Educational Objectives National Guidelines: Family Medicine - Emergency Medicine Residency Programs Editor-In-Chief Dr. Duncan S. Mackey University of Alberta Associate Editor Dr. Ivan P. Steiner University of Alberta 1 Contributing Authors Dr. Lisa Bryski Dr. James Kellner Dr. May Patton University of Manitoba University of Calgary University of Alberta Dr. Brendan Carr Dr. John King Dr. Colin Peterson Dalhousie University University of Calgary University of Alberta Dr. Ian Casson Dr. Peter Kwan Dr. Claude Piette Queen’s University University of Alberta University of Montreal Dr. Richard Chan Dr. Edward Lang Dr. Michelle Rico University of Alberta McGill University University of Alberta Dr. Jeremy Etherington Dr. Constance Leblanc Dr. Patrick San Agustin University of British Dalhousie University University of Alberta Columbia Dr. John Mackey Dr. Dan Vouriot Dr. James Goulding University of Alberta University of Alberta University of British Columbia Dr. Kevin Martin Dr. Cindy Wong University of Calgary University of Alberta Dr. Debra Hutchinson McMaster University Dr. Julian Marsden Dr. Bernard Unger University of British McGill University Dr. Peter Harasym Columbia University of Calgary Dr. Rajiv Vadera Dr. Karen Mulder McMaster University Dr. Peter Johns University of Alberta University of Ottawa Dr. Philip Yoon Dr. Paticia Murphy University of Alberta Dr. Kevin Johnson University of Alberta University of Calgary Dr. Wesley Orr Dr. Victor Jordan University of British University of Alberta Columbia 2 Introduction The “National Guidelines: Family Medicine - Emergency Medicine Residency Programs” has been developed in order to provide all participants in the educational and accreditation process of family medicine - emergency medicine residency programs with a consistent and simple to use tool. It reflects the work and commitment of family medicine - emergency medicine educators in Canada to provide educational guidelines that are consistent with the philosophy and vision of the College of Family Physicians of Canada. The current objectives have been formatted along the four principles of family medicine and reflect the often stated view by family medicine - emergency medicine educators and care providers that the practice and teaching of acute care medicine is inalienably linked to these guiding principles. The approach to developing these Educational Objectives was guided by educational content regardless of the setting in which the learning takes place and was not clinical rotation oriented.. We believe that this approach will likely make them more suitable for all parties. These National Guidelines should prove to be useful to many. The “Part 1: Terminal Objectives” are summarized into a simple 13 page document. This will assist Program Directors in building terminal objectives for their programs. It can also be a useful and user friendly yet comprehensive tool in the review and credentialing of the family medicine - emergency medicine residency programs for the Assessment and Evaluation Committee of the CFPC. The larger document that follows is called “Part 2: Guidelines for Programs”. This abbreviated “study guide” will allow Program Directors to develop program specific enabling objectives and it also could provide both educators and residents with a guide to core content emergency medicine requirements. This Part 2 may also provide direction and assistance to those individuals on the CFPC’s Emergency Medicine Committee whose responsibility it is to develop exam questions for the national examination. We believe that this document is comprehensive yet minor omissions may have occurred. This tool does not replace standard textbooks for educational purposes. The Educational objectives will allow each program in Canada the latitude to adapt some of the contents to their local specific needs. We would further like to suggest to programs that the task of attaining these objectives by individual residents should be looked at as a full-year work-in-progress. The training of residents takes place in many settings; urban and regional practices as well as off- service rotations in other traditional hospital-based disciplines. Parts of these objectives can be met during all rotations. The ultimate goal should be that by the end of comprehensive training, residents complete all the educational objectives recommended in this document. D.S.M I.P.S 3 PART 1: TERMINAL OBJECTIVES ........................................................ 9 PRINCIPLE NO. 1: THE DOCTOR-PATIENT RELATIONSHIP ....................................................................................................................... 10 COMMUNICATION .................................................................................................... 10 ETHICS AND MEDICOLEGAL ASPECTS OF CARE .............................................. 10 Ethical Problems ....................................................................................................... 10 Medicolegal Principles ............................................................................................. 10 PRINCIPLE NO. 2: THE FAMILY PHYSICIAN AS AN EFFECTIVE CLINICIAN ..................................................................... 10 PRINCIPLES OF EMERGENCY MEDICINE ............................................................ 10 Approach to the Emergency Patient ......................................................................... 10 Anaesthesia Analgesia and Procedural Sedation ..................................................... 11 RESUSCITATION ....................................................................................................... 11 Airway Management ................................................................................................. 11 Breathing................................................................................................................... 11 Circulation ................................................................................................................ 11 Disability ................................................................................................................... 12 Pediatric Resuscitation ............................................................................................. 12 ADULT NON-TRAUMATIC PRESENTATIONS ...................................................... 12 Head Neck and Neuro Presentations ........................................................................ 12 Chest presentations ................................................................................................... 13 Abdominal and Gi presentations .............................................................................. 13 Genitourinary Presentations ..................................................................................... 13 Gynecologic and Obstetric presentations ................................................................. 14 Musculoskeletal and Extremity Presentations .......................................................... 14 Dermatologic Presentations ..................................................................................... 14 Psychiatric Presentations ......................................................................................... 14 General Presentations .............................................................................................. 14 PEDIATRIC NON-TRAUMATIC PRESENTATIONS .............................................. 15 Neonatal Presentations ............................................................................................. 15 Head Neck and Neuro Presentations ........................................................................ 15 Chest presentations ................................................................................................... 15 Abdominal and Gi presentations .............................................................................. 15 Genitourinary Presentations ..................................................................................... 16 Musculoskeletal and Extremity Presentations .......................................................... 16 Psychiatric Presentations ......................................................................................... 16 General Presentations .............................................................................................. 16 TRAUMATIC DISORDERS ........................................................................................ 16 Approach to Multiple Trauma .................................................................................. 16 Principles of Soft Tissue Injuries .............................................................................. 16 Principles of Fracture Management ......................................................................... 17 Special Considerations in Pediatric Trauma ............................................................ 17 Principles of Casting and Splinting .......................................................................... 17 4 Head and Neck Trauma ............................................................................................ 17 Chest and Abdominal Trauma .................................................................................. 18 Upper Limb Injuries .................................................................................................. 18 Lower Limb Injuries ................................................................................................