OUWB School of MedicineEM Clerkship Orientation

Leadership

• Clerkship Director• Troy Site Director• Clerkship Coordinator• EM residency director• Department Chair

Leadership

• Clerkship Director– Amy Smark, MD– amy.smark@beaumont.edu– Cell: 586-260-6339–Office: 248-898-0018– Spectralink: 248-898-7932

Leadership

• Troy Site Director– Shanna Jones, MD– Shanna.jones@beaumont.edu– Cell: 586-899-2311

Leadership

• Clerkship Coordinator– Takesha Shelton– Takesha.shelton@beaumont.edu– 248-898-8172

Leadership

• EM Residency Program Director– Ryan Fringer, MD– ryan.fringer@beaumont.

edu

Leadership

• EM System Chair– Terry Kowalenko

Orientation Folder

• Clerkship Guidelines• Student didactic schedule• EM Resident Grand Rounds schedule• Student Clinical Shift Schedule• Patient/Procedure Log sheets• Troy Information• End of Rotation Forms

Medical Student Website

• Beaumontem.com– Follow the EM clerkship link– Policies– Schedules– Online lectures– Contact information– Useful links

GRADES

Grades

• Your overall grade is based on the following:– Clinical evaluations– End of Rotation exam– OSCE– Participation/Attendance

Grades

• Clinical Shift evaluations– We use the OUWB clinical eval– You are expected to have at least one eval for

every shift you work– This also serves as attendance– will be a composite of all evals

• End of Rotation Exam

Grades

• Exam– NBME SHELF for OUWB clerkship students• Administered at OU

– Departmental Exam for outside students, 2nd rotation• Must contact Takesha Shelton to take during the last

week of your rotation

Grades

• OSCE– Administered at the Troy Clinical skills center

• Participation/attendance– Completion of all clinical shifts– Participation in student didactic, lab, and SIM

sessions– Attendance at EM Resident didactics

Grades

• We follow the OUWB grading requirements• Pass:– Must earn “meets expectations” on composite

clinical evaluation– Must pass the NBME (or departmental) exam– Must pass the EM OSCE– Must attend all required clerkship didactic/lab

activities– Must complete all required shifts

Grades

• High Pass– Complete everything for pass PLUS– Earn either an “above expectations” on your

composite clinical eval OR– Earn ≥80th percentile on the NBME exam or ≥85%

on the departmental exam– Attend >50% of the optional resident grand rounds

Grades

• Honors– Fulfill all Pass requirements plus:– Must earn Exceeds Expectations on Composite

Clinical evaluation– Must achieve ≥80th %ile on the EM SHELF or ≥85%

on the departmental exam. – Must have attended all the resident grand rounds

DIDACTICS

Didactics

• On-line lectures• Discussion Sessions• Procedure Lab• SIM session (advanced students)• Are all REQUIRED to pass the rotation• If a scheduled session, take precedence over

clinical shifts

Online Lectures

• Self-directed/asynchronous learning• Access on the student website• These are required for review • They will correlate with the discussion

sessions

Discussion Sessions

• Required Participation• Case based review of online lectures• Make sure to review lecture correlating with

discussion session Prior to attending• Participation counts and is noted

Student Presentation

• You will need to prepare a short, 5-10 min presentation on an interesting patient. Please provide a handout on the case to your fellow students

• This will take place after the discussion sessions

• Please sign up for your presentation time

Procedure Lab

• REQUIRED for ALL students• Surgical Learning Institute, 3rd Floor, South Tower• Using Task Trainers– Lumbar Puncture– Central Venous Line– Airway/intubation– Suturing– Splinting– Ultrasound

SIM

• Simulation session in SLC

• Required for advanced students

• Review pre-scenario information prior to scheduled time

• Be PROMT. If you are late, you will not be allowed to participate.

EM Resident Grand Rounds

• Thursday mornings; 0900-1300• ABW basement (location will vary, will be

noted on your schedule)• Please sign in with chief resident• These are optional • Required for High Pass or Honors

CLINICAL SHIFTS

Clinical Shifts

• You will have 14-15 scheduled shifts– Variety of modules:• A, B, CD, Peds

– Variety of times• Morning, afternoon, nights, weekends

– Procedure shift• Will work with an EC tech to get IV starts, foley

catheters, EKGs and more.

