The Emergency Medicine clerkship is a required four-week block for students at the University of Missouri-Kansas City School of Medicine. In 2017 the SOM transitioned to 4 week blocks instead of a monthly rotation, so there are 13 block rotations per year. Students participate in direct patient care under the supervision of attendings and senior residents. Emergency Medicine faculty and chief residents give approximately 12-15 hours of lecture per month, including ACLS certification.
There is assigned reading from Tintinalli’s Emergency Medicine Manual, 7th Edition by David M. Cline et al. Multiple resources are provided including an iPad (more below) and online access to Tintinalli and Access Medicine. Our clerkship functions largely paperless. Each student is loaned an iPad mini for the duration of the clerkship. The iPad can be used access course information and content during patient care. On the iPad, students can review patient charts, document electronically, view the course schedule, submit evaluation forms and receive course-related emails. Multiple medical applications have been installed and helpful web pages have been bookmarked. The clerkship’s iTunesU course houses course content with more than 50 pre-loaded videos on common emergency medicine problems and procedures.
The clerkship goals and objectives are consistent with the UMKC School of Medicine competencies and objectives, and are designed to help prepare students for the content of NBME subject exam and the USMLE Step 2 CK & CS exams. The Clerkship Directors of Emergency Medicine (CDEM) published their updated and revised Emergency Medicine clerkship curriculum in 2010. Our objectives are heavily based and structured on their recommendations. For more information visit: https://cdemcurriculum.com.
In addition, some objectives are derived from the ACGME Emergency Medicine Milestone Project, which can be found at www.acgme.org. At the start of the clerkship, students are provided with an extensive syllabus (housed in the iTunesU course) outlining the clerkship objectives. The following is a list of our student learning outcomes (i.e. what students should be able to know or do at the conclusion of your month):
- The student should be able to develop a list of common emergent causes for patients presenting with common emergent complaints (i.e. chest pain, abdominal pain, altered mental status).
- The student should be able to accurately describe the classic presentations of emergent causes of common complaints that patients present to the emergency department with (i.e. chest pain, abdominal pain, altered mental status).
- The student should be able to explain the initial evaluation (history and exam, diagnostic modalities) of patients presenting with common emergent complaints (i.e. chest pain, abdominal pain, altered mental status).
- The student should be able to explain the key management strategies for patients with the classic presentations of common emergent complaints (i.e. chest pain, abdominal pain, altered mental status).
- The student should be able to explain the indications, contraindications, complications and limitations of basic clinical procedures (examples include basic laceration repair and simple incision and drainage).
- The student should be able to effectively perform basic clinical procedures (examples include basic laceration repair, and simple incision and drainage).
- The student will be able to interact with patients, families and all members of the health care team in a professional manner (with respect, compassion, empathy, altruism, honesty, accountability and excellence) at all times during the clinical clerkship.
Students will spend all of their clinical time at Truman Medical Center, the primary training site of our Emergency Medicine residency. Students participate in direct patient care under the supervision of attendings and senior residents. Five days per week, students benefit from the presence of an additional “teaching resident” that helps take students’ learning experience to the next level.
Students work an average of 12 eight-hour shifts, including one nursing shift and one or two ambulance ride-a-alongs with a local EMS agency. There is ample opportunity to see and perform a variety of procedures. We encourage our students to be active in the care of their patients, and we expect students to present patients directly to faculty.
The UMKC/TMC Emergency Medicine faculty and chief residents have prepared medical student lectures, group discussions, workshops and simulations to challenge senior students and help them meet clerkship objectives. The schedule varies every block, and students will be provided a schedule on the first day of the clerkship. All UMKC medical students receive ACLS certification during orientation.
We utilize the flipped classroom approach for many of our didactics. Each student receives an iPad at the start of the clerkship. Students access the clerkship’s iTunesU course to view the course content. Students are expected to spend on average 8-10 hours per week in self-directed study. The current clerkship lectures, case-based discussions and simulation activities include:
- Airway Simulation Lab (Teaching Block PGY-3 Resident)
- Hands-on Emergency Ultrasound Workshop (Kevin O’Rourke, M.D., Assistant Program Director, and Andrew Balk, M.D. Both are Fellowship-trained in Ultrasound)
- Pharmacology Lecture (Subject varies; Jeremy Hampton, Pharm D)
- Toxicological Emergencies (Adam Algren M.D., Fellowship-trained in Toxicology)
- ACLS Certification Course, Simulation Lab (Chief resident)
- Sick or Not Sick? Moderate Fidelity Simulation (Stefanie Ellison, M.D., Associate Dean of Learning Initiatives UMKC School of Medicine)
- Approach to Abdominal Pain Group Case-Based Discussion (Chief Resident)
- Approach to Pulmonary Emergencies Group Case-Based Discussion (Chief Resident)
- Approach to Chest Pain Group Case-Based Discussion (Chief Resident)
- High-yield review of common emergency problems and procedures (Melanie Camejo, M.D., Associate Clerkship Director)
- Approach to Neurologic Emergencies High Fidelity Simulation (Emily Hillman, M.D., Clerkship Director and Assistant Program Director).
- Multidisciplinary Trauma Conference
Evaluation and Grading
Final grades are based on a combination of clinical performance (55%) and National Board of Medical Examiner’s Advanced Clinical Exam (NBME ACE; 45%) performance. At the conclusion of each clinical shift, your faculty member will provide you with direct 1:1 feedback, and you will be provided a clinical performance evaluation (0-4 scale). Using the iPads, faculty members electronically submit student evaluations at the end of each shift. The scores are averaged at the conclusion of the month.