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Psychiatry Clerkship MPSY700
SYLLABUS
2018-2019 ACADEMIC YEAR
Education Director: David Garfield, M.D. [email protected]
Clinical Education Specialist: Kathleen Fisher, DNP, APRN/CNS, CHSE, CCRN, CCNS [email protected]
Undergraduate Medical Education Specialist: Christine Walker [email protected] 847-578-8722 RWCLC 1.086
CLERKSHIP DESCRIPTION
The psychiatry clerkship is a required 6 week rotation in the third year of medical school. Students rotate at a variety of medical sites including the Federal Health Care Center, Illinois Masonic Hospital, Elgin State Mental Hospital, Centegra, RFUHS Clinic, Lutheran General Hospital, Mt. Sinai Hospital, St. Mary’s and Elizabeth’s Hospital (Presence Health) and Billings Clinic. Medical students are supervised by both psychiatry residents and attendings. They are assigned to inpatient acute psych wards, consultation psychiatry services, and outpatient mental health clinics. Students have assigned readings, required patient interview exercises, required quizzes and exams in addition to a full day of didactic teaching at RFU during the 2nd week of the rotation. At some but not all sites the students will take two evenings on call with a resident. During this rotation some students will observe Electroconvulsive Therapy being administered to psychiatric patients at the Federal Health Care Center.
CLERKSHIP OBJECTIVES
1. Order, perform, interpret appropriate diagnostic technical procedures and studies and develop appropriate differential diagnostic and therapeutic strategies for psychiatric patients with common acute and chronic conditions. (1.1, 1.5) 2. Perform and document a reliable history, physical and mental status exam for psychiatric patients and provide a differential and working diagnosis and treatment plan. (1.2, 1.4) 3. Propose and perform routine medical and diagnostic procedures for patients and psychiatric illnesses. (1.6) 4. Demonstrate interpersonal and communication skills that result in effective education with patients and family members, and other members of the healthcare team. (1.7) 5. Identify risk factors and preventive strategies for psychiatric patients, taking into account psychosocial and cultural demographics in the joint decision making process. (1.9, 2.4, 2.5) 6. Distinguish the causes and underlying mechanisms of disease as it relates to psychiatric cases/management. (2.1, 2.2) 7. Use technology to search for, evaluate, and apply evidence in the care of psychiatric patients. (2.3, 3.6, 3.7, 3.9, 3.10) 8. Use reflection to recognize and seek feedback from others to identify one’s own limitations, biases, and vulnerabilities that may impact patient care as well as provide constructive feedback to others. (3.1, 3.2, 3.3, 5.5, 8.1) 9. Demonstrate effective professional relationships and communication by demonstrating respect, patient autonomy, dignity, integrity, honesty, trust, cultural awareness and compassion when engaging with patients, their families, peers, the public, the university community and other healthcare providers in the psychiatry rotation. (3.8, 4.1, 4.6, 5.1, 5.3, 7.1, 7.3, 7.4) 10. Demonstrate effective communications skills verbal, non-verbal and written skills when interacting with psychiatric patients and their families and other members of the healthcare team. (4.2, 4.3) 11. Document an organized and comprehensive medical records including history and physical and progress notes. (4.5) 12. Discuss one’s own emotional responses to patients and their families to better respond to ongoing treatment processes. (4.7) 6/06/18 2 13. Describe health care settings in psychiatric practice and interprofessional members of these practices and how they are used to meet patient, family and community needs. (6.1) 14. Demonstrate team-based behaviors in the assessment and treatment of psychiatric disorders. (6.2) 15. Identify systematic interprofessional practices that improve patient safety, minimize error, and contribute to continuous quality improvement.(6.5) 16. Identify one’s own role as a student physician on the psychiatric healthcare team, how it relates to other members and recognize when and how to initiate their assistance. (6.6, 7.2, 7.3)
Reference D2L for COMPETENCY MAP
CLERKSHIP-SPECIFIC PERFORMANCES, PROJECTS, REQUIREMENTS
In addition to the required minimum patient encounters listed, the following are requirements of the clerkship:
1. Psychopharmacology Quiz – Available For First Week Only • Required and available for the first week only. It will not be graded. • It is an open book exam. • It helps review information you will need during the clerkship. • These questions are based on information you should have learned in M2 psychopharmacology lectures. • This quiz must be completed within the first 7 days of the rotation.
