MILESTONE-BASED GOALS AND OBJECTIVES FOR FELLOWS (Updated: 2/23/2017)

Transcription

1 MILESTONE-BASED GOALS AND OBJECTIVES F FELLOWS (Updated: 2/23/2017) Rotations: Clinical Outpatient, Self-Paced Learning Goal 1: Understand and develop skills necessary for diagnosis and management of a chronic / complex care patient using in integrative medicine approach Objectives Instructional Strategies Evaluation Associated Milestones Develop skills necessary for communication with a variety of practitioners. Collaboration, relationship building, and comanagement, consultation and referral skills are emphasized Summarize and present patient information back to program director and integrative care team for feedback and consultation Identify key aspects of health care systems as they apply to specialty care, including the referral process, and differentiate between consultation and referral. Recognize and advocate for families who need assistance to deal with systems complexities such as the referral process, lack of insurance, multiple medication refills, multiple appointments with long transport times, or inconvenient hours of service. Recognize one s limits and those of the system; take steps to avoid medical errors. Explain lab work-up, studies, and clinical management of the following conditions using an integrative medicine approach: Abdominal pain Headache Joint pain Frequent respiratory infections Difficult case noon conferences Observing Fellow and Attending PC7 PBL1 SBP2 SBP4 SBP2 SBP2 ICS2 P4 SBP4 PBLI1 P4 PC7 Noon conferences SBP2 Goal 2: Develop an understanding of Mind-Body Interventions Objectives Instructional Strategies Evaluation Associated Milestones Recognize indications when a patient may benefit from mind-body interventions and appropriately refer to mind-body practitioners Demonstrate knowledge in mind-body interventions: biofeedback, clinical hypnosis, mindfulness based stress reduction, yoga Noon Conference AZCIM assessments PC1

2 Noon Conference Develop ability to help patients identify lifelong preventative PC1 strategies for stress reduction: deep breathing techniques, utilization of smart phone applications Noon Conference Goal 3: Develop an understanding of dietary interventions and nutritional supplements Objectives Instructional Strategies Evaluation Associated Milestones Develop skills in the use of laboratory testing to help identify dietary and nutritional deficiencies Understand and apply basic knowledge and skills in the use of dietary and nutritional supplements, including identifying the most critical indications and contraindications of their use Understand and apply basic knowledge and skills in the use of botanic supplements, including identifying the most critical indications and contraindications of their use Identify the most common drug-nutrient and drug-herb interactions for a pediatric integrative medicine practitioner. Case conferences AZCIM assessments AZCIM assessments AZCIM assessments AZCIM assessments Goal 4: Develop an understanding of alternative health care systems such as Traditional Chinese Medicine, Ayurveda Medicine and Homeopathy Objectives Instructional Strategies Evaluation Associated Milestones Demonstrate knowledge in Traditional Chinese Medicine in acupuncture clinics AZCIM online curriculum Experiential observation at 5 Branches, San Jose Noon conference Demonstrate knowledge in Aruyveda AZCIM online curriculum Noon conference Observation with affiliate aruyvedic medicine practitioner Demonstrate knowledge in Homeopathy AZCIM online curriculum Noon conference Observation with affiliate homeopathic medicine practitioner Goal 5: Develop skills to incorporate the research and evidence base into integrative medicine practice AZCIM online assessment AZCIM online assessment AZCIM online assessment PC1 PC1 PC1

3 Objectives Instructional Strategies Evaluation Associated Milestones Develop familiarity with the latest CAM/ IM research literature AZCIM Case conference Journal Club Utilize IM research literature and apply to patient care Patient Care Case Conference Journal Club Learn to use reliable reference tools for exploring potential CAM Patient Care and integrative modalities for patients Case Conference Journal Club AZCIM online assessment Medhub MK1 PBL1 MK1 PBL1 PBL1 MK1 Reference: Kittredge D, Baldwin CD, Bar-on ME, Beach PS, Trimm RF (Eds) (2004). APA Educational Guidelines for Pediatric Residency. