SYLLABUS
College of Medicine
AY 2015-2016
Course title and number
Term (e.g., Fall 200X)
Meeting times and location
EMED 04-00T
All Year
8:00 a.m. on first Monday of the block; Meeting places may vary.
Course Description and Prerequisites
The practice of emergency medicine entails the rapid assessment and stabilization of patients
presenting with acute injuries and illnesses as well as those with exacerbations of many chronic
illnesses. At the completion of this rotation, students will:
Better appreciate the role of emergency medicine within the healthcare system
-threatening
conditions and appropriate interventions
ems
history and physical and the development of an appropriate differential diagnosis;
(http://curricularservices.tamu.edu
Prerequisite: Satisfactory completion of year three of the medical curriculum
Instructor Information
Elective Director
J. Scott Wieters, M.D.
Name
(254) 724-0884
Telephone number
jswieters@sw.org
Email address
By appointment
Office hours
Office location
AG67, Chlapek
Education Suite,
Scott & White
Memorial Hospital
and Clinic Temple,
TX 76508
Coordinator
Carla Owens
Name
(254) 724-0884
Telephone number
cjowens@sw.org
Email address
By appointment
Office hours
Office location
AG67, Chlapek
Education Suite,
Scott & White
Memorial Hospital
and Clinic Temple,
TX 76508
Learning Outcomes & Objectives
The course goals will be achieved through a combination of clinical shifts in the emergency
department under faculty supervision along with lectures, procedural training/skill labs, practicebased learning exercises, and simulation. During clinical shifts, students will be responsible for the
care of patients with a wide range of conditions and across the lifespan, including pediatric,
traumatic, and psychiatric complaints. Discussion group sessions, labs, and lectures will be unique
to each site. These experiences will be used to supplement clinical exposure to key concepts within
Date Created/Revised: _3/17/15____ By: __CO___
the educational core. A list of required procedures and patient encounters will also be used to ensure
each student receives the appropriate breadth of experience while on the rotation.
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
Upon completion of the course, students will be able to:
Course Objective:
1. Obtain an accurate history and
physical on patients presenting with
urgent problems.
COM Competency
Based Learning
Objectives
(CBLO):
PC1, PC2,
PC8
2. Recognize immediate life
threatening illnesses
PC4
3. Develop an appropriate emergent
differential diagnosis based on
patient presentation
PC4
4. Identify worst case diagnosis that
must be excluded
PC10, PC14,
PC5, PC6
5. Develop management plans for
common emergency medicine
complaints
PC10, PC14,
PC5, PC6
6. Interpret common diagnostic tests
and procedures
PC3
7. Perform basic procedural skills
under appropriate supervision
PC3
8. Discuss key concepts within the
educational core
9. Effectively use available
technology to improve patient care
and improve knowledge
MK2, MK4
10. Effectively communicate with
patients and family members.
11. Demonstrate competency in
presentation skills and present cases
in a complete, concise and orderly
pattern.
ICS1, ICS2, ICS4
SBP4
ICS3
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Taught (T)
and/or
Evaluated (E):
Taught AND
Evaluated
Taught AND
Evaluated
Evaluation:
Shift evaluation
card and NBME
Exam
Shift evaluation
card and NBME
Exam
Taught AND
Evaluated
Shift evaluation
card and NBME
Exam
Shift evaluation
card and NBME
Exam
Taught AND
Evaluated
Shift evaluation
card and NBME
Exam
Taught AND
Evaluated
Procedure log
Taught AND
Evaluated
Procedure Log,
SIM experience
Taught AND
Evaluated
NBME Exam
Taught AND
Evaluated
Shift evaluation
card
Taught AND
Evaluated
Shift evaluation
card
Taught AND
Evaluated
Shift evaluation
card
Taught AND
Evaluated
12. Complete documentation that is
accurate, well organized, and
appropriate for the level of car
provided.
13. Follow up on specific patent
encounters and incorporate lessons
learned to future patients.
ICS5
Taught AND
Evaluated
Shift evaluation
card
Taught AND
Evaluated
PBL Forms
PBL1, PBL2,
PBL3,PBL4, PBL5,
PROF10
PROF1, PROF6,
PROF10
14. Practice ethical decision making.
15. Work in a collegial manner with
all members of the healthcare team.
