SYLLABUS
College of Medicine
AY 2015-2016
Course title and number
Term (e.g., Fall 200X)
Meeting times and location
MEID 809-00R Teamwork in Wilderness Medicine Elective
Spring 2016
3/21/16 – 4/1/16; The Retreat at Balcones Springs, Marble Falls, Texas
Course Description and Prerequisites
The purpose of the Teamwork in Wilderness Medicine Elective is to enable senior medical students to
excel as first year residents by providing a capstone experience that requires confident application of
medical knowledge and skills in challenging environments where success is only possible with effective
leadership and extraordinary teamwork. Prerequisites: 4th year status.
Instructor Information
Elective Director
Name
Telephone number
Email address
Office hours
Office location
Other instructors:
Coordinator
Ed Sherwood, MD
512-705-9759
Sherwood@medicine.t
amhsc.edu
By appointment
Round Rock Campus
Name
Telephone number
Email address
Office hours
Office location
Jody Ping
512-341-4997
ping@tamhsc.edu
8am – 5 pm
Round Rock Campus
Roque Ruggero, MD
Nelson Avery, MD
Tyler Jorgenson, MD
Learning Outcomes & Objectives
Goals: At the conclusion of this elective experience, participants will have…

Increased self-confidence derived from performing outside their “comfort zones;”

Improved communication skills in the face of extraordinary distractions;

Proficient team skills in stressful and challenging environments;

Achieved effectiveness in leading small groups to perform difficult tasks; and

Had fun.
Wilderness medicine requires meeting the challenges of working in a low resource environment.
Wilderness medicine requires one to look at delivering medical care from a unique perspective that is
not readily taught in most hospital or clinic based practices. In addition, requires exceptional leadership
and teamwork to achieve optimum outcomes. The learning objectives for this course fall under four
major competency goals:
Date Created/Revised: __5/22/15___ By: ___J Ping__ Revised R Ruggero 6/24/15

Participating as a safe and effective team member.

Leading a small team in the provision of urgent care under hazardous conditions without
incurring additional casualties;

Providing emergent field care for common wilderness medicine situations;

Achieving certification as a Wilderness First Responder (WFR).
The first week of this elective will consist of the Wilderness Upgrade for Medical Professionals (WUMP)
Course provided by the National Outdoor Leadership School (NOLS) taught primarily by NOLS faculty
assisted by COM faculty. The second week of this elective reinforces material learned during the first
week through extensive application in student-designed wilderness medical emergency simulations and
other outdoor activities.
Participants will need to arrive the evening before classes begin. Learning activities extend into the
evenings, allowing a generous break for the holiday weekend. The course delivery is at The Retreat at
Balcones Springs, 104 Balcones Springs Drive, Marble Falls, Texas 78654. Participants will need to
arrange their own transportation and reside at the venue during both weeks of the course.
Shared housing will be provided for Sunday through Friday of the first week and Monday through
Friday of the second week.
Participants that will be training in various outdoor settings and are required to bring the following
items for the course:

Hat for sun protection.

Boots with ankle support.

Suitable clothing for outdoor activities in temperatures ranging from 50 F. to 100 F.

Raingear suitable for search and rescue operations. Class exercises are conducted rain or
shine.

Headlamp and/or handheld flashlight with extra batteries.
We recommend that due to the strenuous nature of search and rescue activities; participants should be
in good physical condition and/or secure a professional evaluation of their medical condition prior to
enrolling in this course.
The NOLS Wilderness Upgrade for Medical Professionals requires a minimal enrollment of fifteen
(maximum of thirty) participants by July 1, 2015. If you want to take this elective, please contact course
coordinator prior to July 1, 2015.
VI. Course Objectives and Evaluation Method
Upon completion of the course, students will be able to:

