Infectious Disease Curriculum

Faculty Coordinator: Allison Liddell, M.D.

Hospital: Texas Health Presbyterian Hospital Dallas

Periods offered: All

Length: 4 weeks

Max no. of residents: 1

First Day Contact: Connie Alonzo (214) 691-8306

First Day Time: 8:30 a.m.

First Day Place: 8230 Walnut Hill Lane, Suite 414, Dallas, TX 75231

Requirements: Monday-Friday from 8:30 a.m. to 5:00 p.m.

Weekends: Check with attending

I.                      Course Description

Resident will be working one-on-one with an Infectious Disease physician with a busy in-patient and out-patient practice. The resident will be exposed to a wide variety of infectious diseases. He/she will participate in initial evaluations as well as follow up evaluations in the infectious disease office. He/she will also see inpatient consults.

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: Always obtain old charts and cumulative MAR from the pharmacy pertaining to prior antibiotic therapy.
  
  
• 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 always formulate a plan prior to presentation/discussion with faculty.
  
  
• Develop, negotiate and implement effective patient management plans and integration of patient care. Examples: After discussion with faculty the resident may modify the plan outlined above. Follow-up visits proceed faculty's visits.
  
  
• Perform competently the diagnostic and therapeutic procedures considered essential to the practice of internal medicine. Examples: Spinal tap is the only procedure regularly performed.

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: Text books, articles, and computer assisted.
  
  
• Access and critically evaluate current medical information and scientific evidence. Examples: Use of computer based information.
  
  
• Develop clinically applicable knowledge of the basic and clinical sciences that underlie the practice of internal medicine. Examples: Discuss pathophysiology with faculty. Selected reading as assigned by faculty.
  
  
• Apply this knowledge to clinical problem-solving, clinical decision-making, and critical thinking. Examples: As assessed by faculty.

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.
  
  
• Analyze and evaluate practice experiences and implement strategies to continually improve the quality of patient practice.
  
  
• Develop and maintain a willingness to learn from errors and use errors to improve the system or processes of care.
  
  
• Use information technology or other available methodologies to access and manage information, support patient care decisions and enhance both patient and physician education. Example: Internet sites including MD Consult, NML, CDC-Gov, IDSA website, NEJM website.

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 relationship with patients, their families, and colleagues. Examples: Prompt, thorough, meaningful notes - not just recitation of lab values and lists of antibiotics.
  
  
• Use effective listening, nonverbal, questioning, and narrative skills to communicate the patients. Examples: See consult with attending present. Attending will perform occasional consult with resident present.
  
  
• Interact with consultants in a respectful, appropriate manner. Examples: Daily face-to-face or phone communication after resident has seen patient.
  
  
• Maintain comprehensive, timely, and legible medical records. Examples: Daily progress note when indicated.

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. Example: Addressed daily.
  
  
• Demonstrate sensitivity and responsiveness to the gender, age, culture, religion, sexual preference, socioeconomic status, beliefs, behaviors and disabilities of patients and professional colleagues. Example: Addressed daily.
  
  
• Adhere to principles of confidentiality, scientific/academic integrity, and informed consent. Examples: Addressed daily.
  
  
• Recognize and identify deficiencies in peer performance. Examples: Ask faculty for help. Acknowledge weaknesses.

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: Medical Records, Pharmacy, Micro Lab, Radiology.
  
  
• Understand the limitations and opportunities inherent in various practice types and delivery systems, and develop strategies to optimize care for the individual patient. Examples: See patients in office when feasible.
  
  
• Apply evidence-based, cost-conscious strategies to prevention, diagnosis, and disease management. Examples: After discussion with faculty.
  
  
• 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: Utilize social services, Home Care, Pharm D., Infection Control Resources.

III.                Methods of instruction:

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 Grand Rounds - IM Training Room
Wednesday afternoons 12:15-1:00 p.m. - Internal Medicine Update - Haggar Hall

B)     Clinical

Evaluate and treat patients with infectious diseases in the outpatient setting. Performing histories and physicals. Formulating and carrying out a diagnostic and therapeutic plan and communicating that plan verbally and/or in writing to the patient, the supporting medical team and the consulting physician.