MASSACHUSETTS COLLEGE OF PHARMACY AND HEALTH SCIENCES-
                        Manchester/Worcester
                      ...
GRADING
Rotation grades will be determined from the list below. If the student’s grand rounds-type
presentation is given a...
the Director of Academic Support Services (Elizabeth Smith-Freedman) at (508) 373-5608 or
through e-mail at elizabeth.smit...
•   Report all incidences resulting in student or patient injury to the supervising provider,
    Clinical Experience Coor...
Learning Objectives: Upon completion of the surgery clinical rotation the student will be
responsible for the following:

...
-    Explain use and placement, describe and evaluate information obtained from a Swan-
             Ganz catheter.
      ...
Valvular Disease
Aortic stenosis/insufficiency
Mitral stenosis/insufficiency
Mitral valve prolapse
Tricuspid stenosis/insu...
Benign Conditions of the GU Tract
Benign prostatic hyperplasia
Neoplastic Diseases
Bladder carcinoma
Prostate carcinoma
Re...
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Surgery Rotation Syllabus.doc

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Surgery Rotation Syllabus.doc

  1. 1. MASSACHUSETTS COLLEGE OF PHARMACY AND HEALTH SCIENCES- Manchester/Worcester Physician Assistant Program MPA 605 SURGERY CLINICAL ROTATION COURSE SYLLABUS 5 Credits Course Coordinator: Susan White, M.D., FACOG Phone: (603) 314-1738 Email: susan.white@mcphs.edu REQUIRED TEXTBOOKS: (*Available on-line at Sheppard Library) • Lawrence, Essentials of General Surgery, 4th ed., Lippincott RECOMMENDED TEXTBOOKS: • *Way, L., Current Surgical Diagnosis & Treatment, 11th ed., McGraw-Hill Co COURSE DESCRIPTION This rotation will provide clinical experience in general surgery. Students will engage in all aspects of patient care from history and physical exam to treatment plan design and evaluation including operative procedures. Patient and family education will be stressed as they apply both to treatment plans and after care / recovery. COURSE GOALS The goal of MPA 605 is to provide practical experience and exposure to students in the field of surgery which will merge the didactic knowledge gained in MPA 532 with patients in the clinical setting. COURSE OBJECTIVES The specific objectives are outlined in Appendix A at the end of this syllabus. These objectives address knowledge areas to be studied as well as professional behavior and student activities to be accomplished during the clinical rotation. It should be noted, it is the student’s sole responsibility to study the subject matter contained within Appendix A. It is not feasible to ensure the student is exposed to all disease states mentioned within Appendix A or procedures outlined for student activities during any given clinical rotation as disease presentations can vary greatly from clinical site. Further, it should be noted that practice styles may differ from preceptor to preceptor. For testing purposes, exams will use the required text as the ultimate reference. COURSE PRE-REQUISITES Successful completion of all didactic year requirements. Prior to beginning this rotation the student must complete HIPAA training and OSHA training. Additionally, the student must have documentation of valid BLS and ACLS training. Page 1 of 8 Surgery Clinical Rotation Syllabus Updated 9/06
  2. 2. GRADING Rotation grades will be determined from the list below. If the student’s grand rounds-type presentation is given at the end of this rotation, it will be graded as Pass/Fail. If a passing grade is not given, the student will receive an “Incomplete” until competency is achieved. The final grade for this course will be calculated using the following percentages for each module: Final Evaluation from Preceptor 50% End of Rotation Exam 25% Senior Professional Seminar Attendance 10% H & P Write-ups 10% Typhon Group Entries 5% Includes weekly audits, student eval of preceptor, and patient encounters Total 100% The grading scale is: A = 93-100 = 4.0 A- = 90-92 = 3.7 B+ = 87-89 = 3.3 B = 83-86 = 3.0 B- = 80-82 = 2.7 C+ = 77-79 = 2.3 C = 73-76 = 2.0 C- = 70-72 = 1.7 D = 60-69 = 1.0 F = 59 and below = 0 ACADEMIC HONESTY POLICY All students are reminded that academic dishonesty is unethical and a violation of the academic honesty policy at Massachusetts College of Pharmacy and Health Sciences. Any student found guilty of academic dishonesty will be subject to the procedures described in the Massachusetts College of Pharmacy and Health Sciences Student Handbook. Students are expected to abide by the College’s Academic Honesty Policy as explained in the Student Handbook. Plagiarism is considered a violation of this policy. Plagiarism is defined as submitting another person’s work as one’s own without proper acknowledgement or using the words or ideas of others without crediting the source of those words or ideas. This policy extends to falsifying medical records. STUDENTS WITH DISABILITIES Students with documented disabilities who wish to request reasonable accommodations under Section 504 of the Rehabilitation Act and the Americans with Disabilities Act should contact Page 2 of 8 Surgery Clinical Rotation Syllabus Updated 9/06
