PEDIATRIC SURGERY
SUR 815
Course Title, Department, & Number: SUR 815, Pediatric Surgery
Course credit or length: 2 Weeks
Course directors and contact information (office phone and e-mail):
Dr. Bonnie Beaver, ; 304.691.1200
Course coordinator and contact information (office phone and e-mail):
Lisa Clagg-Blizzard, 304.691.1281;
Course location: Cabell Huntington Hospital
Brief Course Description
The Pediatric Surgery elective will allow the student to participate in the evaluation and care of babies and children with surgical problems on the wards and in the operating room. They will attend out-patient clinics, round on children to the hospital, and participate in ward rounds throughout their stay. Students will also be required to read selected topics in order to appreciate the range of problems which may be seen by a pediatric surgeon.
Physiology will be stressed. An understanding of basic surgical principles and wound healing is important for all specialties of medicine. The specific childhood differences will be covered and used to highlight these principles.
Institutional Objective
Patient Care - Students must demonstrate the ability to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.
Course Objectives
The student will be able to: 1) demonstrate an understanding of appropriate preoperative, operative, and postoperative evaluation and management of pediatric patients; and, 2) demonstrate an understanding of the etiology, diagnosis, clinical presentation, surgical treatment (including preoperative, operative, postoperative evaluation and management) of the top ten most common pediatric surgical problems.
Outcome Measures
The student will 1) demonstrate orally to a faculty member and by on-line exam the ability to perform an appropriate preoperative, operative, and postoperative evaluation and management of at least five pediatric patients; and, 2) demonstrate orally to a faculty member and by on-line exam an understanding of the etiology, diagnosis, clinical presentation, surgical treatment (including preoperative, operative, and postoperative evaluation and management) at least two cases of the following top ten most common pediatric surgical problems (to be randomly selected by the faculty member):
a) Acute Appendicitis
b) Adhesive Bowel Obstruction
c) F.B. GI tract
d) Hirchsprung’s Disease
e) Ileus of Sepsis (Abdominal compartment Syndrome)
f) Incarcerated Inguinal Hernia
g) Intussusception
h) Neonatal Intestinal Obstruction (Volvulus/malrotation, NEC, congenital Intestinal Atresia and Congenital Abdominal Wall Defects)
i) Pyloric Stenosis
j) Trauma
Institutional Objective
Professionalism- Students must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles.
Course Objective
The student must behave in an ethical, responsible, reliable and dependable manner.
Outcome Measure
The student will be directly observed by faculty to determine ethical behavior, reliability and level of dependability of the student.
Basic Science Course Objective
Basic Science Objective
The student should possess a basic knowledge of the anatomy and physiology of the abdominal wall as it relates to abdominal incisions, hernias and hernia repairs in infants and children.
Outcome Measure
The student will demonstrate to the faculty a basic understanding of the unique aspects of infant and childhood hernias, the preoperative assessment of patients with a hernia, the indications for repair, and the operative approaches to inguinal and umbilical hernia in infants and children.
Basic Science Objective
The student should possess a basic knowledge of the pathophysiology, clinical manifestations, and diagnostic and therapeutic approaches to infants and children with gastroesophageal reflux.
Outcome Measure
The student will demonstrate to the faculty a basic understanding of the above objective.
Basic Science Objective
The student should possess a basic knowledge of the pathophysiology, clinical manifestations, diagnostic and therapeutic approaches to common gastrointestinal conditions of infancy and childhood.
Outcome Measure
The student will demonstrate to the faculty a basic understanding of the above objective including pyloric stenosis, mesenteric volvulus, intestinal obstruction, acute appendicitis, and intussusception.
Self-Directed Learning
As a medical student, you are encouraged to use any unstructured time as a time to read about your patients, research questions that arise during the day, prepare for case conferences, and prepare for student-faculty rounds. Preceptors have been specifically asked to look for evidence that you have read articles and books between clinic sessions. Use this time to build your knowledge of medicine and learn from your patients.
Student Responsibilities:
Expectations Daily:
Participate in morning and afternoon rounds.
Discuss your patient, problems, and plans with primary services each morning and check for their plan, etc.
Discuss the patient status and plan with the family each day.
Perform bedside procedures as needed and appropriate.
A procedure note must be written for each procedure.
Assist other team members with procedures, admission, orders, etc
Prior to leaving in the afternoon, review and checkout all of your patients, procedures, orders, films to check, etc with the on call person.
When post call- CHECK OUT thoroughly with the on call resident so that patient care can be continued in your absence.
