11. ACEICE Student Preparation Reading/Prep questions (ungraded)Online Virtual Case, parts A-C, with reading/questions (graded) Grading & Assessment Quiz- at end of live session- 1% Live session student evaluation- 1.5% Total: 2.5 % Online Case Questions- 2% Live session student evaluation- 1.5% Total: 3.5% Facilitator Briefing8:00-8:30 am Live Session8:30-10:30 Facilitator Debrief10:30-11:00 Facilitator Expectations  Prepare utilizing CSIE website  Facilitate live session  Administer quiz  Complete student evaluations/session feedback form  Prepare utilizing CSIE website  Facilitate live session  Debrief online case/questions  Complete student evaluations/session feedback form

13. * Note that the CV briefing session on 4/28 will be 8-9 and live session from 9-11

17. Day of the live session STEP 1 Introduction/Get Started  Meet the students and let designated student connect to google folder. STEP 2 Clinical Approach Questions  As a group, discuss the clinical approach questions for the given chief complaint. STEP 3 ACE Table  Divide students into smaller subgroups and let them complete Differential Diagnosis ACE Table using google docs.  Regroup to allow each subgroup to share. STEP 4 Practice Clinical Case Examples  As a group, lead the students to apply what they have learned to brief clinical cases. STEP 5 Quiz and Evaluations  Give students 10 minute quiz.  While taking the quiz, complete student evaluations.  Review quiz answers with students.  Release students. STEP 6 Debriefing and CME  Complete session evaluation/debriefing and CME questions. STEP 7 Brown Folder  Put quizzes, evaluations, and debriefing forms in brown folder.

18. PLEASE ENSURE THAT ALL COMPLETED QUIZZES ARE IN THE BROWN ENVELOPE ALONG WITH YOUR FILLED-IN STUDENT EVALUATION AND SESSION FEEDBACK BEFORE YOU LEAVE THE ROOM

19. S TUDENTS ARE EXPECTED TO ARRIVE ON TIME, IN PROFESSIONAL DRESS, WHITE COAT / BADGE. S TUDENTS ARE EXPECTED TO ACTIVELY PARTICIPATE, SHOW PROFESSIONAL BEHAVIOR SUCH AS APPROPRIATE LISTENING SKILLS AND REFRAINING FROM DISRUPTING THE SESSION ( PLEASE SEE THE STUDENT EVALUATION RUBRIC FOR MORE DETAILS ) S TUDENTS ARE EXPECTED TO HAVE PREPARED FOR THE LIVE SESSION BY READING THE PREPARATION GUIDE AND ASSIGNED READING MATERIAL TO PREPARE THEM FOR THE LIVE SESSION.

29. G ET STARTED A CTIVITY 1: O NLINE V IRTUAL C ASE S UMMARY P RESENTATION AND D EBRIEFING A CTIVITY 2: P RACTICE C LINICAL C ASES A CTIVITY 3: H IGH Y IELD “USMLE S TEP 1” A CTIVITY S TUDENT EVALUATIONS AND SESSION FEEDBACK FORM

30. STEP 1 Introduction/Get Started  Meet the students and let designated student connect to google folder. STEP 2 Oral Presentations and online case Debriefing (Activity 1)  Maroon or White group will practice oral presentations of online case.  Answer any questions students have about online case STEP 3 Clinical Cases (Activity 2)  Assign groups (per suggested instructions) to complete provided cases.  Regroup to allow each subgroup to share. STEP 4 High-Yield Content (Activity 3)  Assign groups (per suggested instructions) to complete activity covering organ specific anatomy, physiology, pathology, and pharmacology.  Regroup to allow each subgroup to share. STEP 5 Evaluations  Release students.  Complete student evaluations. STEP 6 Debriefing and CME  Complete session evaluation/debriefing and CME questions. STEP 7 Brown Folder  Put evaluations, and debriefing forms in brown folder.

31. 66-year old woman presents with progressive jaundice over 6 weeks associated with pruritus, pale stools, and dark urine. She complains of mild right upper quadrant pain, nausea, and fullness with eating fatty foods. Laboratory values: Hgb: 11.7 g/dL Total Bilirubin: 22.2 mg/dL Conjugated (Direct) Bilirubin: 14.8 mg/dL AST >700 U/L Alkaline phosphatase: 258 U/L Lipase: 59 U/L Hepatitis serologies – negative Antinuclear antibody (ANA) – positive Anti-smooth muscle antibody (Anti-sm) – 1:116 IgG level > 2000 mg/dl US of RUQ shows mild dilation of common bile duct, CT of Abdomen – normal Answer the following questions: 1)Isolated bilirubin level? 2)Hepatic or cholestatic pattern? 3)What do laboratory and imaging studies suggest? 4)What is the likely diagnosis? 5)What is the treatment for this condition? Example of a clinical case for Activity 2

32. A 19-year-old white man was found to have abnormal serum liver test results 3 years ago when he was first diagnosed as having ulcerative colitis (UC). He denied any previous transfusions, gallstone disease, intravenous drug use, tattoos, or significant alcohol consumption. The patient had no family history of liver disease and, with the exception of his ulcerative colitis, he reported that he was healthy. Even after stopping all medications, his liver function test results remained abnormal. Laboratory Values: Total Bilirubin level - <1 mg/dL Alkaline phosphatase (ALP): 289 U/L AST: 68 U/L ALT: 56 U/L Anti-mitochondrial antibodies - negative Endoscopic retrograde cholangiopancreatography (ERCP) - multiple stenosis and dilatations throughout the intrahepatic biliary system, with a pruning type pattern. The common bile duct and extrahepatic portion of the common hepatic duct appeared normal, without strictures. Answer the following questions: 1)What are the lab abnormalities? 2)What is the significance of the patient’s diagnosis of UC? 3)What is the likely diagnosis? 4)What are the classic histopathologic findings on liver biopsy? 5)What is the treatment?

33. Example of Activity 3: Cardiac “jeopardy” game

34. STUDENT EVALUATION AND SESSION FEEDBACK/EVALUATION “DEBRIEFING” FORM (10 MINUTES) C OMPLETE THE PROVIDED STUDENT EVALUATION AND SESSION DEBRIEFING FORMS AND PLACE BACK IN THE BROWN ENVELOPE.

35. MEDICINE. TAMHSC. EDU / CSIE / MEDICINE. TAMHSC. EDU / CSIE A CCESS ALL CSIE INFORMATION & MATERIALS AT THIS WEBSITE USERNAME AND PW PROTECTED

36. WEBSITE USERNAME AND PASSWORD