ME535M.3

Emergency Medicine

Sites: MGH
Director(s): Alberto Puig, Eric Shappell
Prerequisites: HMS Principal Clinical Experience (Core Clinical Clerkships) or equivalent
Offered: Full time every month. Not offered in November or December.
Location: MGH - Mass. General Hospital (3)
Open to Exclerks: US/Canadian
Description: This course offers broad exposure to acute medical and surgical patients in a very busy ED with approximately 100,000 annual adult and pediatric visits. It emphasizes the development of diagnostic and management skills critical to proper initial patient evaluation and resuscitation. Students are afforded significant latitude in determining their level of autonomy in providing patient care. Students will work in four clinical areas of the MGH ED (Acute, Urgent, Fasttrack, and Pediatrics), and will be involved in the care of a broad spectrum of patients, from the most acutely ill patients to those with non-life-threatening, minor injuries. Clinical time performed in the MGH ED is supplemented by the formal didactics sessions of the Harvard Affiliated Emergency Medicine Residency and by a set of core student lectures on emergency medicine fundamental principles. The latter are most often held on Thursday mornings at the various Harvard hospitals and attendance is required. Students are also required to complete a final examination, typically scheduled for the final Friday morning of the clerkship. Completion of a scholarly project, such as a written, evidence-based literature review and assessment of a clinical problem, is optional, however is required for students wishing to be considered for the Honors with Distinction grade. This work is a minimum requirement for consideration of the Honors with Distinction grade, but does not ensure an Honors with Distinction grade will be awarded. This requirement for eligibility for Honors with Distinction applies to all EM clerkships offered through HMS. Students are required to review all orientation materials that are emailed prior to the beginning of the course.
Incorporation of Basic Science Content and Evidence-Based Medicine:
Basic Science Content and Evidence-Based Medicine are routinely incorporated into the weekly Didactic lectures. These lectures are given by Emergency Medicine faculty at the Harvard-affiliated teaching hospitals on core emergency medicine topics such as trauma resuscitation, wound care, analgesia, toxicology, and airway management. Evidence-based medicine is supported by an extensive online collection of reference teaching handouts compiled by the Harvard-Affiliated Emergency Medicine Residency. Weekly didactic sessions conducted by the residency involve core emergency medicine content as outlined in the EM Model (Hockberger et al, Annals of Emergency Medicine, 2001).
As criteria for Honors with Distinction, students are required to perform a literature based, referenced review of the clinical encounter or emergency medicine topic of their choice which is reviewed at the end of their clerkship.
Grade Criteria:
Honors with Distinction:
The Honors with Distinction grade will be awarded to students who are deemed to be clinically outstanding, have an exceptional fund of knowledge, and demonstrate superior interpersonal and communication skills and professionalism, as well as a commitment to practice-based learning. It is anticipated that approximately one-third of students will achieve the Honors with Distinction grade.
In addition, consideration for a Honors with Distinction grade will require the production of a scholarly work by the student. This may include, but is not limited to the following:
� A written, evidence-based literature review and assessment of a clinical problem
� A publishable case report and discussion
� A presentable scholarly educational offering
This work is a minimum requirement for consideration of the Honors with Distinction grade, but does not ensure an Honors with Distinction grade will be awarded for this elective. This requirement for eligibility for Honors with Distinction applies to all EM and Pediatric EM clerkships offered through HMS, and must be submitted in electronic format (preferably Microsoft Word) on or before the last Friday of the clerkship.
Honors:
The majority of students are expected to achieve the Honors grade. To do so, a student must demonstrate sound medical knowledge and its application in the clinical setting; compassionate, appropriate and effective patient care; professionalism; an affinity for practice-based learning and improvement; and effective interpersonal and communication skills. An Honors student performs thorough and efficient histories and physical exams, delivers succinct yet complete patient presentations, generates appropriate differential diagnoses and management plans, reliably carries through on care plans, communicates effectively with the healthcare team and patients, and independently engages in practice-based learning.
Satisfactory:
Examples of performance meriting a Satisfactory grade include: performing histories and physical exams that are in general complete but occasionally miss relevant details, exhibiting a passable depth of medical knowledge, delivering verbal presentations that convey relevant material but that are sometimes rambling or disjointed, demonstrating an immature ability to formulate a differential diagnosis or follow through on a plan of care, employing adequate communication skills, demonstrating a modest interest in practice-based learning and improvement.
Unsatisfactory:
Examples of performance meriting an Unsatisfactory grade includes, but is not limited to: performing histories and physical exams that miss important details or require excessive time to complete, delivering patient presentations that do not focus on the clinical situation at hand or that lack relevant information, demonstrating an inability to generate appropriate differential diagnoses or carry out patient plans, exhibiting superficial medical knowledge without a demonstrated interest to develop a deeper knowledge base, utilizing ineffective communication skills, engaging in unprofessional or dishonest behavior, failing to show up for lectures.