SYLLABUS
College of Medicine
AY 2015-2016
Course title and number
Term (e.g., Fall 200X)
Meeting times and location
IMED 904-00R Coronary Care Unit
Year Round
It is student’s responsibility to contact the preceptor one week prior to the
scheduled start date to confirm when and where to report on first day.
Course Description and Prerequisites
https://medicine.tamhsc.edu/elective/2015-16/imed/rr/index.html
This elective will allow a 4th year student to work directly with an attending for a 2 or 4 week
rotation. Patients will be evaluated and admitted by the student / attending, as a part of their
daily activities. Patients will be seen in different settings including the ED, office setting, and
in-hospital, depending on the attending. Different levels of acuity patients are expected to be
seen, from admissions with heart failure to STEMI patients who are going acutely to the cath
lab. The student will attend cardiology conferences (as available) with the attending in addition
to rounds.
Instructor Information
Elective Director
Vijay Divakaran, MD,
Name
MPH
512-509-0200
Telephone number
vdivakaran@sw.org
Email address
Office hours
Office location
By Appointment
Scott & White
Healthcare–RR 302
University Blvd.
RoundRock, TX 78665
Name
Coordinator
Natalie Washburn
Telephone number
Email address
Office hours
Office location
512-341-4960
Washburn@medicine.t
amhsc.edu
M-F / 8-5
3950 N. AW Grimes,
3rd Floor
Round Rock, TX 78665
Learning Outcomes & Objectives
The Faculty will strive to:
1.
Improve student skills in obtaining a thorough history and performing a physical examination
with particular emphasis on pertinent cardiovascular history as well as comprehensive examination of
the cardiovascular system that encompasses the following five key areas:
1.
General examination of the patient
2.
Assessment of the venous pulse, both in normal and diseased states.
3.
Assessment of the arterial pulse, both in normal and diseased states.
4.
Precordial examination
5.
Auscultation of the cardiovascular system, including identification of cardiac murmurs.
2.
Review with student relevant cardiovascular anatomy and physiology.
3.
Improve understanding of coronary artery disease, including the mechanisms underlying
progression of disease states with specific reference to the cellular and molecular basis of
atherosclerotic disease.
4.
Improve knowledge of and treatment of cardiac emergencies including acute coronary
syndromes, congestive heart failure, cardiac arrhythmias and cardiogenic shock.
Date Created/Revised: 5/1/2015 By: NW
5.
Discuss the diagnostic utility of electrocardiogram (EKG) and improve student skills in
identification of EKG abnormalities and arrhythmias.
6.
Discuss the importance of bedside hemodynamic monitoring, and review normal hemodynamic
waveforms, and alterations in disease states.
7.
Introduce student to non-invasive testing and its role in risk-stratification of patients with
suspected heart disease. This includes two-dimensional echocardiography, stress echocardiography,
tread-mill stress testing and nuclear cardiac imaging.
8.
Introduce student to invasive and interventional cardiology including diagnostic cardiac
catheterization, percutaneous coronary intervention, peripheral vascular intervention, cardiac pacemaker
implantation and follow up.
9.
Integrate the use of evidence-based medicine in making routine clinical decisions in the care of
cardiac patients.
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:
1.
Perform a thorough history
and physical examination and plan
the initial diagnostic workup for
common cardiac problems including
angina pectoris and heart failure.
2.
Understand the
pathophysiology of major cardiac
conditions
COM Competency
Based Learning
Objectives
(CBLO):
Taught (T)
and/or
Evaluated (E):
Evaluation:
PC1, PC2
Taught AND
Evaluated
MK1, MK2
Taught AND
Evaluated
3. Know the therapy for all
significant arrhythmias.
4. Understand the role of
hemodynamic monitoring of acute
myocardial infarction and be familiar
with the variations in wedge
pressure and cardiac output
PC4, MK3, MK4,
PC15
Taught AND
Evaluated
Multisource
Assessment
(360 eval)
Multisource
Assessment
(360 eval)
Multisource
Assessment
(360 eval)
PC4, PC5, PC14
Taught AND
Evaluated
Multisource
Assessment
(360 eval)
5. Understand the rational therapy
of hypertension.
