GOALS &OBJECTIVES - SATIN



CanMeds Goals & Objectives- Community Rotations

1) Contents

Community Radiology Rotation (SMH) 3

Program Goals: 3

Specific Objectives: 3

Medical Expert 3

Communicator 3

Collaborator 3

Leader 3

Health Advocate 4

Scholar 4

Professional 4

Schedule 4

Expected case volumes (depending on specific daily rotation) 4

Attending Staff Radiologists: 4

2) Community Radiology Rotation- Lakeshore General Hospital 5

Program Description: 5

Program Objectives: 5

Medical Expert 5

Communicator 5

Collaborator 5

Leader 5

Heath Advocat 5

Scholar 5

Professional 6

Program Structure 6

Orientation 6

Schedule 6

Clinical Responsibilities 6

Call Duties 6

Quality Improvement 6

Performance Metrics 6

Report Metrics 6

Stress and Fatigue Screening 7

Resident Evaluation 7

References 7

Preparation Material 7

Department Information 7

3) Community Radiology Rotation (LACHINE HOSPITAL) 8

Program Goals: 8

Specific Objectives: 8

Medical Expert 8

Communicator 8

Collaborator 8

Leader 8

Health Advocate 9

Scholar 9

Professional 9

Schedule 9

Expected case volumes (depending on specific daily rotation) 9

Attending Staff Radiologists: 9

Community Radiology Rotation (SMH)

Resident Level: PGY 4 or 5

Program Goals:

▪ This Community Radiology elective will provide the trainee with the opportunity to experience life in a typical University-associated General Diagnostic Radiology practice, and prepare for eventual practice after completion of residency. It is a senior rotation, with significant independence and responsibility.

▪ The resident shall be a valuable member of the patient care team, providing expert knowledge related to indications, contra-indications and limitations of various imaging modalities and interventional procedures.

Specific Objectives:

Medical Expert

▪ Knowledge of common pathologies in MSK, Neuro/ENT, GI/GU, Chest and Gynecology including most appropriate imaging modality for pathologies

▪ Safely plan and perform interventional procedures: ex. thoracentesis, paracentesis, ultrasound-guided biopsies, CT or US guided abscess drainage, arthrography, etc.

▪ Be familiar with contraindications for CT, MRI, and administration of IV contrast in different patient populations (elderly, renal failure, pregnant, known contrast-induced allergic reaction, etc.)

▪ Be able to manage minor and major contrast-induced allergic reactions

▪ Be able to field questions from CT and MRI technologists regarding specific problems that arise throughout the workday re: uncooperative patient, determining study protocol, prioritizing ER and inpatient study requests, etc.

▪ Participate in clinical-radiological conferences (Tumor Board or Respiratory Medicine Rounds)

Communicator

▪ Produce succinct, accurate and timely reports.

▪ Effectively communicate with referring physicians; with particular attention to timely transmission of life-threatening findings and unexpected significant findings.

▪ Effectively communicate study protocol with technologists

▪ Be able to consent a patient for a diagnostic study or interventional procedure

Collaborator

▪ Demonstrate adequate consultation skills when interacting with other physicians & health team members

▪ Interact appropriately with other radiology departmental staff (technologists, nurses), demonstrating a team-based approach to managing patients.

▪ Participate in clinical-radiological conferences (Tumor Board or Respiratory Medicine Rounds)

Leader

▪ Be able to field questions from CT and MRI technologists regarding specific problems that arise throughout the workday re: uncooperative patient, determining study protocol, prioritizing ER and inpatient study requests, etc

▪ Be able to manage minor and major contrast-induced allergic reactions

▪ Utilize information technology to optimize patient care.

▪ Consider advantages and disadvantages of various available imaging modalities, and advise consultants accordingly.

▪ Demonstrate awareness of the indications for various interventional modalities

▪ Consider advantages and disadvantages available of operative versus interventional techniques.

▪ Consider available imaging resources when planning and recommending patient care, using them effectively and efficiently.

Health Advocate

▪ Recognize and consider consent issues, patient comfort and other patient-related issues, when participating or recommending imaging procedures.

▪ Recognize and consider radiation doses when recommending, approving and performing diagnostic or interventional cases

▪ To demonstrate knowledge and awareness of radiation protection

Scholar

▪ Develop, implement and monitor a personal continuing education strategy.

▪ Critically evaluate information and its sources, and apply this appropriately to practice decisions

▪ Contribute to continuing medical education within the Radiology department through a short case presentation

Professional

▪ Deliver the highest quality care with integrity, honesty and compassion.

