VA Cardiology.doc.doc


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VA Cardiology.doc.doc

  1. 1. ROTATION: Cardiovascular Medicine & Cardiac Imaging INTENED: MS-4, PGY 1,2,3 DURATION: 1-2 months; Monday-Friday 7:30 am – 4 pm The VA elective in Cardiovascular Medicine & Cardiac Imaging is structured to provide an academic introduction to clinical cardiology and cardiovascular imaging (EKG, echocardiography, stress testing, nuclear cardiology, transesophageal echo, and cardiac MRI). OBJECTIVES At the completion of the rotation participants will be expected to have achieved the ability to perform a focused cardiovascular exam, provide a basic EKG interpretation, arrive at a differential diagnosis for common presenting cardiovascular complaints, and understand the indications and contraindications for commonly employed cardiac imaging techniques. ACTIVITIES and EXPECTATIONS Participants will spend their time evaluating new cardiology consults as well as working directly with cardiology staff in the performance of stress tests, cardiac nuclear imaging studies, echocardiograms, and cardiac MR. There will be daily rounds during which time participants will be expected to present their patient evaluations and management plans. Over the course of the rotation publications covering 5-10 major cardiology trial will be distributed and each participants will be expected to present the articles in an informal “journal club” format. At various times throughout the day there will be assorted reading sessions where nuclear stress tests, echocardiograms, and cardiac MRI’s are interpreted that participants are encouraged to attend. DIDACTICS and CONFERENCE In addition to clinical activities participants will be expected to attend the following didactic conferences: EKG (Monday 4 pm), Cardiac Cath (Thursday 1 pm), Medicine (Daily 12 pm), and Cardiac Imaging (Friday 7 am). EVALUATIONS Participants will be individually evaluated based on their attendance, active participation in the service, quality of patient evaluations and interrogatories, level of preparation and presentation of assigned articles. RECOMMEND READINGS It is strongly recommended that the following texts be obtained and read prior to start of the elective. - The Only Ekg Book You’ll Ever Need, Malcolm S.Thalerm Lippincott Williams & Wilkins - Cardiac Elective Syllabus and Core Curriculum (available from VA Medicine Office) Sincerely, Michael D. Greenberg, MD Chief, Echocardiography & Nuclear Cardiology Co-Director, Cardiac MR
  2. 2. Learning Venues: 1. Direct patient care: supervised by attending physician 2. Management Rounds with Cardiology team 3. Cardiology Specialty Conferences: Cardiology Conference, echocardiography conferences 4. Self Study 5. Core Department of Medicine Lecture Series 6. Demonstration Evaluation Methods: A. Attending Evaluation B. Direct Clinical Observation C. Peer Evaluation D. Nursing Evaluation E. In-Training Examination 1) Patient Care Principal Educational Goals: Learning Venues Working with the Attending Cardiologist, provide effective care for 1 patients admitted to patients diagnosed with cardiovascular diseases Improve auscultation and physical examination skills. Correlate the 1,6 examination of patients during care with the results from the echocardiography and catheterization lab. Effectively evaluate and manage patients with acute cardiac illness. 1 Evaluation Methods: A,B,C 2) Practice-Based Learning and Improvement Principal Educational Goals: Learning Activities: Identify and acknowledge gaps in personal knowledge and skills in the ALL care of acute cardiac patients and cardiology. Develop real-time strategies for filling knowledge gaps that will benefit ALL patients on the cardiology primary service. Residents will accept feedback and work to improve deficiencies. ALL Effectively evaluate and manage patients with acute cardiac illness. 1 Effectively manage patients with chest pain, including the appropriate 1 use of diagnostic testing. Effectively evaluate and manage selected interesting patients who have 3,4,5 undergone invasive procedures. Evaluation Methods: A,B,C,E 3) Medical Knowledge Principal Educational Goals: Learning Activities: Identify and understand the management of the most common cardiac ALL conditions in hospitalized patients including chest pain/coronary artery disease, congestive heart failure, arrhythmia management, valvular heart
  3. 3. disease and the evaluation of chest pain syndromes. Understand the appropriate use and interpretation of diagnostic cardiac ALL testing and the appropriate patient selection criteria. (ECG, exercise stress testing, myocardial scanning, echocardiography, and stress echocardiography), know absolute and relaive contraindications related to cardiac tests. Understand and identify the appropriate patient candidates for the various ALL non-invasive imaging modalities and how these tests are performed. They should also understand the limitations of these procedures and their applicability in different circumstances. Expand clinically applicable knowledge base of the basic and clinical ALL sciences underlying the care of patients with chest pain and acute cardiac disease. Access and critically evaluate current medical information and scientific ALL evidence relevant to acute cardiac care. • Pose answerable questions to solve dilemmas in patient care • Identify which type of article (primary [diagnostic, treatment, prognostic, etc…] vs. secondary [reviews]) that is needed to answer the particular question) • Demonstrate the ability to use computer-based literature searches to identify references relevant to patient problems • Understand how individual patient demographics may affect the application of medical literature. Understand the physiologic and pathophysiologic principles of invasive ALL hemodynamic monitoring including indications. Evaluation Methods: A,B,C, E 4) Interpersonal Skills and Communication Principal Educational Goals: Learning Activities: Communicate effectively with patients and families. 1 Communicate effectively with physician colleagues and members of 1,2 other healthcare professions to assure timely, comprehensive patient care. Communicate effectively with colleagues from other services to 1,2 coordinate optimal patient care. Evaluation Methods: A, B,C,D 5) Professionalism Principal Educational Goals: Learning Venues Seek to excel in their clinical and scholarly work ALL Maintain a state of inquiry and actively seek out new information by ALL reading to enhance knowledge Attend and be prepared to actively participate in all conferences Accept and complete all patient care responsibilities with the utmost care 1,2 Behave with the utmost professionalism toward towards patients, 1,2 families, colleagues, and all members of the health care team. Seek out, accept feedback, and work to improve deficiencies. ALL Provide feedback to the course director to improve the rotation as needed ALL Evaluation Methods: A,B,C,D 6) Systems-Based Practice
  4. 4. Principal Educational Goals: Learning Venues Understand and utilize the multidisciplinary resources necessary to care 1,2 optimally for the cardiac patient. Collaborate with other members of the health care team to assure 1,2 comprehensive care for patients with cardiac illness and complaints. Use evidence based, cost-conscious strategies in the care of patients with cardiac illness and complaints. 1,2 Evaluation Methods: A,C