Sleep Medicine Rotation Resident Goals and Objectives

Contact: Robyn Beard 747-7482 Location: Sleep Center – Center 40, Suite 600, 1600 S. Brentwood Blvd Parking: Behind the Center 40 building; turn on Rose and park in the surface lot behind the 2 story lot Arrival Time: Morning Review starts at 7:30 am, clinic starts at 9 or 9:30 am

Educational Purpose  The subspecialty resident will become proficient in the evaluation and management of patients with common sleep disorders.  The subspecialty resident should be familiar with the basics of polysomnogram interpretation.

Core Competencies for this rotation:

Patient Care: Residents are expected to provide patient care that is compassionate, appropriate and effective for the promotion of health, prevention of illness, treatment of disease and at the end of life.

All PGY3/4 • Demonstrate an ability to obtain a comprehensive and accurate history of present illness for commonly encountered sleep disorders.

• Demonstrate general physical examination skills with an emphasis on systems relevant to specific sleep disorders, such as upper airway examination in patients with suspected obstructive sleep apnea syndrome.

• Develop and carry outpatient diagnostic and management plans in association with the supervising sleep medicine physician

• Demonstrate the ability to interpret polysomnography, multiple sleep latency tests and other diagnostic sleep testing.

• Demonstrate the ability to provide a clear, concise note which directly addresses the problems presented by the patient and the questions asked by the referring physician.

• Demonstrate caring and respectful behaviors when interacting with patients.

• Counsel and educate patients and their families regarding sleep disorders, diagnostic procedures and treatments.

• Use information technology to support patient care decisions and patient education

• Demonstrate an ability to work with a variety of health care professionals to provide patient-focused care

• Evaluation methods for this competency: Attending evaluation

Medical Knowledge: Residents are expected to demonstrate knowledge of established and evolving biomedical, clinical and social sciences, and the application of their knowledge to patient care and the education of others.

All PGY 3/4 • Demonstrate a basic knowledge of: a. Fundamental mechanisms of sleep, major theories in sleep medicine, and the generally accepted facts of basic sleep mechanisms b. Chronobiological mechanisms c. Respiratory physiology during sleep and the pathophysiology of sleep apnea. d. Cardiovascular physiology during sleep and how it is affected by sleep apnea. e. Ontogeny of sleep f. Clinical manifestations and pathophysiology of common sleep disorders: Narcolepsy Idiopathic hypersomnia Insomnia Parasomnias Restless legs syndrome Obstructive sleep apnea syndrome Central sleep apnea syndrome Circadian rhythm disorders g. Treatment of common sleep disorders: Treatment approaches for obstructive sleep apnea including CPAP, BiPAP, upper airway surgery, and oral appliances Treatment approaches for insomnia including cognitive behavioral therapies and pharmacological therapy Treatment approaches for parasomnias and circadian rhythm disorders, narcolepsy, idiopathic hypersomnia and restless legs syndrome.

• Demonstrate an ability to include a discussion of recent literature when developing diagnostic and treatment plans for patients.

• Evaluation methods for this competency: Attending evaluation

Practice-Based Learning: Residents are expected to be able to use scientific evidence and methods to investigate, evaluate, and improve patient care practices.

All PGY 3/4 • Apply knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness

• Use information technology to manage information, access on-line medical information and support their own education, and apply this information to their own practice in the diagnosis and management of patients with sleep disorders.

• Demonstrate teaching of students and other health care professionals on the rotation

• Evaluation methods for this competency: Attending evaluation

Interpersonal and Communication Skills: Residents are expected to demonstrate interpersonal and communication skills that enable them to establish and maintain professional relationships with patients, families, and other members of health care teams.

All PGY 3/4 • Demonstrate an ability to develop a therapeutic and ethically sound relationship with patients and their families

• Demonstrate an ability to use verbal and non-verbal skills to communicate effectively with patients.

• Demonstrate effective listening skills

• Work effectively with others as a member of a health care team

• Evaluation methods for this competency: Attending evaluation

Professionalism: Residents are expected to demonstrate behaviors that reflect a commitment to continuous professional development, ethical practice, an understanding and sensitivity to diversity and a responsible attitude toward their patients, their profession, and society

All PGY 3/4 • Demonstrate compassion, respect, integrity and honesty.

• Accept responsibility for direct patient care activities.

• Always act in the best interest of the patient.

• Demonstrate responsiveness to the needs of patients and society.

• Demonstrate accountability to patients, society and the profession

• Demonstrate a commitment to excellence and on-going professional development

• Demonstrate sensitivity to patient’s culture, ethnicity, age, gender, sexual orientation and disability.

• Evaluation methods for this competency: Attending evaluation

Systems-Based Practice: Residents are expected to demonstrate both an understanding of the contexts and systems in which health care is provided, and the ability to apply this knowledge to improve and optimize health care.

All PGY 3/4 • Appraise how their patient care and other professional practices affect other health care professionals, the health care organization, and the larger society

• Practice cost-effective health care and resource allocation that does not compromise quality of care

• Advocate for quality patient care and assist patients in dealing with system complexities.

• Evaluation methods for this competency: Attending evaluation

Revised 03/02/2012

Detailed Directions to the Sleep Center 2nd Floor

The Washington University Sleep Medicine Center is located within the Chase Park Plaza Hotel at Kingshighway and Lindell, approximately 5 blocks north of the Barnes Hospital complex. From Barnes Hospital go north on Kingshighway, there is a stop light at Kingshighway and Lindell, go one block pass the stop light and make a right turn onto Maryland Avenue (Straub’s market will be on your left when you make the right turn). The entrance to the Chase garage is on the right just before you get to the fountain. As you enter the garage pull a ticket that will activate the gate into the garage. Bring the ticket with you so we can validate it and you will not have to pay for parking.

The entrance to the hotel is located on the third level in the garage, if you park on another level take the elevator and press Lobby Entrance on the key pad of the elevator. Upon entering the hotel take the stair down; follow the hallway which will lead you into a large sitting area.

Proceeded through the sitting area, and exit to your left, down two small stairs, cross the small lobby and walk up the ramp. Follow the ramp around until you come to a stone floor, the Sleep Center elevators will be on your left. Take this elevator to the second floor and exit to your left; you will then be at our front desk reception area.

Numbers to call for assistance are: 747-3810, 747-3826, 747-3809

Sharon Klein Administrative and Fellowship Coordinator