2014-2015 Syllabus
I.
Pediatric Clerkship – MPED 800
II.
Core Clerkship in Pediatrics, 7.5 Credits
III.
Fall and Spring
IV.
Course Directors and Coordinators
Course Director
Daniel Richards, M.D.
dgrichards@seton.org
267-259-0561
Round Rock, Texas
By appointment
Round Rock
Coordinator
Derek Medack
medack@medicine.tamhsc.edu
512-341-4988
Round Rock, Texas
By appointment
Round Rock
Name
Email
Phone
Office location
Clerkship Director
Jesse Parr, M.D.
jparr@university-pediatrics.com
979-696-4440
1602 Rock Prairie Rd., Suite 1100
College Station, TX 77845
Office hours
Campus
By appointment
Bryan/College Station
Coordinator
Becky Richards
Richards@medicine.tamhsc.edu
979-862-1611
St. Joseph Regional Hospital
2801 Franciscan Drive, Bryan,
TX 77802
By appointment
Bryan/College Station
Name
Email
Phone
Office location
Office hours
Campus
Clerkship Director
Sarah McCormick, DO
smccormick@sw.org
254-935-5008
Temple, TX
By appointment
Temple, TX
Coordinator
Theresa Lykins
TLYKINS@swmail.sw.org
254-935-5008
Temple, TX
By appointment
Temple, TX
Name
Email
Phone
Office location
Clerkship Director
Dr. Myron Rosen
Myron.rosen@baylorhealth.edu
469.800.2060
601 Clara Barton Blvd
Garland, TX 75042
Office hours
Campus
By appointment
Dallas, TX
Coordinator
Melanie Ester
Melanie.Ester@baylorhealth.org
214-820-2233
Baylor University Medical Center 3500
Gaston Avenue
1st Floor Roberts Hospital
Dallas, TX 75246
By appointment
Dallas, TX
Name
Email
Phone
Office location
Office hours
Campus
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2014-2015 Syllabus
Name
Email
Phone
Office location
Office hours
Campus
Campus Director
Campus Coordinator
Michael Dulaney, MD
“Dedie” Denise Rosales
Mike@Dulaney.net
Dedie.rosales@dchstx.org
361-510-5815 (Cell)
361-694-4069
361-694-4069
361-739-1745 (Text Only)
Driscoll Children’s Hospital - Corpus Christi, Texas
By appointment
By appointment
Corpus Christi, TX
Corpus Christi, TX
Other participating faculty (may include in Appendices)
V. Course Description (from HSC Course Catalogue) and Overview
http://www.tamhsc.edu/education/catalog/
Clinical pediatrics, under supervision of the faculty, through participation in routine and emergency
inpatient and outpatient pediatric care. The student performs pediatric histories and physicals, learns
problem-solving techniques, and participates in conferences, seminars, and rounds. Prerequisites:
Satisfactory completion of years one and two of the medical curriculum.
“A Texas A&M medical student is a professional who exhibits leadership, honesty, integrity,
compassion, respect and self-discipline.” (Student Handbook, College of Medicine)
Curriculum Insight
COMSEP: The Council On Medical Student Education in Pediatrics (COMSEP) has formulated a
core curriculum for pediatric education with the intent to provide a framework to build a workable
program at each medical school. The national curriculum can be found at www.comsep.org and will
serve as the framework for this six-week course.
The importance of self-directed learning is obvious since much of pediatric care is seasonal, e.g.
increased sport physicals in the late summer and viral illnesses in the fall and winter months. There is
much to learn in a short period of time, thus appropriate educational planning is a must to avoid
excessive stress at the close of the rotation. The national curriculum is outlined in computerized
simulated cases (CLIPP: Computerized Learning in Pediatrics Project at www.med-u.org ) offering
the student an opportunity to hone history and problem solving skills. These cases have been
reviewed for content by the national curriculum committee, of which a smaller subgroup authors
exam questions for the national board (USMLE-CK).
Clerkship Goals
These are taken directly from the COMSEP curriculum document:
1. Acquisition of basic knowledge of growth and development and of its clinical application from
birth through adolescence.
2. Development of communication skills that will facilitate the clinical interaction with children,
adolescents and their families and thus ensure that complete, accurate data are obtained.
3. Development of competency in the physical examination of infants, children and adolescents.
4. Acquisition of the knowledge necessary for the diagnosis and initial management of common
acute and chronic illnesses.
5. Development of clinical problem solving skills.
6. An understanding of the influence of family, community and society on the child in health and
disease.
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2014-2015 Syllabus
7.
8.
9.
10.
Development of strategies for health promotion, as well as disease and injury prevention.
Development of attitudes and professional behaviors appropriate for clinical practice.
An understanding of the approach of pediatricians to the health care of children and adolescents.
Exposure to health care teams in the management of patients of all ages.
VI. Course Objectives and Evaluation Method – Determined locally & granular details were filled
in from COMSEP materials
(COM Competency Based Learning Objectives: http://medicine.tamhsc.edu/academicaffairs/curriculum/objectives/)
Upon completion of the course, students will be able to:
IV.
Course Objectives and Evaluation Methods
At the completion of the clerkship, students will be able to:
Course Objectives:
COM
Taught (T)
Competency
and/or
Based Learning Evaluated
Objectives
(E):
1. Identify developmental
milestones for well
checkups from birth to
age 18 months.
2. List and utilize the
HEADSS protocol in
interviewing teens.
3. Correctly examine
HEENT on all patients,
allowing for accurate
diagnosis and minimal
patient discomfort.
4. Identify risk factors for
the diseases: asthma,
otitis media, and
obesity.
5. List common antibiotic
treatment for impetigo,
Evaluation
PC1
T, E
Written history/physical; SOAP
notes; mid-rotation test; OSCE;
NBME; attending observation
PC7
T, E
PC1
T, E
PC7
T, E
PC2
PC4
T, E
T, E
PC5
T, E
PC7
PC8
T, E
T, E
PC1
PC4
T, E
T, E
PC5
T, E
MK3
MK5
T, E
T, E
PC4
T, E
Written history/physical; SOAP
notes; mid-rotation test; OSCE;
NBME; attending observation
Written history/physical; SOAP
notes; mid-rotation test; OSCE;
attending observation
Written history/physical; SOAP
notes; mid-rotation test; OSCE;
attending observation
OSCE; attending observation
Written history/physical; midrotation test; OSCE; NBME;
attending observation
Written history/physical; SOAP;
mid-rotation test; OSCE; NBME;
attending observation
OSCE; attending observation
mid-rotation test; OSCE; NBME;
attending observation
OSCE; attending observation
mid-rotation test; OSCE; NBME;
attending observation
mid-rotation test; OSCE; NBME;
attending observation
OSCE; attending observation
mid-rotation test; OSCE; NBME;
attending observation
mid-rotation test; OSCE; NBME;
attending observation
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2014-2015 Syllabus
6.
7.
8.
9.
10.