▪ The patient must be respectful in interactions with all members of the patient care team

▪ Demonstrate awareness of one’s own limitations.

Schedule

Resident will rotate through four different assignments:

▪ CT

▪ MRI

▪ Ultrasound

▪ Procedures and Plain Films

Expected case volumes (depending on specific daily rotation)

▪ CT: approx. 30-40/day

▪ MR: 10-12/day, depending type of study

▪ Xrays: 20-30/day

▪ Ultrasound: 60-70/day

▪ Procedures: 8-10/day

Attending Staff Radiologists:

▪ Dr. Jeremy O’Brien (Coordinator)

▪ Dr. Jack Glay

▪ Dr. Vitaly Sygal

▪ Dr. Fadi Habbab

▪ Dr. Helene Guilbeault

▪ Dr. Edouard Yeghiyan

Updated: February 2017

Community Radiology Rotation- Lakeshore General Hospital

Program Description:

The community radiology elective at Lakeshore General Hospital (LGH, part of the west-island CIUSSS) offers residents the opportunity to practice their role as radiologists in a non-academic practice. In keeping with the graded responsibility model of medical education, it is an important if not necessary step for transitioning from supervised to independent radiology practice.

The emphasis of this rotation is mainly on performance assessment and improvement and less on didactic teaching offered in academic residency programs. Residents are challenged to balance clinical service and productivity with utilization optimization and quality improvement in a high-volume, fast paced community hospital.

This setup will allow residents to gauge their, their preparedness for external moonlighting, and may assist in career decision making. The resident will have the opportunity to critically appraise and improve all aspects of department operations. Such full immersion is an exercise in self- and inter-personal management skills and an introduction to basics of radiology leadership.

The program is only available to PGY5 residents.

The program is a requisite for future moonlighting at this institution.

Program Objectives:

The program seeks to challenge and improve the following CANMEDS competencies:

Medical Expert

▪ Understanding of appropriate case management/ follow-up

Communicator

▪ Inter-professional relationships with other physicians

▪ Communication with other allied health professionals

▪ Production of succinct, well organized and structured report

Collaborator

▪ Establishing good relationship with peers, other health care professionals, and recognizing their expertise

▪ Collaborating effectively with other team members

Leader

▪ Organization of daily work & time management

Heath Advocat

▪ Recognition of when investigations would be detrimental

Scholar

▪ Being current with medical literature (specifically regarding follow-up of incidental findings)

Professional

▪ Integrity & honesty

▪ Compassion and empathy

▪ Recognition of own limitations, seeking advice when needed

▪ Understanding principles of ethics, applied to clinical situations

Program Structure

Orientation

▪ First day: 8am – 12 pm

o Visiting the facilities & meeting the personnel

▪ First day: 1pm – 4pm

o RIS, PACS, Reporting Standards, Metrics, QA

Schedule

▪ 2 days / week: ER CT & MRI

▪ 1.5 days / week: US

▪ 1 day / week: Outpatient CT & MRI

▪ 0.5 day/Week: Administration, Metrics, QI

Clinical Responsibilities

▪ Timely and accurate reporting

o Structured reporting based on department templates

o Objective, concise reporting

o Actionable diagnosis, limited differential diagnosis if applicable

o Standard follow-up guidelines and recommendations

▪ Critical results communication and documentation

▪ Utilization optimization; first call on protocols & study prioritization

▪ Technologist support

Call Duties

▪ One week: Monday to Monday

▪ First call, on pager or cell phone

▪ Weekday home call starts at 5pm

▪ Weekend on-site call from 8am-12pm

▪ Weekend home call starts at 12pm

Quality Improvement

▪ Radiologist Peer Review

▪ Tech QI

▪ Completion of one departmental QI project

Performance Metrics

▪ Daily case load

Report Metrics

▪ Preliminary report generation time

▪ Final report turnaround time

▪ Final report sign-off time

▪ Backlog Statistics

Stress and Fatigue Screening

▪ Two time points: 1-2 month before & at end of rotation

▪ Perceived Stress Scale (PSS)

o

▪ Samn-Perelli Seven-Point Fatigue Scale (SPS)

o

Resident Evaluation

▪ Case readout using RADPEERTM

▪ 360o evaluations at mid and end rotation by:

