Pulmonary Curriculum

Department: Internal Medicine

Faculty Coordinator: Wyatt Rousseau, M.D.

Hospital: Texas Health Presbyterian Hospital Dallas

Offered: All

Length of Rotation: 4 weeks

Max no. of residents: 1

First Day Contact: Dr. Rousseau (214) 361-9777

First Day Time: 7:30 a.m.

First Day Place: 8220 Walnut Hill Lane, Suite 408, Dallas, TX

Weekends: 2 weekends/month

Vacation: 1 week

1. Course Description:

Residents will be integral members of a team participating in providing comprehensive subspecialty consultations for inpatients with pulmonary diseases.

2. Course Goals and Objectives: (based on ACGME competencies for resident education and modified for medical student education)

Patient Care:

Residents, together with supervising faculty, must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotions of health.

Residents are expected to:

• Gather essential and accurate information for their patients. Examples: History (including record review), physical examination and results of pertinent tests for patients with abnormal pulmonary function tests, dyspnea, respiratory failure, pneumonia.

• Make informed recommendations about diagnostic and therapeutic interventions based on patient information and preference, up-to-date scientific evidence, and clinical judgment. Examples: Patients with lung masses, chest pain and interstitial lung diseases.

• Counsel and educate patients and their families. Examples: Risk of smoking in relation to emphysema and cancer.

• Provide health care services aimed at preventing health problems or maintaining health. Examples: To prevent pneumococcal pneumonia and influenza, screening for lung cancer.

• Work with health care professionals, including those from other disciplines, to provide patient-focused care, develop and carry out patient management plans. Examples: Respiratory therapy consultation for patients requiring frequent inhaled medications, pharmacy and nursing consultations for patients requiring chronic anticoagulation.

• Use information technology to support patient care decisions and patient education. Example: Provide patients with pamphlets and information on how to access web sites pertaining to their disease.
  

Residents must demonstrate knowledge about established biomedical and clinical sciences and the application of this knowledge to patient care.

Residents are expected to:

• Demonstrate an analytic thinking approach to clinical situations. Examples: Recognize different patterns of spirometric data and provide a differential diagnosis for the same; recognize epidemiological factors that predict the cause of lung diseases.

• Know and apply the basic and clinically supportive sciences that are appropriate to their discipline. Examples: Genetics of alpha-1 antitrypsin deficiency, mechanisms of drug and toxin induced lung diseases.
  
  

Practice-Based Learning and Improvement:

Residents must be able to assimilate scientific evidence and improve their patient care practices.

Residents are expected to:

• Locate and assimilate evidence from scientific studies related to their patients’ health problems. Example: Randomized controlled trials for treatment of sepsis.

• Use information technology to manage information, access on-line medical information; and support their own education. Example: Use Clinical Data Repository to provide summary course of pulmonary function test abnormalities in patients with acute and chronic lung disease.
  
  

Residents must be able to demonstrate interpersonal and communication skills that result in effective information exchange and teaming with patients and their families.

Residents are expected to:

• Use effective listening skills and elicit and provide information using effective nonverbal, explanatory, questioning, and writing skills. Example: Educating patients regarding the cause and progression of smoking related obstructive lung disease, providing appropriate information regarding prognosis to patients with interstitial pulmonary fibrosis or lung cancer.

• Work effectively with others as a member of a health care team.
  
  

Residents must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.

Residents are expected to:

• Demonstrate respect, compassion, and integrity; a responsiveness to the needs of patients that supercedes self interest; accountability to patients and the profession; and a commitment to excellence and on-going professional development. Example: Willingness to seek additional patients for evaluation. Willingness to stay with critically ill patient until stable.

• Demonstrate a commitment to ethical principles pertaining to provision or withholding of clinical care, and confidentiality of patient information.

• Demonstrate sensitivity and responsiveness to patients’ culture, age, gender, and disabilities.
  
  

Residents must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.

• Understand, access and utilize the resources, providers and systems necessary to provide optimal care.

• Understand the limitations and opportunities inherent in various practice types and delivery systems, and develop strategies to optimize care for the individual patient.

• Apply evidence-based, cost-conscious strategies to prevention, diagnosis, and disease management.

• Collaborate with other members of the health care team to assist patients in dealing effectively with complex systems and to improve systematic processes of care.
  

III. Methods of instruction:

1. Didactic (schedule, topic, faculty)

Daily residents conference 12:00-1:00 p.m. - IM Training Room
Wednesday mornings 7:30-8:00 a.m. - Clinical Grand Rounds - IM Training Room
Wednesday afternoons 12:15-1:00 p.m.- IM Update - Haggar Hall

2. Clinical