Clerkship
Syllabus Template
I. Template for Clerkship Syllabus
IA. Overview (Sample from Pediatrics)
1) Description of course or clerkship:
The Pediatrics
Clerkship consists of 4 weeks of inpatient pediatrics, 2 weeks of ambulatory
pediatrics, 1 week in the newborn nursery, and 1 week in the emergency
department. The emphasis is on
acquiring competence in history taking and physical exam skills across the
pediatric age range (birth to 21 years old) and experience how common diseases
present in the developing individual.
The opportunity to perform hands-on care and to participate in
developing differential diagnoses, diagnostic and care plans with the team of
residents, nurses, and attendings should be exciting and hopefully convince
some of you that pediatrics is a great career.
There will be a
series of case-based interactive lectures for which you are expected to be
prepared. In addition to written
materials, there will be introductions to your expected activities by the chief
residents and clerkship directors.
Please feel free to contact any of these individuals or the clerkship
secretary if there are misunderstandings or any problems. We have all chosen pediatrics because
we enjoy it and care about the welfare of children. We also are concerned about your well being and will go out
of our way to make this enjoyable for you.
The evaluation
process is based primarily on your clinical performance and you should expect
formative feedback throughout the clerkship and formally at the midway point of
the ward rotation. We tape each
student doing a well child exam with review and feedback by one of the
clerkship directors. Objective
evaluation will be based on performance on the oral and the written exams. Be sure to study some basic pediatric
text to prepare for the written.
You will also be evaluated on your attitude and interactions with the
team, patients, and families.
We believe we
have developed an excellent clinical learning environment and hope you will
feel the same. Be sure and let us
know how we can improve.
2) Administrative structure of the course
a) Course or clerkship director:
Maureen Kays,
M.D. (Gainesville)
Donald Eitzman,
M.D. (Gainesville)
Frank Genuardi,
M.D. (Gainesville)
b)
Department chair: Terrence
Flotte, M.D.
c) Teaching faculty: All faculty and housestaff in the
Department of Pediatrics, Gainesville and Jacksonville campuses
d) Course or clerkship administrative
assistant or secretary:
Pat
Stopa, stopape@peds.ufl.edu,
265-0451, Room 4462 PSB
3) Overview of course content
a) Length of course or clerkship, hours,
units of study: 4 weeks
inpatient, 2 weeks ambulatory pediatrics, 1 week newborn, and 1 week emergency
department
b) Number of contact hours: See (d)
c) Sites of didactic sessions and laboratories:
Lectures primarily will be on Monday afternoons in Shands Teaching Hospital in
Gainesville and Thursday afternoons in Jacksonville.
d) Schedule of activities for a typical
week:
Wards: 8-10 hours x 5 days plus 4-5 overnight
call
Nursery: 1 week (M-F) with one weekend day
rounding responsibilities
Emergency
room: 6 days with 8, 10, or 12
hours shifts (varies)
Ambulatory
Outpatient Clinics: 8 hour shifts
Monday-Friday
4) Educational philosophy of the course
or clerkship: We are anxious
to provide a stimulating educational environment in which you become competent
with the knowledge, skills, and attitudes important in the care of infants,
children, and adolescents. The
Department of Pediatrics places the highest priority on your education.
5) Course outline of content: Each
week a case will be discussed with most of the discussion by the student group
using the same format as the oral exam.
Clinical presentations are made by students on daily rounds and after
patient interactions in outpatient settings. (Appendix 1)
IB. Learning Objectives (Sample from Ob/Gyn)
The Association of
Professors in Obstetrics & Gynecology (APGO) Educational Objectives
(national) are listed in the text recommended for this clerkship on page 32.
The NBME Subject Examination given at the end of the clerkship is based on
these national objectives. Topics presented formally during this clerkship are
listed as CBC topics on page 33 and as Required Skills and Achievements on page
15. The remainder of the APGO
Objectives are covered in clinical situations or other courses and clerkships.
STUDENT LEARNING
OBJECTIVES
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1.
Professional behavior: |
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Learning
Objective: |
Demonstrates
respect for patients, families, and members of the health care team; is
truthful and honest with colleagues; communicates an attitude of empathy and
caring; places patient’s well-being over self-interest and is dedicated
to patient care; shows ability to resolve conflicts between personal moral
convictions and patient’s choices; preserves patient confidentiality;
and shows appropriate self-assessment and willingness to admit mistakes. |
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Learning
Activity: |
Instruction
and role modeling by faculty, residents and staff during clinical activities,
Nurse Shadowing and CBC’s |
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Evaluation
Method: |
Direct
observation by faculty, residents, staff, and Nurse Shadowed using level of
competency. |
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2.
