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M-ID 725 MECH OF HEART FAILURE 4 Credit Hours

SELECTIVE

Objective: To introduce students to basic mechanisms involved in the mediation of acute and chronic heart failure. Concentration on contractile, electrophysiological and neurohumoral dysfunction. Emphasis will be placed on basic pathophysiological mechanisms. Format: Students will meet once per week for two hours in groups of at least four students. Current literature will be reviewed and discussed. Students will be given a specific problem area to research and present a position paper on. This will be in a pro/con format (e.g., ACE inhibitors vs. digitalis in the treatment of decompensated heart failure; Sympathoexcitation in heart failure is due to arterial baroreceptor inhibition). In addition, a laboratory experience will be provided. This will entail either performing or evaluating an echocardiograph or an evaluation of cardiac catheterization data in animals with experimental heart failure.

Contact: Drs. Irving Zucker, Harold Schultz and Kaushik P. Patel.

Typically Offered: August.

Capacity: 4 minimum required.

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

M-ID 728 DVLPMNT OF PBL CASES 4 Credit Hours

SELECTIVE

This selective is designed to provide an opportunity for a student to review knowledge of basic sciences as it applies to a particular clinical case. The focus of the activity should be on all of the basic science mechanisms and explanations for the signs and symptoms in a selected patient and on the disease process itself. The object of the selective is a case for use in problem-based learning sessions for first- or second-year students in the medical curriculum. Initially, the student should select a disease of interest, one manifested by a patient encountered during clinical rotations. The patient's history, including the history of the disease process, any predisposing conditions, attempts to treat the disease, and outcome of treatment will form the introductory phase of the study. Then the student should consult the literature to obtain information about the causes of the disease, variations in its presentation, the different treatments used and their relative effectiveness, the prognosis for patients and psychosocial issues impacting the outcomes. During this process, mastery of all basic science issues connected to the case must be considered more important than all other components. The student is expected to consult with clinical and basic science faculty regarding the case, the disease, basic science facts or mechanisms. Students will be expected to contact Dr. MacDonald to obtain approval for the topic then the Office of Medical Education (OME) to obtain a case number. If the COM already has too many cases on a particular topic/disease, the student may be asked to select a different patient/topic. The OME will then enroll the student in the Blackboard course "PBL Case Writing for M4 Students" and provide access to the PBL case database.-The end product of the selective will be a finished, ready-to-use case. Full instructions for the assembly of the case will be found in the case-writing handbook found in the Blackboard course.-The case should be submitted on a computer disk or as an email attachment with the word processor files for the entire case, preferably in Microsoft Word format.-A Form (the checklist) signed by the clinical consultant and basic science consultant should be submitted with the case. Also, include a pharmacologist in the review process for all M2 cases or if any drug therapy is included in the case.-Only complete cases (i.e., those with all of the parts listed in the case-writing handbook), written in acceptable English and typed in proper format will be accepted.-To receive a letter grade, the case must be completed by the end of the Fall Semester for those registered during July, August, September, October, or November OR by April 1st for those registered in January or February. A letter grade (H, HP, P, M, F) will be assigned to the submitted case based upon the following criteria: Usability-Can the case be used for PBL with little modification? Readability-Is the case written in acceptable English and comprehensible? Is the case written as a case, not as a patient's chart? Completeness-Are all facts, data and exhibits necessary to understand the case included? Understanding-Is there evidence that the student understands the case and the basic science involved? Mastery of the basic science underpinnings of the case and their incorporation into the presentation is considered a major requirement of the selective.

Contact: Dr. Richard MacDonald.

Typically Offered: July through February, excluding December.

Capacity: Variable.

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

M-ID 731 DEV PBL CASES PHARMAC 4 Credit Hours

SELECTIVE

The topic of the PBL case should be determined primarily by the interest of the student and in consultation with the Selective director. If possible, it should come from a patient seen by the student in the M3 year. The process would be overseen by a basic scientist and a clinician. It is intended that a significant portion of the student's time will be spent researching the current literature and obtaining basic scientific material from texts and monographs on the area. Part of the process will involve time spent with the faculty members to review the literature and basic concepts with the student. The clinician will assist in making the information relevant to the clinical setting.

Contact: Dr. David McMillan.

Typically Offered: Variable.

Capacity: Variable

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

M-ID 748 HUMANITIES&LAW/CULTURE 4 Credit Hours

SELECTIVE

Students will broaden their understanding of health care from the literary, humanistic, and social standpoints by reflecting on and discussing selected works. Objectives: Students will be better able to: Identify and discuss the philosophical and emotional dimensions of health care practice. Relate health care practice to larger moral, social, and public policy concerns. Compose and present to the group a well-constructed book review, essay, short story, dramatic scene, poem, or visual representation of one or more themes emerging from the readings and films. Topics Covered: Students will read at least four noted interpretations of medicine in literature and social science, such as: The Doctor Stories, Being Mortal, The Emperor of All Maladies, Cutting for Stone, Five Days at Memorial, The House of God, The Immortal Life of Henrietta Lacks, The Spirit Catches You and You Fall Down, Blood and Bone (collected poems), The Citadel, When Breath Becomes Air, selections from On Doctoring. Three films will be shown followed by discussion, such as: A Civil Action, The Verdict, The Doctor, Contagion, Something the Lord Made, Vera Drake, Supersize Me, Extremis. The meeting schedule, readings, and films will be established by agreement of the faculty and students on the first day of the rotation. Student Activities: Students will divide into two groups of ten. The groups will meet four times (typically weekly) to discuss the chosen literature and view the chosen films. The final meeting will also include presentation of individual projects. Meetings typically are 4 hours in duration and include viewing a film (or presenting projects). Assessment: Students are expected to attend each meeting and actively engage in discussion. Students will develop a final project relating to the topics discussed, present this to the group as a whole, and forward a hard copy to the faculty. Grades will reflect seriousness of purpose in participation and projects.

