Clerkship Curriculum

Students receive instruction by lecture, demonstrations, video tape, and small groups in aseptic technique in the operation room; surgical scrubbing, gowning, and gloving in the operating room; an introduction of how to use electronically-stored records; an overview of Advance Cardiac Life Support certification and procedures; a review of the LSU Health Shreveport Clinical Orientation Manual, and a tour of hospital clinical areas.

Students are assigned to the medical wards where they participate as part of the health care team. They record the history and physical examination on a limited number of patients. Many of the diagnostic and therapeutic procedures are performed by the student on patients under close supervision. Attending rounds are conducted regularly by faculty members for students and house staff. These rounds are oriented toward the problems and care of ward patients. At other rounds, lectures and conferences, emphasis is on a physiologic approach to medicine. At all times, emphasis is on thoroughness in the study of a patient’s disease, plus compassion and respect for the patient as a sick human being.

Students are assigned to general surgery for 12 weeks. The goals of students taking the course include learning how to perform a problem-focused history and physical on a surgical patient, developing substantial knowledge and skill regarding the diagnosis and treatment of surgical diseases, becoming facile in the written documentation of inpatient and outpatient care, maturing the various aspects of professionalism, and gaining insight into the degree to which one possesses the aptitudes for the technical skills required for a career in surgery. These goals are met with a series of 14-16 lectures; patient encounters onwards, in clinics, on call, and in the operating room; simulation labs for knot tying and suturing; standardized patient encounters; teams interaction and learning; and a multiplicity of conferences that are didactic and interactive. Case logs, procedure logs, and exposure logs are used to validate the achievement of a global experience. To assure access to multiple faculty and resident teachers and to assure a broad exposure, students rotate through a general surgery service and a specialty service.

In this 6-week clinical clerkship, the MSIII year medical student will be exposed to a broad variety of patients on the obstetrical and gynecologic services. They will participate in outpatient care of patients who are being seen for annual health maintenance, acute clinic with problems of both the obstetrical and gynecologic nature, routine OB clinics of both low and high-risk patients, gynecologic clinics encompassing the whole spectrum of gynecologic care from annual health maintenance to gynecologic oncologic conditions. They will also participate in inpatient care on gynecologic and obstetrical patients. This will include scrubbing in on surgeries under the supervision of the attending faculty and the house officers assigned to the services. The MSIII year student will rotate on the obstetrical service, which will consist of the Labor and Delivery rotation for one week. On the alternate week, they will be assigned to Oschner Academic Medical Center in Monroe where they will participate in the care of both obstetrical and gynecologic patients. Students will also be assigned for 2 weeks in the Women’s Clinic for a variety of outpatient services that are provided. During their week in outpatient clinics, they will take call once or twice for Labor and Delivery at night. Students will also be assigned for 2 weeks to the gynecologic services. One week will be spent on the Benign GYN service where they will participate in both inpatient and outpatient care of patients with benign gynecologic conditions. One week will be spent on the GYN Oncologic service where they will, under the direction of our Gyn Oncology faculty, care for patients in both the inpatient and outpatient setting. This will include rotating at Willis-Knighton Medical Center to attend surgeries during that week with the gynecology faculty. Students on the Gyn service will take call in Labor during the weekends. Each week there will be a series of didactic lectures covering basic topics in obstetrics and gynecology. In addition, the students will participate in patient simulations using the birth simulator “NOELLE”. There will also be small group sessions to which the students will be assigned, including focused discussions with faculty members in reproductive endocrinology, high-risk obstetrics, and small group sessions in medical ethics in obstetrics and in safety.