Clinical Shifts

• You are required to complete all of your shifts• Unexcused absences will NOT be tolerated• If you have an unexcused absence, you will be

required to make up 2 shifts for every one you miss

• If it is noted that you have missed multiple, you will not pass the rotation

• Shifts are 10 hours– 1st 8 hrs to pick up new patients, last 2 hours for dispo

Clinical Shifts

• Shift Swaps– Must be mutually agreed upon– Must still have 10 hours off between shifts– Must be approved by Dr Smark– Must be made at least 3 days ahead of scheduled

shift– Keep in mind, not all “open” spots on the schedule

are open, they may be filled with other learners

Clinical Shifts

• Sign in book-Module A• Wear your white coat,

scrubs, name badge• Bring your stethoscope!• Be interested• Stay busy• Track your patients

progress• Follow up on studies,

results• Understand the plan

EC MODULESBeaumont Hospital-Royal Oak

Module A

• Critical Care Module– 9 Cat 1 Beds– Sickest patients– Get Involved!– Additional Cat 2 beds

Module B

• 23 Category 2 beds• All capable of cardiac

monitoring• (+) hallway beds;

marked as “x” bed

Modules C/D

• Cover modules C and D• Common work area in the walk-through of C• All charts come to the area C rack

Pediatric EC

• Staffed by general EM docs as well as fellowship trained Peds EM docs

• 2 pediatric critical care beds

• Significant pediatric trauma starts in the Trauma room, bed 3

PATIENT CARE

Patient Care

• Grab a chart from the Available for Provider rack

• Eventually will be chartless and new patients will only be denoted by on the EPIC dashboard– Currently in place in the

PEDS EC

Patient Care

• Chart– Cover sheet with CC and

vitals– Have patient stickers– EKG/EMS sheets– ECF info

Patient Care

• Orange Bin Charts– PRIORITY pts– Let resident/attending

know you are seeing them

– Significantly abn vital signs

– Abn EKG– Time dependant CC

Presentations

• Make sure to staff at least 2 patients directly with attending physicians

• Remaining cases may be with resident or attending

Presentations

• Concise• Organized• Include your differential diagnosis• Present your assessment/plan

Documentation

• You will complete a medical student note in EPIC

• You will be expected to enter your orders for cosign by the resident or attending on the case

Follow up and Disposition

• Make sure to follow up on all studies and results

• Re-evaluate your patients!!• Make sure to update the staff with results and

discuss progression of/change in plan• Be a part of the disposition • Call consultants

Procedures

• IVs, foleys, EKGs, will be supervised by RNs or techs

• Remaining procedures will be supervised by the EM residents/Attendings

• Be Assertive/Proactive in doing procedures

• SIM/Procedure Lab counts towards required

• Required Procedure list – Foley– IV start– ABG– Intubation– Central line– LP– Lac repair– EKG– FAST exam

Clinical Shift evaluations

• It is your responsibility to hand out on every shift!

• This gives us a well-rounded evaluation of your clinical performance as well as proves attendance

WBH-TROY

WBH-Troy

• You will have at least 3 shifts at the Troy site• You will work directly with EM attendings• Troy Site Director is Dr Shanna Jones• Map/instructions are included in your

orientation packet

Computer Access

• You MUST have EPIC access prior to your first shift

• If you have problems with access, please contact Monica Demres or Lori Kurkowski in UGME

Kaizen

• For OUWB clerkship students only• During your EM clerkship, you will be completing a

day with the Kaizen team.• This is a part of your OUWB Curriculum, not part of

the EM curruiculum.• It is not evaluated under EM• This is REQUIRED and only occurs 2 days of the

month. You will be assigned one of these dates and MUST attend. There is no make-up for this requirement.

MIDCLERKSHIP EVAL

Midclerkship Eval

• Students are required to meet with Dr Smark for their mid-clerkship evaluation

• We will discuss your performance to date as well as any concerns

Advanced Rotations

• Advanced EM• Advanced Peds EM• Must have 1st completed a core EM rotation

Advanced EM

• Your month will focus more in the critical care areas• Will have additional U/S time– Will scan with residents on U/S rotation– Will attend an u/s review session with u/s staff

• Can do an EMS ride along shift– Will take place of one of your regular shifts of your

choosing. Must let Dr Smark know which shift you are dropping.

– Give EMS providers eval to sign for attendance• You will complete the departmental exam

Advanced Peds EM

• You will rotate exclusively in our Peds EC• Will work with our Peds EM staff, fellows• Will attend the Peds EM grand rounds• Will take an end of rotation written exam

ROTATION PEARLS

Rotation Pearls

• Be assertive!• Focus on areas that may be different from your

intended speciality• Be sure to follow up/re-eval your patients• Know the results• Be involved in the plan• Be efficient-do not spend more than 20 minutes

in a room• Do not disappear on shift

ORIENTATION COMPLETION

Orientation Completion

• Please sign and turn in the orientation completion form

• By signing this, you understand the rotation expectations, grading and required activities

• Please contact Dr Smark for any questions

THE END