2. Observed Interview Exercise • You arrange with one of your preceptors to have an observed 30 minute interview that you perform with a patient unknown to you during the first 2 ½ weeks of the clerkship. • An “interview exercise” form (available on D2L) is to be completed by the preceptor and signed. • This is to be submitted via the D2L dropbox and is due by the Wednesday before the shelf exam.
3. De-identified History and Physical with Mental Status Exam, Differential Diagnosis, and Treatment Plan • A completed write up for an H&P that you have done must be submitted via the D2L dropbox and is due by the Wednesday before the shelf exam. • Please use caution and delete names and any identifying information.
6/06/18 3 4. Presentation of Assigned Topic • You are required to make one or two PowerPoint presentations during the rotation. The topic is decided by you and your preceptor and is usually about 15-20 minutes. • A preceptor signed presentation form (available on D2L) and hard copy of the presentation must be submitted via the D2L dropbox and is due by the Wednesday before the shelf exam.
5. 11 Online Questions (D2L) • The rotation has a question bank of approximately 100 shelf-like questions. • In the first 3 weeks you will receive access to 6 questions, and the last 3 weeks you will have access to 5 additional questions. • These are shelf-like questions and may pertain to diagnosis, management, evidence based research, child psychiatry, pharmacology, psychopathology. • Although the score is not part of your grade, you are required to answer the questions. This is a great learning tool for you.
6. Mid-Clerkship Evaluation • You must print the mid-clerkship evaluation form (available on D2L) and bring it to one of your preceptors during the 3rd week of the clerkship. This is important, so make sure you plan this ahead of time. • The front page of the form helps you review your requirements. The back side of the form is where your preceptor will give you three written, specific pieces of feedback, thus helping you to work on any weaknesses or problems they perceive. This form must be signed by your preceptor. • The feedback form should be submitted to the D2L dropbox by the end of the 3rd week of clerkship.
7. Assessment of Interprofessional Activities • You will have many opportunities to participate in interprofessional activities during this rotation, such as attending a team- based staff meeting or shadowing a psychologist in a group therapy. You are required to complete a formal, meaningful, written reflection of your experience. • Please describe the psychiatric healthcare setting, identify your and other health professionals’ roles, when and how to initiate assistance of other healthcare professionals to provide comprehensive care to meet patients’ needs. • You must discuss this experience with a faculty member for feedback and obtain their signature. Submit the signed reflection form and attach your narrative reflection and submit via the D2L dropbox. This is due by the Wednesday before the shelf exam.
8. Assessment of Ethical Decision Making
6/06/18 4 • Please identify an ethical issue you came across during the rotation and complete a formal, meaningful, written reflection. • You must discuss this experience with a faculty member for feedback and obtain their signature; the signed reflection and separate narrative must then be submitted via the D2L dropbox and is due by the Wednesday before the shelf exam.
9. Patient Logs • You are required to enter the number and type of patients you have had contact with and their diagnoses (not names) on one45.com. • This will help you keep track of your patients. • Important: If you find that you have not been exposed to the required patient diagnoses that are listed in the psychiatry clerkship required encounters, you need to inform your attending or the site coordinator who will assist you in resolving this with an alternate learning experience.