11.
cellulitis, abscess,
pneumonia, otitis
media, bacteremia,
neonatal sepsis, and
meningitis.
Demonstrate accurate
prescription format and
dosing of acetaminophen, ibuprofen, and
common antibiotics.
Demonstrate an
understanding of
nebulizers and spacers
in medication of asthma
patients.
Demonstrate knowledge
of how insurance
coverage dictates
treatment options.
Identify correct car seat
use based on age.
Counsel on the Back to
Sleep program.
List maternal risk
factors for fetal
development and
influence on the
newborn.
12. List components of
APGAR score and
significance of jaundice
in the newborn.
13. Identify early resuscitation of the sick child,
including initial fluid
management.
14. Demonstrate techniques
in approaching patients
of different age groups.
15. Demonstrate respect for
patients and parents in
counseling on parenting,
safety, disease, and
treatment plans.
16. Identify appropriate
childhood immuniza-
PC5
T, E
Written history/physical; SOAP;
mid-rotation test; OSCE; NBME;
attending observation
PC8
T, E
SOAP notes; OSCE; attending
observation
PC6
PC9
T, E
T, E
OSCE; attending observation
OSCE; attending observation
SBP1
SBP4
T
T
N/A
N/A
PC8
T, E
OSCE
PC8
T, E
OSCE
PC4
T, E
PC5
T, E
PC7
T, E
MK3
PC4
T, E
T, E
PC5
T, E
PC7
T, E
PC4
T, E
PC5
T, E
PC8
T, E
PC2
PC7
ICS1
ICS1
T, E
T, E
T, E
T, E
mid-rotation test; OSCE; NBME;
attending observation
mid-rotation test; OSCE; NBME;
attending observation
mid-rotation test; OSCE; NBME;
attending observation
OSCE; attending observation
mid-rotation test; OSCE; NBME;
attending observation
mid-rotation test; NBME;
attending observation
mid-rotation test; NBME;
attending observation
mid-rotation test; OSCE; NBME;
attending observation
mid-rotation test; OSCE; NBME;
attending observation
mid-rotation test; OSCE; NBME;
attending observation
OSCE; attending observation
OSCE; attending observation
OSCE; attending observation
OSCE; attending observation
PC8
T, E
Date Created/Revised: ___6/10/14__ By: __DR & DM_____
mid-rotation test; OSCE; NBME;
attending observation
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2014-2015 Syllabus
tions, based on age.
17. Demonstrate an
understanding of
indications, contraindications, risks, and
benefits of common
procedures, adhering to
the principles of
informed consent and
appropriate language
levels.
18. Demonstrate proper
format, legibility of
admission orders,
including understanding
of appropriate IV fluids,
diet, antibiotics, and
nursing orders
PC12
T, E
OSCE; attending observation
PROF3
T, E
OSCE; attending observation
ICS1
ICS2
T, E
T, E
OSCE; attending observation
OSCE; attending observation
ICS3
T, E
OSCE; attending observation
ICS4
T, E
OSCE; attending observation
PC4
T,E
OSCE, attending observation
PC6
T,E
OSCE, attending observation
PC7
T,E
OSCE, attending observation
PC14
T,E
OSCE, attending observation
ICS5
T,E
OSCE, attending observation
VII. Attendance Policy
A component of professionalism is to be present, prepared, and punctual. In the event of personal illness,
critical illness within your immediate family, family death, or other extenuating event, please
communicate this to the clerkship director and administrator in a timely manner. Please do not leave a
message with a unit clerk, resident, or fellow student, as this is an unreliable way to obtain an excused
absence. Attendance at national conferences or other TAMHSC events is encouraged, however must be
tempered based on absences during the clerkship. Per the student handbook, students are afforded two
personal days in the third academic year -- these should be used appropriately in terms of timing and
importance. If the student opts to use these, please let this be known as soon as possible, as well. These
days may not be taken, for obvious reasons, during final testing or during orientation. The student should
also be aware that a MAXIMUM of three days of the six-week clerkship may be missed FOR ANY
REASON. After three days of absence, the student will require remediation.
Resources: Texas A&M Health Science Center Medical Student Handbook:
http://medicine.tamhsc.edu/student-affairs/docs/handbook.pdf (see pages 19-20).
It is the students responsibility to submit the online Phase III (M3) Absence form
http://medicine.tamhsc.edu/current/absence-forms/m3-absence.html to request an absence or personal day
for any reason. Absences and personal days may or may not be approved by the Clerkship Director and/or
other applicable staff.
Students are allowed up to two personal days during their third year rotation. Personal days must be
approved in advance and approval is not guaranteed, but will depend on the activities of the team and the
number of students off on any given day.
Please note that these personal days may not be taken during an OSCE exam, NBME or other scheduled
exam (no half days or hour counts are permitted).
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Absences, regardless excused or unexcused, totaling 10% or more of the days for a clerkship will require
counseling and the development of a remediation plan. If absences exceed 20% of the days required for a
clerkship, the student may be required to repeat the clerkship before being promoted to the fourth year. If
absences exceed 20% of the days for two clerkships, the student may be required to repeat the entire year
as determined by the Student Promotions Committee. Unauthorized absences will result in a failure of the
clerkship, academic probation or dismissal by the Student Promotions Committee.
For a complete description of the absence and personal day policy please see the Student Handbook
(http://medicine.tamhsc.edu/student-affairs/docs/handbook.pdf).
VIII. Policies and Procedures (generic information for all campuses)
At the completion of the clerkship, students will have completed the competency procedures list and
patient encounter table (see appendix C&D):
Competency: The student knows indication, contraindication, expectations or side effects of a
procedure.
Procedures and Patient Encounters must be logged in “One45” at https://tamhsc.one45.com/, weekly
by 5:00 p.m. each Friday, with all logging completed by 5:00 p.m on the last Wednesday of the
rotation.
Professionalism and Ethics: Students are expected to uphold and adhere to the ethical and
behavioral standards of the profession of medicine. Information/sources on ethics in
pediatrics and general medicine are included below.
Resources:
Texas A&M Health Science Center Medical Student Handbook
Recommended core ethical values at www.niee.org/case_of_the_month/ethics3.cfm AMA
Principles of Medical Ethics at www.ama-assn.org/ama/pub/physician-resources/medicalethics/code-medical-ethics/principles-medical-ethics.page
Dress and Appearance: In order to be accepted as a member of the health care team, it is important
to assume the same basic manner of dress, appearance and conduct as the other members of the
team. A picture name identification tag must be readily visible on your shirt or coat collar, with
introduction of your full name including “Ms.” or “Mr.” or “medical student”. If the
parent/patient refers to the students as a “doctor”, it is the student's duty to correct this error. One
should not misrepresent his/her role. Remembering that you are serving as a role model for
children should help one determine an appropriate appearance. With approval from your
attending, scrubs may be worn only in the PICU, NICU or on call after 5 pm. They are not ideal
attire for outpatient clinic visits.
