The Department of Anesthesiology & Perioperative Medicine Faculty of Medicine Queen’S University
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Department of Anesthesiology, Queen’s University Residency Program Goals, Objectives and Evaluation Page 1 of 187 THE DEPARTMENT OF ANESTHESIOLOGY & PERIOPERATIVE MEDICINE FACULTY OF MEDICINE QUEEN’S UNIVERSITY POSTGRADUATE EDUCATION PROGRAM IN ANESTHESIOLOGY GOALS AND OBJECTIVES MANUAL Revised October 15, 2014 Department of Anesthesiology, Queen’s University Residency Program Goals, Objectives and Evaluation Page 2 of 187 THE DEPARTMENT OF ANESTHESIOLOGY & PERIOPERATIVE MEDICINE FACULTY OF MEDICINE QUEEN’S UNIVERSITY POSTGRADUATE EDUCATION PROGRAM IN ANESTHESIOLOGY GOALS AND OBJECTIVES MANUAL Table of Contents: Section Goals …………………………………………………………………………………I Introduction Objectives for Training in Anesthesiology Terminal Goals of the Training Program in Anesthesiology at Queen’s RCPSC Objectives of Training in Anesthesia CanMEDS 2005 Framework for Physician Competencies Guidelines for Graded Responsibility Concurrent Coverage Objectives of the Postgraduate Program in Anesthesiology: PGY1 Objectives ……………….………………………………………… II Block Rotation Objectives………………………………………………… III Critical Care, NICU, and Medicine Objectives …………………………… IV Block Science Objectives Basic Science ……………………………………………………. V Clinical Science………………………………………………….. VI Ancillary Objectives ……………………………………………………………….. Appendix A Professional Skills Personal Attitudes and Ethics Basic Science Objectives Clinical Science Objectives Department of Anesthesiology, Queen’s University Residency Program Goals, Objectives and Evaluation Page 3 of 187 OVERVIEW OF THE ACADEMIC PROGRAM Below is a schematic presentation of the components of the academic program in Anesthesiology at Queen’s University. Sections I to VI of this manual outline the Goals and Objectives of individual components of the program. In order to become a competent consultant anesthesiologist, a resident must achieve mastery of all the compentencies described herein. Section V (Block Objectives) indications how the residents will be assessed during each block rotation. More details regarding the day-to-day function of the program can be found in the Resident Handbook. A copy of the handbook can be found on the Departmental website: http://meds.queensu.ca/anesthesiology/assets/revised%20resident%20handbook%20FINAL%20update%202009%20Oct.pdf Goals of the Program What Must be Learned How Taught How Evaluated Knowledge Objectives: A. Clinical Experience A. Daily Evaluations (DECs) Skills 1. Basic Sciences B. Reading B. Rotation ITERs Attitudes 2. Clinical Sciences C. Core Program C. Biannual Performance Review 3. Block Objectives D. Simulator Sessions D. Annual Anesthesia Knowledge (defined by 4. CanMEDS 2005 E. Grand Rounds Test (MCQ) CanMEDS 2005 Framework F. Subspecialty Rounds E. Triannual Oral Examinations Framework) G. Journal Club F. Presentations (Grand Rounds, H. Case Mgmt Rounds Resident Research Day, …) I. Visiting Spkeakers G. Teaching Evaluations (Medical J. Resident Retreat School, …) K. PGME Events H. Attendance Records L. Resident Research Day I. Participation in RLB Case M. CanMEDS Portfolio logging N. Conferences & J. Participation in Evaluation of Workshops Teaching Faculty O. Other CME K. Peer (360o) Assessment L. CanMEDS Portfolio M. FITER N. RCPSC Fellowship Examinations Competent Consultant Anesthesiologist Department of Anesthesiology, Queen’s University Section V: Block Rotation Objectives Page 4 of 187 SECTION I GOALS OF THE POSTGRADUATE PROGRAM IN ANESTHESIOLOGY The mandate of the training program is to train and prepare residents to become successful Consultant Anesthesiologists, whether they choose an academic, administrative or community environment. In doing so, we inevitably focus on meeting the educational requirements of the Royal College Specialty Program in Anesthesiology and success at the specialty examinations. The Goals of the resident training program are outlined on pages 1 – 4. The Objectives to meet these Goals during the residency are outlined in Sections II through VII. The resident must be familiar with these Goals and Objectives. They can be used as a guide to learning, and form the basis of both the educational curriculum and the criteria by which resident performance is evaluated. The Medical Expert roles of each clinical domain draw heavily upon the National Curriculum document written by the ACUDA Education committee. This document can be found on the Departmental website. The goals for the postgraduate program in Anesthesiology at Queen’s University conform to those Objectives of Training outlined in the green “General Information” booklet distributed by the Royal College of Physicians and Surgeons of Canada. Terminal goal: The goal of the Queen’s University Postgraduate Anesthesiology