Fourth Year Medical Student - Anesthesia in the Clinical Setting (AE501M.23)

Credits: 4 CREDITS (Clinical Elective)
Sites: BWH
Directors: McSweeney, Jennifer Marie
Prerequisites: HMS Principal Clinical Experience (Core Clinical Clerkships) or equivalent
Offered: Full time for one month. Not offered July and August. U.S./Canadian Exclerks only.
Open to Exclerks: U.S./Canadian

Description:

During the Anesthesia elective, students will work closely with faculty preceptors and residents in the pre-operative, intra-operative and post-operative management of patients. Students will spend the first week with a faculty mentor in their clinical area of expertise. During the remaining weeks, students are proactively assigned to anesthesiology subspecialties according to their personal interests. These sub-specialties include cardiac, thoracic, vascular, orthopedic, plastic, neurosurgical and obstetrical anesthesiology, as well as the acute and chronic pain management services. In addition to weekly Problem Based Learning Discussions, students will also participate in our departmental conferences.

While students will have the opportunity to participate in hands on learning, the goal of this clerkship is to provide a more in depth exposure to the diverse field of anesthesiology and further develop their critical thinking and decision making skills. Rather than focus on technical skills, we strive to help students understand important clinical concepts applicable no matter what specialty they choose. Real time applied physiology and pharmacology will be emphasized. As the month progresses and in accordance with level of enthusiasm and ability, students can expect to be given limited responsibility in caring for patients. If students are interested in exploring anesthesiology as a career, we will provide them with mentorship and career exploration opportunities.

Learning Goals:

Upon completion of the elective, students will:

History taking:

  • Demonstrate the ability to complete a thorough preoperative assessment
  • Demonstrate the ability to complete a thorough postoperative assessment

Physical examination:

  • Demonstrate the ability to complete a focused physical examination, including an airway evaluation

Fund of knowledge:

  • Describe the pharmacology of intravenous and inhalational anesthetics
  • Describe the elements of a complete pre-operative assessment
  • Describe the ASA classification
  • Identify predictors of a difficult airway
  • Identify strategies for managing a difficult airway
  • Describe the standard ASA monitors
  • Identify management strategies for common intra-operative problems
  • Describe the signs, symptoms and triggers of Malignant Hyperthermia
  • Demonstrate a basic understanding of cardiac and respiratory physiology
  • Describe pain management strategies in the peri-operative period
  • Describe the indications and contraindications of regional anesthesia
  • Identify the components of effective teamwork

Technical and procedural skills:

  • Demonstrate willingness to practice technical skills including intubation, intravenous and arterial line placement
  • Set up the operating room for a standard ASA-1 anesthetic

Clinical evaluation and management skills:

  • Demonstrate how the information derived from the preoperative assessment and physical examination is used to guide clinical decision making
  • Demonstrate the ability to use real time applied physiology and pharmacology in the operating room to guide clinical decision making
  • Demonstrate the ability to use intra-operative monitoring to guide clinical decision making
  • Demonstrate the ability to manage common intra-operative problems under the supervision of faculty

Interpersonal skills:

  • Demonstrate the ability to communicate effectively with patients, families and colleagues
  • Demonstrate the ability to work effectively as a member of the peri-operative team

Presentation skills:

  • Demonstrate the ability to present a preoperative assessment and plan to faculty
  • Actively participate in clinical discussions and conferences

Professionalism:

  • Demonstrate respect for patients, families and colleagues
  • Demonstrate willingness to provide and accept feedback
  • Discuss all requests for excused absences with the course director

Cultural/social/systems awareness:

  • Demonstrate cultural, social and systems awareness in working with patients, families and other health care providers

Initiative and desire to learn:

  • Demonstrate personal initiative and desire to learn

Incorporation of Basic Science Content and Evidence-Based Medicine:

Throughout their clinical experience in the operating room, students participate in the direct application of evidence based medical practice in conjunction with their clinical faculty.

Evaluation:

As outlined in the Harvard Medical School Elective Clerkship Evaluation Form, students will be evaluated in: history taking, focused physical examination, fund of knowledge, technical and procedural skills, clinical evaluation and management skills, interpersonal skills, presentation skills, professionalism, cultural/social/systems awareness and initiative and desire to learn as outlined above in the course objectives.

Grade Criteria:

High Honors

  • Students who consistently demonstrate skills above a 4th year medical student level

Honors

  • Students who often demonstrate skills above a 4th year medical student level

Satisfactory

  • Students who demonstrate skills appropriate to the level of a 4th year medical student

Unsatisfactory

  • Students who consistently demonstrate skills below the level of a 4th year medical student
  • Students who demonstrate unprofessional behavior

Applicants are advised to read the detailed information provided before applying to the HMS Visiting Exchange Clerkship Program.

The Application and more information can be found at: http://ecommons.med.harvard.edu/org.asp?exclerk