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 Surgery component spans 9 weeks and is comprised of three 3-week blocks chosen from a wide variety of surgical disciplines, made up of core surgical and surgical subspecialties. These experiences give learners a broad-based exposure to the different disciplines of surgical practice and provide the fundamental basic science and clinical knowledge base that underlies the practice of general surgery. An understanding of the evaluation of the surgical patient, pre- and post-operative management, development of technical skills, as well as writing and presentation skills will be acquired during the course of the rotations. As well, learners will develop the essential patient care skills and professional behaviors required in the management of acute and critical illness.
Along with direct patient care with active learning at the bedside or in the office, based on the specific rotation, teaching is enhanced with didactics, assigned readings, conferences and presentations. Weekly didactics, problem-based teaching conferences and simulation-based training are an essential component of teaching throughout the surgery rotation to provide a structured curriculum to encompass the essentials of management of the surgical patient.
Assessments are provided through comprehensive subjective evaluations from attendings, staff, midlevel providers, residents and others with whom the student works. Evaluations are assigned and collated through dedicated rotation liaisons within each discipline, and additional evaluations can be solicited by the student. Radiology assignments, case and procedure logs, supervised physical exams, and a computerized, self-assessment test are also integrated into the clerkship experience.
- Learn the clinical knowledge and apply basic science concepts to evaluate and treat common presentations in general surgery.
- Apply knowledge of anatomy and physiology in the operative and non-operative management of patients.
- Use clinical reasoning to synthesize data into a prioritized differential diagnosis and plan, including the role of surgical management.
- Demonstrate behaviors consistent with the highest standards of professionalism and medical ethics in all patient encounters and interactions with colleagues.
- Recognize the essential elements of informed consent in the care of the surgical patient.
- Appreciate team dynamics and leadership skills required in care of surgical patients in the operating room.
- Demonstrate effective communication with patients, families, and all members of the healthcare team, including communication within the operating room.
- Evaluate the surgical patient using concepts of pre- and post-operative management.
- 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.
- Recognize whether to obtain and how to interpret common diagnostic studies in general surgery.
- Perform basic procedural skills fundamental to operative management including sterile technique, exposure, and simple suturing in operative or simulated situations.
- Demonstrate sensitivity and responsiveness to diverse patient populations.
- Appreciate how patient health care needs are impacted by social and structural determinants of health.
- Recognize the importance of time-outs and other procedures in the operating room to improve patient safety.
- Consider risks and benefits of surgical interventions in manner that is respectful and consistent with patients’ goals of care.
- Utilize effective methods of acquiring and applying evidence-based practices to guide diagnosis and treatment decisions.
- Appreciate the overlapping skills, knowledge, and approach to patient care in surgery and emergency medicine 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.