Leavenworth VAMC Goals and Objectives

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Leavenworth VAMC Goals and Objectives

  1. 1. Inpatient General Medicine Services Curriculum Leavenworth VA Medical Center The Residency Review Committee requires that the resident and attending have a face to face meeting at the beginning of the rotation to review the learning objectives. Educational Objective: 1. Allows residents to develop skills, knowledge, and experience in a community/rural hospital setting. 2. Allow the resident to acquire critical care skills in an open intensive care unit. 3. Allow the resident to learn a multidisciplinary approach in a community based hospital setting Resident Responsibilities: Two upper level residents and 2 PGY-1s are assigned to the Leavenworth VA rotation for a one month basis. There are two medicine teams comprised of one upper level, 1 PGY-1 and 1 Family Medicine resident. They have close interaction with on-site Chief Resident and dedicated hospitalist staff. The smaller number of learners at these sites allows for close observation of residents’ performance, and also enhances the residents’ experience in direct patient care. The facility has open ICU allowing residents to gain valuable experience in critical care. The setting allows residents to experience Internal Medicine from a community/rural hospital setting. Upper level residents get additional experience in basic podiatry and minor podiatric surgery, substance abuse management, especially as it relates to pain management in the setting of substance abuse, and in the supervision and evaluation of cardiac stress testing using standard Bruce protocol and nuclear imaging. Upper level residents also function as general medicine consultants. Residents also have team interaction with students from an osteopathic and physicians assistant background. Goals: 1. Train internal medicine residents to competently practice general internal medicine in preparation for ambulatory and hospital practice, further subspecialty training, or an academic career. 2. Train preliminary medicine residents in the basics of internal medicine practice to become fully prepared for careers in a variety of medical disciplines. Teaching/Learning Activities: Residents meet daily with Attendings for morning report and noon didactic sessions. In addition, the site holds regular Journal Club, televised participation in core conferences and Grand Rounds held at KUMC, and monthly Morbidity and Mortality conferences. Daily teaching and work rounds are multi-disciplinary including Pharmacy and Nursing. Residents are required to select a journal article of their interest at the beginning of the rotation. The resident will read and present the findings and critical evaluation of the article to the staff and fellow residents at the end of the rotation. Evaluation Methods: During floor rotations, as with all other rotations, residents are formally evaluated online, using the Myevaluations.com system, according to ABIM parameters. Evaluations are completed by faculty Attendings, as well as by medical students on service with the resident. All evaluations are reviewed by the Program Director at the time of submission, and are also discussed with the resident during biannual feedback meetings with the Program Director. If an unfavorable or marginal evaluation is received on any resident, an urgent appointment with the Program Director is scheduled with that resident to review the issues raised in the evaluation.
  2. 2. Throughout the year, the chief residents, Program Director, and other faculty program leaders meet weekly to review resident performance in an ongoing fashion. Information from these meetings is incorporated into the feedback that residents receive at their regular meetings with the Program Director or Associate Program Director. General Objectives (Based on the six ACGME core competencies): 11. Provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health in adults. Residents will define and prioritize patients’ medical problem, generate and prioritize differential diagnoses and develop rational, evidence-based management strategies. 22. Demonstrate knowledge about established and evolving biomedical, clinical, and cognate (epidemiological and social-behavioral) sciences and the application of this knowledge to patient care. Residents will work to expand their clinically applicable knowledge base of the basic and clinical sciences underlying the care of medical inpatients and access and critically evaluate current medical information and scientific evidence relevant to patient care 33. Investigate and evaluate their patient care practices, appraise and assimilate scientific evidence, and improve their patient care practices. Residents will identify and acknowledge gaps in their personal knowledge and procedural skills in the care of hospitalized patients and will work to develop and implement strategies for filling gaps in knowledge and skills 44. Demonstrate interpersonal and communication skills that result in effective information exchange and teaming with patients, patient families, and professional associates. 55. Demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population. The resident will behave professionally towards patients, families, colleagues, and all members of the health care team 66. Demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value. The resident will understand and utilize the multidisciplinary resources necessary to care optimally for hospitalized patients and collaborate with other members of the health care team to assure comprehensive patient care. 7 Principle Educational Goals by Relevant Competency: In the tables below, the principle educational goals for inpatient rotations at KUMC are indicated for each of the six ACGME core competencies. The second column of the table indicates the most relevant principle teaching/learning activity for each goal, using the abbreviations listed below (please see above for descriptions). Legend for Learning Activities: DPC= Direct Patient Care TR= Teaching rounds, or daily attending rounds MR= Morning Report GR= Grand Rounds DC= Didactic Conference JC= Journal Club CC= Care Coordination with RN’s, social workers, other team members 1. Patient Care Principle Educational Goals Learning Activities Interview patients more skillfully DPC, TR Examine patients more skillfully DPC, TR Define and prioritize patients’ medical problems DPC, TR, MR, DC Generate and prioritize differential diagnoses DPC, TR, MR
  3. 3. Develop rational, evidence-based management strategies TR, MR,JC, DC, GR 2. Medical Knowledge Principle Educational Goals Learning Activities Expand clinically applicable knowledge base of the basic and clinical sciences underlying the care of medical inpatients DPC, TR, MR, GR, DC Access and critically evaluate current medical information and scientific evidence relevant to patient care TR, MR, JC, DC 3. Practice-Based Learning and Improvement Principle Educational Goals Learning Activities Identify and acknowledge gaps in personal knowledge and skills in the care of hospitalized patients DPC, TR, MR Develop and implement strategies for filling gaps in knowledge and skills TR, JC, DC, MR 4. Interpersonal Skills and Communication Principle Educational Goals Learning Activities Communicate effectively with patients and families DPC, TR Communicate effectively with physician colleagues at all levels DPC, TR, MR, JC Communicate effectively with all non- physician members of the health care team to assure comprehensive and timely care of hospitalized patients DPC, TR, CC Present patient information concisely and clearly; both verbally and in writing DPC, TR, MR Teach colleagues effectively TR, MR 5. Professionalism Principle Educational Goals Learning Activities Behave professionally towards patients, families, colleagues, and all members of the health care team All 6. Systems-Based Practice Principle Educational Goals Learning Activities Understand and utilize the multidisciplinary resources necessary to care optimally for hospitalized patients DPC, TR, MR, DC, CC Collaborate with other members of the health care team to assure comprehensive patient care DPC, TR, CC Use evidence-based, cost-conscious strategies in the care of hospitalized patients DPC, TR, MR, JC, CC Recommended Resources:
  4. 4. Residents are expected to read and learn about their patients’ diagnoses and treatment during the rotation. Because it is frequently updated and extensively referenced, and can be accessed easily on the hospital’s computer system, most residents use UpToDate as a primary resource. However, use of board review texts as well as general medicine and hospital medicine texts for reference is also encouraged. Residents are expected to perform focused reviews of current literature when indicated as well.
  5. 5. Review of Goals and Objectives with Resident Block ______ Rotation_________________________________ Resident statement: The above goals and objectives were reviewed with me at the beginning of my rotation, and I understand the expectations for the rotation and how I will be evaluated. Resident Signature: ______________________________________________________ Printed Name: ______________________________________________________ Date: ______________________________________________________ Staff Signature: ______________________________________________________ I have discussed with my staff my need for a Mini-CEX during this block. 
  6. 6. Review of Goals and Objectives with Resident Block ______ Rotation_________________________________ Resident statement: The above goals and objectives were reviewed with me at the beginning of my rotation, and I understand the expectations for the rotation and how I will be evaluated. Resident Signature: ______________________________________________________ Printed Name: ______________________________________________________ Date: ______________________________________________________ Staff Signature: ______________________________________________________ I have discussed with my staff my need for a Mini-CEX during this block. 

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