Learn standard triage protocols

Learn how to maximize effectiveness in setting of overwhelmed medical resources

Learn common environmental emergencies

Learn basic orthopedic reduction techniques and splint applications

Create presentations on specific wilderness medicine topics

Define mass casualty incident

Assess medical rescue, treatment and transport capacity

Provide emergent field care for common wilderness medicine situations

Participate as a safe and effective team member

Lead a small team in the provision of urgent care under hazardous conditions without incurring
additional casualties
Date Created/Revised: __5/22/15___ By: ___J Ping__ Revised R Ruggero 6/24/15
COM Competency Based Learning Objectives: http://medicine.tamhsc.edu/academicaffairs/curriculum/objectives/
Principles and Guidelines for Curriculum Development:
http://medicine.tamhsc.edu/policies/pdf/curriculum-principles-guidelines.pdf
Course Objective:
COM Competency
Based Learning
Objectives
(CBLO):
Taught (T)
and/or
Evaluated (E):
Learn common environmental
emergencies
MK1, MK2
T,E
Learn basic orthopedic reduction
techniques and splint applications
PC9, MK4
T,E
Create presentations on specific
wilderness medicine topics
PBL13, PBL14,
PBL15
T,E
Define mass casualty incident
PC6
T,E
Evaluation:
Observation by
faculty of group
participation and
individual
presentations.
Observation by
faculty of group
participation and
individual
presentations.
Observation by
faculty of group
participation and
individual
presentations.
Observation by
faculty of group
participation and
individual
presentations.
Successful
completion of
NOLS WUMP
course.
Assess medical rescue, treatment and
transport capacity
PC6, PC7
T,E
Observation by
faculty of group
participation and
individual
presentations.
Successful
completion of
NOLS WUMP
course.
Assess medical rescue, treatment and
transport capacity
PC6, PC7
T,E
Observation by
faculty of group
participation and
individual
presentations.
Successful
completion of
NOLS WUMP
course
Date Created/Revised: __5/22/15___ By: ___J Ping__ Revised R Ruggero 6/24/15
Provide emergent field care for
common wilderness medicine situations
Participate as a safe and effective team
member
PC3, PC6, PC7
ICS1, ICS2M ICS3,
PROF2, PROF6,
PROF10
T,E
T,E
Observation by
faculty of group
participation and
individual
presentations
Observation by
faculty of group
participation and
individual
presentations.
Successful
completion of
NOLS WUMP
course
Lead a small team in the provision of
urgent care under hazardous conditions
without incurring additional casualties
ICS1, ICS2, ICS3,
PROF2, PROF4,
PROF6, PROF7,
PROF8, PROF10,
PROF11, PROF12,
PBL12, CC2
T,E
Observation by
faculty of group
participation and
individual
presentations.
Successful
completion of
NOLS WUMP
course
Textbook and/or Resource Material
This elective will focus on wilderness medicine and be comprised of team building and leadership
exercises, small group lectures, and outdoor experiences/workshops. Small group lectures will be held
by faculty and students on wilderness medicine topics.
Textbooks (Required and Recommended Resources)
REQUIRED: There is no required textbook, but additional reading will be provided.
RECOMMENDED:
Wilderness Medicine: Expert Consult, 6th edition, Auerbach
Field Guide to Wilderness Medicine: Expert Consult – 4th edition (companion book)
Grading Policies
The final course grade will be based on the following: active participation in team building and
leadership activities (50% of grade) and successful completion of the NOLS WUMP course
(50% of grade).
Attendance and Make-up Policies
While expectation is 100% attendance, absolute maximum of two excused absences may be allowed
with prior approval by course director, but only during second week. The five day course by NOLS
during first week requires 100% attendance. Additional information on attendance can be found at
http://student-rules.tamu.edu/rule07.
Date Created/Revised: __5/22/15___ By: ___J Ping__ Revised R Ruggero 6/24/15
Course Topics, Calendar of Activities, Major Assignment Dates
This elective will focus on wilderness medicine and be comprised of team building and leadership
exercises, small group lectures, and outdoor experiences/workshops. Small group activities and
simulations will be conducted by faculty and students on various wilderness medicine topics as outlined
in course calendar (see appendices B and C).
Course calendar and NOLS WUMP outline are attached.
Other Pertinent Course Information
Clerkship Courses MUST include patient encounter and Log Information here. Actual log list can be
included in the appendix. Include information that is pertinent to ALL campus locations here like