Taught AND
Evaluated
Taught AND
Same as above
Evaluated
Textbook and/or Resource Material
Shift evaluation
card
Shift evaluation
card and SIM
experience
All course materials are available online 24/7 through www.cdemcurriculum.org. This is a website
with self-directed learning exercises on the approach to the top undifferentiated chief complaints
you will encounter in your rotation. It also contains short descriptions of the high points of dealing
with specific diseases divided up by organ systems. Students are expected to review the entire
supply of material on the “approach to” tab as well as the “specific disease” sections.
There are other resources available at sites and on line with the medical library which you may
find helpful such as electronic copies of First Aid for EM
http://guides.library.tamu.edu/medicine
Grading Policies
GRADING SCALE
Satisfactory
70-100
Unsatisfactory
69 and below
Should the course director determine remediation is required, the remediation plan will be at the
discretion of the course director and on a case by case basis depending on the issues involved.
Remediation plans could entail some (or all) of the following examples: Additional clinical shifts,
research papers, presentations, article reviews, exams, directed reading, web-based modules, etc. If the
student performance results in a failure of the elective, it will be recommended that the elective be taken
again in its entirety.
Attendance and Make-up Policies
Clinical Shifts
You are expected to work a total of 16 eight-hour clinical shifts over your four-week rotation.
These shifts are distributed across morning, afternoon, evening, and night shifts. Shift work is an
integral and at times unpleasant feature of Emergency Medicine. Every effort has been made to
avoid isolated shifts and provide a circadian-friendly schedule progression with at least one
weekend free from clinical duties. Schedule requirements:
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not work 10p-6a, attend Thursday conference, and then work 2p-10p);
You are excused from your shifts for clerkship labs and lectures. Moving/trading a shift without
approval is unprofessional. If an act of God occurs and you need to reschedule or otherwise change
one of your shifts, please let the campus coordinator know before that shift begins. Failure to show
up for a scheduled shift is considered unprofessional behavior and will result in a failure of the
professionalism component for the rotation. Thus, Any Unexcused Absence from a clinical shift
may result in a failing grade for the rotation. The shift evaluation cards (see below) serve as a
simple way to ensure that you receive credit for your clinical shift. Please write the name of the
faculty or resident with whom you worked the most in the appropriate blank and give the card to
that physician before leaving. You are encouraged to make a note of which faculty or resident
completed your shift card. This will ensure you receive credit for the shift in the unlikely event a
shift card is not received.
Website link to student rule 7 http://student-rules.tamu.edu/rule07.
Excused Absences
In accordance with medical school policy, you are only allowed to miss 20% of the required clinical
activities to pass required rotations. Approved absences for academic needs such as residency
interviews/illness/or other emergencies will be granted for up to TWO SHIFTS, ONLY. These
will be granted AFTER ALL PERMUTATIONS OF THE SCHEDULE HAVE BEEN
EXHAUSTED. Sick/bereavement/ interview days can be one of your excused absences provided
by the medical school if available or repeated during clerkship. For whatever reason, if you miss
more than two shifts you may fail. Remediation plans will be granted on a case by case basis,
depend on site director and will require approval by the course director. The remediation plan is
expected to be completed in 30 days after the end of the clerkship.
You must attend orientation day. If you foresee or anticipate missing that day even for
excused absences ie interviews, USMLE or other planned absences, you will not be
excused from missing orientation day. You are able to attend an earlier but not later
orientation day to make up for planned absences. Last minute interview requests/excuses
will not be granted.
Clinical Duties
At the start of each shift, report to the senior resident or attending in your assigned area. The
supervising physician will assign you a patient, whom you should assess. Perform a focused history
and physical exam, then discuss your findings and develop a plan with the resident.
If at any point you believe the patient’s condition is such that immediate intervention is
required, alert your supervising physician before proceeding further.