Resources: Texas A&M Health Science Center Medical Student Handbook
Confidentiality: This is a critical issue that demands attention daily. When accessing the electronic
record, one is required to close the screen and not leave it unattended at the workstation for
anyone to read. Charts and labs should be turned face down on the desk and records outside the
patient doors are turned away from the hallway where anyone could read them in passing.
Students should not take any documents from the department that reference the patient’s name or
vital information. Accessing electronic records of any kind inappropriately may have severe
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consequences, including dismissal. Regarding student testing in either written or OSCE format,
it is expected that these will be not discussed, copied, disseminated, or shared.
Student Documentation
The Liaison Committee on Medical Education (LCME) mandates documentation of the number
and types of patients and procedures seen by the medical student. In past years, this was done on
paper; however this prevents the ability to readily track the data in real time to assure mastery or
remediation. Due to this requirement, the students will need to enter the information into the
database at https://tamhsc.one45.com/.
Procedure competency list and patient log data will be reviewed, mid-clerkship, to assess progress.
All documentation must be completed by 5:00 pm on Wednesday the day in the final week, (hard
copies will be turned into the Clerkship Administrator at your site). Accurate and timely
completion of this data set will be reflected in the professionalism portion of the TAMHSC clinical
evaluation.
IX. Learning Materials and Activities
Course materials are available online 24/7 and are located within one45.
Responsibilities and Competencies
Inpatient
Student Responsibilities:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
Daily attendance, except as designated by site schedules.
Attend morning reports and teaching rounds, if available at site.
Perform H&P's with supervision/observation.
Write admission orders or daily/discharge orders with supervision.
Actively assist in care of patients each day.
Write daily legible, concise SOAP notes, including on weekends when present.
Participate in all procedures on patients followed, including any studies or blood draws or IV
placements.
Present patients to attending staff/chief resident during work rounds.
Present in morning report or teaching conferences as requested by supervisors.
Take initiative to seek out other interesting cases on the hospital wards.
Call (if available/required at your site): You will be assigned three short-calls, with one being a
weekend day. Any changes in the call schedule must be communicated to the clerkship
administrator.
Competencies:
1. Written communication: During the inpatient portion of the course, the student will demonstrate
accurate, concise written skills by submitting two complete H&P’s* to the assigned Inpatient
attending/resident. These can be done on a new admission or an established patient assigned by
the staff/resident. The feedback form (appendix E) should be completed and attached to the front
of each H&P. In order for the student to improve, feedback should be obtained after each
submission. *Complete H&P’s include history of present illness, past medical history, social
history, family history, medications, allergies, growth/development if indicated, and
immunizations. Physical exam should include growth percentiles with the vitals. All pertinent
exam findings must be included. Some exams may be painful or not indicated, thus see the
staff/resident for some guidance. Assessments should be complete problem lists with a plan for
each item identified. At the end, a discussion of the main assessment should also be included. The
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discussion section should include three reliable reference sources. NOTE: The books in the
resident work area may suffice. Each H&P should take only 1-1.5 hrs to complete.
** These are due by 5:00 pm on Thursday of each inpatient work week, or as determined by your
site (exception: The H&P is due on Wednesday of the final rotation week.) Late submissions
will not be accepted.
2. Oral communication: The student will demonstrate accurate, concise oral presentations on
assigned patients. The student should be aware of appropriate material to disclose in various
scenarios: work rounds, attending rounds, check-out rounds and morning report. Morning report
presentation may be assigned by the staff or senior resident.
3. Admission orders: The student will demonstrate the correct format, legibility and understanding
on appropriate IV fluids, diet, antibiotics and nursing orders. This can be an exercise only or part
of the medical record. The student needs to seek out physician signatures for any orders written
in the patient chart.
4. Counseling: The student will demonstrate comprehension on indication, contraindications and
risks of a procedure while adhering to principles of informed consent and appropriate language
levels. The opportunity for procedures such as lumbar puncture, circumcision, or central lines
arises more frequently on the inpatient sector. Counseling can be an exercise only, or part of
patient care.
Evaluation:
The staff attending, residents and nursing all may have input into the final evaluation.
All students should actively seek feedback and review written evaluations as soon as available.
Outpatient
Student Responsibilities:
1.
2.
3.
4.
5.
Daily attendance, as designated by site schedules.
Attend morning report (if available at your site).
Perform either focused or complete history and physical exam as instructed by the teaching staff.
Participate in all procedures and treatment plans on your patients.
Orally present patients to staff and to consultant when necessary.
Competencies:
1. Observation: The student will be observed taking history in one acute-care patient and one wellchild check and performing one acute-care and one well-child physical exam (Appendix C & D).
The observation checklist should be available from the student prior to beginning the patient
encounter. This is opportunity for feedback to hone the student’s history or physical exam skills,
as well as prepare for the OSCE. Forms will be turned into the administrator at each site when
completed.
2. Oral presentation: The student will give concise, brief oral presentations on acute problems.
Usually these are informal in nature and used to direct the student on organizational skills and
forming differential diagnosis. Be prepared to speak appropriately in the presence of the
parent/patient.
3. Written skills: During the outpatient portion of the course: The student will write three SOAP
notes on acute illnesses seen in the general outpatient clinic. Each note is due by 9:00 am on the
Friday of each outpatient week, or as determined by your site. They may be legibly hand-written
or typed and are turned-in to teaching staff for review and feedback. All notes will need to be
turned in at the end of the outpatient block.
4. Counseling: The student will demonstrate the ability to instruct parents at well-child visits on
safety issues for age, on how to give a medication, or about a specific treatment plan.
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5. Write prescriptions: The student will demonstrate ability to legibly write an accurate prescription.
Opportunities for this will occur during the patient encounter.
Evaluation:
The staff attending, residents and nursing all may have input into the final evaluation. All students
should actively seek feedback and review written evaluations as soon as available.
Nursery
Student Responsibilities:
1. Daily attendance. As expected for any clinical rotation, the student should page the attending
physician prior to start of the week to determine when/where to meet.
2. Attend morning report, if available at your site.
3. Perform chart review, parental interview, and physicals with supervision of teaching staff.
4. Write orders or discharge with supervision.
5. Write daily legible, concise SOAP notes.
6. Participate in all procedures on your patients, including blood draws, bili”flash”, hearing screens,
and circumcisions (optional).
7. Present in morning report or teaching conferences as requested, as determined by your site.
Competencies:
1. Observation: The student will perform a complete physical exam on a newborn. Immediate
feedback should help the student hone skills.
2. Written skills: Concise, complete SOAP notes should be recorded into the record.
3. Oral communication skills: The student will present the prenatal and delivery history in an
organized and complete fashion.
4. Circumcisions: Students should understand the risk/benefits for circumcision and how to counsel
for the procedure. It is not a mandatory procedure to perform, however students who desire
experience with this should let the resident/instructor know. It will never be done by the student
without staff supervision.