processes and procedures. If there are campus specifics, include those locally not in this syllabus.
Indicate where course materials can be accessed for example Blackboard, One45, etc.)
Americans with Disabilities Act (ADA)
The Americans with Disabilities Act (ADA) is a federal anti-discrimination statute that provides
comprehensive civil rights protection for persons with disabilities. Among other things, this legislation
requires that all students with disabilities be guaranteed a learning environment that provides for
reasonable accommodation of their disabilities. If you believe you have a disability requiring an
accommodation, please contact Disability Services, in Cain Hall, Room B118, or call 845-1637. For
additional information visit http://disability.tamu.edu
Any student with a disability who needs accommodation should inform the instructor at the beginning of
the course.
Academic Integrity
“An Aggie does not lie, cheat, or steal, or tolerate those who do.” For additional information please visit:
http://aggiehonor.tamu.edu
College of Medicine
Professionalism and integrity Statement (Academic Honesty and Plagiarism)
All College of Medicine students are required to comply with the student code of conduct and the academic integrity and
honesty standards published in each component’s Student Handbook. Disciplinary action will be taken in accordance with
the policies of each component. Students found guilty of Academic Dishonesty will receive an “F”/Unsatisfactory in the
course. For a full list of actions qualifying as academic dishonesty, please review the College of Medicine Student
Handbook at http://medicine.tamhsc.edu/student-affairs/docs/handbook.pdf.
According to the Aggie Honor System Office, plagiarism is defined as the appropriation of another person's ideas,
processes, results, or words without giving appropriate credit. Intentionally, knowingly, or carelessly presenting the work of
another as one’s own (i.e., without crediting the author or creator). Plagiarism and other academic misconduct definitions
can be viewed on the Aggie Honor System Office website;
http://aggiehonor.tamu.edu/RulesAndProcedures/HonorSystemRules.aspx#definitions.
E-mail Access and FERPA
Date Created/Revised: __5/22/15___ By: ___J Ping__ Revised R Ruggero 6/24/15
The College of Medicine is communicating all official information to students through the students’ TAMHSC e-mail
accounts. Please check the account frequently during the semester for updates.
This course is supported with web-based and/or e-mail activities. In order to take advantage of these additional resources
and participate fully in the course, you have been assigned an e-mail address by the Texas A&M Health Science Center.
This e-mail address is for internal use only, so that faculty may communicate with you and the entire class. By registering
for this course, you are agreeing to allow your classmates to have access to this e-mail address. Should you have any
questions, please contact the TAMU’s Office of the Registrar at 979-845-1031.
The Family Educational Rights and Privacy Act of 1974 (FERPA), which the HSC complies fully, is intended to protect the
privacy of education records, to establish the rights of students to inspect and review their education records and to
provide guidelines for the correction of inaccurate or misleading data through informal and formal hearings. Students also
have the right to file complaints with the Family Educational Rights and Privacy Act Office of the Department of Education
in Washington, D.C., concerning alleged failures by the HSC to comply with the act.
Mistreatment of Students
The College of Medicine is committed to providing a positive learning environment in which students can meet their
academic goals based on mutual respect in the teacher/learner relationship. Both parties must be sensitive to the needs
of others and differences in gender, race, sexual orientation, religion, age or disability. As outlined in the Student
Handbook under the section titled Standards of Conduct in the Teacher-Learner Relationship, belittlement, intimidation
and humiliation are unacceptable for effective learning and undermine self-esteem. Breaches involving student
mistreatment may result in a faculty or staff member being sanctioned or the loss of faculty and/or staff appointment.
These policies address student mistreatment involving College of Medicine employees, residents, affiliate staff, or
patients. Mistreatment may be reported through the College of Medicine telephone hotline, 1(855)-397-9835 or through
an online form at http://medicine.tamhsc.edu/current/student-mistreatment-form.html. For a full list of reporting avenues,
please refer to the Student Handbook under the Mistreatment Policy.
