Course/Rotation Title: ACADEMIC MEDICINE Date of Last Review/Update 5/08 Course/Rotation Director: David A. Albert, MD Location: Inpatient % time = TBD by project Outpatient% time = TBD by project Course/Rotation description with educational purpose/value The goal of this rotation is to allow residents to develop skills in the areas of scholarship and discovery. At a minimum the resident must complete a project that fulfills one or more of the following scholarship criteria: Initial development of case report for HSP as a Pancreatic Paraneoplastic Syndrome Application to present Secretory Villous Adenomas: A Case Report & Literature Review for poster session at the October meeting of the American College of Gastroenterologists. Credit for the rotation will not be given unless the resident fulfills one of the above categories of scholarship. Types of Clinical Encounters: (PLEASE SPECIFY) Literature review Types of Patients: (PLEASE SPECIFY) Patients with secretory villous adenomas; patient with HSP as pancreatic paraneoplastic syndrome Mix of Diseases: (PLEASE SPECIFY ANY ADDITIONAL DISEASES 1.) Secretory villous adenomas 2.) HSP as paraneoplastic syndrome Types of Procedures: (PLEASE SPECIFY) None Describe the level of supervision by faculty [ ] Attending staff will supervise and precept all patient care activity directly or indirectly. [X] Attending staff will provide mid rotation feedback [X] Attending staff will provide end-of-rotation feedback [ ] Other: see above under rotation description Competency Based Objectives/Expectations. Please see Roman Numeral II with additional items specific to this rotation as below Patient Care: This elective will highlight comprehensive insightful physical exams as essential to timely diagnosis as well as careful integration of laboratory and imaging data in developing an appropriate differential diagnosis and plan of care. Medical Knowledge: Effective electronic literature searches are critical to extracting current knowledge from the vast body of published information. The identified articles then need to be critically reviewed for appropriateness in analyzing the clinical question at hand. In addition appropriate and complete information is essential in synthesizing new insights in disease processes and patient care. To be determined by project type: resident to define as part of their project how this competency is addressed Practice-Based Learning: The presentation process is an excellent opportunity not only to share information, but also to receive feedback both on effective communication as well as additional clinical and procedural insights. Interpersonal and Communication Skills: The presentation process is an excellent opportunity not only to share information, but also to receive feedback both on effective communication as well as additional clinical and procedural insights. Professionalism: This elective will be effective in developing, enhancing and refining a variety of written and verbal communication skills that can be shared with peers pursing similar goals now and in the future. Further, developing these skills can be an important influence on patient care System-Based Practice: This project provides an opportunity to refine a systematic approach to healthcare related problems. Essential to the timely completion of the tasks outlined above is organization, the effective use of electronic resources and the council of others. Experiences gained through this project will be provide insights invaluable not only to myself, but certainly for my peers and potentially for the Berkshire medical community. Check Any Methods Used For Teaching and Assessment [ ] Ambulatory Clinic (feedback written & verbal) [ ] Annual In-service Exam (feedback written) [ ] Attending Rounds (feedback written & verbal) [ ] Board Review (feedback written examination) [ ] Cancer Conference [ ] Case Management Evaluation (360 degree written evaluation) [ ] Chart Stimulated Recall & Feedback (feedback verbal) [X] Direct Observation and Feedback (feedback written & verbal) [ ] GME Core Curriculum [ ] Interns Report (feedback written & verbal) [ ] Journal Club (feedback written & verbal) [ ] Medical Record Review (feedback written & verbal) [X] Mentor Feedback (feedback written & verbal) [X] End of Elective Exam (feedback written) [ ] Monthly Mini CEX (feedback written & verbal) [X] Monthly Competency Based Written Evaluation [ ] Morning Report (feedback written & verbal) [ ] Multidisciplinary Rounds Feedback (feedback verbal) [ ] Nursing Evaluation (360 degree written evaluation) [ ] Patient Evaluation (360 degree written evaluation) [ ] Patient Management Discussions (feedback written & verbal) [ ] Procedure Logs [ ] Performance improvement Multidisciplinary Morbidity and Mortality (feedback written & verbal) [ ] Semi Annual Program Director Feedback (feedback written & verbal) [ ] Student Evaluation (feedback written & verbal) [ ] Supervised Sign-In Rounds (feedback written & verbal) [ ] Supervised Sign-Out Rounds (feedback verbal) [X] Other: Preceptor to review and give formal verbal and written feedback on final project [X] Other: Attending to review and give formal verbal feedback on Secretory Villous Adenoma project [X] Other: Attending to review and give formal verbal feedback on HSP as pancreatic paraneoplastic syndrome. Other Policies The Course Director recognizes that the trainee is accountable to all BMC Residency and GME Personnel Policies and Procedures. The Course Director recognizes that the residents are expected to attend all continuity clinics and mandatory educational conferences unless excused by the Program Director or Chief Medical Resident with advanced notice. Check The Educational Materials Used (beyond direct patient care) [ ] Reading List (Please Specify): None. [X] Review of Appropriate Radiology Images: CT scans, MRIs and CXR relating to the HSP case [X] Review of Appropriate Pathology: Analysis of pathology reports along with consideration of SEMs and light micrographic images for inclusion in final report [X] Review of Appropriate Laboratory Data: Analysis of serologic, immunologic and CBC data [X] Articles from the Literature: In addition to other articles that may be obtained in the course of this elective the following articles will serve as the initial basis for the HSP report: 1. Solans-Laqué R, Bosch-Gil JA, Pérez-Bocanegra C, Selva-O'Callaghan A, Simeón-Aznar CP, Vilardell-Tarres M. Paraneoplastic vasculitis in patients with solid tumors: report of 15 cases. J Rheumatol. 2008 Feb;35(2):294-304. Epub 2007 Dec 15. 2. Fain O, Hamidou M, Cacoub P, Godeau B, Wechsler B, Pariès J, Stirnemann J, Morin AS, Gatfosse M, Hanslik T, Belmatoug N, Blétry O, Cevallos R, Delevaux I, Fisher E, Hayem G, Kaplan G, Le Hello C, Mouthon L, Larroche C, Lemaire V, Piette AM, Piette JC, Ponge T, Puechal X, Rossert J, Sarrot-Reynauld F, Sicard D, Ziza JM, Kahn MF, Guillevin L. Vasculitides associated with malignancies: analysis of sixty patients. Arthritis Rheum. 2007 Dec 15;57(8):1473-80. 3. Chen KR, Carlson JA. Clinical approach to cutaneous vasculitis. Am J Clin Dermatol. 2008;9(2):71-92. 4. Zurada JM, Ward KM, Grossman ME. Henoch-Schönlein purpura associated with malignancy in adults. J Am Acad Dermatol. 2006 Nov;55(5 Suppl):S65-70. 5. Pertuiset E, Lioté F, Launay-Russ E, Kemiche F, Cerf-Payrastre I, Chesneau AM. Adult Henoch-Schönlein purpura associated with malignancy. Semin Arthritis Rheum. 2000 Jun;29(6):360-7.