5. General knowledge: The student should be able to list risk-factors for health from the history and
physical exam, especially the following: Group B Streptococcal infections; understand the
components of neonatal resuscitation including APGAR scoring and it’s utility; understand the
presentation of both physiologic and pathologic jaundice, early lab evaluation, and intervention;
understand concepts in the parent education talk regarding feeding/stooling, bathing, and followup appointments; understand the risk/benefits for circumcision; list disorders on the Texas State
Newborn Screen and understand common presentations of these; list physical features for Turner
syndrome and Down syndrome; list risk-factors for developmental dysplasia of the hip.
Evaluation:
The staff attending, residents and nursing all may have input into the final evaluation. All students
should actively seek feedback and review written evaluations as soon as available.
Teaching formats:
Computerized Learning in Pediatrics Project (CLIPP): These cases will assist the student in patient
encounter documentation and problem solving. A case summary is available at the end of each case for
review.
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Access: Go to the site www.med-u.org. Login instructions were emailed to you prior to the start of the
course. Note: you must use your medical school account, i.e. (name)@medicine.tamhsc.edu or
(name)@dchstx.org.
Scholarly Activity: You will be expected to complete a scholarly activity while on the rotation. Specific
assignment information is provided in the orientation material at each campus.
Forums (If available at your site): Beginning in 2005, the language for medical student education is
“forum”, rather than lecture. Forums offer the faculty creative opportunities to guide an interactive
discussion, perform bedside teaching, explain equipment use, or use multimedia to get patient experience.
Simulation (If available at your site): Simulation and standardized patients may be used as additional
learning resources during your rotation. Simulation may be used to meet course objectives,
competencies, and patient encounters.
Small group session (If available at your site): Informal lunch discussions may be offered to discuss
case presentations with clinic teaching faculty.
Resident Teaching conferences (If available at your site): Attendance will be determined by campus to
correspond with your rotation assignment.
Other conferences (As determined at each site): Throughout the year, the Humanities department may
sponsor a speaker. If it is pertinent to your pediatric education, an email notice will be sent regarding
mandatory attendance. The Pediatric department sponsors several speakers and events throughout the
year. These too will be communicated to the students regarding attendance.
Textbooks (Required and Recommended Resources)
Student initiated learning on CDs, texts, and websites is encouraged. Since all students have different
learning styles, no specific textbooks have been mandated. However, the learning resource centers or
medical library have an abundance of helpful resources. Students are highly encouraged to review and
complete all CLIPP cases as they cover required material for the course.
Suggested Resources:
Helpful Links
Sites
www.aap.org
www.pedicases.org
www.comsep.org
www.med-u.org
www.medicalstudent.com
http://brightfutures.org/index.html
www.pediatriceducation.org
https://tamhsc.one45.com/
Comments
American Academy of Pediatrics
Bright futures cases –variable dx
National Pediatric Education Organization
(CLIPP) Computer-assisted Learning in Pediatrics
Program
Overall good resource
Bright Futures a national health promotion initiative
Resourceful, good cases
Healthcare Education for graduate and
undergraduate environments
Methods of Instruction & Evaluation:
Direct observation of history and physical exam skills with feedback will assist in honing these
skills (Appendix C&D).
Oral presentation skills will be assessed routinely during inpatient, outpatient, and nursery portions
of the rotation.
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Written organization and knowledge skills will be assessed in outpatient SOAP-notes and inpatient
H&P’s (Appendix E).
Self-directed student learning will be assessed in test format to help direct students in study and
testing. CLIPP-case access, interactive CDs, and other web sites of interest are provided.
Patient encounter data must be submitted into www.one45.com/webeval/tamhsc for tracking by the
medical school (Section XIII). Turn-in completed form to Clerkship Administrator at each site.
A procedure competency list must be submitted into www.one45.com/webeval/tamhsc for tracking
by the medical school (Section XIII). Turn-in completed form to Clerkship Administrator at each site.
Knowledge evaluation includes pediatric staff clinical assessment, OSCE, and written exams.
Professional behavior will be assessed in all encounters with patients, parents, physicians, nursing
staff and fellow medical students. Attendance, appearance, participation, and completion of all
assignments comprise this category.
X. Grading and Remediation Policies
The final course grade will be based on the following:
Clinical Evaluation
Midterm Exam and Review (Participation
Grade)
Scholarly Activities (scholarly activities,
H&Ps, SOAP notes, Procedure & Patient
logs)
OSCE
NBME (min pass 5th percentile, per the
NBME national quarterly data)
50%
P/F
P/F
Honors
(Max 20% of Class)
Pass
Fail
P/F
50%
GRADING SCALE
Clinical Grade ≥ 90
AND NBME ≥ 75th percentile**
70-100
69 and below
(also see Phase III Grading and
Remediation Policy)
100%
** Students with professionalism issues including failure to log patient encounters and procedures in a
timely and complete manner are not eligible for Honors.
Clinical Grade Calculation:
College Station
Clinical Grade Calculation
All Clinical Evaluations are averaged equally.
Dallas & Round Rock
Clinical Grade Calculation
Outpatient Clinical Evaluations – 50%
Inpatient Clinical Evaluations – 33%
Nursery Clinical Evaluations – 17%
Temple
Clinical Grade Calculation
Outpatient Clinical Evaluations – 50%
Inpatient Clinical Evaluations – 25%
Nursery Clinical Evaluations – 25%
(Selective Week is Ungraded)
Driscoll
Clinical Grade Calculation
Grading Conference to determine clinical evaluation grade. (Individual feedback from faculty
who cannot attend is considered during the conference.)
Date Created/Revised: ___6/10/14__ By: __DR & DM_____
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AIM
Clinical Grade Calculation
Clinical evaluations are averaged equally. AIM attendings will provide an evaluation each quarter
of the year.
In addition to clerkship specific grading information listed here, all Phase III Grading and Remediation
policies will be followed.
XI. Course Schedule (may include in Appendices if available)
Schedules will be provided during orientation at each site.
Date Created/Revised: ___6/10/14__ By: __DR & DM_____
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XII. Patient Encounter Logs:
Pediatric Competencies
Procedure/Skill
Vital Signs (HR, RR, T, BP)
(Objectives: 1, 14)
Vital Signs (HR, RR, T, BP)
(Objectives: 1, 14)
Growth Measures/Chart
(Objectives: 1,14)
Growth Measures/Chart
(Objectives: 1, 14)
B.M.I. Calculation
(Objective: 4)
Mid-Parental Height
(Objective: 1)
Urine Dipstick
(Objective: 5)
Throat Culture
(Objective: 3 )
Vision Screening (observe)
(Objective: 1)
Hearing Screening (observe)
(Objective: 1)
Pulse Oximeter
(Objective: 7)
Injection/Immunization
(Objectives: 1, 14, 15, 16)
Injection/Immunization
(Objectives: 1, 14, 15, 16)
Nebulizer Treatment
(Objectives: 7, 14)
HFA/MDI Spacer
(Objectives: 7, 14)
Write Rx for Tylenol
(Objectives: 6, 14)
Write Rx for Mortrin
(Objectives: 6, 14)
Write Rx for Antibiotic
(Objectives: 6, 14)
Informed Consent
(Objectives: 14, 15, 17)
Admission Orders
(Objectives: 14, 15, 18)
Date Performed
AGE
Supervisory Staff
Competency: The student knows indication, contraindication, expectations or side effects of a procedure.
