Rotation Objectives

These objectives were taken from a national consensus created by clerkship directors from across the country. They have also been matched with the Rush Medical College objectives. They are grouped into the 6 “competencies” – which are skills you need to master throughout your student and resident training. Get used to these, you will be seeing them again during residency.

Patient Care

Course Objective	How are you going to learn this?	How are we going to assess it?
Under direct faculty supervision, students should be given primary responsibility for patient care (of noncritical patients) and begin to act independently during the fourth-year EM rotation. Primary responsibility for patient care will help foster the students’ ability to think critically, assess their knowledge and skills, and allow them to make clinical decisions affecting patient care.
Recognize immediate life-threatening conditions.	Watch this video on the PRIMARY SURVEY. We will go over this in lecture and you will have plenty of time to practice with patients in the Emergency Department.	During the first week, we’ll go over several cases where patient’s are in distress and you’ll need to manage their care. Chances are likely that you’ll also see some patients who are critically ill during your month in the ER. This is also reviewed on the final exam.
Obtain an accurate problem-focused history and physical examination.	Watch this video on the SECONDARY SURVEY and practice with every patient on every shift!	On every shift, your attending will provide you feedback based on the H&P you present. We want it to be problem-focused! Those last two words are the key. You’ll be evaluated on your end-of-shift evaluations.
Patient management skills: Develop an evaluation and treatment plan; Monitor the response to therapeutic interventions; Develop appropriate disposition and follow-up plans.	Read the material on the specific diseases on the CDEM CURRICULUM WEBSITE. Here you’ll find the essential aspects of the management plans for the various disease processes you should be considering. We will also go over cases during our didactic sessions.	Use that information with your patients during your shifts and with out cases in class. Remember you can refer to the site during your shifts! Your shift-evaluation will represent our assessment of your management skills.
Documentation: provide accurate and organized documentation in the medical record when appropriate.	A video is coming on proper documentation	You’ll have plenty of opportunities to document in the medical record. During the second week, we’ll dissect one or two of your write-ups to see how all could do a better job.
Health promotion: Educate patients on safety and provide anticipatory guidance as necessary related to the patient’s chief complaint ensuring comprehension of their discharge plan.	Watch this lesson on HOW TO WRITE GOOD DISCHARGE INSTRUCTIONS.	At the end of the second week, we’ll go over your examples of discharge instructions. Cut and paste some from patients you saw in the first two weeks and we’ll go over how to write them better.

Medical Knowledge

Course Objective	How are you going to learn this?	How are we going to assess it?
Students should develop a differential diagnosis that is prioritized on potential life-threatening conditions and likelihood of disease. Students should demonstrate knowledge (or understanding) of basic diagnostic modalities and interpretation of results. Most importantly, students should cultivate an appreciation of risk stratification and pretest probabilities for selected conditions.
Develop a prioritized differential diagnosis when evaluating an undifferentiated patient including life-threatening diagnoses.	This is an essential part of the critical decision making of Emergency Medicine. We will go over this process several times during class. Be sure to complete the DIFFERENTIAL DIAGNOSIS EXERCISE prior to your first day of class and bring it to orientation.	You will be assessed on this on each of your shifts with each of your patients.
Create a diagnostic plan based on differential diagnoses and management plan based on specific disease processes.	Refer to the CDEM CURRICULUM WEBSITE for each of the approach to particular chief complaints and treatment for specific disease processes.	Your plan making skill will be assess during your shifts by the attendings with whom you work.

Self-Directed Learning and Lifelong Improvement

Course Objective	How are you going to learn this?	How are we going to assess it?
Practice-based learning can be demonstrated through systematically evaluating patient care and population features; teaching other students and health care professionals; and applying knowledge gained from a systematic evaluation of the medical literature, including study design and statistical methodology
Effectively use available information technology, including medical record retrieval systems and other educational resources, to optimize patient care and improve their knowledge base.	During this rotation you will be doing an evidence based emergency medicine project. The idea is that you find something that you want to know about. Pick a question you had from a patient that you have seen. Then use this EBEM PRESENTATION FORM to help formulate a proper question, find the answer, and then present it to the class.	Your presentations will be graded on the last day of class, using THIS RUBRIC.

Interpersonal and Communication Skills

Students are an important element of the health care team, and effective communication with patients and other health care providers is essential for patient care. Students must demonstrate interpersonal and communication skills that result in effective information exchange and interaction with patients, family members, and health care providers.
Course Objective	How are you going to learn this?	How are we going to assess it?
Humanistic qualities Effectively communicate with patients, family members, and other members of the health care team Demonstrate a compassionate and nonjudgmental approach when caring for patients.		This will be assessed during your clinical practice and reflected on your end-of-shift evaluations.
Presentation skills: Present cases in a complete, concise, and organized fashion; Effectively communicate with consultants and admitting services.	We will review proper presentation skills on the first day and practice it throughout the rotation, both in the Emergency Department as well as within our didactic sessions.	Ultimately your skills will be assessed during your work in the department on the end-of-shift evaluations.

Students are an important element of the health care team, and effective communication with patients and other health care providers is essential for patient care. Students must demonstrate interpersonal and communication skills that result in effective information exchange and interaction with patients, family members, and health care providers.

Course Objective

How are you going to learn this?

How are we going to assess it?

Humanistic qualities

Effectively communicate with patients, family members, and other members of the health care team
Demonstrate a compassionate and nonjudgmental approach when caring for patients.

This will be assessed during your clinical practice and reflected on your end-of-shift evaluations.

Presentation skills:

Present cases in a complete, concise, and organized fashion;
Effectively communicate with consultants and admitting services.

We will review proper presentation skills on the first day and practice it throughout the rotation, both in the Emergency Department as well as within our didactic sessions.

Ultimately your skills will be assessed during your work in the department on the end-of-shift evaluations.

Professionalism

Course Objective	How are you going to learn this?	How are we going to assess it?
Professionalism should be viewed as an academic virtue, not just an expected set of behaviors. Students should learn to reflect on their professionalism during clinical rotations and learn from faculty role models.
Work ethic Be conscientious, on time, and responsible; Exhibit honesty and integrity in patient care.		This is assessed during your shifts and didactic sessions. As long as you show up on time, complete what is expected of you, and are not deceptive with staff or patients, you should do well. This is reflected on the professionalism piece on the end-of-shift evaluation.
Practice ethical decision-making.
Professional behavior: Exercise accountability; Maintain a professional appearance Be sensitive to cultural issues (age, sex, culture, disability, etc.); Work in a collegial manner with other members of the health care team.		This is assessed during your shifts and didactic sessions. As long as you show up on time, complete what is expected of you, and are not deceptive with staff or patients, you should do well. This is reflected on the professionalism piece on the end-of-shift evaluation.

Putting Care in a Practical Context

Course Objective	How are you going to learn this?	How are we going to assess it?
Called Systems-based practice in the resident lingo, this competency extends beyond the individual patient’s bedside to include an understanding of how EM relates to other practitioners, patients, and society at large, while considering the cost of health care and the allocation of health care resources. Understanding the ‘‘system’’ involves learning ways to advocate for patient care and assist patients in dealing with system complexities (such as assuring appropriate follow-up) and how to partner with health care providers to assess, coordinate, and improve patient care.
Recognize when patients should be appropriately referred to the emergency department (ED).
Recognize the importance of arranging appropriate follow-up plans for patients being discharged from the ED.
Recognize the role of EM in the community, including access to care and its impact on patient care.
Understand the indications, cost, risks, and evidence behind commonly performed ED diagnostic studies.