GUH Cardiology

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GUH Cardiology

  1. 1. Georgetown University Hospital Division of Cardiovascular Diseases Educational Goals for Residents on the Cardiology Consult Service Welcome to the Division of Cardiology at Georgetown University Hospital. We are happy you have decided to spend this month working as a part of our team. Our primary mission each month is two-fold. First, we strive to provide superb care to our patients -- whether in the hospital, the outpatient clinic, or in our non-invasive or catheterization laboratories. Second, we work to help all of our trainees (students, residents, and fellows) develop the competencies required to provide excellent cardiovascular care to their patients in an increasingly independent manor. We believe these two pursuits are complementary and are of equal and highest priority. Enclosed you will find educational goals for the cardiology consult service rotation and descriptions of the progress toward these goals that is appropriate for each year of your residency. The faculty and fellows in our division are committed to helping you achieve these educational goals, both during your focused time with us and throughout your training. We look forward to a productive and enjoyable month. Additionally, you are welcome to join us for additional time whenever the opportunity arises. This includes attendance at our weekly Cardiac Catheterization Conference every Wednesday (7:30 – 9:00) and weekly ECHO Cardiology Conference Thursday (7:45 – 9:00) and our Journal Club every Monday (12:00 – 1:00pm).
  2. 2. The Principal educational goals for the Cardiology Rotations are listed by ACGME core competencies. Learning Venues: 1. Direct patient care: supervised by attending physician 2. Management Rounds with Consult team 3. Cardiology Specialty Conferences: Nuclear Cardiology, ECHO, cath conference 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 undiagnosed chest pain, including the 1 appropriate use of diagnostic testing. Effectively evaluate and manage selected interesting patients who have 3,4,5 undergone interventional 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) 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 Progressive management goals for Cardiovascular Medicine rotation: PGY1 Interns should be expert in the collection, organization, and presentation of the data necessary for the daily management of patients. They should be expert and totally reliably in enacting the management plans of the patients for whom they are responsible. They should be able to independently direct a team providing Advanced Cardiac Life Support. They should demonstrate initial competency in the physical examination of the cardiovascular system, in the reading of electrocardiograms and chest radiographs, and in the interpretation of laboratory values (including cardiac biomarkers, BNP levels, lipid profiles, and right heart cath data). They should have a solid understanding of the diagnosis and management of common cardiovascular conditions (including chronic and acute myocardial ischemia, valvular heart disease, acute decompensated heart failure, atrial fibrillation, and malignant ventricular arrhythmias). They should have an initial level of competency in selecting methods for stress testing. PGY2 Second Year Residents should be proficient in the aforementioned responsibilities. They should be expert in directing a team providing Advanced Cardiac Life Support. They should demonstrate the ability to independently perform a reliable and accurate physical examination of the cardiovascular system, and begin to correlate exam findings with echo and cath data. They should be able to independently interpret more common findings on electrocardiograms, chest radiographs, and laboratory studies (including cardiac biomarkers, BNP levels, lipid profiles, and right heart cath data), and demonstrate initial competency in interpreting less common findings. They should be able to independently diagnose and manage common cardiovascular conditions (including chronic and acute myocardial ischemia, valvular heart disease, acute decompensated heart failure, atrial fibrillation, and malignant ventricular arrhythmias), and have a solid understanding of less commonly encountered cardiovascular diseases. They should be able to independently select appropriate methods for stress testing. They should demonstrate initial competency in reading echocardiograms, right heart pressure tracings, and coronary angiograms. PGY3 Senior Residents should be proficient in the aforementioned responsibilities. They should be expert in the physical examination of the cardiovascular system, and be able to correlate exam findings with echo and cath data. They should be expert in the interpretation of more common finding on electrocardiograms, chest radiographs, and laboratory studies (including cardiac biomarkers, BNP levels, lipid profiles, and right heart cath data), and they should be able to independently interpret many less common findings. They should be expert in the diagnosis and management of common cardiovascular conditions (including chronic and acute myocardial ischemia, valvular heart disease, acute decompensated heart failure, atrial fibrillation, and malignant ventricular arrhythmias), and be able to independently diagnosis and manage many less commonly encountered cardiovascular diseases. They should be expert in the selection of appropriate methods for stress testing. They should demonstrate a significant level of competency in reading echocardiograms (including the assessment of LV/RV function, severe valvular disease, tamponade, etc), right heart pressure tracings, and coronary angiograms. They should have an initial level of competency in performing stress testing and reading nuclear perfusion images.

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