In order to successfully complete the rotation, you MUST complete all of the following:


A. Clinical shifts (15) with satisfactory clinical performance
B. Lectures and clinical labs unless excused absence by course director.
C. Computer modules
D. Submission of patient log
E. Demonstrate professional behavior
F. Written exam
G. Standardized Patient Interaction: Informed Consent  

A. Clinical Shifts/Performance

• The majority of your Emergency Medicine rotation consist of clinical shifts in the
  Emergency Department.  These shifts will include days, evenings, nights and weekends, as resources and presenting pathology varies greatly.

• Students will complete 15 clinical shifts.  With the exception of Beaumont, these shifts are 8 hours in length.  In addition, students must complete the following types of shifts:

  • Minimum of 2 shifts in the pediatric ED
  • Minimum of 1 nurse/tech shift (maximum of 2)
  • Minimum of 6 shifts in the adult ED
  • A third-rider observation shift (12 hours) with Huron Valley Ambulance may replace one adult ED shift (Not available until further notice).

  There will never be more than 1 student per shift (unless specific arrangements have been made with the EM Student Coordinator/Director for extenuating circumstances). The EM Student Coordinator and/or Director MUST approve all shifts changes in writing in advance of any changes. Any students making deviation(s) to the schedule without the Coordinator and/or Director’s approval is subject to discipline and possible failure of the course. Except for exceptional circumstances, all changes to the schedule will be finalized 48 hours after the start of the rotation.

General guidelines for shift changes include:

While working in the ED, students will be matched with a senior EM3 or 4 (occasionally EM2) level resident or attending physician.  Students will obtain a focused history at physical examination on designated patients.  They are also expected to generate a differential diagnosis and propose an initial management plan.  Students will present patients to their assigned attending or senior resident. The student will then follow each patient evaluated throughout the ED course and participate in all aspects of their care.  

Due to the nature of Emergency Medicine, it will be typical for a student to work with multiple residents and faculty over the course of the month.  Therefore, it is crucial that you establish expectations for your role at the beginning of each shift.  

Evaluations: Since your supervising physician will change daily, you will receive a clinical evaluation for each shift.  At the end of each clinical shift you are expected to distribute one of your clinical evaluations to the resident and/or attending physician, whomever you spent significant time with on that shift. These online forms are then completed by the faculty and residents and returned to the EM Student Coordinator to compile your grade. Please also update the matchup sheet with the names of your Attending and Resident for each shift, so that we can track your evaluations.  A copy of this log should be submitted weekly.  The evaluation form utilized for this rotation is available for your review and a download of additional copies under "Forms" on this website.

Before and after lectures, you may review your completed evaluations in order to receive feedback on your clinical performance. These will be available in individual folders at lecture and are to remain within the lecture room.  Individual evaluations are blinded as to the evaluator in order to obtain timely and unbiased feedback.  If a concern is identified on an evaluation, the course director will contact you to discuss it further.  In addition, you will receive written mid-rotation feedback on the third Monday of each rotation, indicating whether you are performing satisfactorily and containing any major suggestions for improvement. 

Dress code:  A UMHS ID badge and/or ID badge from your assigned hospital must be prominently worn at all time.  Shirt and tie or equivalent professional attire for women is expected during all clinical activities. Clean scrubs worn under short white coat are also appropriate for the adult ED.  However, scrubs may not be worn in the UMHS Pediatrics Emergency Department.  Blue jeans and shorts are not acceptable for patient care activities but are reasonable for lectures/labs.  Comfortable closed toe shoes should be worn in the ED.

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B. DIDACTIC CURRICULUM

The didactic curriculum will occur on the first two days of each period, and the third Monday with a final exam on the morning of the final Friday of the four-week rotation. The didactic curriculum will be attended by all rotators, regardless of what site they are assigned. Shift assignments will allow students appropriate release time to fully participate.

The course will use Glenn C. Hamilton’s Emergency Medicine: An Approach to Clinical Problem Solving, 2nd Edition as the textbook. This text will be loaned to you during the rotation and must be returned in good condition at the final exam in order to receive credit for this course. If the textbook is returned with any marks or highlights, you will be charged $70.00 and we will withhold your grade until the fee is paid. Corresponding reading assignments to topics are as listed below.  

Trott’s Wounds and Lacerations is available to be checked out by interested students during the rotation. Must be returned in good condition by the final exam or a $72 charge will be incurred.

                                                            
Monday 3:
8a-8:30                    Management of the Violent Patient                  Articles
8:30-9:30a               Environmental Emergencies
9:30-10                    Administration break
10a-12                     Code skills and simulated cases
1p                            Standardized patient interaction – informed consent

Friday 4:
9a-12                     Final written exam
**One additional time for the entire class for exam administration may be arranged with the course coordinator, dependent on proctor and room availability.

Goals and objectives for each session are available under "Goals & Objectives" on this website.

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C.  COMPUTER MODULES

During the course of the 2007-2008 academic year, we will be phasing in additional computer modules. These modules allow you to work through the diagnostics and evaluation of common ED complaints. You will be responsible for this information on the final exam.

These cases utilize the Professional Skill Builder Program located at URL:  https://www.umms.med.umich.edu/psb/. You will need your unique name and Kerberos password for access. These programs work optimally with a broadband connection on a PC (not Mac). You will also need to disable your pop-up blocker.

Topics include:                   

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D. PATIENT & PROCEDURE LOG

In order to provide structure to the clinical portion of the rotation, students must complete a chief complaint and procedure log. This must be submitted to the course director by the end of the rotation. This form will be handed out during orientation. Additional copies can be downloaded from this website under "Forms."

                    Patient Complaints                                  Procedures
                    Chest pain (2)                                        Wound care (3)
                    Dyspnea (2)                                           Initiation of IV access (6)
                    Abdominal pain (2)                                C-spine clearance (2)
                    Traumatic injury (3)                                Airway procedures (3)
                    Altered mental status (2)                        Application of extremity splint(1)
                    Intoxication / overdose (2)                     Arterial blood gas draw (1)
                                                                                 Placement of NG tube (2)
                                                                                Placement of Foley catheter (2)
                                                                          Participation in a lumbar puncture (1)

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E. PROFESSIONAL BEHAVIOR

It is expected that all students will demonstrate high levels of professional behavior during this rotation. The Emergency Department is the ultimate fishbowl with patients and families able to easily observe the activities of medical personnel.  This mandates that everyone working in the ED display exemplary behavior at all times.  Failure to do so will require a meeting with the course/site director and/or additional measures. Examples of unprofessional behavior would include:

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F.  WRITTEN EXAMINATION

A written examination is given at the end of the rotation. This is based on the objectives for each of the chapters and modules assigned, as well as the lectures and labs. It takes on average about 1.5-2 hours. A passing grade for the exam is 70% or higher. You must pass the exam in order to pass the rotation.

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G.  STANDARDIZED PATIENT INTERACTION
     
Starting with the 2006-2007 academic year, the Medical School has initiated an SPI on Informed Consent. This activity will be scheduled the afternoon of the 3rd Monday of the rotation after didactics. Background materials and grading criteria will be distributed in a separate handout. This interaction must be successfully completed and passed in order for your EM grade to be finalized and released.

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