The Department of Emergency Medicine hosts fourth year medical students as they complete a clerkship that lasts a total of six weeks. The clerkship is most valued for its rich clinical experience which allows students to play an active role in the ongoing care of the ED patient. Students are responsible for the initial evaluation of patients; they obtain a thorough history, and perform a focused physical exam, formulate a differential diagnosis, suggest a diagnostic workup and treatment plan, and determine a disposition for each of their assigned patients under the direction of senior residents and faculty. Students acquire important procedural skills by being exposed to and encouraged to participate in the supervised performance of a wide variety of procedures in the ED.
In order to maximize their learning experience, students are asked to participate in a variety of teaching activities which take place at the department. Namely, students attend and participate in the weekly “Emergency Medicine Conference Series” and the weekly “Radiology Teaching conference”, both of which form an important learning experience in the clerkship. The Radiology Teaching Conference was enhanced by the presence of attending physicians from the Department of Diagnostic Radiology, bringing their expertise to the evaluation of ED patients.
In addition, students attend two simulation lab sessions: the IV/NG and the resuscitation scenario. The purpose of the IV/NG simulation session is to teach the students the proper and safe way to perform a procedure. It is made clear that the principles taught in this session should be applied to every procedure they perform in the future in order to minimize the chance of patient harm. The resuscitation scenario has been the most popular activity in the clerkship. Students get a real feeling of what it is like being an EM physician who is faced with a critical patient. They have to think on their feet, practice good communications skills and perform procedures in real time. We hope to further enhance students’ educational experience by introducing more simulation sessions in the future.
As part of their clinical rotation, students present an interesting case they have seen in the ED. They are expected to discuss the clinical presentation, workup, diagnosis and management of the case. The case presentation sessions provide students with the opportunity to improve their teaching skills as well as learn to a greater depth about a subject.
A student’s performance is directly assessed through the end of shift evaluation form. By engaging the student and their supervising physician in a dynamic dialogue about their performance, this form provides a richer assessment experience for the students. Physicians evaluate students based on the following skills: history taking and physical exam, clinical reasoning, and professionalism. Introducing this form proved to be effective in terms of providing more accurate evaluations scores to students and having attendings discuss those scores so that students reflect on their performance and improve their critical thinking and clinical skills.
In terms of clerkship evaluation, the highest scores of students’ evaluations of the clerkship were observed in 2016-2017. The ED was identified as the best clerkship experience across Med III and Med IV. Students specifically enjoyed the hands on experience and the direct patient exposure and described the clerkship as being excellent in terms of teaching patient management skills as well as providing exposure to diverse cases. The comments of students were almost all positive (Figure 1)
Excerpts from Students Comments for the academic year 2016-2017:
“Best rotation so far, acute care and sharp management made us better and fast thinkers”
“A lot of hands on work for students and involvement in patient care"
“I love the responsibility given to us as medical students when it comes to taking care of the patients. We have autonomy that is supervised, allowing us to think and to obtain guidance to make sure we are doing what is best for the patient by best understanding the case at hand”
“Great rotation learned a lot, lots of patients and diverse mix of cases. Loved the one-on-one interactions, and being the first contact with the patient”
“I loved the hands on experience and the variety of patients we got to see”
“Great variety of patients Helps us in quick management”
Elective Rotations for AUB Medical Students
Students attending AUBMC are welcome to schedule elective rotations in the DEM where they will receive the opportunity to fully participate in the care of our patients. A fulfilling mix of clinical experience, didactics, workshops and simulation labs will ensure a challenging, educational and thoroughly enjoyable elective rotation for those with an interest in EM.