JenniferH: /* Differential Diagnosis */

2020-11-21T04:19:53Z

Differential Diagnosis

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	R3 – reliable diagnosis with well justified exclusions of other possible diagnosis (i.e. infant with fever and fussy, explain why not meningitis; or abdominal pain and constipation, why not acute abd/appendicitis)		R3 – reliable diagnosis with well justified exclusions of other possible diagnosis (i.e. infant with fever and fussy, explain why not meningitis; or abdominal pain and constipation, why not acute abd/appendicitis)


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JenniferH at 01:42, 13 January 2017

2017-01-13T01:42:39Z

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JenniferH: Created page with "Resident Expectations 1. History Taking a. R1 – thorough b. R2 – more focused c. R3 – targeted 2. Physical Exam a. R1 – thorough b. R2 – more focused (i.e.: more..."

2017-01-13T01:28:05Z

Created page with "Resident Expectations 1. History Taking a. R1 – thorough b. R2 – more focused c. R3 – targeted 2. Physical Exam a. R1 – thorough b. R2 – more focused (i.e.: more..."

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Resident Expectations

1. History Taking

a. R1 – thorough

b. R2 – more focused

c. R3 – targeted
2. Physical Exam
a. R1 – thorough
b. R2 – more focused (i.e.: more pertinent to chief complaint), increased reliability (consistent findings to preceptor)
c. R3 – targeted, reliable
3. Patient Interaction
a. Exam Interaction
i. R1 –order exam in an opportunistic way; observing child during history taking and parent child interactions; learning pleasant distraction techniques
ii. R2 – increased comfort of above
iii. R3 – comfortable with above
b. Verbal Patient Instructions/Education
i. R1 – Able to give basic education (common childhood illnesses and conditions) after discussing with attending, working on confirmation of parent/family understanding (i.e. closed loop)
ii. R2 – Basic education without supervision as well as more in depth topics (i.e. well child anticipatory guidance)
iii. R3 – Proficient in education of complicated medical problems and well child anticipatory guidance with family demonstrating clear understanding
4. Presentation
a. R1 – full, with assistance
b. R2 – more focused, some assistance
c. R3 – targeted, independent
5. Interpretation of Data – labs, radiology, EKG
i. R1 – methodical evaluation and access resources to help interpret data, be familiar with techniques (i.e. CXR – ABCDE); familiarity with patterns of common conditions or gross abnormal results
ii. R2 – improved proficiency in evaluation of data without preceptor supervision
iii. R3 – proficient evaluation
6. Documentation
a. R1 – SOAP note format; include all aspects of note sections (CC, HPI, ROS, etc, etc); be aware of communication of problem, billing component; more global evaluation of patient and emphasize data gathering. +++HPI/++DD/+A&P
b. R2 – more focused. ++ HPI/+DD/++A&P
c. R3 – pertinent positive and negative information in HPI with clear assessment and plan with appropriate diagnosis +HPI/+DD/+++A&P
7. Time Management
a. Prioritization
i. R1 –learning to rank tasks appropriately for individual patients and between patients (i.e. depart completed prior to completing note)
ii. R2 – ranking tasks appropriately with some preceptor support
iii. R3 – autonomously ranking and accomplishing tasks appropriately
b. Multitask
i. R1 – develop awareness of multiple tasks and determine order of completion for maximum efficiency in clinic
ii. R2 – completing multiple tasks for maximum clinic efficiency with preceptor support
iii. R3 – autonomously completing multiple tasks for maximum clinic efficiency
c. Ability to utilize ancillary staff
i. R1 – become comfortable asking unit clerks and nurses for appropriate help in pt care. Learning to access clinic support staff (case managers, unit clerks, nurses, etc)
ii. R2 – utilizing appropriately with some preceptor input
iii. R3 – proficient and autonomous utilization of ancillary staff
8. Patients a day
a. R1 – 6-7
b. R2 – 10
c. R3 – 14-16
9. Guideline Practice (National and Local)
a. R1 – be familiar with existence of national and local guidelines for common conditions
b. R2 – improved utilization of guidelines
c. R3 – proficient with utilization of guidelines and documentation in notes justification if deviated from guidelines
10. Autonomy
a. R1 – with help, direct supervision with every patient
b. R2 – less help; review all patients and go in on complicated
c. R3 – relatively independent; review all patients and go in on patients when requested
11. Medical Knowledge
a. Developmental Milestones
i. R1 – utilizing charts
ii. R2 – memorizing charts
iii. R3 – knowing and utilizing in practice efficiently
b. Immunization Schedule
i. R1 – utilizing charts
ii. R2 – memorized charts for routine schedule
iii. R3 – memorized routine schedule and knowing how to use catch up
c. Health Maintenance
i. R1 – learning schedules for preventative care
ii. R2 – memorized schedules for preventative care
iii. R3 – special needs preventative care, Down’s
12. Procedures (Track Procedures)
a. R1 – direct supervision
b. R2 – indirect supervision
c. R3 – independent with help as needed
13. Differential Diagnosis
a. R1 – complete with appropriate justification for likelihood of diagnosis and developing ability to choose most likely diagnosis
b. R2 – focused and relevant
c. R3 – reliable diagnosis with well justified exclusions of other possible diagnosis (i.e. infant with fever and fussy, explain why not meningitis; or abdominal pain and constipation, why not acute abd/appendicitis)

General Residency Expectations - Revision history

JenniferH: /* Differential Diagnosis */

JenniferH at 01:42, 13 January 2017

JenniferH: Created page with "Resident Expectations 1. History Taking a. R1 – thorough b. R2 – more focused c. R3 – targeted 2. Physical Exam a. R1 – thorough b. R2 – more focused (i.e.: more..."