Turn in Completed form to Clerkship Administrator by last week of the rotation.
Date Created/Revised: ___6/10/14__ By: __DR & DM_____
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Patient Encounter Table – COMSEP 2005 Appendix 2 Clinical Encounter Table
Types of Patients to be Seen
Number
required to
be seen
(real or
simulated)
Level of
student
responsibility*
(OB, PP, FP)
Clinical
setting+
(O, I, E)
Alternative
clinical
learning
experience^
Domain-patient
type/core
condition
Symptom, sign,
or concern
Examples of diagnosis
or issue addressed
Health
Maintenance
Well child care
Newborn (0-1 month)
O
CLIPP case
1
Well child care
Infant (1-12 months)
O
CLIPP case
2
Well child care
Toddler (12-60 months)
O
CLIPP case
3
Well child care
School aged (5-12
years)
Adolescent (13-19
years)
O
CLIPP case
4
CLIPP case
5, 6
Well child care
Growth
Parental
concerns or
abnormalities
related to the
domain
Nutrition
Parental
concerns or
abnormalities
related to the
domain
FTT, poor weight gain,
obesity, short stature,
microcephaly,
macrocephaly,
constitutional delay,
small for gestational
age, large for gestational
age
FTT, breast vs. formula
feeding, questions about
switching to formula,
when to add solids,
beginning cow's milk,
diet
Date Created/Revised: ___6/10/14__ By: __DR & DM_____
O
Documentation
(Date, signature,
student initials)
Computer
case 1
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2014-2015 Syllabus
Development
Parental
concerns or
abnormalities
related to the
domain
Delayed or possibly
delayed language, gross
motor, fine motor, or social
adaptive skills
CLIPP case
28, 29
Behavior
Parental
concerns or
abnormalities
related to the
domain
Sleep problems, colic,
temper tantrums, toilet
training, feeding problems,
enuresis, ADHD,
encopresis, autistic
spectrum disorder, eating
disorders, head banging,
poor school
performance
CLIPP case
4
Upper
Respiratory
Tract
Sore throat,
difficulty
swallowing,
otalgia
Pharyngitis, strep throat,
viral URI, herpangina,
peritonsillar abscess,
common cold, allergic
rhinitis, otitis media,
sinusitis, otitis externa
CLIPP case
14
Lower
Respiratory
Tract
Cough,
wheeze,
shortness of
breath
Nausea,
vomiting,
diarrhea,
abdominal pain
bronchiolitis, bronchitis,
pneumonia, aspiration,
asthma, bronchiectasis,
CLIPP case
12, 13
gastroenteritis,
giardiasis, pyloric
stenosis, appendicitis,
HSP, peptic ulcer disease,
gastroesophageal reflux
disease
CLIPP case
15, 27
Gastrointestinal
Tract
Date Created/Revised: ___6/10/14__ By: __DR & DM_____
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Dermatologic
system
Rash, pallor
Viral rash, scarlatina,
eczema, urticaria, contact
dermatitis, toxic shock,
thrush, atopic dermatitis,
seborrheic dermatitis, acne,
anemia
Central nervous
system
Lethargy,
irritability,
fussiness,
headache
meningitis, concussion,
seizures, ataxia, closed
head injury, headache
Emergent
Clinical Problem
Respiratory
distress, shock,
ataxia,
seizures,
airway
obstruction,
apnea,
proptosis,
suicidal
ideation,
trauma,
cyanosis.
Meningitis, shock,
testicular torsion, DKA,
SIDS, acute life
threatening event
(ALTE), congestive heart
failure, burns, status
asthmaticus, status
epilepticus,
encephalitis, child abuse
etc.
CLIPP
cases: 23,
25
seasonal allergies,
asthma, cerebral palsy,
cystic fibrosis, diabetes
mellitus, malignancy (e.g.
acute lymphocytic
leukemia or Wilms
tumor), sickle cell
disease, epilepsy, atopic
dermatitis, obesity, sensory
impairment, HIV/AIDS
CLIPP
cases: 30,
31
Chronic medical
problem
Date Created/Revised: ___6/10/14__ By: __DR & DM_____
CLIPP case
3, 21
CLIPP case
20, 24, 28
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2014-2015 Syllabus
Unique
condition: fever
without
localizing
findings
Unique
condition:
neonatal
jaundice
fever
rule out sepsis; urinary tract
infection, systemic viral
infection (e.g. EBV),
autoimmune diseases
CLIPP case
10
jaundice
jaundice
CLIPP case
8
monitored and
verified (date)
interim clinical
learning plan
given
Table Key:
*OB = Observation (CR only)
PP = Partial participation (Hx or PE)
FP = Full participation (Hx, PE and CR)
CR= Clinical reasoning
Hx = History taking/data gathering
PE = Physical examination
+O = Outpatient
I = Inpatient
E = Emergency
Date Created/Revised: ___6/10/14__ By: __DR & DM_____
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Common Pediatric Illness Table - COMSEP 2005 Appendix 1
For each presenting symptom, finding, or laboratory value the columns list the suggested
differential diagnosis based on level of competence.
Presenting symptom, finding,
or laboratory value
Cough and/or wheeze
Core pediatric level
Mastery level
Asthma
Allergic rhinitis
Bronchiolitis
Community acquired pneumonia
Croup
Chlamydia pneumonia
Cystic fibrosis
Gastroesophageal reflux (GERD)
Viral upper respiratory tract infection
Laryngomalacia and tracheomalacia
Pertussis
Tuberculosis
Fever without a focus
Bacteremia/sepsis
JRA
Meningitis
Occult bacteremia
Urinary tract infection
malignancy
Viral illnesses
Sore Throat
Group a streptococcal pharyngitis
Mononucleosis
Postnasal drip
Viral upper respiratory tract infection
Peritonsillar abscess
Retropharyngeal abscess
Otalgia
Otitis media, Acute and Recurrent
Otitis media with effusion
Otitis externa
Dental caries
Foreign body of the canal
Mastoiditis
Pharyngitis
TMJ syndrome
Rhinorrhea
Allergic rhinitis
Sinusitis
Viral URI.
