PROCEDURAL COMPETENCY: PULMONARY FUNCTION …



PROCEDURAL COMPETENCY:

PULMONARY FUNCTION TESTING (PERFORM / INTERPRET)

Name: ______________________________________ Date: ______________________________

| |Knowledge Based |Performance of the|Interpretation of |Overall Perform |

| | |test |the test |safely and |

| | | | |competently |

|A/I Fellow verbalizes indications for doing spirometry. | | | | |

|A/I Fellow verbalizes contraindications for doing spirometry. | | | | |

|A/I Fellow explains procedure to the patient. | | | | |

|A/I Fellow asks appropriate questions about medications | | | | |

|and last use. | | | | |

|A/I Fellow demonstrates ability to instruct the patient properly| | | | |

|and perform a pulmonary function test. | | | | |

|A/I Fellow demonstrates ability to calibrate machine. | | | | |

|A/I Fellow demonstrates ability to prepare spirometer for | | | | |

|accurate testing. | | | | |

|A/I Fellow demonstrates ability to interpret pulmonary function | | | | |

|tests: | | | | |

| | | | | |

|#1 (obstructive pattern) | | | | |

|#2 (restrictive pattern) | | | | |

|#3 mixed pattern | | | | |

|#4 poor effort / can’t interpret | | | | |

| | | | | |

| | | | | |

CHECK LEARNING RESOURCES USED:

______ Observation of procedure/review with faculty & staff

______ Lecture(s)

______ Selected readings

______ Problem Based Learning/ Case studies

______ Web based resources

I attest that A/I fellow, _____________________________________________, is considered competent in ordering and interpreting pulmonary function testing in appropriately selected adult and pediatric patients. The fellow meets or exceeds a Level 4 Milestone for this procedure.

Date: _______________________________ Program Director’s signature: ________________________________

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