Burn Clerkship

The Burn Elective is a surgical preceptorship in the Burn Center. The student will function as a “junior extern” to care for burn and wound patients in the ICU and stepdown unit. They will work side-by-side with the burn fellow and faculty. The student will participate not only in the preoperative care but also the intra- and post-operative care of these patients. The student will gain insight into the pathophysiology of burns, the fluid and electrolyte requirements, and the operative and post-operative care of these patients.

Dr. Hickerson, Departmental Faculty, and fellows assigned to the Burn Service for the month will supervise students in the evaluation and management of patients.

The goal of the elective is to expose the student to wounds and burns and learn to diagnose the problem, formulate a plan of action, and assist with the care of these patients. The student will also develop an understanding of the team approach to the care of burn and wound patients.

Major objectives of the rotation:

Patient Care

The primary objective of this rotation is to introduce the student to the field of burn and wound care.

Medical Knowledge

After completing this rotation, the student will understand the pathophysiology of burn injury and wound healing; understand fluid and electrolyte requirements of patients with burn injuries; be introduced to the pathophysiology and treatment of inhalation injuries; gain insight into the complex care of critically ill burn and wound patients; become familiar with the use of central venous catheters and other invasive lines.

Practice-Based Learning and Improvement

This rotation is intended to expose the student to multiple procedures and skills used frequently in burn care, which the student will use in other elective rotations.

Interpersonal and Communication Skills

The student will learn to communicate and interact with a multidisciplinary team.

Professionalism

The student will develop an understanding of the role of the burn surgeon as well as the roles of all team members involved in burn care.

ONE HUNDRED PERCENT ATTENDANCE is expected from all medical students. Permission to be absent must be obtained from the course coordinator PRIOR to any planned absence. Absences for reasonable cause, as determined by the course coordinator will be approved.

Required Experiences: The student's primary responsibility is to acquire the essential knowledge to make him/her an effective member of the surgical team.

1. Gathering data on the patient
   1. The surgical history and physical exam.
   2. Essential laboratory and ancillary testing.
   3. Accessing important medical intelligence related to this patient.
   4. Formulating your own differential diagnosis.
2. Communicating
   1. Presenting pertinent information to intern, resident attending, or the group.
   2. Comparing your differential diagnosis to that of more experienced team members.
3. Monitoring
   1. Observing the clinical course of your assigned patient.
      1. Daily rounds.
      2. Frequent un-scheduled visits.
      3. Chart and information system review.
   2. Be prepared to discuss and defend your assessment.
4. Participating – This is expected!
   1. Be available to help with or watch procedures or surgeries.
      1. Remember, it is more important that you "learn" than "do" at this stage of your development.
      2. Students are expected to attend all procedures, rounds and conferences. Check with your plastic surgery resident regarding weekly conferences.
   2. Be present and prompt for lectures, rounds, etc.
   3. Be an enthusiastic, active learner.
   4. Read the appropriate literature and discuss it with your colleagues.
   5. Attend cases at all times.
5. Synthesizing
   1. Begin to develop the ability to synthesize multiple data points into a coherent explanation for the patient's signs and symptoms.
6. Duty Hours
   1. Students should expect to spend 40-80 hours per week
   2. These hours are clinical, OR and didactic related
   3. Student should expect to be on call should duty hours allow during the rotation. (1/4)

Students should expect to spend 40-80 hours per week.

• Duty hours will be limited to 80 hours per week averaged over a four-week period, inclusive of all in-house or at-home call and patient care activities.
• Continuous on-site duty, including in-house call, will not exceed 30 consecutive hours. Students may remain on duty additional hours to participate in transferring care of patients, conducting outpatient clinics, maintaining continuity of medical and surgical care, and attending required didactic activities.
• Students will be provided with one day in seven free from all educational and clinical responsibilities, averaged over a rotation, inclusive of call. One day is defined as one continuous 24-hour period free from all clinical, didactic, and administrative activities.
• Students should be provided with a 10-hour period after in-house call during which they are free from all patient care activities.

Rotation Weekly Schedule (include hospital work, attending rounds, conferences, journal clubs, etc.)

	Monday	Tuesday	Wednesday	Thursday	Friday
7 - 8	Rounds	Rounds	Rounds	Team Conference	Rounds
8 - 9	Surgery	Surgery	Surgery	Clinic	Surgery
9 - 10
10 - 11
11 - 12
12 - 1
1 - 2
2 - 3
3 - 4
4 - 5

In 1986, the College of Medicine established its Code of Professional Conduct. The document, available in The Centerscope, addresses those responsibilities to patients, colleagues, family, and community as well as to the individuals themselves. Following discussion with incoming students, it is assumed that all will subscribe to this code as part of their commitment to the profession of medicine. An egregious professionalism violation may be considered grounds for course failure.

Any student who would like to self-disclose as a student with a disability in the College of Medicine at UTHSC must register and officially request accommodations through the Disability Coordinator in Student Academic Support Services and Inclusion (SASSI). Regardless of a student’s geographic location for experiential education, all requests for accommodations must be submitted with supporting documentation and reviewed for reasonableness by the Disability Consultant. Students should contact Laurie Brooks to set up an appointment to discuss specific needs at lbrook15@uthsc.edu or (901) 448-1452. All conversations regarding requests for accommodations are confidential.

Students have a formative assessment at the half-way mark of the preceptorship and a summative clinical assessment at the end of the rotation based on clinical performance as defined in the objectives.

Letter Grade	Final Percentage
A	89.5 - 100
B	79 - 89
C	67.5 - 78
F	< 67.49

Students having difficulty in the course are strongly encouraged to seek help as soon as possible by seeking advice from the resident, fellow, and attending on the service. Students are also encouraged to check with the SASSI and the Kaplan Clinical Skills Center to see if academic support is available.

Students are strongly encouraged to participate in the Hall Tacket evaluation survey on New Innovations at the conclusion of the course. May not be available to outside rotators.

As assigned by Dr. Hickerson and/or Burn Faculty.