Clinical Excellence Evaluation
To excel in this rotation, plan ahead and know your teammates. Introduce yourself to those who will be helping you care for patients. Take a moment and discuss with your senior resident the expectations that they have of you in critical settings.
- Develop a personal plan in advance for dealing some of the more common acute problems that you will likely encounter:
- What is the chief complaint.
- What are the common severe or life threatening causes?
- What findings would support those diagnoses?
- What measures to initiate before making a diagnosis?
- What measures for treatment after the diagnosis appears more certain?
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Example Plan
Chief complaint: Respiratory distress- Severe causes: pneumothorax, anaphylaxis, acute bronchospasm, CHF.
- Findings: Absent breath sounds and history of chest trauma, prior allergy, history of asthma and wheezing, rales and leg swelling
- Initial management: Oxygen/Monitor/IV for all of these patients, needle decompression, epinephrine, bronchodilator treatment, nitrates.
- Definitive management: Chest tube, antihistamines, steroids, diuretics.
- Show enthusiasm, initiative, and interest during the EM rotation. You will have the best experience and make the best impression on evaluators.
- Know one's limitations and asking for help when needed.
- Over confidence at the student level will be perceived negatively.
- Working overly hard only to make a favorable impression will be noticed.
- Focus on learning, providing good care to patients and getting the most that you can from the provided experiences.
- Follow cases through to completion of the pertinent ED work-up.
- Stay after your scheduled shifts to tie things up, esp. if the faculty attending does so.
- Ask to observe interesting cases and or procedures that you are not directly involved in.
- Dress and act professionally.
- Be non-judgmental about patient's diverse ethnic backgrounds, socioeconomic status, and variable levels of acuity of illness. Respect goes a long way!
- Be diligent in tracking down the studies you order on patients and keep your staff informed of the results.
- Be cognizant of personal safety - use universal precautions, seek help with potentially combative or violent patients.