After discussing the patient with the resident or staff, it is important to follow up on any labs or
diagnostic imaging studies you may obtain as well as to reevaluate your patient frequently. The
more pro-active you are in picking up patients and following up on them, the more learning
opportunities you will have, including opportunities to practice various procedural skills. However,
your role is not to perform an H&P and then abdicate care of the patient; you should be involved in
the patient’s care from initial assessment to disposition. Do not attempt to carry more patients than
you can comfortably manage (three patients at a time is likely a maximum, and you should not
expect to start out managing three comfortably).
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Documentation is an important aspect of medicine, and you will have the opportunity to practice
these skills while in the ED. You must document and turn in H&Ps on the 13 undifferentiated chief
complaints documented similar to the charts specific to your site:
1. Abdominal pain
2. Chest Pain
3. Dyspnea
4. Endocrine Complaint
5. Acute Severe Pain
6. Wound Care
7. Musculoskeletal Injuries
8. Pediatric Fever
9. Trauma
10. Vaginal Bleeding
11. Neurologic Emergency /AMS
12. Adult Fever/Sepsis
13. Psychiatric Complaint/Overdose
You may complete prescriptions, referrals, and other forms for review and signing by your
supervising physician; make sure to sign any documentation you complete and leave a space for
your supervisor to co-sign.
Procedures
You may assist with or perform all procedures done on your patients under appropriate supervision.
You will receive a procedure list detailing seven procedures you are expected to be able to perform
competently by the conclusion of your rotation; other procedures such as thoracostomy, central
venous access, and lumbar puncture may also be performed if indicated. Log procedures on one 45.
Many of the procedures are common, simple procedures that you likely are already competent in
performing; however, because students with varied backgrounds and experiences will be rotating,
the procedure log allows us to ensure that each student meets certain basic procedural competencies.
You must document the required diversity of procedures on one45 and have a total of 45
procedures documented. If not completely documented by 1700 of the last Friday of the
clerkship, you will be required to meet with the clerkship Site Director to discuss remediation
process and be reported to the SPC for professionalism. The specifics of the remediation are
to be determined by each Clerkship Site Director and require approval by the Course
Director. The SPC will determine consequences for the unprofessional behavior of not
completing assignments on time.
Failure to complete this aspect of the clerkship on time may result in a failing grade.
Required Patient Encounters
You will have the opportunity to see a wide variety of patient presentations while in the Emergency
Department. Please take this opportunity to round out your medical education and become a
competent undifferentiated physician by seeing patient presentations that you may not see elsewhere
in your training. As part of this goal, you are required to document patient encounters of thirteen
conditions commonly seen in the ED. All thirteen conditions must be logged in order to receive
credit for the rotation. You should also document AT LEAST 60 total patient encounters. If
not completely documented by 1700 of the last Friday of the clerkship, you will be required to
meet with the clerkship Site Director to discuss remediation process and be reported to the
SPC for professionalism. The specifics of the remediation are to be determined by each
Date Created/Revised: _3/17/15____ By: __CO___
Clerkship Site Director and require approval by the Course Director. The SPC will
determine consequences for unprofessional behavior of not completing assignments on time.
Failure to complete this aspect of the clerkship on time may result in a failing grade.
Course Topics, Calendar of Activities, Major Assignment Dates
Week
1-Monday
Topic
Orientation & Lectures- Morning
2-Monday
3-Monday
4-Monday
4-Friday
Pedi EMED Lecture -Morning
Lectures - Morning
Lectures – Morning
NBME Test - Morning
Required
Labs-Ortho Splinting, ED Ultrasound,
Slit lamp and Suturing - Afternoon
SIM Experiences - Afternoon
SIM Experience - Afternoon
SIM Experience - Afternoon
Other Pertinent Course Information
Dress Code
While on duty, students may wear scrubs or other appropriate professional dress. Name badges
should be worn at all times while in the department. Attire for conferences is typically more
relaxed; if you have any questions, feel free to ask any of the residents and when in doubt, err on the
side of caution (“over dress” rather than under).
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
For additional information please visit: http://aggiehonor.tamu.edu
“An Aggie does not lie, cheat, or steal, or tolerate those who do.”
College of Medicine
Professionalism and integrity Statement (Academic Honesty and Plagiarism)
Date Created/Revised: _3/17/15____ By: __CO___
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
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.
Date Created/Revised: _3/17/15____ By: __CO___