- Learn the advanced neurologic exam by the end of the
course and be able to demonstrate either the reflex or sensory
exam benchmarks in a clinical setting.
- Recognize that bioethical issues arise frequently in
neurology; identify, observe and reflect on at least one
clinical scenario.
Clinical & Bioethical Mini-CEX
Away students will need to
ensure that you have completed both mini-CEXs successfully
by the end of the course. The clinical CEX cards (in the back
of your pocket syllabus or the PDF versions below) should
be mailed and received by our office by Thursday following
the last Friday of the course. Please fax to Goldie Pontrelli
at 206-685-8100 or mail to Box 356465, 1959 NE Pacific St,
Seattle, WA 98195-6465.
The mini-CEXs in neurology will be of two types: Clinical
and Bioethical
Clinical:
The first mini-CEX is an observed, focused clinical encounter
followed by immediate feedback. The goal is to make students
more proficient in two aspects of the exam that are often
poorly done by the non-neurologist. It is not meant to be
thorough in every aspect of the reflex and sensory exams,
but rather an achievable benchmark for the student. Both exams
will be taught, but the student is only required to perform
one exam of their choice in the presence of their preceptor.
Performance of the clinical mini-CEX is best done at the
midpoint (3rd week) of the rotation so that if remediation
is necessary there will be time to complete it. Estimated
time to complete a mini-CEX is 5-10 minutes followed by 5
minutes of feedback. The clinical opportunity for the mini-CEX
is huge. In every inpatient or outpatient encounter with a
student, the preceptor could ask the student to perform a
portion of the exam. It is also the student's responsibility
to make sure the mini-CEX is accomplished. For example, “Dr.
_______, at some point today can we complete the reflex/sensory
mini-CEX?”
The forms below will be incorporated into the pocket syllabus.
Videos demonstrating the mini-CEX should be viewed by both
student and preceptor alike.
Bioethical:
The second mini-CEX focuses on a few of the many bioethical
issues that arise in neurology. In contrast to the clinical
mini-CEX, the bioethical mini-CEX is more passive. You are
required to identify a bioethical problem during your 4 weeks
and reflect on how it was dealt with. For instance, Dr. Jones
told a 54 year-old male that he had ALS (breaking bad news).
How did the preceptor handle the situation? Who was present?
Was enough time set aside? Etc.
Remember that bioethical issues happen all the time. Look
for them. Physicians may or may not be particularly skilled
at resolving these issues. At times, it may seem like the
encounter went poorly though everything was done right. Use
these encounters to adopt what is done well and reject what
is not. Negative role modeling can be as useful as positive.
Requirements:
- CHOOSE TOPIC: Identify a bioethical
problem from the following:
- Breaking Bad News
- Do Not Resuscitate Orders
- Termination of Life-Sustaining Treatment
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- READ: Read about the issue in the UW
Ethics in Medicine website, work through the sample cases,
and read the reserved article. Articles listed below are
available on E-Reserves (UWNet ID required).
Breaking Bad News
Do Not Resuscitate Orders
Termination of Life-Sustaining Treatment
- WRITE-UP: Write-up your specific case
by either: writing a reflection paper (1/2 to 1 page typed),
or filling in the 4-box paradigm: http://depts.washington.edu/bioethx/tools/4boxes.html.
Email your write-up to Dr. Kraus before the end of the course
to ekraus@u.washington.edu.
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