Patient care

Goals: The resident will be able to provide compassionate, evidence-based and effective patient care upon completion of the rotation. Residents will develop the ability to diagnose and manage burn injuries of all depths, dimensions, and etiologies.

Objectives/Surgical Resident will:

• Acquire knowledge of patients by obtaining appropriate information via history and physical examination
• Devise diagnostic and therapeutic treatment plans based upon clinical findings, lab reports, and evidenced-based medical strategies
• Partner with ancillary staff and physician extenders to render the best, most compassionate and ethical care possible
• Participate in the education and counsel of patients and their families

Teaching Strategies/Surgical Faculty will:

• Examine patients regularly with residents
• Supervise the resident’s performance of invasive procedures
• Provide an example of ethical, compassionate, and professional behavior when interacting with patients, their families, and other health care team members
• Provide feedback to residents concerning patient care documentation o Devise treatment algorithms with the resident

Evaluation Strategies/Surgical Faculty will:

• Complete the global evaluation form at the end of the rotation
• Verify that resident case logs have been properly entered into the computerized system
• Determine if invasive procedures performed were free of adverse outcomes

Medical Knowledge

Goals: The surgical resident will acquire an understanding of the pathophysiology, diagnosis, and treatment options available for the traumatically injured patient, with particular emphasis on the care of the burn-injured patient.

Objectives/Surgical Resident will:

• Synthesize information in order to formulate an appropriate diagnostic and therapeutic plan.
• Be required to present one detailed lecture on a selected trauma management case during their rotation.
• Be expected to prepare in advance for participation in operative procedures through consultation of operative atlases and standard comprehensive surgical textbooks.

Teaching Strategies/Surgical Faculty will:

• Recommend reading assignments.
• Provide formal and informal didactics related to medical knowledge.
• Outline decision algorithms and decision trees used to establish a diagnosis.

Evaluation Strategies/Surgical Faculty will:

• Complete the end-of-the rotation global rating form
• Practice-Based Learning and Improvement

Best Practices

Goal: Resident patient-care practices will be supported by the best scientific evidence.

Objective: The resident will demonstrate clinical decision-making that is supported by evidence-based medicine (EBM).

Teaching Strategies/Surgical Faculty will: 

• Collaborate with residents to identify EBM electronic sources.
• Diagram commonly-used EBM statistics during didactic and morbidity/mortality discussions.
• Aid the resident in identifying influential EBM citations.

Patient Communication

The resident will incorporate EBM literature into her/his presentations.
The resident will share IBM citations with the health care team.
Interpersonal & Communication Skills

Goal: The resident will develop effective and empathic communication skills with the patient and the patient’s family members.

Objective: The resident will present accurate patient information to members of the health care team and establish a favorable rapport with the patient.

Teaching Strategies/Surgical Resident will:

• Observe the faculty obtain an oral history from the patient.
• Deliver news to a patient/family member with the faculty present and receive faculty feedback.
• Learn how to accurately develop a relevant clinical question in order to request a consult.

Evaluation Strategies/Surgical Faculty will:

• Provide oral and written feedback to the resident during and at the completion of the rotation.

Professionalism

Goal: The resident will demonstrate professionalism by completing all assigned clinical responsibilities, maintaining cultural sensitivity, and ethical standards.

Objective/Surgical Resident will:

• Demonstrate integrity, empathy, respect, high ethical standards, and cultural sensitivity toward all patients and their families.
• Complete all assigned clinical tasks in a prompt manner (i.e. documentation, patient care responsibilities, sign-out).
• Demonstrate ownership, responsibility, and personal accountability in patient care.
• Adhere to ACGME duty hour guidelines. o Attend all regularly scheduled educational sessions unless otherwise excused.
• Adhere to professional and medicolegal standards when confronted with the decision to withhold clinical care.

Teaching Strategies/Surgical Faculty will:

• Model ethical, honest, respectful, empathic, and culturally-sensitive behavior toward all patient and their families.
• Maintain the highest professional standards in their daily practice and interactions.
• Ensure resident attendance at scheduled educational sessions.
• Construct algorithms with the resident when faced with decisions to withhold clinical care.

Evaluation Strategies/Surgical Faculty will:

• Document resident attendance at educational sessions.
• Observe residents interacting with patients and family members, and provide direct and immediate feedback.
• Complete the global evaluations form at the completion of the rotation.

Treatment of chronically injured patients

Goal: The resident will develop an understanding of system integration in the treatment of the traumatically-injured and/or burn-injured patient.

Objective: The surgical resident will make appropriate referrals to extended care and rehabilitation facilities.

Teaching Strategies

• Residents and surgical faculty will jointly outline the steps required to refer patients to extended care and rehabilitation facilities.
• Outline pharmaceutical formulary practices and policies.

Evaluation Strategies/Surgical Faculty will:

• Appraise medication selection.
• Complete the end of the month global rating form.

Resident Responsibilities

• Residents must carry a pager and rotation cell phone, and are expected to respond promptly when paged.
• Residents will perform sign-out rounds daily under the direction of the Trauma Fellow and/or surgical faculty, and in particular, those in the SICU.
• Residents are required to read all assigned readings and to attend all teaching conferences.
• Residents should be familiar with their assigned cases prior to surgery, and will be expected to follow-up all assigned patients post-operatively.
• Resident will partner with physician extenders to ensure that patients receive evidenced-based, quality and compassionate care.
• Residents are expected to communicate effectively with physician extenders to ensure that patients have a scheduled post-operative clinic appointment.
• Residents will adhere to the 80-hour maximum workweek, as required by the ACGME.
• Residents will be assigned burn clinic duties with surgical faculty as dictated by the clinic schedule.
• Residents should request mid-rotation feedback as needed.
• Residents will be assigned operative cases under the direction of the Trauma Fellow and/or surgical faculty at least 24 hours in advance. Each resident is expected to read source information on the technique of the operative procedure or of the disease being treated.
• Residents are expected to report to Hurley Medical Center for morning rounds no later than 7:00am.
• Residents are expected to familiarize themselves with the Health Information System at Hurley Medical Center, and to ensure that all verbal orders are cosigned promptly.
• Residents must adhere to all patient confidentiality policies and HIPAA regulations.

Faculty Responsibilities

• Faculty will be familiar with all facets of burn wound management, and will endeavor to involve the resident in all aspects of both inpatient and outpatient burn care.
• Faculty is expected to provide timely oral and written feedback to the resident.
• Faculty is required to be cognizant of the 80-hour workweek restrictions.