MDC7700
Anesthesiology Required Clerkship

ANESTHESIOLOGY CRITICAL CARE MEDICINE – ANS R1-8 CLERKSHIP SYLLABUS – 2025-2026

Duration: 4 weeks
Clerkship web page: https://elearning.ufl.edu/

CLERKSHIP INFORMATION

Welcome to your Anesthesiology & Critical Care Clerkship for 4th year medical students! This is a four-week required clerkship that is divided into two different components. Two weeks will be dedicated to the Perioperative Management of the surgical patient, including pre-, intra- and post-operative patient care under the direct supervision of a resident or attending. A typical day would include arriving at ~7:00am to help set up the OR, attending conference at 6:30 am (based on didactic usefulness), and starting the first OR case of the day between 7:30 and 8:15am. Typically, there will be several cases throughout the day in which the student will participate. Additionally, a continuity of care is expected by performing or at least reviewing the next day’s pre-operative evaluation along with visiting the post-operative patients from the preceding day.

During the other two weeks of the clerkship, the student will participate in their elected or assigned ICU management team. Each team differs slightly in schedule and management styles. Therefore, the specific times and rounding formats are left to each service to define within the framework of achieving the goals and objectives listed below. One-half of the group will start in the operating room for the anesthesiology portion of the clerkship; the other half of the group will start in the ICU. At the two-week interval, the groups will switch.

Online learning modules are required and available for the students to complete on their own time. These will correspond to a simulation or problem-based learning discussion that requires material to be understood in order to critically appraise the patient scenarios. The student must complete the online learning modules before the scheduled simulation / problem-based learning session. Lectures and Small Group Discussions are held in the Harrell Medical Education Building. A complete schedule of lectures is available online, as are all handouts, and necessary paperwork. Evaluation is through objective examinations performed by the residents, Fellows and Attendings.

If your assigned resident in the Operating Room portion of the clerkship is unavailable for any reason, please do the following in order of preference: contact Clerkship Coordinator and Dr. Giordano, choose from the alternate resident list, or call the Attending of the Day (AOD) on 494-4990 who can help assign you to a faculty member to develop your clinical and educational development.

POLICIES AND PROCEDURES

Communication
E-mail is the predominant source of communication regarding updates in the Clerkship. It is expected for you to check your e-mail daily since this is our primary means of communication. The Department of Anesthesiology is committed to an excellent student experience and we believe good communication is the principle foundation to achieving this goal.

Dress Code Students should come to the hospital dressed professionally. If you will not be seeing any patients until the Operating Room (when you will dress in scrubs) appropriate casual attire is acceptable (no short shorts, revealed midriffs, etc.). While in the ICU, long sleeve shirts and dress pants will be worn along with white coats; Scrubs may be worn during extensive patient contact. Please never wear scrubs outside of the hospital, as you become a vector transporting microbes in and out of sterile environments in the hospital. Badge identification should be visible at all times.

Reporting Problems
Problems with your senior, an attending, intern or a general concern should be reported to Clerkship Coordinator and Dr. Giordano as soon as possible. The Clerkship should be a great experience and all concerns will be addressed appropriately. You may also submit a Student Mistreatment Report directly to the COM Office of Students Affairs via the following form: https://students.med.ufl.edu/about/student-mistreatment-report/

Attendance

Attendance is required at all Clerkship activities. In the fourth year clinical Clerkships and electives, daily attendance is required for all aspects of the clinical rotations. Due to the highly interactive nature of this rotation you cannot be absent more than 2 days in the rotation. If you have any unexpected or planned absences, you MUST notify your resident or ICU Team who you are working with during your clinical experiences and Clerkship Coordinator.

In the event of an absence, you will be required to make up the time missed in order to ensure adequate clinical experience. This may require an extra call or weekend experience. Failure to adhere to these policies and procedures will result in a lowered professionalism competency score. Missed days and unexcused absences, which cannot be completed before Clerkship end date, will result in a grade of “Incomplete.” During your rotation in the ICU, daily attendance is imperative. We ask you to not be absent unless an emergency.

Unexpected Absences
In the event of an unexpected absence due to illness, you MUST notify the Clerkship Coordinator, Dr. Giordano, and your assigned resident as soon as possible. Text, e-mail, phone call, all forms of communication are acceptable. Failure to communicate unexpected absences in a timely manner is a professionalism concern which can impact your final clerkship grade and if a pattern of behavior is identified necessitate review by the Academic Status Committee. If the absence is of greater duration than three days (including missed days that are not back-to-back) the clerkship will notify the Office of Student Affairs and Registration and provide the student with an appropriate remediation plan.

