Description of Rotation or Educational Experience

This is a one month required rotation for the acute care surgical resident. Exposure to cardiothoracic patients and their diseases will occur at University Medical Center. While on this rotation, residents will acquire a broad understanding of the evaluation and management of patients with diseases of the heart, great vessels, chest, lungs, mediastinum and vascular system.

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 and document detailed history, physical exam, and radiographic interpretation in patients with cardiovascular injuries and disease.
• Develop skills for cardiopulmonary support devices.
• Learn the management of empyema thoraces, including tube drainage, VATS drainage, and formal decortication.
• Demonstrate an understanding of indications and treatment of patients needing endovascular prosthesis.
• Develop proficiency in surgical exposures to access cardiovascular injuries and disease.
• Demonstrate proficiency in cardiovascular critical care in the intensive care unit.

Objectives

• Place tube thoracostomy
• Perform video assisted thoracoscopy
• Assist thoracotomy with decortication
• Perform median sternotomy and closure
• Assist endovascular stent placement
• Assist with placement and management of cardiopulmonary assist devices

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 principles of partial and complete heart bypass.
• Understand principles of core re-warming techniques
• Recognize and treat common dysrythmias.
• Appropriately manage vasoactive medications.
• Recognize and treat complications of acute vascular thrombosis including myocardial infarction.

Objectives

• Complete required reading on cardiovascular disease from acute care surgery text.
• Obtain or maintain Advanced Cardiac Life Support certification.

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 and perform appropriate learning activities
• Locate, appraise and assimilate evidence from scientific studies related to their patients’ health problems
• Use information technology to optimize learning

Objectives

• Present cases at weekly departmental morbidity and mortality conference.
• Create PowerPoint presentation on cardiothoracic topic for resident lecture databank.

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

• Coordinate patient care within the health care system relevant to their clinical specialty
• Participate in identifying systems errors and in implementing potential systems solutions

Objectives

• Act as primary consultant to referring physicians.
• Attend and participate in weekly quality assessment/quality improvement meetings.

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
• Accountability to patients, society, and the profession

Objectives

• Perform mandatory HIPAA compliance training for sponsoring institution.
• Obtain satisfactory results on post-rotation evaluation tool.

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 satisfactory score on post rotation evaluation tool regarding communication skills.
• Complete all medical records upon completion of 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.