REQUIRED PATIENT ENCOUNTERS
Student will: Be able to differentiate among common etiologies based on presenting symptom(s). Recognize “don’t miss” conditions that may present with symptoms. Elicit a focused history and perform a focused exam. Describe the initial management of common and dangerous diagnoses that present with symptom(s). Discuss the importance of cost effective approach to the diagnostic work-up. * Partial Participation (PP) = Participate in at least 2 of the components above. * Full Participation (FP) = Practice in at least 4 of the components above.
It is expected that most patient encounters counting toward the minimal encounter requirement will be at Full Participation. If the student is unable to complete the required diagnoses minimal numbers, then alternative experiences are available via the link on the “Content” tab on D2L.
Clinical Setting Type of Patient/ IP = Inpatient Level of Student Benchmark/Explanation Alternative Clinical Condition OP = Outpatient Responsibility CL= Consult
6/06/18 5 Clinical Setting Type of Patient/ IP = Inpatient Level of Student Benchmark/Explanation Alternative Clinical Condition OP = Outpatient Responsibility CL= Consult Major Depression All settings FP Student will participate in the evaluation of If a student is unable to complete the Major 3 Patients the patient. Student will obtain history, Depression encounter by the end of the clerkship, perform exam, and participate in developing alternative learning experiences will be available via clinical assessment and diagnostic and D2L from the Association of Directors of Medical therapeutic plan, along with or under the Education in Psychiatry (ADMSEP). It is encouraged guidance of an attending (or resident) that students communicate with the site director physician. throughout the clerkship for minimal encounter opportunities for full participation. Bipolar Disorder All settings FP Student will participate in the evaluation of If a student is unable to complete the Bipolar Disorder 2 Patients the patient. Student will obtain history, encounter by the end of the clerkship, alternative perform exam, and participate in developing learning experiences will be available via D2L from the clinical assessment and diagnostic and Association of Directors of Medical Education in therapeutic plan, along with or under the Psychiatry (ADMSEP). It is encouraged that students guidance of an attending (or resident) communicate with the site director throughout the physician. clerkship for minimal encounter opportunities for full participation. Anxiety Disorder All settings FP Student will participate in the evaluation of If a student is unable to complete the Anxiety Disorder 2 Patients the patient. Student will obtain history, encounter by the end of the clerkship, alternative perform exam, and participate in developing learning experiences will be available via D2L from the clinical assessment and diagnostic and Association of Directors of Medical Education in therapeutic plan, along with or under the Psychiatry (ADMSEP). It is encouraged that students guidance of an attending (or resident) communicate with the site director throughout the physician. clerkship for minimal encounter opportunities for full participation. Alcohol and/or All settings PP Student will participate in the evaluation of If a student is unable to complete the Alcohol and/or Substance Abuse the patient. Student will obtain history, Substance Abuse encounter by the end of the 2 Patients perform exam, and participate in developing clerkship, alternative learning experiences will be clinical assessment and diagnostic and available via D2L from the Association of Directors of therapeutic plan, along with or under the Medical Education in Psychiatry (ADMSEP). It is guidance of an attending (or resident) encouraged that students communicate with the site physician. director throughout the clerkship for minimal encounter opportunities for full participation.