Planned Absences/Residency Interview Absences
Students must contact the Clerkship Coordinator as far in advance as possible (these requests must be made at least four (4) weeks prior to the beginning of the Clerkship) to discuss and obtain the permission of Dr. Giordano to be absent from assigned responsibilities in the case of planned meetings, events such as weddings or family gatherings, or the observation of a personal religious holiday. If permission is obtained for the planned absence, the student must notify the Office of Medical Education of the approved dates for the absence and log the absence in the Absence Monitoring System.

Holidays
Students are allotted the following holidays: Thanksgiving, Summer Break, and Winter Break. Thanksgiving is defined as beginning 7pm Wednesday and ending 5am Monday. Summer and Winter Break are determined by the UF COM Academic Calendar. The COM recognizes other holidays, both religious and secular, which are of importance to some individuals and groups. Students wishing to observe these holidays must inform the Clerkship Coordinator before the clerkship begins. In the event of such request, an alternate assignment or arrangement may be provided to the student to ensure adequate clinical experience.

Students with Disabilities
The University of Florida is committed to providing academic accommodations for students with disabilities. Students requesting accommodations must first register with the Disability Resource Center (DRC) (352-392-8565, https://disability.ufl.edu/) by providing appropriate documentation. Once registered, students should present their accommodation letter to the College of Medicine’s ADA Representative, Mr. Jim Gorske, who will distribute the accommodation letter to appropriate course and/or clerkship directors, as needed, as well as the testing center. The University encourages students to register with the DRC as soon as they begin medical school or upon the verification of a disability.

Counseling Services
Contact information for the Counseling and Wellness Center: https://counseling.ufl.edu/outreach/ and the University Police Department: 392-1111 or 9-1-1 for emergencies.

Performance Criteria
All faculty and residents submit competency-based summative evaluations of students with whom they worked a sufficient amount of time. These evaluations count for a significant portion of your final grade. Written formative feedback is provided at the end of weeks one and three via a student self-assessment form.

Course Evaluation in New Innovations
All students are expected to log into New Innovations and complete a confidential survey regarding your sub-internship experience. These evaluations are vital to the success of the clerkship by ensuring adequate levels of teaching. This feedback is also helpful in resident/faculty evaluations and award nominations.

Grading Committee for Evaluations
A grade committee determines your final grade based on clinical evaluations, examination scores, and required assignments as outlined in the grade explanation. “Coaching up” evaluators (telling them that certain numeric scores on their evaluation correlate to the grade) is misleading, unfair to the majority of students who do not do this and is considered unprofessional behavior. Engaging in this behavior will result in a lower professionalism evaluation and could affect your grade and the comments submitted for the MSPE. All summative evaluations will be compiled and reviewed by Dr. Chris Giordano, Dr. Amanda Frantz, Dr. Adrienne Warrick, and other members of the didactics program for discussion and arbitration if any issues arise.

LEARNING ACTIVITIES

All assignments are must be submitted via Canvas by 5pm on the last day of the rotation, unless otherwise specified. All assignments submitted after their specified deadlines will lose points. If you are having problems submitting assignments, please contact the Clerkship Coordinator

Modules
Each class-based Simulation or Problem-Based Learning Discussion has a corresponding educational module that is designed to introduce medical knowledge to the student prior to the start of the corresponding lecture. Refer to the lecture schedule for lecture dates. These modules are available on Canvas and are meant for self-teaching. There are questions infused throughout the module meant to keep you stimulated and to reinforce topics that are critical to appropriately applying during the simulation. These modules have many elements and topics that are controversial and are not necessarily universally applied – as are many things in medicine you will encounter! Please feel free to bring up any questions, uncertainties or ideas that you think need further addressing or explaining during the following class activity. Ideally, these modules will stimulate a dialogue for you to bring up with your resident or Attending in the OR and ICU.

Case Review
During the Anesthesiology (OR) two weeks, you will complete one Case Review Form including all of the Perioperative management strategies implemented. This should include a brief review of the patient’s history and physical, the anesthetic plan, any remarkable intraoperative events, the post-operative pain plan and dispositional plan. Example case-write ups that will correspond to full credit, half credit and no credit are available in Canvas. These cases will be submitted for review and be counted as part of your final grade.

Team Reflection Piece
It is pivotal for you to do this piece in order so that you can maximize the value of this exercise. Please complete Prompt 1 by the half way point and upload to Canvas accordingly. Please complete Prompt 2 after our Team Training Simulations by the end of the rotation and upload to Canvas accordingly.

*Teamwork Knowledge, Skills, and Attitudes table available in the Supplemental Materials section at the end of the syllabus.

