In patients with surgical problems, demonstrate a method of focused evaluation, including the approach to workup and preparation of patients for anesthesia and surgical intervention
Curriculum: Students will regularly evaluate patients together with residents and attendings in the clinic, in the ER, and on the wards (as consults).
Benchmark: Students will be expected to perform initial patient evaluation (prior to evaluation by resident or attending) in each of these settings on a weekly (at minimum) basis; each student is required to complete a detailed patient write-up, including thorough history and physical as well as a focused discussion of the patient’s disease process and management.
Test: Student write-ups are turned in to the attending of record for the patient; the write-up is reviewed by the attending, who is required to grade it and is expected to discuss it directly with the student for one-on-one feedback.
Identify what constitutes appropriate surgical referral by recognition of which problems are clearly surgical, potentially surgical, and those which do not require surgical intervention
Curriculum: Students will regularly discuss evaluations with residents and attendings and receive feedback and guidance concerning differential diagnosis, triage, and care plans.
Benchmark: All students are expected to discuss patients and cases on a regular basis with their resident/attending team as part of the patient-evaluation process, as in item 1.
Test: The clinical grade includes evaluation of students’ problem-solving ability and knowledge as it applies to patients whom they have evaluated.
Accurately assess patients, particularly postoperatively, for pain and propose a strategy for safe pain management, including the use of multimodal pain therapy
Curriculum: Students will receive a detailed lecture on post-operative pain management (recorded and available in Canvas)
Benchmark: Each student is encouraged to complete a detailed pain assessment and SOAP note for a patient in their care during the rotation.
Test: If this optional exercise if performed, the pain assessment should be discussed with the care team in efforts for valuable feedback to be provided to the student.
Identify the important factors in the diagnosis, workup, and management of specific surgical problems in the following categories:
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- Abdominal Pain
- Bowel Obstruction
- Endocrine disease (thyroid, parathyroid, and adrenal)
- Gallbladder surgery
- Gastrointestinal Disease
- Hernia Repair
- Pain Management
- Postoperative Check
- Surgical Oncology
- Vascular disease (carotid, aortic, and peripheral vascular)
- Wound Care
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Curriculum: A lecture series is available in Canvas covering each of the above topics, which the students are required to review. Additionally, students should participate in the care of patients with these conditions if there is opportunity during their clerkship.
Benchmark: Students are expected to review the lectures, and are asked to maintain a log in eValue indicating that they have directly participated in the care of a patient in each category (performing an H&P in clinic, performing an ER evaluation, or consult evaluation, directly caring for a patient on the wards, or scrubbing into the case in the operating room). Because different clerkship sites have varied offerings in terms of case experience, web-based case scenarios will be offered for each category as well. Students will be expected to complete the case scenarios by the last week of their clerkship for those categories in which they have not been involved in direct patient care.
Test: Student case logs will be submitted in eValue by the end of the clerkship, indicating that they have either participated in the care of a patient in each category, or completed the relevant web-based case scenario. Students will also take a standardized multiple-choice examination (the NBME Surgery Subject Examination) at the conclusion of the clerkship.
Perform some basic surgical techniques, particularly basic suturing skills and general wound management
Curriculum: Students will receive instruction in wound closure skills during their clerkship, in which they will learn suturing and knot-tying techniques. Opportunities to further develop these techniques will be an integral part of their operating room experience. Additionally, wound management skills will be learned through activities on the wards and in clinic.
Benchmark: Students are required to participate in wound closure education opportunities at their assigned site, as well as to participate in cases in the OR.
Test: Assessment of technical skills is a component of the clinical grade for the clerkship. Assessment of these skills is on the basic level of understanding, NOT how well you are able to suture.