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Medical School TeachingThe academic year 2001-2002 marked the graduation of the first class completing the new "Double Helix" curriculum. This new curriculum blends both strands (basic science and clinical) of medical education throughout the four years of medical school. The new curriculum also depends more on the use of problem based learning in the basic science classes. These small group sessions require the use of a facilitator to help the students develop the appropriate learning objectives for the case. The department takes its role in medical education very seriously and its faculty play important roles in the education of our future physicians. For example, Dr Denham Ward is the chair of the first and second year instruction committee and a member of the Curriculum Steering Committee.Although, the anesthesiology department does not have a required clinical clerkship, our elective clinical clerkships (clinical anesthesia, pain, hemodynamic monitoring, obstetric anesthesia and ICU) are very popular with both third and fourth year students. Many members of the faculty also participate in the basic science strand throughout the four years. One of the most notable teaching (and evaluation) innovations that the department has contributed to the medical school is the high fidelity human patient simulator. The simulator center (David Stern, M.D., director) is used in several courses and in an integral part of the unique comprehensive assessment (Denham Ward, M.D., co-director) component of the curriculum. In the 2nd year comprehensive assessment, teams of students diagnosis and treat the simulator for a shock condition. The team receives a score based on both clinical management and teamwork. In the 3rd year comprehensive assessment, the students manage a simulated post-operative patient with hypotension and hypoxemia. Several faculty lecture and lead problem based learning (PBL) discussions. Raymond Zollo, M.D. gives lectures in the Mind Brain and Behavior (MBB) course on the mechanisms of action of anesthetics (general and local) and on opioid analgesics. Denham Ward, M.D., Ph.D. gives lectures on control of breathing in Human Structure and Function (HSF) and on aspects of oxygen transport in the Challenges to Homeostasis block of Year 2 Case Seminars. Both Drs. Zollo and Ward, along with Drs. Norton, Bailey and Karan assist with PBLs, problem sets, and laboratories in HSF and Challenges to Homeostasis. Dr. Ward is the course director for the six-week required Year 2 Case Seminars course as well as co-director of the Challenges to Homeostasis week. Sheldon Isaacson, M.D. also lectures on the anatomy and physiology of pain pathways and perceptions in the Medical Humanities course. An important part of the new curriculum is the continuation of formal basic science teaching in years three and four. Richard Wissler, M.D., Ph.D. provides a day of obstetrical anesthesia teaching in the basic science part of the Woman's and Children's Health in-patient rotation for each of the four groups of 3rd year students. This day emphasizes anatomy, pharmacology, ethics and the impact of clinical research of OB anesthesia care. Joe Dooley, M.D. participates in the "Bench and Bedside" basic science section of the Adult Inpatient Clerkship. The department also provides several opportunities for the students to participate in clinical anesthesia care. Paul Bigeleisen, M.D. has organized a summer anesthesia clerkship for students between years one and two. For the past two years there has been four students in the program each year. These students are chosen based on exceptional work during their first year of medical school, prior research or clinical experiences. All of the students have expressed an interest in anesthesia as a career. The clerkship is ten weeks long. The first four weeks is devoted to operating room anesthesia including time in the ASC where they learn to start IVs and in ECT where they learn to perform mask ventilation. The next four weeks are divided between ICU (two weeks), pain management and labor analgesia. The final two weeks are used for electives and invasive homodynamic monitoring. The operating room anesthesia two-week elective clerkship is directed by Suzanne Karan, M.D., and provides the students with a mentored experience in the wide range of clinical anesthesia. Case discussions, lectures, airway management practice and simulator session round out the elective. This is a very popular clerkship, with the majority of students taking it in either their 3rd or 4th years. Janine Shapiro, M.D. has directed the hemodynamic monitoring elective for many years. This popular elective provides the students with a hands-on understanding of invasive hemodynamic monitoring and how to interpret the information in a clinical context of the operating room. The learning objectives for the course are:
All of the cardiac faculty (Drs Bailey, Eaton, Shapiro, Wojtczak, Stern and Glance) participate heavily in this elective. Students on the OB anesthesiology elective spend two or four weeks as part of the clinical service. Teaching is one on one and in small discussion groups daily. Students participate directly in regional anesthesia and analgesia, with appropriate supervision from attendings and residents. Dr. Wissler designed and directs this elective. The two-week (occasionally 4 weeks) course in Pain Management for Medical Students directed by Rajbala Thakur, M.D. includes direct patient care (supervised directly by the attending), didactic conferences, readings and hands on teaching addressing basics of assessment and management of pain both in an inpatient and a comprehensive multidisciplinary outpatient setting. Students get exposure to pharmacological management, behavioral modification and cognitive strategies and invasive interventions utilized for pain management. For the first few days, students shadow the senior residents or the fellows. Subsequently they evaluate the patient independently and make an initial assessment and plan. Then they present the patient to the attending and together formulate the final set of recommendations. A written evaluation based on direct observation and feedback from residents, fellows and other pain faculty is prepared at the end of rotation. In the fourth year as part of the successful interning series of lectures, Stew Lustik, M.D., runs a seminar on preoperative patient evaluation. Each session is 3 hours and with two sessions per year, each with 7 to 15 students. There is also a elective simulator session on managing an ICU patient as part of the successful interning course. Dr P. J. Papadakos is involved in leading a elective in trauma critical care for senior medical students. He also developed programs for several Rochester students to study abroad. Dr. Chhangani teaches medical students during their elective working summer clerkships in Critical Care Medicine in SICU at RGH. Other 4th year electives in clinical anesthesiology for 2 to 4 weeks are frequently arranged for students intending to pursue a career in anesthesiology. These "Sub-Internships" allow the student to take a more active role in the various aspect of the specialty. Also in the 4th year is a required four week basic science course entitled "Process of Discovery". This innovative course was developed by Dr. Denham Ward and provides the students with an opportunity to propose a research agenda that addresses aspects of important clinical problems. The purpose of the course is to help students understand the process by which basic science discoveries are translated into improved clinical care. Dr. J.L. Robotham participates as a mentor to a student group within this well received course. The Anesthesiology department continues to be an integral part of the medical student curriculum. Perhaps one measure of our success is the appropriate number of students we attract into our specialty from the University of Rochester, but more importantly is the fact that all the other students, no matter what specialty they pursue, leave here with an understanding of how important the practice of Anesthesiology is to modern health care. |