6/06/18 6 Clinical Setting Type of Patient/ IP = Inpatient Level of Student Benchmark/Explanation Alternative Clinical Condition OP = Outpatient Responsibility CL= Consult Cognitive All settings FP Student will participate in the evaluation of If a student is unable to complete the Cognitive Impairment/ the patient. Student will obtain history, Impairment/ Dementia encounter by the end of the Dementia perform exam, and participate in developing clerkship, alternative learning experiences will be 2 Patients clinical assessment and diagnostic and available via D2L from the Association of Directors of therapeutic plan, along with or under the Medical Education in Psychiatry (ADMSEP). It is guidance of an attending (or resident) encouraged that students communicate with the site physician. director throughout the clerkship for minimal encounter opportunities for full participation. Schizophrenia All settings FP Student will participate in the evaluation of If a student is unable to complete the Schizophrenia or or Psychosis the patient. Student will obtain history, Psychosis encounter by the end of the clerkship, 2 Patients perform exam, and participate in developing alternative learning experiences will be available via clinical assessment and diagnostic and D2L from the Association of Directors of Medical therapeutic plan, along with or under the Education in Psychiatry (ADMSEP). It is encouraged guidance of an attending (or resident) that students communicate with the site director physician. throughout the clerkship for minimal encounter opportunities for full participation. Suicidal Risk or All settings PP Student will participate in the evaluation of If a student is unable to complete the Suicidal Risk or Assessment the patient. Student will obtain history, Assessment encounter by the end of the clerkship, 2 Patients perform exam, and participate in developing alternative learning experiences will be available via clinical assessment and diagnostic and D2L from the Association of Directors of Medical therapeutic plan, along with or under the Education in Psychiatry (ADMSEP). It is encouraged guidance of an attending (or resident) that students communicate with the site director physician. throughout the clerkship for minimal encounter opportunities for full participation. Violence Risk or All settings PP Student will participate in the evaluation of If a student is unable to complete the Violence Risk or Assessment the patient. Student will obtain history, Assessment encounter by the end of the clerkship, 2 Patients perform exam, and participate in developing alternative learning experiences will be available via clinical assessment and diagnostic and D2L from the Association of Directors of Medical therapeutic plan, along with or under the Education in Psychiatry (ADMSEP). It is encouraged guidance of an attending (or resident) that students communicate with the site director physician. throughout the clerkship for minimal encounter opportunities for full participation.
REQUIRED AND RECOMMENDED CLERKSHIP MATERIALS
6/06/18 7 • Please reference D2L for recorded lectures and reading materials. Students are encouraged to read and review these learning materials. There is no particular required text designated for the Psychiatry Clerkship; however, it is expected that all students make use of Psychiatry Online through the Boxer Library e-resources.
• Recommendations: o First Aid for Psychiatry o U World for Psychiatry o Case Files for Psychiatry o Psychiatry Online Contact Boxer Library for questions on obtaining these resources
• Note: The American Psychiatric Association Textbook of Psychiatry is available through Psychiatry online
• Additional Resources o American Board of Psychiatry and Neurology (ABPN) https://www.abpn.com/ o American Psychiatric Association https://www.psychiatry.org/ o Jeffrey W. Bulger Ph.D.; http://platospress.com/ o Psychiatryonline. Chapter 7 Ethical Aspects of Clinical Psychiatry at http://psychiatryonline.org.ezproxy.rosalindfranklin.edu:2048/doi/full/10.1176/appi.books.9781585625031.rh07 o PsychiatryOnline: Chapter 33 Supportive Psychotherapy http://psychiatryonline.org.ezproxy.rosalindfranklin.edu:2048/doi/full/10.1176/appi.books.9781585625031.rh33
EVALUATION, EXAMINATION, AND REMEDIATION POLICIES
Refer to D2L for: • CMS Excused Absence Policy document for examination and other clinical experience remediation guidelines. • CMS Clerkship Grading Policy • Clinical Evaluation Standards • Required Minimum Patient Encounters are included in the syllabus and indicate specific patient type/clinical condition remediation guidelines. • CMS Exam Conduct Policy • RFUMS Exam Loaner Laptop Policy
6/06/18 8 • CMS Clerkship Retake/Rescheduled Exam Policy • RFU Remediation Policy
NBME Online Shelf Exam:
The NBME Online Shelf Exam is typically held at the RFUMS Campus on the last Friday of the rotation from 9:00 a.m. to 12:00 p.m. However, please refer to D2L for the most recent updates.
The NBME is responsible for grading exams. No challenges are accepted for NBME exams. Scores will be available approximately 1-2 weeks after the exam has been completed, but will not be published until clinical evaluations have been received.
In general, Clerkship Directors will determine how the student will make up patient encounters, clinical activities or other clerkship requirements. Clerkship Directors will determine if and when the student will be required to repeat the clerkship. Clerkship Directors will use case-by- case evaluation and coordinate with the Office of Student Affairs & Education.