RECOMMENDED TEXTBOOKS AND RESOURCES

Recommended Texts

• Essential Anesthesia: From science to practice by Drs. Euliano & Gravenstein. There are numerous copies are available in the Health Science Center Library.
• Civetta, Taylor and Kirby’s Critical Care, 5ed. 2009 (edited by Andrea Gabrielli, MD, FCCM, Joseph Layon, MD, FACP and Mihae Yu, MD).

Recommended Overviews

• Marino’s The ICU Book, 4ed. 2013
• Morgan & Mikhail’s Clinical Anesthesiology, 5ed. 2013 (edited by John F. Butterworth IV, David C. Mackey, John D. Wasnick)

“First Source” Reference Texts

• Miller’s Anesthesia, 7ed. 2009 (edited by Ronald Miller, MD, Lars Eriksson, MD, PhD, Lee Fleisher, MD et al.)

Internet Resources

• Morgan & Mikhail
• Principles of Critical Care

The Science of Patient Safety
On your CCM rotations, you will have the opportunity to gain the experience and knowledge base to skillfully care for the critically ill patient in a collaborative, team-oriented and multidisciplinary setting. Prior to your rotation, review the following:

• https://www.youtube.com/watch?v=GOJJHHm7lnM
• https://www.youtube.com/watch?v=wpzb7nM6oFQ
• https://www.youtube.com/watch?v=6BnXs4KtER8

BOG ATTESTATION REGARDING INSTRUCTIONAL MATERIALS

Instructional materials for this course consist of materials reviewed, selected, and assigned by the instructor(s). The instructor(s) is only responsible for these instructional materials. Based on self-assessment of learning needs, students may identify other credible resources to augment the identification, analysis, and synthesis of relevant information.

COMPUTER REQUIREMENT

Please do not use electronic devices (including laptops, tablets, and cellphones) during didactic lectures or simulations. During the clerkship, personal items can be stored in Medical Student Lounge, Communicore Student Lounge, Clinical Anesthesia Offices (one in each hospital tower), resident workrooms, or Anesthesiology Resident Library (located in North Tower 2036).

A personal laptop is required for the final exam, computers will not be provided. Download and install Respondus LockDown Browser on your personal device before your exam.

Personal laptops can be utilized in clinical spaces and should meet the computer requirements laid out by the College of Medicine. While desktops are typically available on all clinical rotation sites it is recommended that you bring a personal laptop in case a desktop is not available.

COMPETENCIES, GOALS, AND OBJECTIVES

The Department’s expectations of your performance are aligned with the College of Medicine’s competency-based curriculum. You will experience, be taught and evaluated specifically on your performance of the following competencies, goals and objectives. The Institutional Learning Objectives have been mapped to the clerkship Learning Objectives accordingly.

Competencies:

• Patient Care (PC)
• Medical Knowledge (MK)
• Practice-Based Learning (PBL)
• Systems-Based Practice (SBL)
• Professionalism (P)
• Interpersonal and Communication Skills (IC)

MID-CLERKSHIP FORMATIVE FEEDBACK

The Formative Feedback form should be completed with your resident/attending (whomever you spent the most time with) at the end of the first week of your ICU and OR period (2 total). The first step of the Formative Feedback is to complete the Self-Assessment portion, and then ask your resident/attending to complete their portion. For areas you feel you are struggling, brainstorm 1-2 ways you might be able to improve your performance in these areas. If faculty/resident ratings don’t align with your evaluation, this is a natural time to ask the faculty/resident, why the score they gave you was lower (or higher!) and how you can improve performance. Since formative feedback is meant to provide you with information to improve, weaknesses and deficiencies may be stressed more than strengths. The formative feedback narrative does not influence your final Summative Evaluation.

The Formative Feedback form should be completed electronically via Qualtrics.

ASSESSMENT

The University of Florida Honor Code: “We, the members of the University of Florida community, pledge to hold ourselves and our peers to the highest standards of honesty and integrity.”

Formative

• Mid-OR Feedback Evaluation
• Mid-ICU Feedback Evaluation
• Didactic Lectures and Simulations

Summative

• End of OR Rotation Evaluation (Clinical Performance)
• End of ICU Rotation Evaluation (Clinical Performance)
• Written Assignments (Case Review and Team Training Prompts)
• Clerkship Final Exam

GRADING

*Students are evaluated on the following professionalism domains:

• Respectfulness
• Work Ethics and Dependability
• Motivation and Excellence
• Honesty

REQUIRED CLINICAL PRESENTATIONS, SKILLS, AND PROCEDURES

The clerkship is designed to expose you to the following core presentations, skills, and/or procedures, which are graduation requirements. If you have difficulty meeting any of these, an alternate method is listed in the table below.

