Competency

Objectives

Specific

Educational Experiences

Knowledge/ Skills

Integration/Application

Assessment

Tools

Patient Care

That is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health

To experience first hand the spectrum of disorders commonly seen in a neurology service and learn how to evaluate, workup and treat such conditions under the supervision of board certified neurologist.

In-patient neurology consultative service:

Neurology cases morning report.

Ambulatory office based neurology.

Mid and end of rotation evaluation by supervising attending.

Performance in monthly and annual in-training examinations.

Medical Knowledge

About established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care

To learn the pathos-physiology, epidemiology, clinical presentation, laboratory and radiographic evaluation and management of important disorders related to neurology.

Detailed history Taking in Neurology Patients along with a full bedside neurologic examination including all Physical Examination

Mental status testing, Language testing, Tests of orientation and visual spatial abilities, Cranial nerve examination

Motor system, Gait, Coordination, Sensory

Relevant aspects of the general medical examination

Education for the role of ancillary neurologic testing like Angiography, EEG, EMG, Evoked Potentials Tensilon test and ENG

Topic based didactic lectures and case based discussions encountered on consultative rounds and office based practice to include the following disorders.

Headache, Cerebral vascular disease, Dementia, Movement disorders.

Demyelinating disorders, Epilepsy, Altered states of consciousness including coma and toxic and metabolic encephalopathies.

Infections of the Nervous system, Neurological emergencies including head trauma, acute cord compression, acute stroke

Neuromuscular diseases, Diseases of the spine.

Mandatory participation in educational activity during rotation and evaluation by rounder of resident’s knowledge and clinical skills.

Performance at monthly and annual in-training examinations.

Chart reviews and audits by attending physicians and chief medical residents to determine quality of care.

Interpersonal and Communication Skills

That result in effective information exchange and teaming with patients, their families, and other health professionals

To observe and develop required communication skills to evaluate patients with neurologic disease, discuss concerns related to management of patients with chronic neurologic diseases, importance of compliance, educate patients on nutrition and complications associated with neurologic diseases.

To interact with multi-disciplinary team members involved in the management of patient. Approach to patients with chronic conditions with significant physical limitation

To observe and learn how to communicate the evaluation and management of patients with neurologic disease during rounds with attending physicians and multi-disciplinary team members.

To interact and communicate with health care personnel involved in the care of patients with neurologic disease including the following.

Radiology: ultrasound and computerized tomography, Biochemistry and serologic laboratories; Speech support service;

Social services:

Surgery including vascular surgery, Neurosurgery and infectious disease services.

Attending and consultant physician evaluate the trainees interpersonal and communication skills and effectiveness of providing care based on direct observation during rounds, reviewing standard and quality of care and feedback provided by patients and ancillary staff.

Professionalism

As manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population

To educate residents on the complex professional and ethical principles of care involved in the care of patients with neurologic disease.

Promote excellence in care through self-directed motivation to provide the best care for patients under the care of the trainee.

To develop an understanding of the concerns of patients with chronic disabling neurologic conditions leading to significant functional morbidity.

Incorporate discussion on ethical principles, standards of care and professional conduct as pertinent to the care of patients with neurologic disease.

To promote the highest standards of professional care though complete and through assessment of patient, thoughtful and complete workup, and compassionate and caring approach to patients with neurologic disease.

Residents receive training in medical ethics and professionalism in the form a dedicated set of conferences delivered at noontime and during the multidisciplinary medicine course.

Evaluate resident performance by direct observation and supervision during rounds and feedback from patients and ancillary staff.

Practice-Based Learning and Improvement

That involves investigation and evaluation of their own patient care, appraisal and assimilation of scientific evidence, and improvements in patient care

The resident will be capable of self directed learning to keep up with new developments in the management of neurologic disease and changes in practice guidelines.

The resident will be able to perform a literature search to identify important publications on neurologic disorders.

The resident has the knowledge of important guidelines and resources available on the internet such as practice guideline, knowledge databases and clinical tools.

Residents are encouraged to write up interesting cases that they see on rounds for presentation as case reports as regional and national professional meetings.

Residents may participate in a dedicated two-month research elective if they are in good academic standing from the standpoint of clinical training.

Trainees receive specific instruction on clinical epidemiology, statistics and evidence-based medicine during the multi-disciplinary medicine rotation.

Residents are required to review a selected topic using principals of evidence-based medicine and develop a critically appraised review.

PGY2 and 3 residents present a topic review at noon conference as part of the resident grand rounds conference series including topics in nephrology.

Residents present a review and critique of an article relevant to internal medicine practice including nephrology as part of the journal club conference series.

Evaluation during rounds and case discussion of resident’s performance in self directed learning and capabilities of doing literature searches and critically reviewing selected publications using evidence based medicine concepts.

Presentations at regional and national meeting on case reports and research presentations developed during training.

At least 3 faculty members would review the resident presentations at resident grand rounds and journal club.

Systems-Based Practice

As manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system for health care and the ability to effectively call on system resources to provide care that is of optimal value

Understand, access and utilize the resources, providers and systems necessary to provide

Optimal care for patients with neurologic disease with special emphasis for reimbursement and coverage of inpatient and outpatient rehabilitative services.

To develop and awareness of currently accepted criteria for admission of patients with neurologic disease, coverage for treatments such as advanced therapy for Multiple sclerosis and other degenerative and demyelinative diseases.

To develop skills and knowledge necessary to interact with social workers, case managers and utilization review specialist to optimize care for the individual patient

Incorporate discussion on systems based practice related to admission criteria, reimbursement for services and referral to community and state sponsored resources for patients with neurologic diseases.

Provide an opportunity for trainees to interact with a multidisciplinary team of professionals experienced in providing care for patients with neurologic disease.

Trainees are required to participate in a dedicated series of conferences and seminars delivered throughout the year related to managed care, reimbursement and practice management.

Evaluated resident knowledge on resources available to provide care for patients with neurologic disease.

Observe and evaluate resident performance in resource management, interaction with multidisciplinary team members and facilitating appropriate inpatient and ambulatory care of patients with neurologic diseases