Cardiology Curriculum

Department: Internal Medicine

Faculty Coordinator: Jorge Cheirif, M.D / John Harper, MD

Hospital: Texas Health Presbyterian Hospital Dallas

Periods offered: All

Length: 4 weeks

Max no. of residents: 3

First Day Contact: Tony Locklear 214-361-3415 (Dr. Cheirif) / Denise Chapa 214-345-6000 (Dr. Harper)

First Day Time: 8:00 am

First Day Place: Non Invasive Cardiology Lab, First Floor, Hamon Building (Dr. Cheirif) / PB3, Suite 204 (Dr. Harper)

Requirements: Monday through Friday 7:00 am to 6:00 pm

Weekends: check with attending, no more than two weekends/month

I.               Course Description 

Residents will work with a cardiologist with a busy in-patient and out-patient practice. They will be exposed to a wide variety of cardiac diseases and will see patients in consultation, perform non-invasive procedures and monitor intensive care patients in the CCU.

II.             Course Goals and Objectives: (based on ACGME competencies for resident education)

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.

Objectives:

• Gather accurate, essential information from all sources, including medical interviews, physical examinations, medical records and diagnostic/therapeutic procedures. Examples: Resident will demonstrate skill in obtaining a complete history and physical exam on the patient with cardiovascular disease.

• Make informed recommendations about preventives, diagnostic and therapeutic options and interventions that are based on clinical judgement, scientific evidence, and patient preference. Examples: Resident will be able to advise patients with angina, congestive heart failure, aortic stenosis, etc. about the appropriate interventions as above.

• Develop, negotiate and implement effective patient management plans and integration of patient care. Examples: Resident will work with the patient, family and other health providers to develop and implement a plan to manage the patient with congestive heart failure, inoperable CAD, multiple cardiac risk factors, etc.

• Perform competently the diagnostic and therapeutic procedures considered essential to the practice of internal medicine. Examples: Resident will develop skills in reading EKG's, echocardiograms, inserting a Swan-Ganz catheter and interpreting the data. 

Medical Knowledge:

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.

Objectives:

• Apply an open-minded, analytical approach to acquiring new knowledge. Examples: Resident will actively pursue readings pertaining to the patients they have seen or assigned by the attending. 

• Access and critically evaluate current medical information and scientific evidence. Examples: Resident will develop the skills to assess the medical literature through their attendance at Journal Club. He/she will use these skills to evaluate cardiology literature. 

• Develop clinically applicable knowledge of the basic and clinical sciences that underlie the practice of internal medicine. Examples: Resident will build a firm knowledge of cardiac anatomy and physiology, the pathogenesis of hyperlipidemia and hypertension, etc. and apply this knowledge to the clinical care of their patients with cardiac dysfuntion.  

• Apply this knowledge to clinical problem-solving, clinical decision-making, and critical thinking. Examples: See above.

Practice-Based Learning and Improvement:

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

Objectives:

• Identify areas for improvement and implement strategies to enhance knowledge, skills, attitudes and processes of care. Examples: When areas of weakness are identified, the resident will work with the attending to develop a plan to improve in those defined areas.

• Analyze and evaluate practice experiences and implement strategies to continually improve the quality of patient practice. Examples: Resident will learn the processes of care provided in a busy private cardiology practice and apply that knowledge to improve the care of his/her patients in the Internal Medicine Clinic.

• Develop and maintain a willingness to learn from errors and use errors to improve the system or processes of care. Examples: Resident will demonstrate an open mind when an attending or peer identifies and error in judgement or practice. He /she will quickly work to correct that error.

• Use information technology or other available methodologies to access and manage information, support patient care decisions and enhance both patient and physician education. Example: Resident will demonstrate expertise in obtaining medical literature from the internet, especially using CareGate resources.

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.

Objectives:

• 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: When working as a cardiology consultant, the resident will provide timely, accurate information to the referring physician and work with him/her to manage and educate the patient.

• Use effective listening, nonverbal, questioning, and narrative skills to communicate the patients. Examples: Resident will be skilled in obtaining a history using the above technique. He/she will effectively educate and inform the patient regarding their disease state.

• Interact with consultants in a respectful, appropriate manner. Examples: See above.

• Maintain comprehensive, timely, and legible medical records. Examples: Resident is responsible for dictating the consult on inpatients and writing a daily, informative, organized, legible note. 

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.

Objectives:

• Demonstrate respect, compassion, integrity, and altruism in relationships with patients, families, and colleagues. 

• Demonstrate sensitivity and responsiveness to the gender, age, culture, religion, sexual preference, socioeconomic status, beliefs, behaviors and disabilities of patients and professional colleagues.
  
  
• Adhere to principles of confidentiality, scientific/academic integrity, and informed consent.
  
  
• Recognize and identify deficiencies in peer performance.  

Systems-Based Practice:

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.

Objectives:

• Understand, access and utilize the resources, providers and systems necessary to provide optimal care. Examples: In caring for the patient with multiple cardiac risk factors or CHF, the resident will work with nurses, dieticians, and educators to improve the care of the patient.

• Understand the limitations and opportunities inherent in various practice types and delivery systems, and develop strategies to optimize care for the individual patient. Examples: Resident will be able to access the hospital, community and state resources for patients with cardiovascular disease and limited funding.

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

• 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: See above.

A. 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 Ground Rounds — IM Training Room
Wednesday afternoons 12:15-1:00 p.m. — Internal Medicine Update — Haggar Hall
Friday mornings 7:30-8:00 a.m. — Coffee with Cardiology — IM Training Room

B. Clinical

The resident is expected to work with a cardiologist seeing both his inpatients and outpatients. He/she is expected to read EKGs and echocardiograms with the cardiologist.