The Junior Pediatric Clerkship is a 6 week clinical experience consisting of the following: 3 weeks Inpatient Wards; 1 1/2 weeks Ambulatory Pediatrics; 1 week Newborn Nursery; ½ week Subspecialty Clinics. The Pediatric Clerkship provides the students the opportunity to interview, communicate, examine and interact appropriately with patients, from the neonatal period to the 18 year old adolescent. The rotation also provides the students the opportunity to appropriately interact with patient’s families. The patients seen by the students will have both acute and /or chronic illnesses. The junior students will participate in the principles of health supervision, the recognition of common health problems, and the role of the pediatrician in preventative care. The rotation will illustrate the role of the outpatient general pediatrician in the coordination of medical and psychosocial care of the pediatric patient. It will also stress the importance of collaboration between the general pediatrician and other health professionals. The students will be taught the importance of self-directed learning and will be given the opportunity to learn the importance of public speaking and critical appraisal of the medical literature as an educational tool. Lastly, the rotation provides role models to assist the students in the acquisition of professional conduct, attitudes, and attributes befitting a physician.

Under the supervision of licensed Family Medicine Faculty, MSIII year students participate in 4 weeks of both community and university practices (Comprehensive Care Clinic and Primary Care Family Medicine Clinic) the student assumes the role of primary physician, with continuing responsibility in the care of patients and families throughout the MSIII year. In the community, students will rotate with the same community Primary Care physician throughout the four week clerkship. The didactic content will primarily come from nationally recognized web based clinical cases.

This 4 week rotation will give students an exposure to both inpatient and outpatient neurology and neurosurgical patients. Majority of teaching/learning will occur in the hospital and ambulatory care setting - at the bedside. Students will round with both services over the 4 week period, as well as attend clinics and observe in the operating room. Both faculty attendings and residents in Neurology and Neurosurgery will share the teaching responsibilities. Teaching sessions are expected to be case-based and interactive with minimal formal lectures. Emphasis will be placed achieving competency in obtaining a neurological history and performing an adequate neurological examination. Attention will be given to common neurological problems as well as neurological emergencies. Students will be expected to competently present cases in both written and oral form. Adequate feedback on performance will be part of the learning experience. 

This course includes clinical training in psychiatry. Students participate in the departments’ inpatient wards and outpatient clinics, grand rounds, and didactic sessions. In addition to core knowledge in this specialty, students gain an understanding of the relationship between all disciplines as they are exposed to the evaluation and management of patients on consultative services. Departmental didactic seminars and case conferences involving various aspects of psychiatric pathology, interviewing and examination skills, and therapeutic techniques are offered. Both normal and pathological clinical experiences are gained in the department’s clinical settings under the supervision of attending physicians and residents. The primary goal is to equip the student with knowledge and experience that will be beneficial in the understanding of patients regardless of his or her medical specialty interest. The clinical experience in the third year is on the following services: psychiatry inpatient, psychiatry emergency, psychiatry consultation /liaison, and psychiatric outpatient clinics.

Lectures, audiovisual presentations and panel discussions.  The course deals with clinical and laboratory methods for diagnosis as well as principles of treatment of drug over dosage and ingestion of common poisons. 

Electives are scheduled for 2 or 4 weeks. Electives typically begin at 8:00 a.m. on the first day of the block and end at midnight on the Sunday night of the elective block. Ending dates and time off (including holidays) are at the discretion of the elective director.  

The purpose of the Selectives is to provide fourth-year students with the following opportunities: 

1. To acquire extended knowledge of the fundamental principles of medicine;
2. To build experience on the fundamental concepts and skills learned in the 3rd year Clinical Clerkships;
3. To place emphasis on basic knowledge of pathophysiology and clinical presentation of major and common disease problems, correlation and interaction of laboratory and other diagnostic services, diagnosis and assessment of patients, and treatment;
4. To enhance skills of medical history taking and general physical examination and;
5. To acquire the skills and knowledge to provide a sound foundation for continuing education, regardless of the ultimate career choice of the student.

Students are required to complete Institute for Healthcare Improvement (IHI) Open School’s Basic Certificate in Quality and Safety which comprises 13 individual modules.