Nasal foreign body
Fever and rash
Group A streptococcal infection
drug reaction
Kawasaki disease
JRA
Date Created/Revised: ________ By: _______
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2014-2015 Syllabus
Abdominal pain
meningococcemia
viral exanthem
Lyme disease
Rickettsial disease
Toxic shock syndrome
Appendicitis
Constipation/encopresis
Bowel obstruction
Cholecystitis
Gastroenteritis
HSP
intussusception
Pelvic inflammatory disease
Urinary tract infection/pyelonephritis
Dysmenorrhea
Gastritis
Incarcerated hernia
Inflammatory bowel disease
Malignancy
Malrotation and volvulus
Ovarian or testicular torsion
Pancreatitis
Peptic ulcer disease
pregnancy
Diarrhea
Gastroenteritis
Celiac Disease
Clostridium difficile infection
Encopresis
Inflammatory Bowel Disease
Malabsorption
Toddlers diarrhea
Vomiting
Gastroenteritis
Gastroesophageal reflux
Pyloric stenosis
UTI/pyelonephritis
Bowel obstruction
Congenital adrenal hyperplasia
Diabetic Ketoacidosis
Eating disorder
Hepatitis
Inborn errors of metabolism
Inborn errors of metabolism
Intracranial process (increased
intracranial pressure)
Meningitis
poisoning
Pregnancy
Volvulus/malrotation
Rash
Atopic dermatitis
Contact dermatitis
cellulitis
impetigo
Date Created/Revised: ________ By: _______
drug reaction
erythema toxicum
molluscum contagiosum
warts
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2014-2015 Syllabus
lice
monilial infections
scabies
seborrhea
urticaria
viral enanthem
viral exanthem
Limp or extremity pain
developmental dysplasia of the hip
Acute rheumatic fever
fracture
Legg-Calve-Perthes disease
Nursemaid elbow
Henoch Schönlein purpura
JRA
Lyme disease
Osgood Schlatter disease
Osteomyelitis
Septic arthritis
Slipped capital femoral epiphysis
transient synovitis
malignancy
reactive arthritis
sickle cell crisis
Headache
meningitis
tension headache
Brain tumor
concussion
hydrocephalus
increased intracranial pressure
metabolic disorders
Seizures
febrile seizures
idiopathic seizures
meningitis
post traumatic seizure
toxic ingestions
Bruising
trauma
coagulopathy
leukemia
Petechiae/purpura
ITP
sepsis
leukemia
coagulopathy
trauma
vasculitis
viral infections
rickettsial infection
innocent murmur
anemia
CHF
Heart murmur
Date Created/Revised: ________ By: _______
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2014-2015 Syllabus
myocarditis
PDA
valvular defects
Lymphadenopathy
Bacterial adenitis
Streptococcal pharyngitis
Cat scratch disease
HIV
Viral illnesses (general or specific
such as EBV)
Kawasaki disease
Malignancy
Mycobacterial adenitis
Splenomegaly
Malignancy (e.g. leukemia)
Mononucleosis
Hemolytic anemia
Sickle cell anemia (infancy)
Systemic infectious diseases
Hepatomegaly
hepatitis
congestive heart failure
inborn errors of metabolism
systemic infectious diseases
Abdominal mass
hydronephrosis
malignancy
pregnancy
stool
White pupillary reflex
cataracts
retinoblastoma
Red or wandering eye
conjunctivitis
allergy
strabismus
esotropia
exotropia
foreign body
trauma
Anemia
iron deficiency anemia
sickle cell anemia
thalassemia
anemia of chronic disease
bone marrow failure
hemolytic anemia
hemolytic uremic syndrome
malignancy
Hematuria
glomerulonephritis
benign familial hematuria
Date Created/Revised: ________ By: _______
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Proteinuria
Positive Mantoux skin test
trauma
UTI
hemolytic uremic syndrome
hypercalciuria
nephrotic syndrome
transient proteinuria
orthostatic proteinuria
glomerulonephritis
latent tuberculosis
non-tuberculosis mycobacterial
infection
active tuberculosis
Common Pediatric Diagnosis - COMSEP 2005 Appendix 3
This is a list of the diagnosis listed as either core pediatric (CP) or universal (U) in the
curriculum. In many circumstances, the student only needs to know the context, e.g. that the newborn
screen is useful in detecting PKU deficiency. For others, students should know the epidemiology,
clinical manifestations, differential diagnosis, and initial therapeutic plan (e.g. bronchiolitis).
abdominal pain
abnormal growth patterns
acetaminophen overdose
acidosis (severe)
acne
acute life-threatening event
(ALTE)
acute lymphocytic leukemia
(ALL)
acute otitis media
alcohol overdose
allergic rhinitis
anaphylaxis
anemia
animal bite
appendicitis
asthma
atopic dermatitis
attention deficit
bacterial adenitis
bone fracture
bronchiolitis
candida dermatitis
cataracts
cellulitis
cerebral palsy
child abuse
colic
congestive heart failure
conjunctivitis
constipation
constitutional growth delay
contact dermatitis
head injury headache
hearing lossheart murmur
(innocent)
hematuria
hemophilia
Henoch Schönlein Purpura
hepatitis
hepatomegaly
hydronephrosis
hyperkalemia
hypernatremia
hypoglycemia
hypokalemia
hyponatremia
hypothyroidism
hypoxemia
idiopathic thrombocytopenic
purpura
impetigo
inappropriate ADH secretion
increased intracranial pressure
innocent murmur
intussusception
iron deficiency anemia
iron overdose
irritability
jaundice
Kawasaki disease
large for gestation infant
(LGA)
latent tuberculosis
Legg-Calve-Perthes disease
lethargy
Date Created/Revised: ________ By: _______
pertussis
petechiae
PKU deficiency
pneumonia
poor feeding
positive Mantoux skin test
(PPD)
postnasal drip
prematurity
proteinuria
purpura
pyelonephritis
pyloric stenosis
pyloric stenosis
renal failure
respiratory distress
retinoblastoma
rhinorrhea
risk-taking behavior
scabies
school failure
seasonal allergies
seborrhea seizures
sepsis
septic arthritis
sexual abuse
shock
short stature
sickle cell anemia
sinusitis
sleep problems
slipped capital femoral epiphysis
small for gestation infants
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2014-2015 Syllabus
croup
cystic fibrosis
dehydration
depression
developmental delay
developmental dysplasia of the
hip
diabetes mellitus
diabetic ketoacidosis
diarrhea
drug abuse
drug withdrawal
eating disorder
encephalitis
encopresis
enuresis
epilepsy
failure to thrive
familial short stature
febrile seizure
feeding problem
fever
fissure
foreign body aspiration
gastroenteritis
gastroesophageal reflux
disease glomerulonephritis
head banging
Leukocoria
lice
limp
lymphadenopathy
macrocephaly
Meckel’s diverticulum
meningitis
meningococcemia
microcephaly
minor head injury
monilial infections
mononucleosis
narcotic overdose
neglect
nephrotic syndrome
nursemaid elbow
nursemaids elbow
nutritional deficiencies
obesity
orthostatic proteinuria
Osgood Schlatter disease
osteomyelitis
otalgia
otitis externa
otitis media with effusion
otitis media, acute and
recurrent
pelvic inflammatory disease
(SGA)
splenomegaly
status epilepticus
strabismus
streptococcal pharyngitis
substance abuse
suicidal
temper tantrums
tension headache
thalassemia
transient synovitis
tremulousness
Trisomy 21
tuberculosis
Turner syndrome
urinary tract infection
urticarial
vasculitis
viral exanthem
viral infections
viral upper respiratory tract
infection
vomiting
wheeze
Wilms tumor
XIII. Important Legal Information and Policies
a. TAMHSC E-mail Access and FERPA
TAMHSC 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
Office of the Registrar at 888-523-2905.
