Direct Observation Learner Expectations

Anesthesia Direct Observation Learner Expectations

Scenario: You will meet with a patient to perform a pre-operative anesthesia evaluation (with an airway assessment) and give pre-operative directions.

• You will have 10 minutes to perform a focused anesthesia evaluation and physical exam.

The student is expected to demonstrate the following behaviors:

• Setting the stage/preparation

  • Student reviews the presenting scenario and the patient information prior to the encounter.

• Greeting the patient/Establishing initial rapport.

• Student introduces self using first and last name.

• Student states their current level of training as a medical student.

• Student states the primary purpose of the encounter.

• Student actively verifies the patient name and date of birth.

Focused History

• Obtain a focused, organized pre-anesthesia history

• Ask about relevant medical conditions

• Ask about relevant past surgical history

• Ask about medications and allergies

• Ask about relevant risk factors that are pertinent to anesthesia evaluation

• Ask about relevant social history items

• You are not expected to obtain a complete review of systems or a full preventive history.

Physical Exam

• Perform a focused pre-anesthesia examination.

• Demonstrate appropriate hand hygiene before and after the examination.

• Use appropriate patient positioning, explanation, and draping to maintain comfort and dignity.

• Conduct the exam efficiently and purposefully, avoiding unnecessary maneuvers.

• You are not expected to perform a complete head-to-toe exam.

Interpersonal skills and closure

• Gives clear pre-operative instructions regarding medications .Uses clear, non-medical language.

• Checks for understanding.

• Addresses any concerns.

• Invites questions.

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Surgery Direct Observation Learner Expectations

Scenario: You will meet with a patient who presents to the general surgery clinic with symptomatic gallstones and has been advised they need a laparoscopic cholecystectomy. You have been asked to speak with the patient before the attending comes in to share information about the procedure in preparation for the final consent.

• You will have 10 minutes to explain the purpose and details of the procedure, discuss risks, benefits and alternatives, and address any questions.

• You should NOT perform a history or physical exam on this patient.

The student is expected to demonstrate the following behaviors:

• Setting the stage/preparation

  • Student reviews the presenting scenario and the patient information prior to the encounter.

• Greeting the patient/Establishing initial rapport.

• Student introduces self using first and last name.

• Student states their current level of training as a medical student.

• Student states the primary purpose of the encounter.

• Student actively verifies the patient name and date of birth.

Explanation of Procedure

• Explain rationale/need for procedure.

• Explains procedure, including duration and hospital stay and recovery.

• Discusses risks, benefits and alternatives.

Interpersonal skills and closure

• Uses clear, non-medical language.

• Checks for understanding.

• Addresses any concerns.

• Invites questions.