Goals:
The purpose of this selective is to :

• Introduce students to the fundamentals of quality improvement, patient safety, and the essential components comprising a culture of safety.
• Equip students with the knowledge and skills to provide safe, timely, equitable, effective, efficient, and patient-centered care

Objectives:
Upon completion of this course, the student should be able to:

• Explain the value of improvement science in health care.
• Identify the key elements of an effective improvement model.
• Describe how to lead an improvement project through four key phases.
• Apply strategies to work effectively with inter-professional colleagues.
• List the main types of errors and identify ways providers can improve safety for patients.
• Define a culture of safety and discuss how teamwork/communication can promote a strong safety culture.
• Explain the responsibilities of clinicians and health care systems in optimizing population-level outcomes with available resources.
• Describe several leadership characteristics and leadership approaches that can be effective in healthcare.
• Understand and elucidate the role of socioeconomic background, religious preferences, culture, and the building of trust influence the patient-provider relationship.
• Identify at least four skills to improve clinical interactions with patients.

This two week required web-based selective will provide students with evidence-based clinical nutrition education. The course director will provide instruction to students regarding the way in which the course material is accessed and navigated. Students may complete their assigned modules from any internet-accessible locations. Students will be assigned modules to provide nutritional education.

This course is designed to prepare senior medical students for internship by developing their clinical knowledge, skillset and communication skills to function effectively in their new roles. This course consists of two weeks of shared curriculum and two weeks of specialty specific curriculum.  The shared curriculum focuses on knowledge and skills common to all specialties and is supplemented with specialty specific instruction designed to ensure students excel as they transition into their respective residencies.  This course facilitates student learning with online curricula and small group sessions of simulated clinical experiences, such as standardized patient encounters, high-fidelity manikin scenarios, and procedural task trainers.

Goal:
The purpose of this elective is to:
Ensure fourth year medical students make a seamless transition to residency by refining their knowledge base and communication skills while also reinforcing essential clinical competencies enabling them to perform at a high level as they transition into their intern year.

Objectives:
Upon completion of this course, the student will be able to identify and apply specific skills necessary for successful transition to residency, including:

• Recognize, evaluate and manage common emergency situations
• Recognize indications for and learn how to perform common clinical procedures.  
• Recognize a patient requiring emergent care and demonstrate how to initiate a code response.  
• Order, interpret, and provide rationale for requesting common labs and tests.
• Communicate effectively and compassionately with patients and families in order to form and sustain effective medical care
• Gain specialty specific knowledge and clinical skills that will advance their performance in residency

Specific Features / Specialty Specific Objectives:

Medicine

• Demonstrate patient centered interview skills.
• Provide and oral presentation of a clinical encounter. 
• Identify and treat urgent and emergent conditions semi independently and appropriately escalate care. 
• Provide verbal handoff conveying illness severity, situational awareness and create action plan for including contingencies.
• Learn to work as an effective member of a clinical care team.

OB/GYN

• Establish the fundamentals of basic patient care through a series of didactics and skills labs.
• Engage in interactive case-based learning scenarios for OB Hypertensive / Pre-Eclampsia management and Post-partum hemorrhage.
• Participate in simulations for vaginal delivery, shoulder dystocia, operative laparoscopy, hysteroscopy, amniotomy, IUPC/FSE placement, and endometrial biopsy.
• Practice suturing and knot tying skills.
• Engage with residents / faculty to develop skills for proper documentation and basic Internship training.

Pediatrics

• Establish the fundamentals of basic pediatric patient care through a series of didactics and skills labs.
• Certification in Basic Life Support, Pediatric Advanced Life Support, and Neonatal Resuscitation Program.
• Understand and demonstrate the principle of professionalism.
• Develop skills for proper documentation and efficient and effective transfer of care to minimize loss of information.

Surgery

• Establish the fundamentals of basic perioperative care of the surgical patient through a series of didactics and skills labs.
• Demonstrate proficiency in performing bedside procedures and minor procedures in the operating room and at bedside.
• Understand and demonstrate the principle of professionalism.
• Demonstrate interpersonal and communication skills that result in effective information exchange with patients, families and professional health care staff.
• Develop effective strategies for practice based learning and improvement, utilize and analyze scientific literature for evidence-based practice.
• Understand the role of risk management, medical legal, ethics, and system based practice.