Emergency Medicine Component
The Surgical Approach to the Patient (SAP) is a 12-week integrated clerkship block that is comprised of Surgery and Emergency Medicine rotations. As disciplines with a heavy emphasis on procedures and management of acute disease, Surgery and Emergency Medicine share didactic sessions and simulation-based training over the course of the rotation. An appreciation of the basic and clinical sciences, critical thinking and problem-solving in a fast-paced varied environment will be experienced by learners. Given the complexity of patients with acute and critical illness, a high degree of professionalism and emotional intelligence is an essential skill during these rotations.
Description, Pedagogy, and Objectives
The Emergency Medicine component is a 3-week rotation focusing on the care of patients with undifferentiated chief complaints. Students rotate in the emergency departments at the Yale New Haven Hospital main campus and Saint Raphael's Hospital campus in integrated teams with residents, nurses, APPs and technicians. They are exposed to a wide array of patient acuity including critically ill patients.
This rotation emphasizes clinical learning at the bedside in the emergency department while directly participating in patient care. In addition, our integrated simulation program allows students to take leadership roles in simulated cases focusing on a variety of medical and surgical pathology including myocardial ischemic disease, toxic ingestions, and acute surgical pathology. Weekly reasoning conferences are offered and focus on the metacognition underpinning clinical practice. Students also join residents for didactics including remote and in-person lectures, journal club, M&M conference, and areas of concentration.
The EM component is graded on a pass/fail basis. Narrative summative assessments are collected from preceptors including attendings and residents. EM content is integrated into the final SAP self-assessment exam however exam performance is not documented in the final summative assessment. Students are also encouraged to solicit formative feedback on rotation and can use an online-based feedback form to record feedback given on shift.
- Learn the clinical knowledge and apply basic science concepts to evaluate and treat common presentations in emergency medicine.
- Use clinical reasoning to synthesize data into a prioritized differential diagnosis and plan.
- Demonstrate behaviors consistent with the highest standards of professionalism and medical ethics in all patient encounters and interactions with colleagues.
- Demonstrate a positive and constructive attitude toward interdisciplinary teamwork and patient care in the emergency department.
- Cultivate self-awareness regarding the nature of shift work and variable schedule and its impact on one’s mental and physical wellness.
- Demonstrate effective communication with patients, families, and all members of the healthcare team.
- Educate patients about their emergency department visit and health conditions.
- Demonstrate sensitivity, honesty, and compassion in serious conversations.
- Obtain an accurate and appropriately detailed medical history in a logical and organized manner for a given clinical setting.
- Complete an appropriate and accurate hypothesis-driven physical examination.
- Deliver an effective oral and written presentation, appropriately tailored for a given clinical setting, including communication with supervisors, consultants, nurses, and other members of the healthcare team.
- Recognize whether to obtain and how to interpret common diagnostic studies in emergency medicine such as EKGs, chest x-rays, and blood tests.
- Create organized and prioritized management plans.
- Participate in common emergency medicine procedures such as venipuncture and wound management.
- Coordinate appropriate follow up plans for discharged patients including timely referrals, communication with primary physicians, and home-based services.
- Judiciously propose diagnostic studies with consideration of costs, risks, and benefits.
- Demonstrate sensitivity and responsiveness to diverse patient populations.
- Appreciate how patient health care needs are impacted by social and structural determinants of health.
- Reflect on conditions in the emergency department that influence patient safety such as boarding, crowding, and wait times.
- Utilize effective methods of acquiring and applying evidence-based practices to guide diagnosis and treatment decisions.
- Apply established risk stratification tools in diagnosis and treatment decisions.
- Appreciate the overlapping skills, knowledge, and approach to patient care in emergency medicine and surgery through shared learning activities.
Required Experiences SAP Logbook
The purpose of the logbook is to ensure that each student has fulfilled the required clinical experiences determined by the faculty to meet the objectives of the clerkship rotation. All students are responsible for logging required clinical experiences in the logbook. The logbook is reviewed by clerkship leadership and completion is documented and monitored centrally by the Office of Curriculum.
If you need accessibility assistance with the Logbook, please contact the Office of Curriculum.