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  1. 1. Revised February 26, 2008 GOALS AND OBJECTIVES RESIDENT CURRICULUM FOR RADIOLOGY ROTATION, UMC AND SUBSPECIALTY CLINIC Rotation Director: Dianne Mazzu, MD 2020 Palomino Lane Las Vegas, NV 89106 OVERVIEW Educational Purpose Knowledge of the proper utilization of Radiologic services is an important component of patient care for the Internist. The Radiology elective rotation is available to Internal Medicine residents through the UMC Radiology Department. It can be taken in a 2-week or 4-week block. The resident will be given an assignment schedule and a self-study CD-Rom by Dr. Mazzu or associate. The resident will be assigned to radiologist for the rotation and is excused only for continuity clinic, medical review and noon conferences or department request (sick call). The educational goals and objectives include the following general areas: A. Become familiar with the Radiologic tests and procedures available at UMC including Invasive Radiology. B. To learn the proper utilization of imaging modalities in diagnosis and intervention. C. To understand the clinical indications and contraindication of Radiologic tests and procedures at UMC. D. To understand Radiologic testing procedures cost effectiveness and risk versus benefit analysis. Teaching Methods The resident will work closely with the attending. The resident will review films with the radiologist as they present to the department. In addition, the resident will engage in self- study with a CD-ROM collection of standardized radiographic studies and findings, and take an examination at completion.
  2. 2. Mix of Diseases Patients present a vast array of acute and medical problems for which imaging studies may be indicated. Patient Characteristics The patient population is diverse, male and female, of all ages from adolescent to geriatric, representing most ethnic and racial backgrounds, from all social and economic strata. The hospital serves primarily the indigent population of the city of Las Vegas. There is a mix of medical, surgical, obstetric and trauma cases Types of Clinical Encounters There are few clinical encounters except those in which a diagnostic radiologist might need to interact with a patient, i.e., procedural sedation. Resident Supervision Residents have constant on site supervision by an attending radiologist. Procedures and Services No procedures are performed Didactic Teaching Noon Conference Residents rotating are required to maintain greater than 60 % attendance at noon conference. Noon conference occurs daily, Monday through Friday. These sessions cover the basic core curriculum, and other curriculum topics such as ethical issues, geriatrics, computer systems and informatics, health care systems, occupational and environmental health issues, and other topics of concern. Attending Rounds There are no rounds per se. Cases are reviewed individually with an attending radiologist. Core Reading Materials Self-study CD-ROM Ancillary Educational Materials Subspecialty Texts of Neurology, Pulmonary Medicine, Nephrology, Endocrinology, Infectious Diseases, Rheumatology as well as General Medical References (Harrison’s Principles of Internal Medicine, Cecil’s Textbook of Medicine) are available 24 hours a day, seven days a week in the resident lounge. Savitt Medical Library On-Line Residents have access to the on-line services of Savitt Library (the main library of the University of Nevada - Reno) via their computer in the resident room, Suite 2
  3. 3. 300 of the 2040 W. Charleston Building. Access to this room is available 24 hours a day, seven days a week. Full text is available for many peer-review journals including, but no limited to: ACP Journal Club Annals of Internal Medicine British Medical Journal Cancer Circulation Journal of the American College of Cardiology The Lancet New England Journal of Medicine Stroke Also available on-line: Harrison’s Principle’s of Internal Medicine, 14th ed. Merck Manual, 17th ed. Guide to Clinical Preventive Services, 2nd ed. The Cochrane Library Medline and Grateful Med Databases Pathological Material and Other Educational Resources None Training Sites University Medical Center All of the diagnostic radiology experience occurs at University Medical Center (UMC) under the supervision of one of the full-time radiology attendings. Competency-based Goals and Objectives Radiology Rotation Learning Venues Evaluation Methods Level Specificity 1. Radiology Reading Suite A. Radiologic testing R-1=1 2. Fluoroscopy; CT Scanner; Follow-up IR Procedures B. Attending evaluation 3. Self Study-CD Rom C. Self Evaluation R-2=2 4. Hospital Wards D. Radiologic Tech Evaluation R-3=3 3
  4. 4. Competency: Patient Care Learning Venues Evaluation Methods Level 4
  5. 5. Understand preparation of patients for testing-Radiologic 1, 4 A, B 1, 2, 3 Discuss with patients the risk and benefits of the radiologic procedure. 1, 2, 4 B, D 2, 3 Competency: Medical Knowledge Learning Venues Evaluation Methods Level Interpret radiographs, X-Ray, CT and MRI-head 1, 2, 3 A, B 1, 2, 3 Evaluate indications for invasive procedures-arteriography, Mylograms, Tissue biopsies 1, 2, 3 A, B 1, 2, 3 Understand risk and benefit of Radiologic procedures 1, 2, 3 A, B, C 2, 3 List all hazards of radiation 1, 2, 3 A, B, E 2, 3 Understand preparation of patients for radiologic procedures 1, 2, 3 A, B, D, E 1, 2, 3 Competency: Interpersonal and Communication Skills Learning Venues Evaluation Methods Level Communicate with radiologist and radiology staff effectively 1, 2, 4 B, E 1, 2, 3 Communicate clearly with patients concerning Radiologic testing 1, 2, 4 B, D, E 1, 2, 3 Understand patient preferences for testing 1, 2, 3 B, C, D 1, 2, 3 Maintain patient confidentiality 1, 2, 4 B, C, D, E 1, 2, 3 Competency: Professionalism Learning Venues Evaluation Methods Level Attend scheduled rotation assignments 1, 2, 4 B, E 1, 2, 3 Maintain patient confidentiality 1, 2 B, E 1, 2, 3 Competency-Practice: Based learning Learning Venues Evaluation Methods Level Understand the complications of test performed unnecessarily 1, 2, 3, 4 A, B, C 2, 3 List three ways your utilization of radiology services will change/improve 1,2,3 B,C 1,2,3 Competency-Systems: Based Practice Learning Venues Evaluation Methods Level 5
  6. 6. Determine the most cost-effective ways to diagnose four common problems utilizing Radiologic resources 1, 2, 3, 4 A, B, C 2, 3 *Chest Pain *Pulmonary Embolism *Diabetic Foot-infection *Abdominal Pain EVALUATION A. Of Residents At the completion of each rotation, all clinical faculty are required to complete the standard ABIM resident evaluation form. All clinical faculty are encouraged to provide face-to-face feedback with the residents. The night-float resident is evaluated by one of the three service attendings. In addition, residents may receive interim feedback utilizing the ABIM’s Praise and Early Warning cards. B. Of Rotation and Preceptor All residents are encouraged to evaluate the rotation, and the clinical faculty member, at the completion of the rotation. This evaluation form is included at the end of this document. These evaluations are then converted to type and shared anonymously with the clinical faculty. The program director also discusses the rotation with the residents to ensure rotation quality and satisfaction. 6
  7. 7. Radiology Rotation Resident Check List 1. Evaluation reviewed at mid-month and end of rotation by the supervising faculty member and resident. 2. Completed assigned readings 3. Attended all assigned activities (excluding scheduled time away, required clinics and emergencies). 4. Completed required case report abstracts and/or posters if assigned by the supervising faculty member. 5. Demonstrated understanding of the basic principals of radiologic diagnosis. 6. Received verbal feedback from attending at end of rotation. Intern/Resident Signature_________________________ Date___________________ Supervising Attending Signature ___________________ Date__________________ All items must be completed for rotation credit and checklist returned to the Department of Medicine by the rotation’s end. 7