program is to incorporate the above goals into the program such that at the end of training the resident will demonstrate excellent skills related to data gathering, use of investigation, clinical judgement and performance of technical procedures. In brief, given a patient presenting for surgery, the resident will elicit a complete database from history and physical examination. Subsequently, appropriate laboratory tests should be chosen and interpreted correctly. Using this information an appropriate plan of anesthetic management will be developed. Further, given an emergency situation, the resident will demonstrate not only appropriate intervention but also appropriate speed of intervention. Once an appropriate plan of management is established, the resident will be able to efficiently and effectively implement that plan in a safe manner, while maintaining vigilence in patient monitoring and adaptability to evolving clinical situations. In order to effect the anesthetic plan, the resident will demonstrate skills in performing technical procedures as outlined below. The resident will: 1. Establish venous access in central and peripheral veins. The resident will know the complications and indications associated with each means of venous access. The resident will perform central pressure monitoring using central venous pressure lines and pulmonary artery catheters. The resident will know the indications, contraindications, and complications of each approach. Establish arterial lines knowing the indications, contraindications, and complications of this procedure. 2. Be an expert in endotracheal intubation in the awake or the anaesthetised patient using the oral or nasal approach with both regular laryngoscopes and fiberoptic devices. The resident will know the indications, contraindications, and complications of each means of intubation. 3. Demonstrate expert skills in alternative airway management equipment and techniques, including emergency cricothyroidotomy. 4. Perform spinal and epidural anesthesia, knowing the indications, contraindications, and complications of each. 5. Perform a variety of peripheral nerve blocks, including those of the brachial plexus, cervical plexus blocks, and intercostal and lower extremity nerves. The resident will know the indications and contraindications for each block. The resident will be able to discuss the complications of each type of block. 6. Perform IV anesthetic blocks, knowing the indications, contraindications and complications of this technique. 7. Perform resuscitations on patients of all age groups using the standards adopted in the A.C.L.S., A.T.L.S., and N.R.P. protocols. 8. Be able to evaluate, set up, and trouble-shoot all anesthetic machinery for safe usage. 9. Be able to interpret correctly the data generated from all clinically used physiologic monitoring devices. Department of Anesthesiology, Queen’s University Section V: Block Rotation Objectives Page 5 of 187 OBJECTIVES OF TRAINING IN ANESTHESIA The Royal College of Physicians and Surgeons of Canada Approved by Education Committee, 2008 DEFINITION Anesthesia is a medical specialty which includes patient assessment and provision of life support, amnesia, and analgesia for both surgical procedures and childbirth; assessment and management of critically ill patients; and the assessment and management of patients with acute and chronic pain. GENERAL OBJECTIVES Upon completion of training, a resident is expected to be a competent specialist anesthesiologist, capable of assuming a consultant's role in the specialty. The resident must acquire a working knowledge of the theoretical basis of the specialty, including its foundations in the basic medical sciences and research. Training must also encompass the provision of anesthesia services for all age groups in varied clinical situations. Performance must, therefore, reflect the anesthesiologist's knowledge of surgery, intensive care and resuscitation, the management of acute and chronic pain and includes assessment and provision of appropriate care of the mother and neonate in obstetrics. The resident must demonstrate a thorough knowledge of how perioperative management should be modified in the presence of concurrent medical problems. The resident must also demonstrate the knowledge, skills and attitudes relating to gender, culture and ethnicity pertinent to Anesthesia. In addition, all residents must demonstrate an ability to incorporate gender, cultural and ethnic perspectives in research methodology, data presentation and analysis. Specifically for Anesthesiology, at the completion of training, the resident will have acquired the following competencies and will function effectively as: MEDICAL EXPERT General Requirements Demonstrate diagnostic and therapeutic skills for ethical and effective patient care. 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