Anesthesia Curriculum

Department: Anesthesia

Faculty Coordinator: Alan Frankfurt, MD

Hospital: Texas Health Presbyterian Hospital Dallas

Periods offered: Monthly as arranged with department members

Length: 4 Weeks

Max no. of residents: 1

First Day Time: To be arranged with department members

First Day Place: To be arranged with department members

Weekends: None

1. Course Description:

Residents will work under the supervision of board-certified anesthesiologists in a variety of clinical settings. Residents will learn airway management skills and gain experience in placing peripheral and cetral access.

2. Course Goals and Objectives: Residents will have exposure to general anesthesia, conscious sediation, epidural placement and pain management techniques.

Patient Care:

Residents are expected to provide care that is compassionate, appropriate and effective for the promotion of health, prevention of illness, treatment of disease and at the end of life.

• Gather accurate, essential information from all sources, including medical interviews, physical examinations, medical records and diagnostic/therapeutic procedures. Examples: Performing appropriate pre-operative histories and physicals.

• Make informed recommendations about preventives, diagnostic and therapeutic options and interventions that are based on clinical judgement, scientific evidence, and patient preference. Examples: In conjunction with the attending physician, determining appropriate methods of anesthesia for various surgical procedures.

• Develop, negotiate and implement effective patient management plans and integration of patient care. Examples: Working together with surgeons and medical consultants to ensure continuity of care from the pre-operative to post-operative period.

• Perform competently the diagnostic and therapeutic procedures considered essential to the practice of anesthesia. Examples: Successfully intubating patients and placing central venous lines and arterial lines.

Residents are expected to demonstrate knowledge of established and evolving biomedical, clinical and social sciences, and the application of their knowledge to patient care and the education of others.

• Apply an open-minded, analytical approach to acquiring new knowledge. Examples: Asking appropriate questions of the attending physician and attend conferences within the department.

• Access and critically evaluate current medical information and scientific evidence. Examples: Reading relevant journal articles pertianing to the practice of anesthesia.

• Develop clinically applicable knowledge of the basic and clinical sciences that underlie the practice of anesthesia. Examples: Working with the attending physician to translate knowledge obtained from reading and didactics into care at the bedside.

• Apply this knowledge to clinical problem-solving, clinical decision-making, and critical thinking. Examples: Integrating material learned through reading and conference attendance into daily practice of anesthesia.

Residents are expected to be able to use scientific evidence and methods to investigate, evaluate, and improve patient care practices:

• Identify areas for improvement and implement strategies to enhance knowledge, skills, attitudes and processes of care. Examples: Reflecting on areas where improvement is needed with input from the attending physician.
  
  
• Analyze and evaluate practice experiences and implement strategies to continually improve the quality of patient practice. Examples: Practicing continuous self-assessment and seeking feedback from the attending physician.

• Develop and maintain a willingness to learn from errors and use errors to improve the system or processes of care. Examples: Learning from cases with both good and bad outcomes how to provide a higher standard of care in the future.

• Use information technology or other available methodologies to access and manage information, support patient care decisions and enhance both patient and physician education. Example: Being familiar with Epic including entering notes and orders.

Interpersonal and Communication Skills:

Residents are expected to demonstrate interpersonal and communication skills that enable them to establish and maintain professional relationships with patients, families and other members of health care teams.

• Provide effective and professional consultation to other physicians and health care professionals and sustain therapeutic and ethically sound professional relationships with patients, their families, and colleagues. Examples: Working closely with surgeons, internists and other consultants to ensure the highest quality of care for the surgical patient.

• Use effective listening, nonverbal, questioning, and narrative skills to communicate the patients. Examples: Taking time to talk with and listen to the patient in the peri-operative period including answering the patient's questions to the best of one's ability.
  
  
• Interact with consultants in a respectful, appropriate manner. Examples: Knowing when to consult specialists and presenting information to them in a concise and accurate manner.

• Maintain comprehensive, timely, and legible medical records. Examples: Using Epic to input notes and orders to ensure legibility.

Professionalism:

Residents are expected to demonstrate behaviors that reflect a commitment to continuous professional development, ethical practice, an understanding and sensitivity to diversity and a responsible attitude toward their patients, their profession, and society.

• Demonstrate respect, compassion, integrity, and altruism in relationships with patients, families, and colleagues.Examples: Taking time to listen to the concerns of patients and their families in the peri-operative setting.

• Demonstrate sensitivity and responsiveness to the gender, age, culture, religion, sexual preference, socioeconomic status, beliefs, behaviors and disabilities of patients and professional colleagues. Example: Developing an understanding of who the patient is in his/her social and cultural context.

• Adhere to principles of confidentiality, scientific/academic integrity, and informed consent. Examples: Not discussing patient information with those who are not on the care team; ensuring that informed consent is obtained before performing any procedures.

• Recognize and identify deficiencies in peer performance. Examples: This will not apply on this rotaiton as there will only be one resident.

Residents are expected to demonstrate both an understanding of the contexts and systems in which health care is provided, and the ability to apply this knowledge to improve and optimize health care.

• Understand, access and utilize the resources, providers and systems necessary to provide optimal care. Examples: Becoming familiar with the resources available for patients both in the peri-operative period and after discharge.

• Understand the limitations and opportunities inherent in various practice types and delivery systems, and develop strategies to optimize care for the individual patient. Examples: Being aware of various settings in which anesthesia is practiced including hospitals and outpatient surgery centers.

• Apply evidence-based, cost-conscious strategies to prevention, diagnosis, and disease management.Examples: Avoiding unnecessary tests and procedures.

• 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.Examples: Working with nurses, social workers and other health care personnel to ensure patient needs are met during the hospital stay and after discharge.

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. - Grand Rounds - Haggar Hall

Additional anesthesia department conferences to be determined

2. Clinical
   
   Residents are assigned to an anesthesiologist. The resident is expected to work with the anethesiologist in a variety of clinical settings. Residents are expected to attend every noon conference.