  3. 3. the Director of Academic Support Services (Elizabeth Smith-Freedman) at (508) 373-5608 or through e-mail at elizabeth.smith-freedman@mcphs.edu to discuss the accommodations process. E-MAIL POLICY All MCPHS students are required to open, utilize, and maintain (i.e., keep storage within the maximum set by IS) an MCPHS e-mail account. Official College communications and notices are sent via MCPHS e-mail accounts. All students are responsible for regularly checking their MCPHS e-mail and for the information contained therein. ONLY MCPHS accounts will be used in all matters related to academics, student life, and College notifications. The College does not forward MCPHS e-mail to personal e-mail accounts. GOOD NEIGHBOR POLICY Students who reside in or visit the College neighborhood are expected, as members of the MCPHS Community, to demonstrate respect and concern for all members of the local community. As such, MCPHS expects students to demonstrate responsible citizenship in the local neighborhood. Please refer to Good Neighbor Policy in the Student Handbook page 172. Appendix A Student Activities: • Perform problem oriented evaluation of patients with new complaints and established diagnoses. • Perform pre-operative clearances and post-operative care. • Perform diagnostic procedures as indicated and directed to do so by a supervising provider. • Develop patient management plans with provider supervision. • Maintain all patient encounters in Typhon Group. • Submit Weekly Audit Reports on Typhon Group. • Attend all educational conferences/meetings/lectures offered by the clinical site and/or preceptor when possible. • Participate in after-hour call if available. • Participate in a minimum of 32 hours of patient care or other approved rotation activities per week. Student Responsibilities: • Contact the preceptor 2-3 weeks prior to the start of the rotation. • Contact the persons designated at each site prior to the rotation to ensure all required forms and any orientation activities are completed in accordance with hospital/site time requirements. • Review all pertinent physical examination, laboratory, and diagnostic findings with the supervising preceptor. • Ensure all chart entries are co-signed by the supervising preceptor. • Familiarize self with emergency procedures of the facility during the first day of the clinical rotation. Page 3 of 8 Surgery Clinical Rotation Syllabus Updated 9/06
  4. 4. • Report all incidences resulting in student or patient injury to the supervising provider, Clinical Experience Coordinator, and any designated site authority immediately. Further the student must complete an incident report for the rotation site. This report must be forwarded to the Clinical Experience Coordinator with a narrative of the incidence within one week of the date of the incident. • Complete all preceptor assigned reading assignments in a timely manner above and beyond daily reading on disease entities encountered. • Authorizing and ensuring FileMD/ formerly Medifile® sends the required medical information to the clinical site prior to the rotation start date. • Ensure mid-term evaluations are completed by the preceptor and forward to the Clinical Experience Coordinator by the week following mid-term. • Ensure final evaluations are completed by the preceptor and forward to the Clinical Experience Coordinator at the Professional Seminar or by the week following the end of the rotation. • Complete preceptor/site evaluation on Typhon Group by the Monday after the scheduled Senior Professional Seminar for this rotation. • Complete and submit one full History and Physical for the rotation . Professional Behavior: • Recognize cultural and socioeconomic differences which may exist for patient and families and influence their perceptions of wellness, disease, and the appropriateness of treatment modalities. • Adhere to the programmatic standards for professional interactions with all members of the facility staff. • Recognize personal knowledge and experience limitations. • Actively seek out constructive criticism and opportunities for improvement. • Hold patient welfare as the paramount concern and priority. • Enthusiastically participate in all learning opportunities. • If possible the student should perform the following procedures: o Phlebotomy / IV placement o Assist in operative procedures o Endotracheal intubation o Patient preparation: draping & o Surgical scrub and gowning / skin preparation gloving procedures o Local, regional and epidural o Suturing anesthesia blocks o Surgical tube placement and o Incision and drainage of removal abscesses o Central line placement o Placement and change of sterile o Arterial Blood Gas sampling dressings o Punch /shave/ excisional /needle o Operation of laproscopic cameras biopsy and instruments o Foley catheter placement o Nasogastric intubation Page 4 of 8 Surgery Clinical Rotation Syllabus Updated 9/06