ATTENDANCE
If at any time the medical student is unable to meet their clinical responsibilities they must notify their Clinical Faculty Preceptor and the Department of Surgery at 691-1280 during working hours Monday-Friday, 8:30 am - 5:00 pm. All absenteeism will be required to be made up and students will be required to make up two days for every one day missed.
If a student misses 2 or more unexcused days, the student will be required to reschedule the entire rotation. Request for an excused absence must be submitted in writing at least one week in advance via the Student Scheduler to the course coordinator. The request will be reviewed by the course director who will either grant or deny the request. Excused absences will not be retroactively granted.
Attendance at Surgical Grand Rounds and Surgical Morbidity and Mortality Conference is mandatory with the exception of being assigned to the operating room by your preceptor. Unexcused absences will result in one extra case presentation for each absence. STUDENTS ARE REQUIRED TO ATTEND THE WEEKLY JOURNAL CLUB MEETING.
ASSESSMENT METHODS
Mid Point Evaluation
In accordance with LCME standard ED-30, the Course Director will evaluate student performance at mid-point to review the student’s professional, clinical and academic performance up to that point. The formative evaluation must be reviewed with the student and the student will have an opportunity to discuss with the Course Director. The form must be signed by the student and returned to the Course Director. The Course Director shall then forward a copy of the form to the Office of Academic Affairs. The form will NOT however be included in the student’s official academic record. For two week electives, the faculty will provide students with oral feedback at the end of week one.
On-Line Final Examination- 50%
A final on-line exam will be given at the end of the rotation. Study material and readings will be assigned at the beginning of the rotation and students are encouraged to read the material early in the course. Students must score at least 70% to pass the on-line exam. Passage of the examination is a requirement for passage of the course – irrespective of the student’s performance on other components of this course. The exam will be 50 questions and must be scheduled at least one week in advance by the student contacting Kelly Webster Fuller at 304.691.1743. Students may retest one (1) time only and must retake the examination within two weeks. An unsuccessful second attempt will result in failure of the course, irrespective of other academic or clinical performance.
Students who are unable to retest within the required two week period must submit a written request to the Course Director to be granted permission to delay the retake. The Course Director will decide if the request is acceptable and notify the student of whether the request is granted. The Course Director’s decision may be appealed to the Department Chair whose decision is final.
Case Presentation- 25%
The student will be required to give a 10-15 minute case presentation at a pre-arranged time during their clinical rotation. The presentation will be given to the course director and medical students. Students will be notified of the date and time of their presentation one week in advance. The course director will assess the presentation and assign a percentage score. See Case Presentation Form under General Information for grading details. http://musom.marshall.edu/students/senior-handbook/SUR744.asp
Preceptor Evaluation- 25%
Grading A= 90-100% B= 80-89% C= 70-79% F= below 70%
The preceptors’ evaluation will be based upon, but are not limited to, the following factors:
· Attendance and participation in tutorials
· Conference attendance
• Maturity and Professionalism
• Oral Case Presentation/Patient Workup
• Participation in call
• Participation in Clinic and OR Hours
• The demonstration of basic knowledge of patient care during clinic
Each Assessment Component listed above (on-line final, case presentation and preceptor evaluation) must be passed in order to successfully complete the course.
MUJCESOM Policies: All medical students taking this course will comply with School of Medicine policies given at http://musom.marshall.edu/students/policies.
Individual policies can be found at the following websites:
Student Infectious Material Exposure:
http://musom.marshall.edu/ups/postexposure.asp
MS-IV Attendance:
https://musom.marshall.edu/students/documents/policies/Yr4attendence.pdf
Academic Dishonesty Policy:
https://musom.marshall.edu/students/documents/policies/Standards-of-Professionalism-and-Honor-Code.pdf
Academic Standards Policy:
https://musom.marshall.edu/students/documents/Policies/ASC-FINAL-POLICY.pdf
Policy for Students with Disabilities:
https://musom.marshall.edu/students/documents/Guidelines.pdf
University Computing Services’ Acceptable Use Policy:
http://www.marshall.edu/ucs/CS/accptuse.asp
Affirmative Action Policy:
pp. 16-17
http://www.marshall.edu/catalog/Graduate/S2008/gr_sp08.pdf
Inclement Weather Policy:
https://musom.marshall.edu/students/documents/policies/MUSOM-Inclement-Weather-Policy.pdf
Notification of delays and cancellations of classes are posted on the Medical Education Home Page when Marshall University Main Campus is not in session
https://musom.marshall.edu/weather
Required Reading: Essentials of Surgical Specialities, 3rd Edition, Peter Lawrence, MD
www.UpToDate.com- Articles as assigned.
Additional materials may be assigned by the Course Director
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