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.
Date Created/Revised: ________ By: _______
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2014-2015 Syllabus
b. Students with Disabilities
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 the Disability Services Office at 979-845-1637 or visit the website
http://disability.tamu.edu/. Any student with a disability who needs accommodation should inform the
instructor at the beginning of the course.
c. Professionalism and integrity Statement (Academic Honesty and Plagiarism)
All TAMHSC 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.
As commonly defined, plagiarism consists of presenting as one's own the ideas, words, writings, etc.,
which belong to another. In accordance with this definition, you are committing plagiarism if you copy
the work of another person and turn it in as your own work, even if you should have the permission of
that person. Plagiarism is one of the worst academic violations, for the plagiarist destroys the trust among
colleagues without which academic communication cannot be safely conducted.
d. 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 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. The College of Medicine internal policy for dealing with claims of
student mistreatment or unprofessional behavior is described here. This policy addresses student
mistreatment involving College of Medicine employees. However, we realize that a student may
experience mistreatment from residents, affiliate staff, or patients. These instances will be discussed in
Section V of the document. Please access the policy at http://medicine.tamhsc.edu/dean/policies/studentpolicies/mistreatment-of-students.html for more information regarding reporting, resolution of claims,
appeals, and responsibilities. To report mistreatment via College of Medicine telephone hotline, dial
1(855)-397-9835. To report via web page, click http://medicine.tamhsc.edu/dean/policies/studentpolicies/form.html
e. Exposure and Occupational Hazard
The Needle Stick Policy for Medical Students may be accessed at:
http://medicine.tamhsc.edu/dean/policies/student-policies/needle-stick-policy.html
Note: More information is available on the aforementioned topics to all students in the online course
catalog and or on the College of Medicine website.
Date Created/Revised: ________ By: _______
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XIV. Appendices
Appendix A: College of Medicine Competency Based Learning Objectives
College of Medicine Competency Based Learning Objectives can be found under the Office of Academic
Affairs website:
http://medicine.tamhsc.edu/academic-affairs/curriculum/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
2. 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
determinates of health
PC2 - Perform both complete and system-focused physical examinations
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
3. 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
Date Created/Revised: ________ By: _______
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2014-2015 Syllabus
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
4. 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
5. Systems-Based Practice
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.
6. 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
7. Cultural Competence
Upon completion of the medical school curriculum, our students will be able to:
Date Created/Revised: ________ By: _______
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2014-2015 Syllabus
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: Principles and Guidelines for Curriculum Development
http://medicine.tamhsc.edu/dean/policies/pdf/curriculum-principles-guidelines.pdf
Approved by Curriculum Committee: November 15, 2011
The purpose of the curriculum is to prepare an undifferentiated physician for the demands and
expectations of postgraduate training and medical practice in the 21st Century.
Principle I
Each curricular component has educational goals and objectives which in the aggregate are
specifically designed to meet the COM Curricular Goals and Objectives.
Principle II
Basic and Clinical Sciences are integrated throughout the curriculum.
Guideline 1
All curricular components are directed, designed and delivered by teams that include Basic
and Clinical Science faculty.
Guideline 2
Curricular components and student grades are not discipline or department based.
Guideline 3
Responsibility for curricular component design and delivery rests with the
course/block/clerkship directors with the support of the departments and approval of the central
curricular authority.
Principle III
The curriculum is competency-based, requires students to assume graduated responsibility for patient
care, and is consistent with the ACGME Core Competencies:
Patient Care
Medical Knowledge
Practice Based Learning and Improvement
Interpersonal/Communication Skills
Systems Based Practice
Professionalism
Guideline 1
Achievement of competency is regularly assessed, documented utilizing specific outcome
measures, and is required for advancement.
Principle IV
Curricular content reflects the health risks and disease burdens on society experienced in the
context of the diverse components of our health care delivery system.
Guideline 1
Curricular components are based on the biopsychosocial model of disease.
Guideline 2
Preventive health care is emphasized throughout the curriculum.
Guideline 3
The curriculum assures student experience across the spectrum of health care settings
including ambulatory, inpatient, critical, and emergent.
Guideline 4
The curriculum includes a long term continuity of care experience.
Principle V
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A personalized and nurturing faculty-student interaction is maintained at every level.
Principle VI
There is a shared expectation of preparation, active participation, and partnering in learning by
students and faculty.
Principle VII
The educational program is learner-centered, incorporating multiple methodologies and
resources for teaching and learning to meet the diverse needs of our students.
Principle VIII
Emphasis is placed on student self-directed learning with time provided for independent study.
Guideline 1
In components of the curriculum that are primarily classroom or laboratory-based:
 There are no more than twenty-four (24) contact hours per week.
 There are no more than ten (10) hours of traditional lecture per week.
 The contact hours that are not traditional lecture should be devoted to active learning.
Active learning is defined as content that requires active participation of students.
Examples include case-based learning, team-based learning, problem-based learning, small
group instruction, and any other format in which the students must actively participate
in the class.
 There is a predictable weekly contact hours template including three (3) free half days.
Guideline 2
In components of the curriculum that are primarily centered on patient care:
 There are no more than ten (10) hours of traditional lecture per week.
 Duty hours are defined as all clinical and academic activities related to the clerkship; i.e.,
patient care (both inpatient and outpatient), administrative duties relevant to patient care, the
provision for transfer of patient care, time spent in-house during call activities, and scheduled
activities, such as conferences. Duty hours do not include reading and preparation time
spent away from the duty site.
o Duty hours must be limited to 80 hours per week, averaged over a four-week
period, inclusive of all in-house call activities.
o Students must be provided with one day in seven free from all educational and
clinical responsibilities, averaged over a four-week period, inclusive of call.
o Adequate time for rest and personal activities must be provided. This should
consist of a 8-hour time period provided between all daily duty periods and after inhouse call.
 On-call Activities:
o In-house call must occur no more frequently than every third night, averaged over a
four-week period.
o Continuous on-site duty, including in-house call, must not exceed 24 consecutive
hours. Students may remain on duty for up to six additional hours to participate in
didactic activities, transfer care of patients, conduct outpatient clinics, and
maintain continuity of medical and surgical care.
o No new patients may be accepted after 24 hours of continuous duty
At-home call (or pager call)
 The frequency of at-home call is not subject to the every-third-night, or
24+6 limitation. However at-home call must not be so frequent as to preclude rest and
reasonable personal time for each student.