  5. 5. Learning Objectives: Upon completion of the surgery clinical rotation the student will be responsible for the following: - Identify the special laboratory studies necessary for surgical patients preoperatively. - Explain the fundamentals of wound care and wound healing. Explain how co- morbidities may affect healing time and change wound management. - Differentiate common suture materials and wound closure materials (stainless steel wire, catgut, silk, synthetic non-absorbable, synthetic absorbable, tapes, staples and glues) and their appropriate use sites. - Specify common types of stitches including simple interrupted, simple running, running locking, subcuticular, vertical mattress, horizontal mattress, and purse string stitch. - Identify, evaluate and manage various chronic wounds and ulcers including: o Venous stasis ulcers o Decubitus ulcers o Arterial ulcers - Comprehend and explain the principles of fluid and electrolyte balance as it applies to the surgical patient, specifically: composition of fluid compartments, regulation of electrolytes, disorders of volume, correction of electrolyte imbalances, and disorders of acid-base balance. - Evaluate bleeding and blood replacement as it applies to the surgical patient specifically: special tests of hemostasis, causes of surgical bleeding, bleeding in the post-operative period, and blood and/ or blood product replacement. - Explain common surgical procedures; their indications, contraindications, and possible complications: o Nasogastric intubation o Urethral catheterization o Vascular catheterization o Arterial catheterization o Phlebotomy o Common primary care procedures  Incision and drainage of abscesses (pilonidal)  Paronychia / felon treatment  Ingrown toenail removal  Subungual hematoma - Differentiate etiologies of fever in the post-operative period. - Distinguish common types of anesthesia including, general anesthesia, regional blocks, and local anesthesia. Include commonly used medications for local anesthesia and possible complications and contraindications. o Discuss issues of general anesthesia including airway management and maintenance of neuro-muscular blockade, and complications including malignant hyperthermia and aspiration pneumonitis. o Discuss epidural and spinal anesthesia; its benefits and risks. o Discuss issues of the immediate post-anesthetic period including immediate recovery and most common complications, nausea and vomiting, and pain management. Page 5 of 8 Surgery Clinical Rotation Syllabus Updated 9/06
  6. 6. - Explain use and placement, describe and evaluate information obtained from a Swan- Ganz catheter. - Describe basic principles of organ transplantation including indications and contraindications for transplantation, organs and tissues currently used for transplantation, criteria of establishing brain death, laboratory studies needed for determining organ suitability for transplant, organ preservation, and rejection. - Explain and evaluate the following diagnostic tests; their indications, contraindications, and risks: o Endoscopic retrograde cholangiopancreatogram o Esophagogastroduodenoscopy o Percutaneous transhepatic cholangiogram o Radionuclide biliary scan (HIDA/PIPIDA) o Ventilation-perfusion scan - Describe the following surgical procedures, their indications, contraindications and possible complications. o Hernia repair o Nissan Fudoplication o Appendectomy o Cholecystectomy (open and laproscopic) o Wipple resection (pancreaticojejunostomy) o Mastectomy  Radical  Modified radical  Simple  Segmental (lumpectomy) o Thyroid lobectomy o Vascular surgery  Carotid endarterectomy  Femoral-popliteal bypass  Varicose vein stripping o Skin cancer techniques and removal guidelines o Fasciotomy o Escharotomy - Identify the following surgical landmarks, signs and areas. o Hesselbach’s Triangle o Triangle of Calot o Charcot’s Triad Topics for End of Rotation Exam: Cardiovascular System Vascular Disease Aortic aneurysm/dissection Arterial embolism/thrombosis Chronic/acute arterial occlusion Peripheral vascular disease Varicose veins Page 6 of 8 Surgery Clinical Rotation Syllabus Updated 9/06
  7. 7. Valvular Disease Aortic stenosis/insufficiency Mitral stenosis/insufficiency Mitral valve prolapse Tricuspid stenosis/insufficiency Pulmonary stenosis/insufficiency Pulmonary System Pneumothorax • Traumatic • Tension Neoplastic Disease Bronchogenic carcinoma Carcinoid tumors Metastatic tumors Pulmonary nodules Endocrine System Neoplastic disease EENT (Eyes, Ears, Nose and Throat) Eye Disorders Cataract Retinal detachment Mouth/Throat Disorders Oral leukoplakia Gastrointestinal System/Nutrition Esophagus Neoplasms Strictures Varices Stomach Neoplasms Gallbladder Acute/chronic cholecystitis Cholelithiasis Liver Neoplasms Pancreas Neoplasms Small Intestine/Colon Appendicitis Diverticular disease Ischemic bowel disease Neoplasms Obstruction Toxic megacolon Rectum Anorectal abscess/fistula Hemorrhoids Neoplasms Pilonidal disease Polyps Hernia Hiatal Incisional Inguinal Umbilical Ventral Genitourinary System Page 7 of 8 Surgery Clinical Rotation Syllabus Updated 9/06
  8. 8. Benign Conditions of the GU Tract Benign prostatic hyperplasia Neoplastic Diseases Bladder carcinoma Prostate carcinoma Renal cell carcinoma Testicular carcinoma Reproductive System Uterus Dysfunctional uterine bleeding Endometrial cancer Endometriosis/adenomyosis Ovary Neoplasms Cervix Carcinoma Vagina/Vulva Neoplasm Breast Abscess Carcinoma Fibroadenoma Musculoskeletal System Disorders of the Shoulder Rotator cuff disorders Disorders of the Back/Spine Cauda equina Herniated nucleus pulposis Disorders of the Hip Fractures/dislocations Disorders of the Knee Fractures/dislocations Meniscal injuries Disorders of the Ankle/Foot Fractures/dislocations Neoplastic Disease Bone cysts/tumors Neurologic System Vascular Diseases Cerebral aneurysm Dermatologic System Neoplasms Basal cell carcinoma Melanoma Squamous cell carcinoma Other Decubitus ulcers/leg ulcers Hidradenitis suppurativa Lipomas/epithelial inclusion cysts Page 8 of 8 Surgery Clinical Rotation Syllabus Updated 9/06

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