Facets of Care in the Critical Access/Community Hospital

Department of Health Sciences Education

  • Course Information

    Course Number: RHSE601

    Prerequisites: Completion of the Internal Medicine and Surgery clerkships

    Length of Time: 2 weeks

    Phase Availability: Phase 2 and Phase 3; at discretion of preceptor (4 students/year)

    Credit Type: Patient-facing or Open

    Call: At the discretion of the local preceptor and depending on local community needs, some night duty may be assigned. If required, night call will not exceed 1 night in every 4. The UIC policy on duty hours will apply in this situation.

  • Contact Information

    Program Directors: Dr. Russell Coulter, MD (russell.coulter@gmail.com); Dr. Michael VanAntwerp, MD

    Coordinators/Scheduling: Allison King (aking75@uic.edu); Jessica McGuire (jam226@uic.edu)

    Location: Sparta Community Hospital District (818 E Broadway St., Sparta, IL 62286)

Narrative Description: A 2-week rotation to allow a student to have an extended experience providing ambulatory and hospital care in a rural critical access/community hospital setting with fewer resources than the typical tertiary medical center where their prerequisite clerkship was completed. Hospital based and affiliated ambulatory experience. Students are to participate in care in a wide range of settings from the hospital wards, operating room, radiology reading room, emergency department, to the offices, while under direct supervision. At no time will the student provide any patient care or entries to the medical record without their preceptor being directly present. Preference is given to RMED students, but if available, other interested students may enroll.

Learning Objectives:

  1. Describe/discuss issues facing practitioners caring for individuals, families and communities distant from a comprehensive medical center. How can a critical access hospital be a center of excellence?
  2. Be able to evaluate patients and contribute to treatment planning for patients and families in small communities.
  3. Describe common acute care problems in rural areas.
  4. Be able to demonstrate proficiency in clinical/procedural skills for treatment and management.
  5. Describe strategies for health promotion and illness prevention.
  6. Identify available resources in the host community.
  7. Be able to determine when local treatment is appropriate, when to involve visiting subspecialties, and when to refer patients to higher levels of care. Explain why these decisions are appropriate. How do hospitals adhere to the mandates of EMTALA?
  8. Describe differences in the management approach for practitioners in community-based practices relative to a medical center location for the following conditions:
Stroke Chronic Obstructive Pulmonary Disease
Congestive Heart Failure Asthma
Coronary Artery Disease Lacerations
Cancer GI Bleeding
Bowel Obstruction Trauma
Peripheral Vascular Disease

Learning Activities:

  1. The student will keep a journal, summarizing their daily activities, level of participation (observed, partial or full) and their personal observations & thoughts about the experience.
  2. Students will perform medical histories and physical exams as assigned by their preceptor, present their findings orally, and develop differential diagnoses and treatment plans appropriate to their experience level.
  3. The student will spend time with advanced practitioners, nursing, and support staff, becoming familiar with their responsibilities.

Precepting Physicians:

  • Ziya Baghmanli, MD (General Surgery)
  • Regina Chiu, MD (Cardiology)
  • Russell Coulter, MD (Family Practice)
  • Magret DeGuzman, MD (General Surgery)
  • Robert Mecker, MD (Emergency Medicine)
  • Charles Smittkamp, MD (Radiology)
  • John Vandover, MD (Emergency Medicine)
  • Maria Scarbrough, MD (Emergency Medicine)

Drs. Coulter and Scarbrough will work together to evaluate their schedules and cases and determine what will help the student achieve the goals of the rotation. They will be in contact with the other faculty preceptors during the elective, in order to facilitate a successful and rewarding experience. Changes to the schedule may occur. Opportunities to participate in hospital based committee meetings such as Med Staff may occur. The student will have a great variety in his/her schedule throughout the week, beginning with an introduction by the coordinators with a review of the course objectives, and starting soon thereafter on the wards. On the final day, the coordinators will meet with the student for a debriefing session and review how the objectives were met.

DAY Morning (0730 - 1130) Afternoon (1300 - 1630)
Introduction on the wards Radiology
Tuesday Hospitalist Service Radiology
Wednesday General Surgery (Dr. Baghmanli) General Surgery
Thursday Emergency Department Emergency Department
Friday General Surgery (Dr. DeGuzman) Cardiology Clinic (Dr. Chiu)
Saturday Hospitalist Service Off
Sunday Emergency Department Off
Monday Hospitalist Service Radiology
Tuesday Hospitalist Service Radiology
Wednesday General Surgery (Dr. Baghmanli) General Surgery
Thursday Emergency Department Emergency Department
Friday General Surgery (Dr. DeGuzman) Cardiology clinic followed by debrief with coordinators

Method of Assessment:

  1. The existing Elective Evaluation form will be used to provide feedback to the student about their performance. Grading method will be consistent with College policy. Evaluation forms will be completed by Drs. Coulter and Scarbrough with input to the evaluation sought from the additional named preceptors.
  2. Student’s journal will be reviewed by a supervising provider in the community for accuracy and completeness.

Required Reading:

None required by the campus – readings as assigned by local preceptors. Students are expected to take advantage of the Medical Mobile Resources available from the UIC library (appendix “EBM- Medicine Mobile Resources for out of city students”). Given the variety of these resources at the students’ disposal, note that use of UpToDate as the only clinical resource is not acceptable.

Additional Resources: As determined by the local preceptor.

Miscellaneous Information: None