Orthopedics (PGY-3)

Description of Rotation or Educational Experience

This six-week rotation is designed to expose the resident to the ambulatory evaluation and management of common non-operative orthopedic problems. The resident can gain a working knowledge of conditions involving the musculoskeletal system including physical exam, diagnosis, treatment, and referral as appropriate.

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 be able to:

• Perform an efficient, complete, and focused examination of the musculoskeletal system
• Perform appropriate utilization of ancillary testing including x-ray, ultrasound, CT and MRI

The resident is encouraged to familiarize themselves with the following procedures:

• Splinting of extremities
• Casting of uncomplicated fractures
• Knee aspiration
• Knee unjection
• Sub acromial bursa injection
• Shoulder injection

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 the family medicine-specific training and educational requirements for Musculoskeletal and Sports Medicine; part of the experience in the care of patients with orthopedic and musculoskeletal problems, including experience in sports medicine.

Objectives

By the end of the rotation the resident is expected to be able to:

• Explain appropriate treatment of simple stable closed and nondisplaced fractures
• Explain appropriate treatment of various sprains and strains
• Discuss various overuse injuries including tennis & golf elbow, rotator cuff disease
• Discuss evaluation and management of acute and chronic low-back pain
• Recognize and explain the pathophysiology of joint pain, swelling, erythema, fractures, dislocations, tendon injuries, bone/joint infections
• Discuss various childhood diseases including Osgood Schlatter's, slipped capital femoral epiphyses, clubfoot, intoeing, genu varum/valgum, and the Salter-Harris classification system
• Discuss indications and contraindications of joint aspiration and injections, splinting, plaster and fiberglass casts

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
• Participate in the education of patients, families, students, residents and other health professionals, as documented by evaluations of a resident’s teaching abilities by faculty and/or learners

Objectives

By the end of the rotation the resident is expected to be able to:

• Work with attending physician on developing treatment plans for these topics listed under medical knowledge.

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
• Incorporate considerations of cost awareness and risk-benefit analysis in patient care

Objectives

By the end of the rotation the resident is expected to be able to:

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
• Respect for patient privacy and autonomy

Objectives

By the end of the rotation the resident is expected to be able to:

• Recognize when orthopedic consultation is appropriate.

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
• Act in a consultative role to other physicians and health professionals

Objectives

By the end of the rotation the resident is expected to be able to:

• Give appropriate discharge instructions for patients requiring splinting and casting.

Teaching Methods

What teaching methods are you using on this rotation or educational experience?

• Didactic lecture
• Direct role-modeling and observation

Assessment Method (residents)

How do you measure the resident’s performance on this rotation or educational experience?

• Faculty evaluations of the rotator’s performance
• Real-time feedback during direct observation
• Resident is to generate self-observed behavior reports in each competency at least weekly over the course of this rotation.

Assessment Method (Program Evaluation)

How do you evaluate whether this educational experience is effective?

• Resident evaluation of rotation

Level of Supervision

How is the resident supervised on this rotation?

· Directly by attending physicians

Educational Resources

List the educational resources

• Relevant orientation materials are indicated and/or given at the beginning of the rotation and used throughout.