Emergency Medicine M4 Clerkship Objectives
Patient Care
Under direct faculty supervision, students should be given primary responsibility for patient care (of
noncritical patients) and begin to act independently during the fourth-year EM rotation. Primary responsibility
for patient care will help foster the students’ ability to think critically, assess their knowledge and skills, and
allow them to make clinical decisions affecting patient care.
Specific Learning Objectives
1. Obtain an accurate problem-focused history and physical examination.
2. Recognize immediate life-threatening conditions.
3. Patient management skills:
a. Develop an evaluation and treatment plan;
b. Monitor the response to therapeutic interventions;
c. Develop appropriate disposition and follow-up plans.
4. Health promotion:
a. Educate patients on safety and provide anticipatory guidance as necessary related to the
patient’s chief complaint;
b. Educate patients to ensure comprehension of discharge plan.
Medical Knowledge
Students should develop a differential diagnosis that is prioritized on potential life-threatening conditions and
likelihood of disease. Students should demonstrate knowledge (or understanding) of basic diagnostic
modalities and interpretation of results. Most importantly, students should cultivate an appreciation of risk
stratification and pretest probabilities for selected conditions.
Specific Learning Objectives
1. Develop a differential diagnosis when evaluating an undifferentiated patient:
a. Prioritize likelihood of diagnoses based on patient presentation and acuity;
b. List the worst-case diagnoses.
2. Create a diagnostic plan based on differential diagnoses.
3. Develop a management plan for the patient with both an undifferentiated complaint and a specific
disease process.
Self-Directed Learning and Lifelong Improvement
Practice-based learning can be demonstrated through systematically evaluating patient care and population
features; teaching other students and health care professionals; and applying knowledge gained from a
systematic evaluation of the medical literature, including study design and statistical methodology.
Specific Learning Objectives
1. Effectively use available information technology, including medical record retrieval systems and
other educational resources, to optimize patient care and improve their knowledge base.
Interpersonal and Communication Skills
Students are an important element of the health care team, and effective communication with patients and
other health care providers is essential for patient care. Students must demonstrate interpersonal and
communication skills that result in effective information exchange and interaction with patients, family
members, and health care providers.
Specific Learning Objectives
1. Humanistic qualities
a. Effectively communicate with patients, family members, and other members of the health
care team
b. Demonstrate a compassionate and nonjudgmental approach when caring for patients.
2. Presentation skills:
a. Present cases in a complete, concise, and organized fashion;
b. Effectively communicate with consultants and admitting services.
3. Documentation: provide accurate and organized documentation in the medical record when
appropriate.
Professionalism
Professionalism should be viewed as an academic virtue, not just an expected set of behaviors. Students
should learn to reflect on their professionalism during clinical rotations and learn from faculty role models.
Specific Learning Objectives
1. Work ethic:
a. Be conscientious, on time, and responsible;
b. Exhibit honesty and integrity in patient care.
2. Practice ethical decision-making.
3. Professional behavior:
a. Exercise accountability;
b. Maintain a professional appearance;
c. Be sensitive to cultural issues (age, sex, culture, disability, etc.);
d. d. Work in a collegial manner with other members of the health care team.
Putting Care in a Practical Context
Called Systems-based practice in the resident lingo, this competency extends beyond the individual patient’s
bedside to include an understanding of how EM relates to other practitioners, patients, and society at large,
while considering the cost of health care and the allocation of health care resources. Understanding the
‘‘system’’ involves learning ways to advocate for patient care and assist patients in dealing with system
complexities (such as assuring appropriate follow-up) and how to partner with health care providers to
assess, coordinate, and improve patient care.
Specific Learning Objectives
1. Recognize when patients should be appropriately referred to the emergency department (ED).
2. Recognize the importance of arranging appropriate follow-up plans for patients being discharged
from the ED.
3. Recognize the role of EM in the community, including access to care and its impact on patient care.
4. Understand the indications, cost, risks, and evidence behind commonly performed ED diagnostic
studies.
How EM Objectives pair up with RMC Objectives
Patient Care
EM Objective
RMC Objective
Obtain an accurate problem-focused history and
Complete comprehensive evaluations of patients
physical examination.
Recognize immediate life-threatening
Complete comprehensive evaluations of patients
conditions.
Patient management skills:

Develop appropriate treatment plans
Develop an evaluation and treatment
plan;

Monitor the response to therapeutic
interventions;

Develop appropriate disposition and
follow-up plans.
Health promotion:

Apply the principles of health promotion
Educate patients on safety and provide
anticipatory guidance as necessary
related to the patient’s chief
complaint;

Educate patients to ensure
comprehension of discharge plan.
Medical Knowledge
EM Objective
RMC Objective
Develop a differential diagnosis when evaluating
Demonstrate knowledge of the basic, clinical
an undifferentiated patient:
and social sciences related to medical practice &

Prioritize likelihood of diagnoses based
apply to patient care
on patient presentation and acuity;

List the worst-case diagnoses.
Create a diagnostic plan based on differential
Demonstrate knowledge of the basic, clinical
diagnoses.
and social sciences related to medical practice &
apply to patient care
Develop a management plan for the patient with
Demonstrate knowledge of the basic, clinical
both an undifferentiated complaint and a
and social sciences related to medical practice &
specific disease process.
apply to patient care
Interpersonal and Communication Skills
EM Objective
Humanistic qualities