▪ Radiologists

▪ Hospital physicians

▪ ER

▪ Technologists

▪ Department Personnel

▪ Mid-rotation meeting with LGH community rotation program director

▪ End-rotation meeting with LGH community rotation program director

▪ Rotation Evaluation

▪ Rotation Report

References









Preparation Material

▪ Report templates

▪ Follow-up guidelines

Department Information

Chair: Dr. Fadi Aris

Attending Staff Radiologists:

Dr. Fadi Aris

Dr. Khashayar Rafat Zand

Dr. Dorota Stasiak

Community Radiology Rotation (LACHINE HOSPITAL)

Resident Level: PGY 4 or 5

Program Goals:

▪ This Community Radiology elective will provide the trainee with the opportunity to experience life in a typical University-associated General Diagnostic Radiology practice, and prepare for eventual practice after completion of residency. It is a senior rotation, with significant independence and responsibility.

▪ The resident shall be a valuable member of the patient care team, providing expert knowledge related to indications, contra-indications and limitations of various imaging modalities and interventional procedures.

▪ Expose the trainee to a French speaking environment.

Specific Objectives:

Medical Expert

▪ Knowledge of common pathologies in MSK, Neuro/ENT, GI/GU, Chest and Gynecology including most appropriate imaging modality for pathologies

▪ Safely plan and perform interventional procedures: ex. thoracentesis, paracentesis, ultrasound-guided biopsies, PICC line CT or US guided abscess drainage, arthrography, etc.

▪ Be familiar with contraindications for CT, MRI, and administration of IV contrast in different patient populations (elderly, renal failure, pregnant, known contrast-induced allergic reaction, etc.)

▪ Be able to manage minor and major contrast-induced allergic reactions

▪ Be able to field questions from CT and MRI technologists regarding specific problems that arise throughout the workday re: uncooperative patient, determining study protocol, prioritizing ER and inpatient study requests, etc.

▪ Provide an expert opinion about management of pathologies diagnosed by imaging

Communicator

▪ Produce succinct, accurate and timely reports.

▪ Effectively communicate with referring physicians; with particular attention to timely transmission of life-threatening findings and unexpected significant findings.

▪ Effectively communicate study protocol with technologists

▪ Be able to consent a patient for a diagnostic study or interventional procedure

Collaborator

▪ Demonstrate adequate consultation skills when interacting with other physicians & health team members

▪ Interact appropriately with other radiology departmental staff (technologists, nurses), demonstrating a team-based approach to managing patients.

Leader

▪ Be able to field questions from CT and MRI technologists regarding specific problems that arise throughout the workday re: uncooperative patient, determining study protocol, prioritizing ER and inpatient study requests, etc

▪ Be able to manage minor and major contrast-induced allergic reactions

▪ Utilize information technology to optimize patient care.

▪ Consider advantages and disadvantages of various available imaging modalities, and advise consultants accordingly.

▪ Demonstrate awareness of the indications for various interventional modalities

▪ Consider advantages and disadvantages available of operative versus interventional techniques.

▪ Consider available imaging resources when planning and recommending patient care, using them effectively and efficiently.

Health Advocate

▪ Recognize and consider consent issues, patient comfort and other patient-related issues, when participating or recommending imaging procedures.

▪ Recognize and consider radiation doses when recommending, approving and performing diagnostic or interventional cases

▪ To demonstrate knowledge and awareness of radiation protection

Scholar

▪ Develop, implement and monitor a personal continuing education strategy.

▪ Critically evaluate information and its sources, and apply this appropriately to practice decisions

▪ Contribute to continuing medical education within the Radiology department through a short case presentation

Professional

▪ Deliver the highest quality care with integrity, honesty and compassion.

▪ The patient must be respectful in interactions with all members of the patient care team

▪ Demonstrate awareness of one’s own limitations.

Schedule

Resident will rotate through four different assignments:

▪ Inpatient/procedure shift (Emergency/Inpatients CT scan, Ultrasound, Xray, MRI, plain films & fluoroscopy)

▪ Outpatient shift (Outpatient CT scan, Xray, MRI, plain films)

Expected case volumes (depending on specific daily rotation)

▪ CT: approx. 30-40/day

▪ MR: 10-12/day, depending type of study

▪ Xrays: 40-60/day

▪ Ultrasound: 20-25/day

▪ Procedures: 10-15/day

Attending Staff Radiologists:

▪ Dr. Ali Bessissow (coordinator)

▪ Dr. Alfred Leblanc

▪ MUHC attending rotating at Lachine Hospital

Updated: May 2018

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McGill

Department of Diagnostic Radiology

Département de Radiologie Diagnostique

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