Electives - General Surgery
Transition to Surgical Residency
Elective Number: 3025 (arranged)
Rotation Supervisor: Drs. Anneke Schroen & Philip W. Smith
Designated Signer: Dr. Anneke Schroen (firstname.lastname@example.org)
Duration: 2 weeks
Available: 13b (3/21-4/1/2016) - Class of 2016
Report to: TBA
Time to Report: 9:00 am
Place to Report: TBA
Typical day: 9:00 am - 4:00 pm (see sample schedule)
Attendance: Attendance is mandatory - no time off allowed
- Anyone who is ill or has a personal or family emergency must contact Student
Affairs and the Attending on Service.
- Specific days missed must be approved by the student's college dean.
Number of students per rotation: 16
Course Description: Goal:
- Improve student readiness for residency in a surgical discipline by allowing
them to apply practical knowledge and skills needed to respond to common
internship demands in standardized / simulated scenarios, such as
- Serving as first-responder to critically ill or unstable patients
- Prioritizing multiple simultaneous demands
- Navigating difficult or essential communications
- Performing basic technical skills and bedside procedures
- Gaining better familiarity with basic surgical equipment and procedures
- Executing basic documentation and order-writing tasks
- Functioning effectively and professionally in an inter-professional team
- Curricular content will be taught in all of the following settings:
- Classroom and small group discussion sessions
- Cadaver lab
- UVA Simulation Center
- UVA Clinical Skills Center
- Mock page program from Southern Illinois University
This elective is designed for 4th year students about to enter residency in a surgical discipline. This includes general surgery, surgical subspecialties (urology, ENT, plastics, neurosurgery, orthopedics), or OB-GYN.
- Outline and apply the common components of preoperative, postoperative, and admission orders.
- Identify the signs and symptoms of common electrolyte abnormalities in the surgical patient.
- Outline the management of and write appropriate orders for patients with common electrolyte abnormalities.
- Interpret normal and common abnormal findings on radiographs of the abdomen and chest.
- Interpret a standard 12-lead EKG or rhythm strip and identify common abnormalities.
- Interpret renal function lab abnormalities, specifically elevated BUN and/or Cr, calculate the FeNA and interpret the results.
- Identify and manage the patient with
common or urgent perioperative problems, such as
- Chest pain
- Respiratory distress/Shortness of breath
- Mental status changes/Unresponsiveness
- Urinary retention
- Venous thromboembolism
- Detail the standard dosages for commonly used antibiotics, pain medications, and perioperative steroid use
- Demonstrate the ability to follow ACLS protocols when responding to patients in cardiac or respiratory arrest
- Demonstrate the ability to appropriately prioritize tasks as the dynamics of a patient’s needs change
- Demonstrate the ability to obtain a patent airway (including Bag-Mask ventilation) and to establish IV access to support resuscitation (Technical Skills overlap)
- Demonstrate the ability to appropriately direct other members of the team to facilitate the care of the patient in an urgent or emergent patient care situation.
- Discuss role of universal precautions in all patient care settings, including utilization of contact precautions and infection control principles
- Demonstrate ability to maintain sterile technique in prepping and draping a patient for a procedure
- Outline appropriate drain management protocols for various types of surgical drains and tubes, including safe removal
- Demonstrate proficiency in placing a nasogastric tube
- Demonstrate proficiency in performing venipuncture and inserting a peripheral IV catheter
- Utilize doppler and ultrasound to identify relevant vasculature to facilitate safe placement of intra-vascular catheters
- Demonstrate proper technique for placement and removal of a central venous catheter
- Demonstrate proper technique in performing basic suturing and knot tying techniques.
- Demonstrate ability to properly dose and administer local anesthetics.
- Demonstrate proper technique for skin and soft tissue closure.
- Demonstrate ability to incise and drain a superficial abscess.
- Demonstrate proper technique for applying various types of surgical dressings and describe indications for each.
- Describe the signs and management of a postoperative superficial site infection
- Delineate indications for superficial wound debridement and describe appropriate techniques
- Demonstrate proficiency in performing bag mask ventilation
- Demonstrate proficiency in performing endotracheal intubation
- Demonstrate ability to perform CPR in accordance with ACLS protocols
- Describe indications for tube thoracostomy and demonstrate performance in an inanimate model
- Identify common surgical instruments by name that are utilized in the operating room and describe the appropriate use for each
- Demonstrate ability to perform basic laparoscopic skills in a simulated environment
- Review and prepare for the safe and appropriate use of surgical energy devices
- Describe the elements of and perform a pre-procedural Time-Out
- Perform intern level procedures in a cadaver or simulated lab setting under the supervision of a faculty member
- Dictate a cohesive and articulate operative report for a procedure performed in a cadaver or simulated lab setting
- Display compassionate communication skills and nonjudgmental behaviors
- Discuss the importance of timeliness as it relates to professional behavior (for example, clinic activities, documentation, timeliness for the operating room)
- Discuss or model constructive means of resolving unprofessional behavior in the training environment
- Discuss and review the ACGME resident
duty hour requirements and identify professional situations in which it is
acceptable to remain
engaged in patient
care activities beyond the duty hour restrictions.
41. Discuss, model or review the negative connotations of communication failures
- Provide a framework for evaluating the facts surrounding the adverse event (e.g. presence of error or system failure, results of event analysis, etc)
- Demonstrate appropriate language and communication techniques for expressing regret for unanticipated outcomes, and for providing a formal apology if an unanticipated outcome was caused by an error or system failure
- Develop effective techniques for working with difficult patients
- Demonstrate effective and professional communication with nurses and/or other non-physician medical professionals through standardized clinical scenarios (e.g. mock page exercises)
- Demonstrate effective communication styles with patients through standardized clinical scenarios
- Describe and model effective methods for patient handoff during transitions of care.
- List the important elements of the informed consent process
- Develop a personalized reading plan to cover the core topics of general surgery
- Summarize appropriate resources to be used for ABSITE preparation
- Review the proper steps for preparing for an operation and identify resources to assist with this process
- Discuss the importance of self-reflection and incorporation of formative feedback into daily practice
- Review the importance of reviewing all complications, near-misses, and errors with a focus on future prevention of similar events
- Describe the role of morbidity and mortality conference in health care quality and patient safety
- Demonstrate the ability to efficiently navigate an electronic or written health record to facilitate care for a patient
- Demonstrate the ability to appropriately document a progress note, operative note, and consult note in a patient’s chart
- Demonstrate the ability to appropriately document supervision and chain of command for decisions, e.g. “Discussed with Dr. X”
- Demonstrate the ability to disagree in a professional
manner with consultants in writing