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 Students taking at-home call must be provided with one day in seven completely free
from all educational and clinical responsibilities, averaged over a four-week period.
 When students are called into the hospital from home, the hours students spend in-house
are counted toward the 80-hour limit.
Principle IX
The curriculum is designed to build lifelong learning skills in our students.
Principle X
Faculty is provided the necessary resources and tools to become effective teachers, including
generic and tailored faculty development programs based on a structured faculty evaluation
system and other defined needs.
Principle XI
The curriculum and its components are evaluated on a regular basis by a central authority
structured to work in the best interest of the curriculum as a whole to ensure continuous quality
improvement and achievement of the College of Medicine Curricular Goals and Objectives.
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Appendix C: Observation Checklist 1
Acute illness
History
Comments
______introduces self
______makes eye contact, acknowledges patient
______asks open ended initial question
______asks about fever/max temp/how taken
______asks about runny nose
______asks about cough/timing/nature
______asks about GI sx/vomiting/diarrhea
______asks about rashes
______asks about hydration/quantity of urine
______asks about activity level/mental status
______asks about sleep quality
______explores duration of illness
______asks about current tx given so far (must include dosages)
______inquires about drug allergies
______asks about Past hx pertinent to chief concern
______asks about risk factors for illness/smoke exposure/daycare/ill contacts
______asks if immunizations current
Staff Init.________Date________
Physical Exam
______washes hands before performing exam
______makes patient comfortable on lap or table
______gentle with patient in performing the exam
______uses proper technique in handling otoscope and checking ears
______looks in eyes
______checks mouth/pharynx
______checks neck for lymph nodes
______listens over chest in at least 4 places
______palpates abdomen
______checks for skin rashes
Staff Init_________Date________
Communication skills
______answers any questions
______makes a reassuring or closing statement/thanks patient
Staff Init_________Date________
*Note: The information in the history section should be included in the SOAP note.
Turn in completed form to Clerkship Administrator by last week of rotation.
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Appendix D: Observation checklist 2
Well-child care
History
Comments:
______introduces self
______acknowledges patient
______asks open ended first question
______asks about birth history/risk factors for morbidity
______asks about recent illnesses
______asks about diet
______asks about sleep position/habits
______asks about hearing and vision
______asks about language/vocalization (age appropriate)
______asks about gross or fine motor skills (age appropriate)
______asks about past immunizations/adverse reactions
______asks about any drug allergies
______asks about daycare/family support
______asks about risk factors for illness/daycare/tobacco exposure
______asks about car seat use/physical environment—safety
Staff Init_______Date______
Physical Exam
______reviews growth parameters on chart with parent(s)
______washes hands before exam
______makes patient comfortable on lap or table
______examines head/fontanel
______checks for red reflexes/conjunctivitis/gaze
______uses proper technique in handling otoscope and checking ears
______checks for teeth/oral lesions/pharynx
______auscultates heart
______listens to lungs in 4 places
______palpates abdomen for masses
______checks genitalia
______looks for skin rashes
______checks back/spine
______performs Barlow/Ortolani tests correctly, when indicated
______checks tone/pulls to sitting or standing
Staff Init_______Date________
Communication skills
______explains any abnormal or normal variant exam findings
______makes a reassuring closing statement/thanks patient
Staff Init_______Date_______
Turn in completed form to Clerkship Administrator by last week of rotation.
Appendix E: Inpatient H&P feedback form: H&P Evaluation Form
Date turned in: ______________________ Date reviewed: _____________________
Student:
Evaluator Initial: _______________
This form has been provided courtesy of USUHS members of COMSEP.
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ID
&
CC
HPI
P
M
H
X
F
H
X
SOC
HX
ROS
PE
LAB
IMP
&
P
L
A
N
D
I
S
C
Succinct (in patient’s own words, if possible)
ID (age, sex, underlying conditions)
Informant and reliability addressed
Delineates pertinent signs and symptoms in
chronological order, using days PTA
Includes pertinent past history, therapies
Complete pertinent positives & negatives
Uses appropriate medical terminology
Sentences are clear and concise
Includes hosp, surg., illnesses, meds/allergies
Neonatal, diet, and developmental history as
appropriate for age (to include Denver II)
Includes immunization status
Includes pertinent diseases/diagnoses in
extended family
Identifies health status of parents, siblings
Notes family strengths
Includes child’s current living arrangement
and caretakers
Addresses school performance
HEADDS interview, if adolescent
Addresses all relevant major systems
Contains only issues not pertinent to HPI
Vital signs present
Growth measures, % and curve (Ht, Wt, HC)
General descript. provided w/o stock phrases
All systems included in appropriate detail
Complete pertinent positives and negatives
Includes pertinent normal results
Identifies significant abnormal results
Problem list, with problems logically grouped
and prioritized
Differential diagnoses, addressing all problems
Develops organized Dx and Rx approach for
each problem
Addresses patient education when appropriate
Brief hospital course to date
Discussion of patient’s problems: uses the
literature to answer clinical question(s) regarding
patient’s problems
Reference list (should include at least 3 relevant,
current articles)
Attach form to H&P and submit to assigned resident for review and feedback. Resident will turn in to
Clerkship Administrator after reviewing with student.
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Appendix F: Exam/OSCE Tips
Mid Term exam: Although it’s only Pass/Fail, it is advisable to study for this exam. Each student will
self-score their exam. Review of this exam will be offered prior to the final exam.
Shelf-exam: The Pediatric shelf exam historically has been shallow but thorough, i.e. it covers all organ
systems. It is important that you read on immune deficiencies, since this is commonly something that is
not consistently covered. Also, pace yourselves. It is important to “bubble” as you answer the questions
rather than doing this in haste at the end of the session.
Regarding dress, you may dress casually for the written exams, if desired, however a professional
appearance will be required for the OSCE. Remember that the rooms are frequently cool/cold.
OSCE Needs: Bring your stethoscope, nametag, black ink pens, and calculator. No smart phones, please.
The only paperwork to be carried is the schedule, which will be provided prior to the test. Professional
dress is required (no scrubs) since there are real patients here. Unfortunately, inappropriate attire will
disallow the student to participate in patient stations.
OSCE Stations: Each station is USMLE Step 2 Format, and each one is either 10 or 15 minutes. Please
stay at the station until the time is completed. If completed early, you may stand outside the room.
Please observe quiet zones in the hallways.
Ask questions at the stations if needed.
Tip: At patient stations, hand washing must occur immediately prior to the exam. No hand washing
equals no credit for the exam.
Remember: All students sign a confidentiality statement during orientation. It is intended that there to be
no discussion of stations with peers during the breaks, nor with students who have yet to complete this
course.
Feedback session: This mandatory session will occur immediately after the exam. The day should finish
by 5:00 pm (so do not make any personal plans within this time frame.)
Final note: If there are any concerns after the exam, please email them to your Clerkship Site Director.
Final course grades are not assigned for nearly two weeks.
Good luck!
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