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Clinical Rotations
Abdominal Imaging (GI/GU Fluoroscopy)
Competency-Based Goals and Objectives
by level of training
(Pediatric fluoroscopic imaging G&O are included in the pediatric rotations.)
Rotation One
1. Medical Knowledge
Instrumentation and Protocols
• Basic fluoroscopic instrumentation
• Common fluoroscopic artifacts
• Become familiar with protocols
• Types of oral and intravenous contrast
Bowel
• Normal appearance of the esophagus, stomach, small bowel and colon on fluoroscopic examination
• Common inflammatory conditions of the gastrointestinal tract
• Neoplasms of the gastrointestinal tract
• Perforation/leak: esophagus, post-operative stomach and small bowel
• Normal variants
• Infectious colitis, ischemic bowel and bowel perforation
• Bowel obstructions and underlying etiology
• Intussusception, volvulus, closed loop obstruction, incarcerated hernias, strangulation
Gynecology
• Normal appearance of the uterus and uterine tubes on hysterosalpingography
• Abnormal appearance of the uterus and uterine tubes on hysterosalpingography including complications from pelvic inflammatory disease
Urethra and Bladder
• Normal and abnormal appearance of the urethra on retrograde urethrogram (RUG)
• Normal and abnormal appearance of the urinary bladder and urethra on voiding cystourethrogram (VCUG)
Assessment methods
• Faculty evaluations
• Mock orals
• ACR in-service examination results
2. Patient Care
• Gather essential and accurate clinical information about patients relevant to the interpretation of the examination including correlation with prior radiological studies.
• Communicate effectively and demonstrate caring, respectful behavior when interacting with patients and their families, answering their questions and helping them to understand the image-guided procedure as well as its clinical significance.
• Use information technology to support patient care decisions.
• Perform fluoroscopic examinations such as esophagrams, upper GI series, small bowel follow through series, contrast enemas, video swallow examination, dobhoff tube placement, urethrogram, VCUG
Assessment Methods
• Faculty evaluations
• 360 evaluations
• Mock orals
• Semi-annual review of procedure log
3. Practice-Based Learning and Improvement
• Participate in self-directed learning including outside reading on anatomy and common pathology supplemented with information on emergency/trauma processes.
• Participate in QA/QI activities.
• Use information technology to access on-line medical information, and to facilitate self-directed learning.
Assessment Methods
• Faculty evaluations
• Learning portfolios (learning plan)
• Mock orals
• ACR in-service examination
4. Interpersonal and Communication Skills
• Dictate prompt, accurate and concise radiological reports for basic studies.
• Develop effective communication skills with patients, patients’ families, physicians and other members of the health care team.
• Obtain informed consent for procedures with faculty guidance.
• Promptly communicate urgent, critical or unexpected findings to residents, referring physicians or clinicians and document the communication in the radiological report.
Assessment Methods
• Faculty evaluations
• 360 evaluations
• Formal evaluation of resident dictations documented in resident learning portfolios
5. Professionalism
• Demonstrate integrity, respect and compassion to patients, physicians, staff and other health care professionals.
• Demonstrate positive work habits, including punctuality and professional appearance.
• Demonstrate a commitment to the ethical principles pertaining to confidentiality of patient information.
• Demonstrate a commitment to continuous professional development and lifelong learning through consistent conference attendance and participation.
Assessment Methods
• Faculty evaluations
• 360 evaluations
• Semi-annual review of conference attendance
6. Systems-Based Practice
• Understand how medical decisions affect patient care within the larger system.
• Demonstrate knowledge of and apply appropriateness criteria and other cost-effective healthcare principles to professional practice.
Assessment Method
• Faculty evaluations
Suggested References
• Manual on Fluoroscopic Techniques at workstation
• The Requisites in GI, GU
Rotation Two
1. Medical Knowledge
Bowel
• More complex bowel surgery post-operative appearance
• Uncommon neoplasms of the GI tract
• Barrett’s esophagus
• Rings, webs and strictures
• Polyposis syndromes
• Henoch-Schonlein purpura
• Polyarteritis nodosa
• Systemic lupus erythematosis
• NSAIDS enteritis
• Varices
• Malabsorption
• Sprue
• Lymphangiectasia
• Carcinoid
• Inflammatory conditions of the GI tract
Assessment Methods
• Faculty evaluations
• Mock orals
• ACR in-service
2. Patient Care
• Screen, supervise and perform more complex studies
• Correlate fluoroscopic examinations with cross-sectional imaging such as CT and MRI
Assessment Methods
• Faculty evaluations
• 360 evaluations
• Semi-annual review of procedure log
3. Practice-Based Learning and Improvement
• Participate in self-directed learning with outside reading from the Mayo Clinic Review and the Case Review Series.
• Demonstrate knowledge and the application of the principles of evidence-based medicine in practice.
• Participate in QA/QI activities.
Assessment Methods
• Faculty evaluations
• Learning portfolios (learning plan)
• Mock orals
• ACR in-service examination
4. Interpersonal and Communication Skills
• Interact with residents and attending physicians in consultation to enhance clinical radiological correlation.
• Dictate accurate and concise radiological reports for more complex studies with concise impression including diagnosis and/or differential diagnoses
Assessment Methods
• Faculty evaluations
• Direct observation by the faculty
• Formal evaluation of resident dictations documented in resident learning portfolios
5. Professionalism
• Demonstrate responsiveness to the needs of patients that supercedes self-interest (altruism).
• Demonstrate a commitment to continuous professional development and lifelong learning through consistent conference attendance and participation.
Assessment Methods
• Faculty evaluations
• 360 evaluations
• semi-annual review of conference attendance
6. Systems-Based Practice
• Effectively prioritize patients requiring cross-sectional imaging studies.
• Participate in discussions with faculty regarding system challenges and potential solutions regarding radiological service and patient care.
Assessment Method
• Faculty evaluations
Suggested References:
• Mayo Clinic Gastrointestinal Imaging Review by C. Daniel Johnson and Grant D. Schmit
• Case Review Series for GI, GU
• On-line teaching files
A complete list of GI/GU learning objectives is included in the Abdominal Imaging G&O.
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