Exposure and Occupational Hazard
The Needle Stick Policy and Bloodborne Pathogen Exposure information for Medical Students may be accessed in the
Student Handbook at: http://medicine.tamhsc.edu/student-affairs/docs/handbook.pdf
Note: More information is available on the aforementioned topics to all students on the College of Medicine website.
Appendix A: College of Medicine Competency Based Learning Objectives
1. Medical Knowledge
Upon completion of the medical school curriculum, our students will be able to:
MK1 - Demonstrate knowledge of normal human structure and function at the organ‐system, tissue, cellular and
molecular level; and of the interaction of human systems in maintaining homeostasis
MK2 - Describe the basic mechanisms involved in the causation of human disease and their influence on
clinical presentation and therapy
MK3 - Demonstrate an understanding of how healthy lifestyles and psychosocial factors influence health
MK4 - Apply evidenced-based methods to clinical problem solving
MK5 - Demonstrate an understanding of the epidemiology of common diseases within a population and the
approaches which are useful in reducing their incidence and prevalence
MK6 - Demonstrate knowledge of common societal problems such as domestic violence and substance abuse,
including diagnosis, prevention, reporting, and treatment
II. Patient Care
Upon completion of the medical school curriculum, our students will be able to:
PC1 - Obtain both complete and system-focused medical histories that include psychosocial
of health
PC2 - Perform both complete and system-focused physical examinations
Date Created/Revised: __5/22/15___ By: ___J Ping__ Revised R Ruggero 6/24/15
determinates
PC3 - Develop appropriate differential diagnoses by integrating collected clinical information
PC4 - Develop contextual and individualized diagnostic and treatment plans based upon collected clinical
information
PC5 - Interpret the results of commonly used laboratory and radiologic studies
PC6 - Recognize common, immediately life‐threatening conditions and initiate therapy
PC7 - Formulate an initial management plan for critically ill patients
PC8 - Demonstrate an understanding of the principles involved in the care of patients across the spectrum of the
human life cycle
PC9 - Perform technical procedures including: venipuncture and arterial puncture; insertion of intravenous,
central venous and urethral catheters; insertion of a nasogastric tube; lumbar puncture; basic suturing; and basic
airway management
PC10 - Discuss the principles of pain management and formulate a basic multidisciplinary care plan
PC11 - Assist in the provision of appropriate end‐of‐life care within a multidisciplinary team
PC12 - Educate patients in personalized health maintenance
PC13 - Perform basic health risk assessment and formulate appropriate screening plans
PC14 - Properly utilize clinical, laboratory, radiologic, and pathologic examinations to diagnose and treat
common maladies
PC15 - Formulate preventive, curative, rehabilitative, and palliative therapeutic strategies for common disorders
III. Interpersonal and Communication Skills
Upon completion of the medical school curriculum, our students will be able to:
ICS1 - Demonstrate effective listening skills
ICS2 - Discuss diagnostic and treatment options in a manner comprehensible to the patient
ICS3 - Communicate effectively with patients, patients' family members, peers, and other members of the
health care team
ICS4 - Educate patients, patients' family members, peers, and other members of the health care team at an
appropriate level using appropriate technologies
ICS5 - Maintain accurate medical records
IV. Professionalism
Upon completion of the medical school curriculum, our students will be able to:
PROF1 - Demonstrate an understanding of legal and ethical principles governing the physician-patient
relationship
PROF2 - Display honesty, integrity and ethical behavior
PROF3 - Act in the patient's best interest and serve as a patient advocate
PROF4 - Treat patients and patients' family members respectfully and compassionately, regardless of age,
disability, gender, race, ethnicity, culture, religion, sexual preference, and socio‐economic status
PROF5 - Respect the privacy of patients
PROF6 - Work with other health professionals in a collaborative fashion
PROF7 - Demonstrate an awareness of leadership roles in medicine and society
PROF8 - Recognize potential conflicts of interest and demonstrate awareness of appropriate courses of action
PROF9 - Demonstrate an understanding of peer review and the expectations of professional licensing boards,
including medical jurisprudence
PROF10 - Demonstrate knowledge of responsibilities to patients, peers, and other members of the health care
