American University of Beirut

​​The Department of Emergency Medicine hosts fourth year medical students as they complete a clerkship that lasts a total of six weeks. The clerkship is most valued for its rich clinical experience which allows students to play an active role in the ongoing care of the ED patient. Students are responsible for the initial evaluation of patients; they obtain a thorough history, and perform a focused physical exam, formulate a differential diagnosis, suggest a diagnostic workup and treatment plan, and determine a disposition for each of their assigned patients under the direction of senior residents and faculty. Students acquire important procedural skills by being exposed to and encouraged to participate in the supervised performance of a wide variety of procedures in the ED. 

In order to maximize their learning experience, students are asked to participate in a variety of teaching activities which take place at the department. Namely, students attend and participate in the weekly “Emergency Medicine Conference Series” and the weekly “Radiology Teaching conference”, both of which form an important learning experience in the clerkship. The Radiology Teaching Conference was enhanced by the presence of attending physicians from the Department of Diagnostic Radiology, bringing their expertise to the evaluation of ED patients. 

In addition, students attend two simulation lab sessions: the IV/NG and the resuscitation scenario. The purpose of the IV/NG simulation session is to teach the students the proper and safe way to perform a procedure. It is made clear that the principles taught in this session should be applied to every procedure they perform in the future in order to minimize the chance of patient harm. The resuscitation scenario has been the most popular activity in the clerkship. Students get a real feeling of what it is like being an EM physician who is faced with a critical patient. They have to think on their feet, practice good communications skills and perform procedures in real time. We hope to further enhance students’ educational experience by introducing more simulation sessions in the future.

As part of their clinical rotation, students present an interesting case they have seen in the ED. They are expected to discuss the clinical presentation, workup, diagnosis and management of the case. The case presentation sessions provide students with the opportunity to improve their teaching skills as well as learn to a greater depth about a subject. 

A student’s performance is directly assessed through the Students' Evaluation Form. By engaging the student and their supervising physician in a dynamic dialogue about their performance, this form provides a richer assessment experience for the students. Physicians evaluate students based on the following skills: history taking and physical exam, clinical reasoning, presentation, follow-up, professionalism, and documentation. Introducing this form proved to be effective in terms of providing more accurate evaluations scores to students and having attendings discuss those scores so that students reflect on their performance and improve their critical thinking and clinical skills.

In terms of clerkship evaluation, the highest scores of students’ evaluations of the clerkship were observed in 2018-2019. The ED was identified as the best clerkship experience across Med III and Med IV. Students specifically enjoyed the hands on experience and the direct patient exposure and described the clerkship as being excellent in terms of teaching patient management skills as well as providing exposure to diverse cases. The comments of students were almost all positive (Figure 1)

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 Excerpts from Students Comments for the academic year 2018-2019:   

• “Allows us to be in complete control of the management of our patients”
• “It has been the best rotation in medical school and the best experience"
• “Being involved in patient care from A to Z, including practical skills.”
• "One of the best clerkships, felt involved and learned a lot. Attendings and residents were a pleasure to work with"    
• “Students were very involved. Nice exposure. Great attendings and residents"

Elective Rotations for AUB Medical Students