Instructor: Dr. Rebecca Anderson

Contact: Lisa Paquette.

Typically Offered: November, January, and March.

Capacity: 20

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

M-ID 753 COMPETENT CARE FOR LGBT 4 Credit Hours

ELECTIVE

Lesbian, gay, bisexual, and transgendered (LGBT) individuals have a set of unique health concerns and problems, including higher rates of depression, suicide attempts, alcoholism, cardiovascular disease, some cancers, and sexually transmitted diseases. Their special needs are often overlooked or ignored due to transparency of LGBT individuals and their avoidance of routine healthcare due to a real or imagined fear of discrimination and rejection by physicians. Although a significant segment of society is gay or lesbian, physicians receive minimal formal training in their care. The goal of this elective is to provide the specific training needed for physicians to effectively deal with the healthcare concerns and to provide medically and culturally competent healthcare to this sexual minority and vulnerable population. At the end of this four-week elective, students will be able to: * Define psychosocial issues and risks of self-disclosure by LGBT individuals. * Identify barriers to healthcare for LGBT individuals and methods to overcome those barriers. * Demonstrate appropriate history taking and interviewing skills to foster patient trust. * Identify and successfully address the unique healthcare problems facing LBGT individuals. Learning activities include patient care experiences with the LGBT population, assigned readings, lectures, case discussions, simulations, and visits to LGBT agencies and organizations. Faculty permission is required prior to registration. Instructional methods: Through assigned readings, didactic lectures, seminars and panel discussions, students will learn about the healthcare issues of the LGBT community that impact their health, such as coming out, non-normative stressors, family planning, etc. A series of case discussions and simulations will be conducted to demonstrate comprehension of didactic material. Clinical practice opportunities will be held during the elective for direct patient encounters with members of this population, including clinics with Dr. Mark Goodman and Dr. Susan Swindells (HIV/ID Clinic). (Dr. Goodman's patient population varies from 25-90% LGBT patients on any given day; students will be directed to the care of LGBT patients while in these practices/clinics.) Each student will keep a reflective journal in which the student will record his/his observations and analysis of patients seen and sites visited. This journal will be reviewed with the student by faculty. Visits to various agencies will be arranged and include the following: * PFLAG (Parents, Families, and Friends of Lesbians and Gays) meeting. * GSA (Gay Straight Alliance) meeting at Creighton/UNO. * Meeting with legal counsel to address access to care and others concerns regarding insurance coverage. * Weekend training with NAP (Nebraska AIDS Project) and counseling/testing site experience at either NAP or Douglas County Health Department. * Palliative care for those with AIDS. Activity-Hours/Week. Didactic conferences-6. Independent learning-12. Reflective journal-2. Patient care-12. Agency site visits-8.

Prerequisite:  Pre-arranged with Dr. James Medder.

Instructor: Dr. James Medder and Dr. Gary Beck Dallaghan.

Contact: Jolene Wees; jolene.wees@unmc.edu; 402-559-9327; MSB 2520 (Zip 3075).

Typically Offered: March.

Capacity: Variable.

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

M-ID 763 INDIVIDUALIZED PROGRAM 4-6 Credit Hours

SELECTIVE

If you are interested in pursuing a selective that is not offered in this handbook, permission must be granted by Dr. Richard MacDonald, Senior Selective Coordinator. Please discuss your proposal with him. Credit under the number (M-ID-763) will only be given for an experience that is NOT listed in this handbook. To design your own selective, you must receive the approval of Dr. Richard MacDonald prior to registration. : Anesthesiology Individualized Program: Senior Selective Research 763 is an approved elective for all seniors in many departments on campus. Permission must be granted by Dr. Richard MacDonald after your proposal is approved by your selected department. The Senior Selective Research month in Anesthesiology has certain requirements you must fulfill before you can proceed with research in the department. Therefore, your first point of contact for this selective is the clerkship coordinator, Melinda Murdock. She will explain the steps necessary to do a Senior Selective Research month in Anesthesiology. Once you have spoken with her, you will be directed to contact physicians in the department to inquire about working with them on a research project. You will need to begin this process several months in advance of your rotation to make sure you have proper regulatory training and your requirements for human research training have been met (CITI Training, added to IRB applications, etc.). Your training is required before you can help with any research. Failure to fulfill these requirements will result in a mandatory drop of the course in Anesthesiology.

Prerequisite:  ANES is arranged through Melinda Murdock and Dr. Richard MacDonald.

Contact: Melinda Murdock; mmurdock@unmc.edu; 402-559-4175; BTH 2015 (Zip 4455). Dr. Richard MacDonald for approval.

Typically Offered: Varies (July through April) .

Capacity: By Arrangement

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