6. Recognize major abnormalities on
the electrocardiogram including
supraventricular and ventricular
arrhythmias, heart block, ischemia,
myocardial infarction and
hypertrophy.
7. Interpret an uncomplicated
echocardiogram report,
hemodynamic profiles and nuclear
imaging
8. Understand the benefits,
precautions, and limitations of
stress testing.
PC3, PC4, PC5,
MK3
Taught AND
Evaluated
Multisource
Assessment
(360 eval)
PC5
Taught AND
Evaluated
Multisource
Assessment
(360 eval)
PC5
Taught AND
Evaluated
MK3, PC2, PC5
Taught AND
Evaluated
Date Created/Revised: 5/1/2015 By: NW
Multisource
Assessment
(360 eval)
Multisource
Assessment
(360 eval)
Textbook and/or Resource Material
The following books and case study materials will be used in this course:
Cardiology Texts & Manuals provided by preceptor
Cardiology Articles provided by preceptor
Cardiology Journals
Course materials are available online 24/7 in TAMU online library.
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
TAMHSC – COM student handbook states: Students who miss more than 20% of a 4th year
elective for any reason (2 weekdays during a two-week rotation or 4 weekdays for 4 week
rotation) will require a remediation plan. To request an absence all students must use the online
Phase IV Absence Form at: http://medicine.tamhsc.edu/current/absence-forms/m4absence.html For further information please refer to page 21 in the student handbook:
http://medicine.tamhsc.edu/student-affairs/docs/handbook.pdf
Course Topics, Calendar of Activities, Major Assignment Dates
1.
Students will make daily work rounds with the staff cardiologist. The student will be encouraged
to participate in discussions concerning the patient and his disease.
2.
The student will work-up 5 to 7 patients a week and participate in the care of those patients.
Some of the patients during the daily round may be in the cardiac ICU or on the cardiac telemetry (stepdown) services. The faculty will conduct teaching during rounds and during consultative times.
3.
The student will participate in the reading of electrocardiograms daily and interpretation of
echocardiogram reports and other noninvasive and/or invasive procedures relevant to the care of the
patients in (2).
4.
The student will participate in non-invasive testing and its role in risk-stratification of patients
with suspected heart disease. The student will spend one-half day during the rotation in one or more of
the following areas:
1.
Two-dimensional echocardiography and stress echocardiography
2.
Tread-mill stress testing
3.
Nuclear cardiac imaging laboratory
5.
Introduce student to invasive and interventional cardiology. The student will spend one-half day
during rotation in one or more of the following areas:
1.
Diagnostic cardiac catheterization
2.
Percutaneous coronary intervention
3.
Peripheral vascular intervention
4.
Cardiac pacemaker implantation and follow up
6.
Attend morning report conducted by the staff cardiologist every week as well as cardiology
journal club every other week.
Date Created/Revised: 5/1/2015 By: NW
7.
Discuss journal articles and major trials with Cardiology attending.
** Students will follow the schedule of the attending.
Week
Topic
Required Reading
Other Pertinent Course Information
Students are expected to be present for the various elective activities that will be noted by your
staff.
Attendance is expected at the various clinical activities including morning ward rounds,
operating room when assigned, afternoon rounds, conferences, and any activity specifically
requested by your attending.
Students are expected to be punctual for all of the various activities noted on the weekly
schedule. Failure to adhere to the schedule will result in undue delays and inconveniences to
patients, students and faculty.
The development and maintenance of a professional attitude is an ongoing responsibility of
each student. Professional behavior is expected at all times. All students will be expected to
dress in an appropriate manner, convey a professional appearance or image, and are encouraged
to be neat and clean. For further information please see Student Code of Conduct requirements
here: http://medicine.tamhsc.edu/dean/policies/student-policies/student-code-conduct.html
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: 5/1/2015 By: NW
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: 5/1/2015 By: NW