CMS Remediation Procedures:
Eligibility Criteria for Remediation: At the end of the rotation, students who have a failing grade in any of the applicable course components (final exam, clinical evaluation, and/or performances) will be offered remediation for the component(s) they have failed.
Process for Remediation: Students are required to take exams, if applicable, as scheduled and in the proscribed manner outlined in the CMS Clerkship Retake/Rescheduled Exam Policy. Clinical evaluations and/or rotation-specific performances requiring remediation will be addressed by the Education Director based upon the deficits.
Remediation Grading Outcomes: If the student passes the remediation, they receive a grade of “Pass” for the rotation. If the student fails the remediation, they receive a grade of “Fail” for the rotation. A failure will result in the student repeating all or part of the rotation at the discretion of the Education Director, in consultation with the Assistant Dean of Clinical Education.
Maximum number of attempts to remediate: Students will have one retake opportunity to pass a remediation.
Please reference the following additional Polices and Guidelines posted to D2L: • SEPAC Handbook • SEPAC Policy
6/06/18 9 • Clinical Grade Appeal Policy • Clerkship/Sub-Internship Grade Appeal Form • Student Policies Handbook • Testing Accommodations Guidelines • CMS Learner Mistreatment Policy and Procedures • Medical Student Work Hours Policy • Off-Site Secure Storage Policy • Teacher-Learner Expectations • CMS Professionalism Policy and Procedures • CMS Dress Code Policy • Ebola Virus Policy • Exposure Incidents Policy • Alcohol and Drug Use Policy
Holiday Schedule: You must follow the holiday schedule for your site, not Chicago Medical School's schedule.
Weather Emergencies: If the University is closed due to extreme weather, check with your clinical site regarding its status. Unless otherwise directed by your Site Director, you should go to your clinical site.
ACADEMIC ACCOMMODATION
Rosalind Franklin University of Medicine and Science is committed to providing equal access to learning opportunities for students with documented disabilities. To ensure access to this class and your program, please contact the ADA Coordinator at 847.578.8354 or [email protected] to engage in a confidential conversation about the process for requesting accommodations in the classroom and clinical settings.
Accommodations are not provided retroactively. Students are encouraged to register with the ADA Coordinator as soon as they begin their program. Rosalind Franklin University of Medicine and Science encourages students to access all resources available. More information can be found on the Academic Support InSite page or by contacting the ADA Coordinator.
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OTHER CLERKSHIP INFORMATION
Didactic Day:
Speaker Date Topic Lecture Objectives
Dr. George Gettys See D2L Sleep Medicine To describe common sleep disorders and their underlying pathophysiology and treatment. (CMS objectives: Medical and Scientific Knowledge 1.1, 1.2, 1.3, 1.4, 1.5) Dr. David Garfield See D2L Biopsychosocial To recognize the interaction between biological, psychological, and social elements in Formulation diagnosis, treatment and prevention of psychiatric disease. (CMS objectives: Medical and Scientific Knowledge 1.1, 1.2, 1.3, 1.4, 1.5) Dr. Lori Moss See D2L Psychopathology To recognize symptoms of major depression, bipolar type I and to differentiate secondary Vignettes causes that may underlie common psychiatric syndromes. (CMS objectives: Medical and Scientific Knowledge 1.1, 1.2, 1.3, 1.4, 1.5) Dr. Lin Lu See D2L Child Psychiatry To identify manifestation and treatment of common childhood psychiatric conditions including but not limited to ADHD, Autism spectrum disorder, childhood bipolar effective disorder and Tourette’s. (CMS objectives: Medical and Scientific Knowledge 1.1, 1.2, 1.3, 1.4, 1.5) Dr. Michael Shuman See D2L Substance Abuse To describe addiction concepts of intoxication, use and dependence, tolerance and withdrawal. To obtain knowledge of a wide variety legal and illegal substances of abuse. (CMS objectives: Medical and Scientific Knowledge 1.1, 1.2, 1.3 1.4, 1.5)
Note: Topics, location, or speakers are subject to change. Students will be notified if changes occur via D2L.
