Scope of Practice s1

Scope of Practice

UNIVERSITY OF SOUTH FLORIDA DEPARTMENT OF NEUROSURGERY AND BRAIN REPAIR COMPLEX/MINIMALLY INVASIVE SPINE FELLOWSHIP JUAN S. URIBE, M.D., DIRECTOR

This document pertains to the Complex/Minimally Invasive Spine Fellowship rotation at Tampa General Hospital. This program is part of the resident training program in the Department of Neurosurgery and Brain Repair at the University of South Florida. All ACGME and JCAHO guidelines pertaining to graduate medical education apply to this rotation.

In keeping with ACGME and JCAHO guidelines, the faculty and program director are responsible for providing the spine fellow with direct experience in progressive responsibility for patient management. All patient care at TGH provided by the spine fellow will be provided under direct or indirect faculty supervision. Supervision must be documented in the medical record in accordance with Department of Neurosurgery and Brain Repair at the University of South Florida compliance guidelines.

Activities performed with indirect supervision require access to the supervisory physician for communication and physical access within 30 minutes. Activities performed with direct supervision require presence of the supervisory physician. Fellows are authorized to perform any activity assigned while under direct supervision. Final interpretation of all diagnostic and therapeutic studies requires direct supervision. The spine fellows at their post residency year of training, while not limited to the following activities, are specifically allowed to do these without direct supervision. This document may be modified by the program director based on additions to the training program.

Spine Fellow WITH Indirect Supervision The Fellow Shall: 1) Participate as an integral part of a multi-disciplinary spine surgical team 2) Perform clinical and basic research focusing on development of innovative surgical approaches or the refinement of existing approaches supported by cadaveric dissection in the USF Microsurgical Laboratory. 3) Prepare and publish peer-reviewed articles and solicited writings and will complete an analysis and publication of clinical cases and series. 4) Serve as faculty for the practical courses given annually for the AANS and CNS. 5) Participate in the management of critical, and non-critical care of patients 6) Regularly attend all conferences, journal clubs and all other department meetings/conferences. 7) Perform the designated duties/responsibilities of the PGY 7 Chief resident. 8) Select appropriate articles for presentation at the monthly journal club meeting 9) Share in the call responsibilities with the Chief residents 10) Document all surgical case procedures for fellowship file 11) The spine Fellow will serve as a leader of the spine team through exemplifying the following core competency requirements:

Clinical Care Requirements

 Demonstrate the highest level of patient care skills, problem solving skills and technical skills  Become proficient in the complete management of neurosurgical patients with disorders of the spine.  Demonstrate a high level of multi-tasking for administrative, academic, and clinical endeavors  Manage and administrate the spine neurosurgical team in conjunction with residents 1 Scope of Practice Skills Requirements  The Fellow will be expected to be familiar with open microsurgical as well as endoscopic surgical techniques and approaches.  The Fellow will be expected to be familiar with reconstruction techniques including: skull base defect reconstruction, and cranial nerve anastomosis

Medical Knowledge

 Demonstrate ability to teach effectively  Manage and lead the spine conference  Assist program director in overseeing personal, academic and clinical growth and development of junior residents  Participate actively and lead conferences in a manner that demonstrates a high level of global awareness regarding clinical neurosurgery, applied research, an understanding of the literature, neurosurgical education and program building

Practice-Based Learning and Improvement

 Manage and administrate the quality improvement program for the neurosurgical service  Demonstrate application of evidence-based medical practice  Demonstrate knowledge of current neurosurgical literature  Apply knowledge to clinical practice

Interpersonal and Communication Skills

 Demonstrate a high level of interpersonal communication skills within the neurosurgical team as well as with patients and their families.  Manage the efficient and effective flow of information between the neurosurgical team and attendings

Professionalism

 Demonstrate a high level of professionalism at all times  Demonstrate a high level leadership skills

Systems-Based Practice

 Demonstrate understanding of legal issues in neurosurgery  Demonstrate a high level of understanding regarding practice types, medical economics and medical politics  Incorporate evidenced-based methodologies on an ongoing basis to the clinical practice of neurosurgery  Practice cost-effective neurosurgery

Spine Fellow WITH Direct Supervision

2 Scope of Practice The Fellow shall:

1) Assist the director in spine surgical cases to enhance and refine his/her knowledge and surgical skills. 2) Review all diagnostic and therapeutic studies with the spine fellowship director 3) Assist and instruct junior residents in the preparation process of cadaveric specimens for onsite simulation courses.

Teaching Staff

Juan S. Uribe, M.D.

______Signature: Fernando L. Vale, M.D. Professor, Vice Chair, Program Director, Fellowship Director

Updated 6-29-12