RMC Objective
Communicate and collaborate effectively with
Effectively communicate with patients,
patients, families and other health care
family members, and other members of
providers
the health care team

Demonstrate a compassionate and
nonjudgmental approach when caring
for patients.
Presentation skills:


Communicate and collaborate effectively with
Present cases in a complete, concise,
patients, families and other health care
and organized fashion;
providers
Effectively communicate with
consultants and admitting services.
Function as a member of the health care team
Documentation: provide accurate and organized
Communicate and collaborate effectively with
documentation in the medical record when
patients, families and other health care
appropriate.
providers
Function as a member of the health care team
Putting Care in a Practical Context
EM Objective
RMC Objective
Recognize when patients should be
Analyze the environmental and contextual
appropriately referred to the emergency
factors that influence a patient’s health,
department (ED).
disease and access to health care
Recognize the importance of arranging
Engage the health care system to enhance
appropriate follow-up plans for patients being
patient care
discharged from the ED.
Recognize the role of EM in the community,
Analyze the environmental and contextual
including access to care and its impact on
factors that influence a patient’s health,
patient care.
disease and access to health care
Understand the indications, cost, risks, and
Analyze the environmental and contextual
evidence behind commonly performed ED
factors that influence a patient’s health,
diagnostic studies.
disease and access to health care
Self-Directed and Lifelong Learning
EM Objective
RMC Objective
Effectively use available information technology,
Address personal learning needs
including medical record retrieval systems and
other educational resources, to optimize patient
Appraise evidence that supports patient care
care and improve their knowledge base.
practices
Professionalism
EM Objective
Work ethic:

Be conscientious, on time, and
responsible;

Exhibit honesty and integrity in patient
RMC Objective
Demonstrate the professional values of medical
practice
care.
Practice ethical decision-making.
Display empathy and compassion when
interacting with patients and their families
Professional behavior:
Adhere to the professional responsibilities

Exercise accountability;

Maintain a professional appearance;

Be sensitive to cultural issues (age, sex,
Demonstrate the professional values of medical
culture, disability, etc.);
practice

Work in a collegial manner with other
members of the health care team.
outlined by RMC
Learning Opportunities and Assessment Methods
Patient Care
EM Objective
Obtain an accurate problem-
Learning Opportunity
Assessment Method
Clinical experiences
Clinical evaluations
Clinical experiences
Clinical evaluations
Clinical experiences
Clinical evaluations
Clinical experiences
Clinical evaluations
focused history and physical
examination.
Recognize immediate lifethreatening conditions.
Patient management skills:

Develop an evaluation
and treatment plan;

Monitor the response
to therapeutic
interventions;

Develop appropriate
disposition and followup plans.
Health promotion:

Educate patients on
safety and provide
anticipatory guidance
as necessary related to
the patient’s chief
complaint;

Educate patients to
ensure comprehension
of discharge plan.
Medical Knowledge
EM Objective
Develop a differential diagnosis
Learning Opportunity
Assessment Method
Clinical experiences
Clinical evaluations
Clinical experiences
Clinical evaluations
when evaluating an
undifferentiated patient:

Prioritize likelihood of
diagnoses based on
patient presentation
and acuity;

List the worst-case
diagnoses.
Create a diagnostic plan based
on differential diagnoses.
Develop a management plan
Clinical experiences
Clinical evaluations
for the patient with both an
undifferentiated complaint and
a specific disease process.
Interpersonal and Communication Skills
EM Objective
Learning Opportunity
Humanistic qualities

Assessment Method
Clinical experiences
Clinical evaluations
Clinical experiences
Clinical evaluations
Clinical experiences
Clinical evaluations
Effectively
communicate with
patients, family
members, and other
members of the health
care team

Demonstrate a
compassionate and
nonjudgmental
approach when caring
for patients.
Presentation skills:

Present cases in a
complete, concise, and
organized fashion;

Effectively
communicate with
consultants and
admitting services.
Documentation: provide
accurate and organized
documentation in the medical
record when appropriate.
Putting Care in a Practical Context
EM Objective
Recognize when patients
Learning Opportunity
Assessment Method
Clinical experiences
Clinical evaluations
Clinical experiences
Clinical evaluations
should be appropriately
referred to the emergency
department (ED).
Recognize the importance of
arranging appropriate followup plans for patients being
discharged from the ED.
Recognize the role of EM in the
Clinical experiences
community, including access to
Simulated cases
Clinical evaluations
care and its impact on patient
care.
Understand the indications,
Clinical experiences
Clinical evaluations
cost, risks, and evidence behind
commonly performed ED
diagnostic studies.
Self-Directed and Lifelong Learning
EM Objective
Effectively use available
Learning Opportunity
SDL Project
Assessment Method
SDL Project
information technology,
including medical record
retrieval systems and other
educational resources, to
optimize patient care and
improve their knowledge base.
Professionalism
EM Objective
Work ethic:

Learning Opportunity
Assessment Method
Clinical experiences
Clinical evaluations
Clinical experiences
Clinical evaluations
Clinical experiences
Clinical evaluations
Be conscientious, on
time, and responsible;

Exhibit honesty and
integrity in patient
care.
Practice ethical decisionmaking.
Professional behavior:

Exercise accountability;

Maintain a professional
appearance;

Be sensitive to cultural
issues (age, sex,
culture, disability,
etc.);

Work in a collegial
manner with other
members of the health
care team.