB username and password;
Locate the Conflict of Interest for Researchers module under My Required Training on the homepage; Select this module, then click the arrow on the right side of the page to launch it;
View the PowerPoint presentation completely and answer the attestation question to receive credit.
7. Disclaimer: Part 2 Annual Disclosure of Compensated Outside Activities and Financial Interests, Log onto the U.T. System portal at http://outsideactivity.utsystem.edu/; Acknowledge you have read the policies; Click Return to Employee Portal; Choose either Make a New Disclosure and follow the prompts; OR choose Report No Activity located on the right side of the toolbar; Be sure the system acknowledges your disclosure or declaration before logging out.

Steps for Accessing CITI Training:
1) Go to the iUTMB Home Page
2) Research Heading
3) Click the drop Down Arrow & select Research Services
4) Click IRB
5) Click CITI Program Mandatory Training
6) Once the training is completed, send a copy of the certificate to the Anesthesiology Coordinator, Kathryn Gwinn (kagwinn@utmb.edu).

Type of students who would benefit from the course
This multidisciplinary elective course should be of particular interest to students who wish to pursue a career that includes hospital management, academic medicine, medical and graduate education, or product design.

    Weekly Schedule
          Estimated Course Activities (Start-Time/Finish-Time):
Day of Week   AM   PM
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

 Average number of patients seen per week:
 Call Schedule:

Research / Other Course Activities
(estimated schedule)
Activity Hours per Week
Faculty Contact-Time 10% ~4 Hours
Self-Directed Study 40% ~16 Hours
Data-Collection/Analysis 40% ~16 Hours
Other Attendance at meetings and seminars 10% ~4 Hours


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?
   
  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?
    The student will present to their faculty sponsor and may present to other faculty, residents and students.
  B. Frequency / Duration of Presentation(s)?
    Once at the end of the course or more frequently depending on what the mentor and student agree upon.
  C. Format - What guidelines are set for the student's presentation?
    Oral presentation may be in the form of a presentation of research findings, product display and "safe pitch", participation in a journal club or similar activity depending on the nature of the students project.
  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)?
    A required written plan at the beginning and a required written report at the end. The student and mentor may elect to include other written assignments, as appropriate for the experience and the particular project. The final written product should be at least 5 pages in length, not including references or figures.
  B. Format - What guidelines are set for the student's written work?
    A written plan will be prepared by the student, following the provided guidelines, at the beginning of the course. The plan will describe objectives and how they are to be achieved. The report should make clear how the project contributes to improving the safety and quality of the services provided by anesthesiologists and the implications for patient care of public health.
  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?
    May be required depending on type of project.
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
    Content will be selected by the student and mentor, with guidance from the Course Director, and described in the written plan at the beginning of the course.
  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)?
    The students will gain experience in professional behavior in a clinical/translational research seeting. The student will identify and attend/participate in relevant training seminars, journal clubs or other specific activities identified by research mentor.

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.
    Other modes of evaluation might be used and would be described in the initial plan prepared by the student and mentor or in the final report.

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.