Description of Rotation or Educational Experience

The Orthopedic rotation is intended to provide the resident with an introduction to the diagnosis and management of orthopedic disorders. The focus of this rotation is on developing the proper thought processes and the basics of history and physical examination as well as the general principles of musculoskeletal diseases, pathology, and their manifestation.

Patient Care

Goal

Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. Residents are expected to:

Competencies

• Perform a history and physical pertaining to the orthopedic elements of the injured patient.
• Treatment of simple and complex fractures, bone infection, and bone neoplasm.
• Use the basic principles and techniques of fracture reduction and stabilization, including casting, external fixation, and internal fixation in the management of orthopedic injury
• Manage degenerative disease with the use of reconstructive procedures.
• Manage complex soft tissue injuries as they relate to the musculoskeletal system.

Objectives

• Participate in the operative repair of major and minor fractures and the procedures of reconstructive surgery; this includes instrument, handling, bone fixation techniques, joint replacement procedures and tendon repairs.
• Use proper plaster technique. This includes application of plaster of Paris casts and special materials. It also includes the technique of removal of casts.
• Participate in the repair of soft tissue injury, and perform selected lower extremity amputations.

Medical Knowledge

Goal

Residents must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as the application of this knowledge to patient care. Residents are expected to:

Competencies

• Understand the Preoperative, operative, and postoperative care of orthopedic surgical patients.
• Demonstrate knowledge of the essentials of fracture management including management of soft tissue injuries and the use and complication of casts and fixation devices.
• Show understanding of the basic principles of:
• Wound healing, bone physiology and bone healing.
• musculoskeletal biomechanics
• amputation surgery and rehabilitation.

Objectives

• Participate in the operative repair of major and minor fractures and the procedures of reconstructive surgery; this includes instrument, handling, bone fixation techniques, joint replacement procedures and tendon repairs.
• Use proper plaster technique. This includes application of plaster of Paris casts and special materials. It also includes the technique of removal of casts.
• Participate in the repair of soft tissue injury, and perform selected lower extremity amputations.

Practice- Based Learning and Improvement

Goal

Residents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and life long learning. Residents are expected to develop skills and habits to be able to :

Competencies

• Identify strengths, deficiencies and limits in one’s knowledge and expertise;
• Incorporate formative evaluation feedback into daily practice
• Locate, appraise and assimilate evidence from scientific studies related to their patients’ health problems

Objectives

• Write an evidence-based literature review discussing a topic in the realm of orthopedic surgery
• Formulate a means of applying mid-rotation constructive criticism provided by an online e-value method of evaluation.

Systems Based Practice

Goal

Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care. Residents are expected to:

Competencies

• Work in interprofessional teams to enhance patient safety and improve patient care quality
• Participate in identifying systems errors and in implementing potential systems solutions

Objectives

• Attend interdisciplinary rounds with nutrition, social services, rehabilitation on a semi-weekly basis.

Professionalism

Goal

Residents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Residents are expected to demonstrate:

Competencies

• Compassion, integrity, and respect for others
• Respect for patient privacy and autonomy
• Accountability to patients, society, and the profession

Objectives

• Obtain a satisfactory score on an online e-value post rotation assessment on a measure compassion
• Complete the HIPAA examination for the medical center.

Interpersonal and Communication Skills

Goal

Residents must demonstrate interpersonal and communication skills that result in the effective exchange of information and teaming with patients, their families, and professional associates. Residents are expected to:

Competencies

• Communicate effectively with physicians, other health professionals, and health related agencies
• Maintain comprehensive, timely, and legible medical records

Objectives

• Obtain a satisfactory score on an online e-value post rotation assessment on a measure communication skills
• Complete all outstanding medical records upon completion of the rotation and complete all eSignatures of procedures performed during the rotation

Teaching Methods

• Attendance of all lectures, conferences and quality improvement meetings.
• Review of assigned reading materials
• Attending preceptorship

Assessment Method (residents)

• Focused observation by faculty staff
• 360 degree evaluation by faculty at end of rotation through e-value system.
• Case log review with program director

Assessment Method (Program Evaluation)

• Using e-value system, rotation is assessed on several qualities including but not limited to value, accessibility, and relevance to practice.
• Outcome on national standardized exams.

Level of Supervision

• Residents are under direct or indirect supervision by faculty staff at all times.

Educational Resources

Miller, Orthopedic Trauma