General Resident Expectations: Difference between revisions
(Created page with "==Resident Expectations== ===History Taking=== R1 – thorough R2 – more focused R3 – targeted ===Physical Exam=== R1 – thorough R2 – more focused (i.e.: more perti...") |
|||
Line 111: | Line 111: | ||
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) | ||
[[Pediatric Resident Expectations|Pediatric Resident Expectations Main Page]] |
Revision as of 13:08, 20 November 2020
Resident Expectations
History Taking
R1 – thorough
R2 – more focused
R3 – targeted
Physical Exam
R1 – thorough
R2 – more focused (i.e.: more pertinent to chief complaint), increased reliability (consistent findings to preceptor)
R3 – targeted, reliable
Patient Interaction
Exam Interaction
R1 –order exam in an opportunistic way; observing child during history taking and parent child interactions; learning pleasant distraction techniques
R2 – increased comfort of above
R3 – comfortable with above
Verbal Patient Instructions/Education
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)
R2 – Basic education without supervision as well as more in depth topics (i.e. well child anticipatory guidance)
R3 – Proficient in education of complicated medical problems and well child anticipatory guidance with family demonstrating clear understanding
Presentation
R1 – full, with assistance
R2 – more focused, some assistance
R3 – targeted, independent
Interpretation of Data – labs, radiology, EKG
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
R2 – improved proficiency in evaluation of data without preceptor supervision
R3 – proficient evaluation
Documentation
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
R2 – more focused. ++ HPI/+DD/++A&P
R3 – pertinent positive and negative information in HPI with clear assessment and plan with appropriate diagnosis +HPI/+DD/+++A&P
Time Management
Prioritization
R1 –learning to rank tasks appropriately for individual patients and between patients (i.e. depart completed prior to completing note)
R2 – ranking tasks appropriately with some preceptor support
R3 – autonomously ranking and accomplishing tasks appropriately
Multitask
R1 – develop awareness of multiple tasks and determine order of completion for maximum efficiency in clinic
R2 – completing multiple tasks for maximum clinic efficiency with preceptor support
R3 – autonomously completing multiple tasks for maximum clinic efficiency
Ability to utilize ancillary staff
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)
R2 – utilizing appropriately with some preceptor input
R3 – proficient and autonomous utilization of ancillary staff
Patients a day
R1 – 6-7
R2 – 10-12
R3 – 14-16
Guideline Practice (National and Local)
R1 – be familiar with existence of national and local guidelines for common conditions
R2 – improved utilization of guidelines
R3 – proficient with utilization of guidelines and documentation in notes justification if deviated from guidelines
Autonomy
R1 – with help, direct supervision with every patient
R2 – less help; review all patients and go in on complicated
R3 – relatively independent; review all patients and go in on patients when requested
Medical Knowledge
Developmental Milestones
R1 – utilizing charts
R2 – memorizing charts
R3 – knowing and utilizing in practice efficiently
Immunization Schedule
R1 – utilizing charts
R2 – memorized charts for routine schedule
R3 – memorized routine schedule and knowing how to use catch up
Health Maintenance
R1 – learning schedules for preventative care
R2 – memorized schedules for preventative care
R3 – special needs preventative care, Down’s
Procedures (Track Procedures)
R1 – direct supervision
R2 – indirect supervision
R3 – independent with help as needed
Differential Diagnosis
R1 – complete with appropriate justification for likelihood of diagnosis and developing ability to choose most likely diagnosis
R2 – focused and relevant
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)