team
PROF11 - Respond to conflicts in a professional manner
PROF12 - Project a professional image in demeanor and personal appearance
V. Systems-Based Practice
Date Created/Revised: __5/22/15___ By: ___J Ping__ Revised R Ruggero 6/24/15
Upon completion of the medical school curriculum, our students will be able to:
SBP1 - Apply knowledge of health care systems to improve and optimize patient care
SBP2 - Advocate for continuous quality improvement in patient care and patient safety
SBP3 - Demonstrate an understanding of cost containment principles and their application in the delivery of
health care
SBP4 - Demonstrate an understanding of the legal and regulatory frameworks governing the practice of
medicine which affect payment, reimbursement, referrals and incentives
SBP5 - Recognize various approaches to the organization, financing, and delivery of health care
SBP6 - Utilize information technology in providing medical care for individuals
SBP7 - Recognize health care system deficiencies regarding social needs, access to care issues, and health
disparities when they arise and develop strategies for optimal care of each individual patient.
VI. Practice-Based Learning and Improvement
Upon completion of the medical school curriculum, our students will be able to:
PBLI1 - Identify and rectify deficiencies in their knowledge base and skill set
PBLI2 - Incorporate formative evaluation feedback into personal performance
PBLI3 - Accomplish learning and improvement goals with appropriate self‐directed activities
PBLI4 - Utilize information resources and available data to support life‐long learning
PBLI5 - Select, appraise, and utilize evidence from scientific studies related to clinical questions and patients'
health problems
PBLI6 - Demonstrate an understanding of the basic principles and importance of scholarly activity in the
practice of medicine
VII. Cultural Competence
Upon completion of the medical school curriculum, our students will be able to:
CC1 - Demonstrate an understanding of the manner in which diverse cultures and belief systems perceive health
and illness and respond to various symptoms, diseases, and treatments.
CC2 - Recognize and appropriately address gender and cultural biases in themselves, in others, and in the
process of health care delivery.
Appendix B: Course Outline
Leadership & Teamwork in Wilderness Medicine
March 20 – April 1, 2016
Minimum enrollment of 15 and maximum 30 students
WEEK 1
Sunday, March 20
4 pm
Arrival & registration
Orientation
Dinner
Monday, March 21, 8 am
5 day NOLS WUMP Course Begins
Morning
Introduction: Wilderness Vs. Urban Medicine Patient Assessment In The Wilderness Shock
Chest Injuries
Afternoon
Date Created/Revised: __5/22/15___ By: ___J Ping__ Revised R Ruggero 6/24/15
Head Injury Assessment and Management Spinal: Lifting And Moving
Spinal Immobilization Packaging, Transport Focused Spine Assessment
Tuesday March 22
Morning
Wilderness Wound Management Wilderness Burn Management Wilderness Infection Management
Athletic Injuries
Afternoon
Wilderness Fracture Management Wilderness Dislocations
Scenario
Wednesday, March 23
Morning
Hypothermia
Frostbite And Non-Freezing Cold Injury Heat And Hydration
Altitude Illness
Afternoon
Submersion Lightning
Bites And Stings (North American)
Evening
Case Studies
Thursday, March 24
Morning
Medical Emergencies: Introducti Cardiac
CPR In The Wilderness Diabetes
Gender-Specific Medical Concer Neurological
Afternoon
Respiratory
Allergies And Anaphylaxis Acute Abdominal Pain
Search And Rescue: An Introduct
Evening
Extended Wilderness Rescue
Friday, March 25
Morning
Leadership, Teamwork, Commun Communicable Disease Poisoning
Expedition Medical Problems Wilderness Medical-Legal Issues Wilderness Drug And First Aid Kit
Afternoon
Testing
Closure and Cleanup
Course concludes; Easter break begins: students are free from Friday 3/25 at 5 pm- Monday 3/28/16 at 3 pm.
Date Created/Revised: __5/22/15___ By: ___J Ping__ Revised R Ruggero 6/24/15
WEEK 2
Monday, March 28
3 pm
6 pm
Check in and orientation to Week Two
Panel Discussion and Dinner
Tuesday, March 29
8 – 10 am
10 – Noon
Noon
1–5
6 pm
Classroom
Outdoor activities
Lunch
Lake Activities with water rescues and simulations
Panel Discussion and Dinner
Wednesday, March 30
8 – 10 am
10 - Noon
Noon
1 – 5 pm
6 pm
8 pm
Classroom
Outdoor activities
Lunch
Wilderness emergency simulations
Panel Discussion and Dinner
Movie Night
Thursday, March 31
8 – 12
Noon
1 – 5 pm
6 pm
8 pm
8 – 11 am
Equine safety, examination, care & treatment
Lunch
Wilderness emergency simulations
Panel Discussion and Dinner
Bonfire Sharing
Assessment
Friday, April 1
Date Created/Revised: __5/22/15___ By: ___J Ping__ Revised R Ruggero 6/24/15