Welcome to your third-year Emergency Medicine Rotation. Whether you’ve been assigned to Charlottetown – The Queen Elizabeth Hospital, Dartmouth – Dartmouth General Hospital, Fredericton – Dr. Everett Chalmers Hospital, Halifax – QEII Health Sciences Centre, Kentville – Valley Regional Hospital, Moncton- The Moncton Hospital, Saint John – Saint John Regional Hospital, or Truro – Colchester Regional Hospital, we know you will have an excellent experience as “Emergencies” happen everywhere and this reality standardizes the Emergency Medicine experience.

The Emergency Medicine undergraduate clerkship introduces medical students to the role of our department in the delivery of health care. The Emergency Department is in essence the “show room” for the hospital center. It is a barometer of the well-being of the community, as well as the entire health care system. In the Emergency Department, students will be exposed to a wide variety of undifferentiated illness, from the simple lacerations to the complexity of a myocardial infarction leading to cardiac arrest. Students will also have the opportunity to observe how the triage system prioritizes patients with these conditions and coordinates their care with our inter-professional team.

I am looking forward to working with you and sharing experiences which have made my career in Emergency Medicine challenging and rewarding. Although I will not meet each of you individually, I am always available through e-mail (ljpatrick@dal.ca). I welcome and encourage feedback – whether positive or negative. Other members of the education team include, Drs. Michael Davis (ECH), Tom Goddard (VRH), Stuart MacKinnon (PEI), Michael Matchett (MH), Shikhi Sharma (CRH), Matthew Greer (SJRH), and Albert Williams (DGH).

The syllabus for the Emergency Medicine clerkship rotation is located on Brightspace. If you don’t know your user name, please call MEDIT services, where they can assist you directly.

Modular objectives are located on Brightspace. A second online learning resource is available at https://saem.org/cdem/education/online-education/m3-curriculum. This material was created by the Clerkship Director in Emergency Medicine and is used in over 70 North American universities as a part of their EM Clerkships.

Your standardized end of unit exam created in concert with this curriculum will reflect the information reviewed on this webpage.

Please note, it is MANDATORY that you complete your Patient Encounters and Procedural Skills Log on One45. We also encourage you to help us by completing your preceptor’s evaluations found on One45, so that we can continue to refine our teaching skills.

Mandatory Observed History and Physical (VERY IMPORTANT)

• Students are required to arrange a “Brief, Directed, history and physical exam on one of your patients, which is observed by a resident, attending or nurse practitioner.” This experience should be noted in your procedure log under the category “other procedures” in One45.
• Clearly indicate/record the shift you completed the observed directed history and physical in your Learning Portfolio.
• This should be a brief case involving one system such as: URI, laceration, Cellulitis, UTI etc. in a medically non-complex patient and start to finish should be less than 10 min. This is necessary to be respectful of EM department patient flow given the over-crowding we are experiencing across the Maritimes.
• Student will also need to report that these observed history and physicals have been conducted during their clerkship on all future medical school surveys as these are an accreditation requirement.

Students are required to attend/participate in Simulation. An Intro Session will take place on the first day of the rotation and an Exit Session (typically) on the last day of the rotation in Halifax and Saint John. This is a required part of your training. All rotation sites are aware of this requirement and will adjust your start date to allow for this required participation.

In this Emergency Medicine rotation you will make substantial gains in your history/physical exam, differential diagnosis, diagnostic test interpretation, as well as procedural skills and we look forward to helping you meet these learning goals during your three week rotation.

Learning Portfolio

All students must complete a Learning Portfolio: This document is attached to your orientation email and located on Brightspace. To get the most out of this experience, reflect and complete this immediately after your shift, while it is still fresh in your mind. All students are responsible to submit the Learning Portfolio to their Site Supervisor and also submit an electronic copy to Jennifer Day, JenniferE.Day@nshealth.ca.  At the end of your rotation, please make sure to set up a time with your preceptor for a formal evaluation. ITER’s will be completed on the One45 system. The Undergraduate Clerkship Director, will review the Formative ITERS, Encounter, Skills logs, and the Learning Portfolios to complete the final Summary ITER.

EM Clerkship PoCUS Module

You will be required to complete the EM Clerkship PoCUS module with pre and post test in Brightspace. This is an introduction to bedside ultrasound, the newest EM physical exam tool. This module is designed to be completed at your leisure and in lieu of another Seminar Lecture. I ask, as a favour, that you complete the anonymous survey pre and post test, so that I can evaluate the effectiveness of the module as a learning tool.