SITE DIRECTORS, FACULTY AND STAFF
Site SITE DIRECTOR SITE COORDINATOR
Advocate Illinois Masonic Medical Dr. Rebecca Gilfillan Gertrude Lobo Center 773-296-8977 773-296-8977 836 W. Wellington Ave. [email protected] [email protected]
6/06/18 11 Chicago, IL 60657 Maria Garcia (Medical Student Affairs) 773-296-8977 [email protected]
Advocate Lutheran General Hospital Dr. Maya Ramic Marisol Hernandez- Martinez 1775 Dempster St., 6 South 847-723-6464 847-723-6464 Park Ridge, IL 60068 [email protected] [email protected]
Lovell Federal Health Care Center Dr. Lori Moss Tashekia Ramsey 3001 Green Bay Rd. 224-610-5719 224-610-6719 North Chicago, IL 60064 [email protected] [email protected]
Centegra Hospital Dr. Liz McMasters Edie Best 3701 Doty Rd. 815-334-5567 815-759-8151 Woodstock, IL 60098 [email protected] [email protected]
Elgin Mental Health Center Dr. Malini Patel Sandra Akers 750 S. State St. 847-742-1040 x2084 847-742-1040 x2015 Elgin, IL 60123 [email protected] [email protected]
Mt. Sinai Hospital Dr. Paul Berkowitz Sandra Thompson 1500 S. Fairfield Ave. 773-257-6659 773-257-6659 Chicago, IL 60608 [email protected] [email protected]
Presence St. Mary’s and Elizabeth’s Dr. Mitch Glaser Nadia Kalam Medical Center 312-770-3192 312-770-3192 2233 W. Division St. [email protected] [email protected] Chicago, IL 60622
RFU Behavioral Health Dr. Lin Lu Kristen Serdar 830 West End Ct., #400 847-247-6910 847-247-6910 Vernon Hills, IL 60061 [email protected] [email protected]
6/06/18 12 Billings Clinic Dr. Amy Schuett Kristina McComas 406-435-6141 406-238-5059 [email protected] [email protected]
CLERKSHIP SCHEDULE FOR 2018-2019
Didactic Day NBME Exam Rotation # First Day at Site Simulation Day ** 8:00 a.m. – 3:30 p.m. 9:00 a.m. – 11:45 a.m.
Tuesday, 07/10/18 Friday, 08/10/18 1 Monday, 07/02/18 N/A Location: IPEC L.811 Location: TBD Tuesday, 08/21/18 Friday, 09/21/18 2 Monday, 08/13/18 N/A Location IPEC L.811 Location: TBD Tuesday, 10/02/18 Friday, 11/02/18 3 Monday, 09/24/18 N/A Location: IPEC L.811 Location: TBD Tuesday, 11/13/18 Friday, 12/14/18 4 Monday, 11/05/18 Monday, 11/19/18 Location: IPEC L.811 Location: TBD Wednesday, Tuesday, 01/15/19 Friday, 02/15/19 5 Thursday, 01/24/19 01/07/19 Location: IPEC L.811 Location: TBD Monday, 02/18/19 Tuesday, 02/26/19 Friday, 03/29/19 6 Thursday, 03/07/19 (Presidents Day) Location: IPEC L.811 Location: TBD Tuesday, 04/09/19 Friday, 05/10/19 7 Monday, 04/01/19 Thursday, 04/18/19 Location: IPEC L.811 Location: TBD Tuesday, 05/21/19 Friday, 06/21/19 8 Monday, 05/13/19 Thursday, 05/30/19 Location: IPEC L.811 Location: TBD
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