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Description of Rotation or Educational
Experience
This one-month rotation done in the second year exposes
the residents to ambulatory surgical procedures such as removal of lumps and bumps,
incision and drainage of abscesses, needle aspiration of breast cysts,
removal of foreign bodies, removal of ingrown toenails, and treatment of
chronic skin ulcers. While at the ambulatory surgery center the resident will
spend time in the operating room and the surgical clinic. The resident will
spend three half-days each week in the family practice center for continuity
clinic.
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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
- Receive
training to perform those clinical procedures required for their future
practices in the ambulatory and hospital environments.
- Receive
training that focuses on the core principles of Family Medicine:
including Continuity of Care, Family-Oriented Comprehensive Care
Experience, Family Medicine Center Experience, Patient Care Experience,
FMC Continuity and Accessibility, Medical/Surgical Experiences, and
Inpatient Experiences.
Objectives
By the end of the rotation the resident is expected to:
- Observe
and perform minor surgical procedures under the guidance of the general
surgical or subspecialty surgical faculty member.
- Develop
an understanding of the proper evaluation and preparation of a patient
undergoing surgery in the ambulatory care center at Lakeside.
- Develop
skills in proper surgical technique for minor procedures.
The resident is encouraged to familiarize themselves with
the following procedures:
- Laceration
repair
- Lipoma
removal
- Wound
debridement
- Cyst
aspiration
- local
anesthesia
- Central
line placement
- Wound
closure
- Skin
excision
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
- This
rotation fulfills family medicine-specific training and educational
requirements for Care of the Surgical Patient, with special emphasis on
the diagnosis and management of surgical disorders and emergencies and
the appropriate and timely referral of surgical cases for specialized
care.
Objectives
By the end of the rotation the resident is expected to:
- Learn
about and demonstrate minor surgical techniques.
- Gain
knowledge in pre- and intra- operative recognition of surgical
pathology.
- Develop
the diagnostic skills to know when it is appropriate to refer patients
to a surgeon for treatment.
- Gain
knowledge in identifying and managing incision and wound healing.
- Gain
knowledge in the kinds of surgical treatments that might be employed for
patients as well as their potential risks and complications.
- Become
familiar with the kinds of anesthesia employed, enabling the resident to
provide appropriate advice, explanations and emotional support to the
patients and their families.
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
- Incorporate
formative evaluation feedback into daily practice
- Locate,
appraise and assimilate evidence from scientific studies related to
their patients’ health problems
Objectives
By the end of the rotation the resident is expected to:
- Competently
evaluate and treat post-operative wounds.
- Implement
operating room sterile technique.
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
effectively in various health care delivery settings and systems
relevant to their clinical specialty
- Coordinate
patient care within the health care system relevant to their clinical
specialty
Objectives
Insert a measurable objective for the one or two
competencies you have chosen.
- Evaluate
patients admitted to the Lakeside
Ambulatory Care Center
via a history and physical examination.
- Determine
patient's clinical indications for ambulatory surgery.
Professionalism
Goal
Residents must demonstrate a commitment to carrying out
professional responsibilities and an adherence to ethical principles. Residents are expected to demonstrate:
Competencies
- Responsiveness
to patient needs that supersedes self-interest
- Sensitivity
and responsiveness to a diverse patient population, including but not
limited to diversity in gender, age, culture, race, religion,
disabilities, and sexual orientation
Objectives
By the end of the rotation the resident is expected to:
- Attend
the ambulatory clinic of the general surgeon to evaluate and advise
patients seen for consultation as well as post-operative visits.
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 patients and families across a broad range of
socioeconomic and cultural backgrounds
- Communicate
effectively with physicians, other health professionals, and health
related agencies
Objectives
By the end of the rotation the resident is expected to:
- Discuss
risk, procedures, and follow-up plans with patients in a clear and
effective manner, such that patients understand what will be happening
and what to expect following surgery.
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Assessment Method (residents)
How do you measure the resident’s performance on this
rotation or educational experience? Resident written assessments and real
time feedback are based on the following:
- Knowledge
base of conditions seen during the rotation such as benign and malignant
tumors of the breast and skin, and the management of abscesses.
- Knowledge
of and skill in sterile technique, tissue handling, maintaining
hemostasis, and wound closure.
- Knowledge
of pre- and post-operative care in complicated patients such as those
with diabetes, cardiac disease and hypertension. Understanding potential
complications of surgery such as infection, hematoma, seroma, etc.
- Ability
to communicate with patients, staff and support staff.
- Resident
is to generate self-observed behavior reports in each competency at
least weekly over the course of this rotation.
- Following
this rotation, the resident is expected to achieve 90% post-test score
on the Care
of the Surgical Patient section of the shelf exam.
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