Welcome to Emergency Medicine!

Sincerely,
Lucy Patrick, MD, FRCPC
Assistant Professor
Undergraduate Clerkship Director
Department of Emergency Medicine, Dalhousie University

Orientation is held on the first day your rotation in Suite 355, 1796 Summer Street, Halifax NS, unless otherwise indicated. Time to be determined.

Emergency Medicine Orientation Presentation [pdf 2.5 mb]

Your shift schedule will be sent out, via email, one week in advance of your start date. The schedule includes a variety of day, evening and night shifts. You have been given a maximum of 12 shifts during the 3-week period and a maximum of 9 shifts during the 2- week period. Any change in your schedule will only be accepted with prior approval by the site preceptor.

The Dalhousie University Med III ED clerkship rotation now features two critical event simulation sessions offered in weeks 1 and 3 of the 3 week rotation. This change in the teaching paradigm is a direct result of the increasing focus on simulated medical education being seen in undergraduate medical education across North America. These fast paced, interactive sessions have become a fast favourite among students–where learners get a chance to learn about crisis resource management and team work in a safe and supportive environment. The multidisciplinary team of instructors is keen to teach and is experienced in simulated education. This hands on experience which is based on real ED cases will allow students to learn skills, and bridge gaps in learning, in order to make the most of time in the ED. Come join us for the fun, we can’t wait to meet you!

Early in the rotation, clerks at the QEII site will be scheduled for half a shift (approximately 4 hours) to perform procedures and not have direct patient care responsibilities. The clerk with the assistance/supervision of a nurse should perform procedures that may include: intravenous insertion, venipuncture, foley catheter insertion, NG insertion. The clerk can perform other procedures under the supervision of the respiratory technicians and the orthopedic technicians. Students from other sites have the option to schedule this shift as well.

Early in the rotation, clerks at the QEII site must arrange a 2-3 hour triage shift. The triage shift allows our clerks to obtain a broader understanding of the specialty of Emergency Medicine and is primarily an observership. Students will develop an understanding of the triage process including CTAS scores as well as some of the unique challenges and frustrations of the triage process.

End of Shift Evaluation Forms

You will be scheduled for a total of 12 shifts (11 ED and 1 Triage shift(s)). Please ensure that you complete 12 End of Shift Feedback Forms. We would kindly request that these forms must be completed in their entirety. The administrative contact or Site Supervisor/Preceptor at each site will be able to show you where to find these forms and drop them off in your site. These feedback forms will be used in the final assessment. (Please note that other sites may use a different End of Shift Form). *** You are encouraged to keep a copy of your End of Shift Feedback Forms to assist you in completing your Evaluation of Preceptor by Learner forms and Learning Portfolio.

Evaluation of Preceptor by Learner

For us to know what we’re doing right, how we can improve clinical experience or simply continue what we are doing…. we need your feedback. During your Emergency Medicine rotation, students can complete an online evaluation on One45 on their preceptor after each shift in the ED.
Instructions are attached and available on One45. If the name of the preceptor is not on the list in One45, please provide the name to the site education coordinator.

In-Training Evaluation Form (ITER)

At the end of your Emergency Medicine rotation, the Site Coordinator at your location will meet with you to discuss and evaluate your performance during this rotation.

During your rotation, you will have opportunity to attend several teaching sessions. Emergency Medicine Departmental Rounds occur at the QEII on Wednesday from 12:00-13:00 and include Grand Rounds, Visual Stimulus, Case Based Rounds Complaints and Misses, Multidisciplinary M&Ms rounds and Guest Rounds.

You are expected to attend these sessions, unless you have been working until 0400 or 0500 on the day of the sessions. Please refer to round schedule on a regular basis as the date and times are subject to change.

As House staff in the Emergency Department, you are an extension of us as health care professionals. As learners, we want you to be well received by our staff, patients and their families. ED staff can rely on their experience and expertise for patient respect and confidence, however as learners, you are still developing these qualities and should dress as outlined below.

• Appearance will be professional and in keeping with hospital regulations
• Lab coats (hip or knee length is acceptable) are mandatory and must be clean
• No jeans or shorts
• Midriffs must be covered
• Neckline must be modest
• No bare feet or open toed sandals
• Minimal jewelry may be worn
• Nails must be clean and short