DERU-4055 - Dermatology Consults 2 week elective

DERU-4055 - Dermatology Consults 2 week elective

Elective Title: Dermatology Consults 2 week elective
Course Number: DERU-4055
Elective Type: clinical • Direct Patient Care Duration/Weeks: 2 Max Enrollment: 1
Prerequisites: Successful completion of Year 2
Additional Requirements: C-Form required. Please contact Reynol Lopez (reynlope@utmb.edu)
Responsible Faculty Director: Anthony Linfante, MD Periods Offered: 1A-13A or 1B-13B including holiday period 8 
Coordinator: Reynol Lopez Other Faculty: Brent Kelly, MD; Bernard Gibson, MD; Brandon Goodwin, MD
Location to Report on First Day:
4.112 McCullough Building

Goals
1. Develop an understanding of common dermatology consults in hospitalized patients.
2. Recognize cutaneous manifestations of internal diseases.

Objectives
1. Understand the types of drug eruptions seen in hospitalized patients and the top 5 drugs that cause each type.
2. Know the causes of vasculitides and vasculopathies that can occur in hospitalized patients and be able to differentiate them.
3. Understand treatments available for lower extremity wound care.
4. Understand the causes and treatments for neutrophilic disorders, including pyoderma gangrenosum.

Description of course activities
Students will report to UHC for 8:00 AM morning lecture and then see patients in our outpatient clinic, working alongside our faculty and residents. Over lunch and in the afternoon, they will see UTMB inpatient consults (including those in TDCJ) with faculty and the dedicated consult resident. Generally, there are around 2-3 new consults per day. There are both formal consult lectures and informal bedside teaching. Afternoon duties including rounding on our previous consults, assisting the resident in writing notes, and communicating with the patient’s primary team. The day generally concludes between 5:00-5:30 PM.
In addition to formal lectures, self-directed reading is strongly encouraged. The American Academy of Dermatology’s “Basic Dermatology Curriculum” is online for free. Additionally, “Lookingbill and Marks’ Principles of Dermatology” textbook is available through the online UTMB library for free. These resources are both at the level of a 3rd or 4th year medical student. The student will present a 10-15 minute presentation to the department on a topic of their choosing at the end of the rotation.

Type of students who would benefit from the course
Those interested in pursuing residencies in Dermatology or those entering primary care that wish to increase their knowledge of cutaneous diseases.

    Weekly Schedule
          Estimated Course Activities (Start-Time/Finish-Time):
Day of Week   AM   PM
Monday 8 5
Tuesday 8 5
Wednesday 8 5
Thursday 8 5
Friday 8 5
Saturday
Sunday

 Average number of patients seen per week: Varies. Likely 2-3 consults/day + clinic patients
 Call Schedule: N/A

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?
   
  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?
    Dermatology Department
  B. Frequency / Duration of Presentation(s)?
   
  C. Format - What guidelines are set for the student's presentation?
    5-10 presentation on an interesting patient seen on the consult service. Powerpoint is preferred.
  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)?
    As EPIC allows, we plan to include student notes in the chart.
  B. Format - What guidelines are set for the student's written work?
    Daily notes and consult notes (per EPIC)
  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?
   
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
   
  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)?
    Tuesday afternoon TDC clinic. Friday mornings are resident conference time including 9am Grand Rounds and Noon Journal Club.

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.
   

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.