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M-ID 717 CLIN CONTINUOUS QUALIT 4 Credit Hours

SELECTIVE

This selective will allow students to learn about the principles of clinical continuous quality improvement (CQI) and design and complete a clinical CQI project in a Family Medicine Clinic. Instruction will include readings and faculty discussions. The student will perform data gathering and analysis under the supervision of family medicine faculty.

Contact: Dr. Paul Paulman.

Typically Offered: Variable.

Capacity: 2 per session.

Visiting Student Information: This course is NOT available to visiting students.

M-ID 719 NUTR IN PATIENT CARE 4 Credit Hours

SELECTIVE

Pre-Arrange with Dr. Jim Medder prior to July of senior year. There has been a tremendous increase in consumer interest in nutrition ~ health food stores, articles in the press, multiple weight loss programs, etc. The public is regularly presented with confusing and sometimes contradictory information about optimal nutrition. With the obesity epidemic and four of the ten leading causes of death in the U.S. being diet-related conditions (diabetes mellitus, heart disease, stroke and cancer), physicians must shift their focus from the treatment of diseases to their prevention. The daily clinical practice for most physicians includes numerous patients with nutrition-related problems. Most Americans say they regard their physician as their primary source of reliable nutrition advice, yet many physicians are poorly trained in this area. In addition to the management of public health diseases, the role of nutrition in the hospitalized patient has become an integral part of improved outcomes in the inpatient setting. Physicians caring for hospitalized patients need to have an understanding of nutrition assessment and management of enteral and parenteral nutrition. This selective is an in-depth, comprehensive study of the role of nutrition in patient care. It reviews and builds upon nutrition instruction from the basic science years and provides outpatient and inpatient clinical opportunities to enhance nutritional assessment, counseling, and management skills. Objectives After completing the selective, the student will: Have a greater appreciation of the role nutrition plays in health and disease. Be able to discuss the current basic science aspects of important nutritional problems. Be more competent in diagnosing, treating, and managing patients with nutrition problems. Have a greater awareness of community resources for patients with nutrition problems. Have an increased understanding of evidence-based pharmacological nutritional therapy, including herbal products, dietary supplements, and other medications. Learning Activities. Nutritional support: one week of enteral/parenteral nutrition therapy in the inpatient setting. Chronic disease management: one week of outpatient management of diabetes mellitus, cardiovascular disease, renal disease, and obesity, including behavioral weight management, bariatric surgery, and pharmacological management. Self-directed learning and assessment utilizing online Nutrition in Medicine modules. Case study, including interview of patient, background research, and case presentation. Visits to community nutritional resources (e.g., Overeaters Anonymous, Weight Watchers, health food stores, Women, Infant and Children's Clinic, etc.) and evidence-based review of their effectiveness. Weekly review/discussion sessions with faculty. Evaluation of Student Performance Grades will be determined by attendance and active participation in learning activities, completion of online nutrition modules, and assessment of case study presentation.

Prerequisite:  Pre-arrange with Dr. Medder prior to July of the senior year.

Instructor: COM: Jim Medder, M.D., M.P.H. SAHP: Corri Hanson, Ph.D., R.D., Glenda Woscyna, M.S., R.D.

Contact: Jim Medder, M.D., M.P.H.

Typically Offered: October.

Capacity: 4.

Visiting Student Information: This course is NOT available to visiting students.

M-ID 743 NICOTINE ADDICTION 4 Credit Hours

SELECTIVE

Contact: Dr. Paul Paulman.

Typically Offered: Variable.

Capacity: 1 per rotation

Visiting Student Information: This course is NOT available to visiting students.

M-ID 752 ADDICTION MEDICINE 4 Credit Hours

SELECTIVE

Students will spend this Selective month on the Substance Use Disorders Program (SUDP) at the Omaha VA Hospital. Under the supervision of Dr. Dewan, students will participate in the evaluation, assessment and treatment of chemically dependent patients. Students will also be required to complete assigned readings, including literature on basic science issues related to chemical dependency. Objectives: 1.Students will become skilled in taking substance abuse histories. 2.Students will identify physical and psychiatric consequences of substance abuse. 3.Students will achieve familiarity with the classes of drugs of abuse and their use. 4.Students will be conversant with DSM-V criteria for the diagnosis of substance abuse and dependence. 5.Students will become knowledgeable of detoxification methods used to treat physical withdrawal. 6.Students will participate in both inpatient and outpatient therapeutic interventions including group therapy, individual counseling, 12-step groups (e.g., A.A.). 7.Students will explore basic science topics relevant to an understanding of the etiology, natural history, and treatment of substance abuse (e.g., neurobiology, pharmacology, genetics). Performance Objectives: 1.Skillful completion of history and physical exams on patients admitted to SUDP. 2.Appropriately diagnose and develop treatment plans for patients based on HP and DSM-V criteria. 3.Daily follow-up of patients as they progress through detoxification and treatment, with an emphasis on identifying denial, minimization, craving and other symptoms. 4.Accurate evaluation of patients' status in recovery and recognition of the need for changes in treatment modalities. 5.Students will be expected to review one topic related to addictions and present topic in a conference to patients and/or staff. 6.Students are expected to attend some evening outpatient groups and/or 12-step meetings.

Contact: Vijay Dewan, M.D. (VA Medical Center).

Typically Offered: Every month.

Capacity: 2

Visiting Student Information: This course is NOT available to visiting students.