Human relationships and communication: |
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Learning
Objective: |
Demonstrates
knowledge about psychological, social, and economic factors and cultural
diversity as they pertain to health care. Demonstrates evidence of inquiry
into familial and other support systems, and effectively engages patient and
family in verbal communication. |
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Learning
Activity: |
Instruction
and role modeling by faculty, residents and staff during clinical activities,
Nurse Shadowing and CBC’s. |
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Evaluation
Method: |
Discussion
and direct observation by faculty, residents, staff, and Nurse Shadowed using
level of competency. |
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3.Core
discipline clinical presentations and additional aspects of OB/GYN: |
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Learning
Objective: |
Demonstrates
knowledge for the management of clinical presentations within obstetrics and
gynecology and additional aspects unique to women’s health. The national curriculum is outlined
by the APGO Educational Objectives on page xxi in the recommended text. |
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Learning
Activity: |
Instruction
during clinical activities, conferences and CBC’s, assigned readings
and self-directed learning. |
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Evaluation
Method: |
Assessment
by faculty, residents and staff during clinical activities, conferences,
CBC’s using level of competency and the final NBME examination. |
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4.
Diagnosis: |
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Learning
Objective: |
Demonstrates
the ability to perform problem an focused gynecologic, new and return
prenatal history and physical examination (including complete pelvic exam),
interpret and use laboratory and diagnostic studies and incorporate
appropriate data from medical records, and consultations with family members. |
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Learning
Activity: |
Instruction
and discussion with faculty and residents during clinical activities. |
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Evaluation
Method: |
Assessment
by faculty and residents during clinical activities using level of
competency. |
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5.
Information management: |
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Learning
Objective: |
Demonstrates
adequate oral case presentation skills, mastery of traditional organization
of medical data, and adequate medical record keeping. |
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Learning
Activity: |
Instruction
and discussion with faculty and resident during clinical activities and
conferences. Feedback on Oral
Gyn Presentation. |
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Evaluation
Method: |
Assessment
by faculty and residents during clinical activities and the Oral Gyn
Presentation using level of competency. |
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6.
Procedures: |
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Learning
Objective: |
Demonstrates
the ability to perform skills listed on “Student Skills and Achievement
List” in the front pocket. |
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Learning
Activity: |
Instruction
by faculty and residents during clinical activities. |
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Evaluation
Method: |
Assessment
by faculty and residents using level of competency. Completion of required Skills and Achievement List. |
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7.
Physician scholarship: |
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Learning
Objective: |
Demonstrates
initiative in seeking new knowledge and the ability to analyze the quality
and implications of medical literature, identify future areas of inquiry and
communicate information to peers. |
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Learning
Activity: |
Discussion
with faculty and residents and CBC’s. |
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Evaluation
Method: |
Assessment
of Thesis Presentation by faculty using level of competency. |
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8.
Health care team membership: |
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Learning
Objective: |
Demonstrates
an understanding of the roles and competencies of other health care
professionals and engages them in an organized, team approach to health care
delivery. |
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Learning
Activity: |
Instruction
and role modeling by faculty, residents, staff and during Nurse Shadowing. |
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Evaluation
Method: |
Observation
by faculty, residents and staff during clinical activities and Nurse Shadowed
using level of competency. |
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9.
Problem solving: |
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Learning
Objective: |
Demonstrates
the ability to analyze the patient data base, relate it to basic scientific
and clinical fund of knowledge, generate a ranked differential diagnosis,
draw logical conclusions about the salient problems, and propose cogent
diagnostic and therapeutic approaches. |
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Learning
Activity: |
Instruction
and discussion with faculty and resident during clinical activities and
conferences. Feedback on Oral
Gyn Presentation. |
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Evaluation
Method: |
Assessment
by faculty and residents during clinical activities and the Oral Gyn
Presentation using level of competency |
I.C.1. Internal & External Measures Used to Assess
Students Skills (Sample from Family Med/Geriatrics)
1.
Clinical Performance - 75% of Final Grade
Students
will be evaluated by faculty based on progress towards the achievement of
graduation competencies in the categories listed on the evaluation form, shown
on the following page. Typically, one faculty member at each site is
responsible for completing the form based on a compilation of their assessment
and the assessment of others who worked with the student (primarily other
faculty and residents, although input from clinic staff, patients and peers
will be considered when pertinent).
The Family Medicine component will be worth 2/3 of the clinical grade
(i.e. 50% of the final grade)
and
the Internal Medicine component 1/3 (i.e. 25% of final grade).
2.
Final Examination - 25% of Final Grade
The final examination is a combination of multiple-choice questions and performance based standardized patient encounters. The exam consists of 8 patient stations, each of which is followed by a computer station with multiple-choice questions. It focuses almost exclusively on the clinical presentations shown in Tables 1 and 2 above and requires students to:
a)
Demonstrate
the ability to perform a focused history and physical: Students will be asked
to perform a focused history and/or physical exam on each standardized patient.
As such, the exam provides objective evidence of each student's capability in
the Data Gathering: History, and Data Gathering: Physical Exam Competencies.