Graduation requirements: Peripheral Intravenous Placement, Airway evaluation, Mask Ventilation, Direct Laryngoscopy, Laryngeal Mask Airway Placement, Electrocardiogram Interpretation, Interpret Mechanical Ventilation.

In addition to the graduation requirements, the Anesthesiology/Critical Care Medicine clerkship also requires the following clinical experiences:

Clerkship requirements: n/a

Video instructions on how to complete case logs in New Innovation are on the Phase 2 Canvas Page.

POLICY ON STUDENT EVALUATIONS

• Each student must complete at least 75% of all assigned faculty, resident, and small group leader evaluation forms associated with a course/clerkship in each year of enrollment. There is an expectation of 100% completion on overall course and clerkship evaluations.
• Every student is expected to respond in a professional manner to each item which she/he feels qualified to answer.
• Strict confidentiality of responses is assured. Evaluation data (numerical ratings and student comments) is de-identified. However, the completion of evaluations will be tracked.

COLLEGE OF MEDICINE POLICIES AND PROCEDURES HANDBOOK

SUPPLEMENTAL MATERIALS

• Key Points for Exam
• Teamwork Knowledge, Skills, and Attitudes
• KSA References

KEY POINTS FOR EXAM

1 References
Baker D, Salas E, King H, et al. The role of teamwork in the professional education of physicians: Current status and assessment recommendations. Jt Comm J Qual Patient Saf 2005, 31: 185-202.
Bandow D. Time to create sound teamwork. J Qual Participat 2001; 24: 41-47.
Barach P, Weingart M. trauma team performance. In: Wilson WC, Grande CM, Hoyt DB, eds. Trauma: Resuscitation, anesthesia, surgery, and critical care. New York: Marcel Dekker, Inc., 2003. P. 96-150.
Cannon-Bowers JA, Tannenbaum SI, Salas E, et al. Defining competencies and establishing team training requirements. In: Guzza RA, Salas E, eds. Team effectiveness and decision-making in organizations. San Francisco: Jossey-Bass, 1995. p. 333-380.
Driskall JE, Salas E. Collective behavior and team performance. Hum Factors 1992; 34: 277-288.
Flin R, Maron N. Identifying and training non-technical skills for teams in acute medicine. Qual Saf Health Care 2004, 13 Suppl 1:i80-i84.
Healey AN, Undre S, Vincent CA. Developing observational measures of performance in surgical teams. Qual Saf Health Care 2004, 13 Suppl 1:i33-i40.
Klein G, Pierce LG. Adaptive teams. Proceedings of the 6th ICCRTS Collaboration in the Informative Age, Track 4: C2 Decision making and Cognitive Analysis, 2001.
Klimoski R, Mohammed S. Team mental model: Construct or metaphor? J manage 1994; 20: 403-437.
Kozlowski SWJ, Gully SM, Nason ER, et al. Developing adaptive teams: A theory of compilation and performance across levels and time. In: Ilgen DR, Pulakos ED, eds. The changing nature of performance: Implications for staffing, motivation, and development. San Francisco: Jossey-Bass, 1999. p. 240-292.
Mathieu JE, Heffner TS, Goodwin GF, et al. The influence of share mental models on team process and performance. J Appl Psychol 2000, 85: 273-283.
McIntyre MR, Salas E. Measuring and managing for team performance: Emerging principles from complex environments. In: Guzzo RA, Salas E. editors. Team effectiveness and decision making in organizations. Mahwah, NJ: Lawrence Erlbaum Associates, Inc.; 1995, p. 194-203.
Porter COLH, Hollenbeck JR, Ilgen DR, et al. Backup behavior in teams: The role of personality and legitimacy of need. J Appl Psychol 2003, 88: 391-403.
Salas E, Burke CS, Stagl, KC. Developing teams and team leaders: Strategies and principles. In: Demaree RG, Zaccaro SJ, halpin SM, editors. Leader development for transforming organizations. Mahwah, NJ: Lawrence Erlbaum Associates, Inc.; 2004, p. 325-358.
Shamir B. Calculations, values, and entities: The sources of collective motivation. Hum Relations 1990; 43: 313-332.
Stout RJ, Cannon-Bowers JA, Salas E. The role of shared mental models in developing team situational awareness: Implications for team training. Traning Res J 1996; 2: 85-116.
Thomas EJ, Sexton JB, Helmreich RL. Translating teamwork behaviors from aviation to healthcare: Development of behavioural markers for neonatal resuscitation. Qual Saf Health Care 2004, 13 Suppl 1:i57-i64.
Wagner JA. Studies of individualism-collectivism: Effects on cooperation in groups. Acad Manage J 1995; 38: 152-172.
Webber SS. Leadership and trust facilitating cross-functional team success. J Manage Develop 2002; 21: 201-214.