The standardized patient portion is worth 1⁄2 of the final exam points,
with a fairly even split between history items and physical exam items.
b) Demonstrate an understanding of the
differential diagnosis and management of common conditions from that
differential: The computer stations include multiple choice questions that test
each student's understanding of the differential diagnosis of presentations in
Tables 1 and 2 and management of common conditions from that differential. Some
questions also test problem solving ability and knowledge of basic science
related to the presentations. As such, this portion of the exam assesses mastery
of the following competencies: Core Discipline (Knowledge Base), Basic Science
Foundation and Problem Solving. The multiple choice portion of the exam is
worth 1⁄2 of the final exam points.
3.
Determination of Final Grade
In
the vast majority of cases, the final grade is derived directly from the
components described above. However, the Clerkship Director reserves the right
to adjust a student's final grade in such a way that it best reflects the
student's actual performance and their achievement of the clerkship
competencies.
I.C.2. Description of Formative and Summative Feedback Systems
(Sample from Ob/Gyn)
EVALUATOR
FORM FOR EVALUATION OF COMPETENCIES
FOR
Student ________________________________ Class of_2004
Rotation________
Evaluator_____________________________________________
Indicate
the box which best describes this student's typical performance for appropriate
competencies.
1.
Professional Behavior: (10% to the summative evaluation) Demonstrates respect for patients,
families, and members of the health care team; is truthful and honest with
colleagues; communicates an attitude of empathy and caring; places patient's
well-being over self-interest (altruism) and is dedicated to patient care;
shows ability to resolve conflicts between personal moral convictions and
patient's choices; preserves patient confidentiality; and shows appropriate
self-assessment and willingness to admit mistakes.
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Honesty, respectfulness,
attitudes towards patients and peers, selflessness, dedication to patient
care, and willingness to concede mistakes are sometimes a cause for
concern. At times inappropriate. |
Respectful and honest. Generally good attitudes to patients
and peers. Demeanor and behavior
always appropriate. Readily
acknowledges mistakes. |
Consistently demonstrates
respect, honesty & compassion for patients, peers and other staff.
Dedicated to patient care. Actively seeks critical feedback. |
Overtly
demonstrates honesty, integrity, selflessness, compassion and respect for
patients, peers and other staff. Goes above and beyond in caring for
patients. A role model. |
2a.
Human Relationships: (5% of the
summative evaluation)
Knowledgeable about psychological, social, and economic factors and
cultural diversity as they pertain to health care, and demonstrates evidence of
inquiry into familial and other support systems.
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Shortcomings in awareness of
the relevance of psychosocial factors, cultural diversity, and support systems
to care of individual patients. |
Shows some awareness of the
relevance of psychosocial factors, cultural diversity, and support systems to
health care and sometimes applies this knowledge in the care of individual
patients. |
Shows
good awareness of the relevance of psychosocial factors, cultural diversity,
and support systems to health care and applies this knowledge in the care of individual patients. |
Has extensive knowledge of
psychosocial factors, cultural diversity and support systems, and shows excellent
judgment and great insight in applying it to individual patients and
families. |
2b. Human Communications: (5% of the summative evaluation) Effectively engages
the patient and/or family in verbal communication.
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Ability to establish
rapport and communicate with patients and families is sufficiently weak to be
a cause for concern. |
Reasonably good at
establishing rapport and communicating with patients and families. Sometimes lapses into medical jargon
or fails to appreciate significant patient responses. |
Effective
in establishing rapport and communicating with patients and families. Engenders confidence. |
Highly effective in
establishing rapport and communicating with patients and families, even under
the most difficult circumstances. |
3.
Core Discipline (Knowledge base): (5% of the summative evaluation) Demonstrates knowledge of general and core discipline basic
science, and knowledge of population-based and evidence-based medicine.
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Level of knowledge and
understanding too often weak and superficial. |
Adequate knowledge and
understanding. Knows enough to
handle common situations. |
Very good knowledge and
understanding. Asks insightful
questions. |
Extensive and in-depth
knowledge and understanding. Actively contributes to discussion and decision
making. |
4a.
Data gathering: History: (4% of the summative evaluation) Demonstrates ability to perform a
problem focused and/or comprehensive new and return history, and incorporate
appropriate data from medical records, consultations with family members,
laboratory and other diagnostic studies.
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Ability to take a history
and retrieve background medical information is too often incomplete and
inaccurate. |
Usually identifies the key
points but misses subtleties.
Chief complaint elaborated but chronology may be unclear. |
Almost always identifies and
characterizes the needed information with accurate chronology. Usually
reports most important data from records, laboratory studies and diagnostic
tests. |
Consistently performs a
complete, accurate and efficient assessment. Elaborates key subtleties. Chronology absolutely clear. Consistently obtains pertinent information from record and
relevant results from laboratory |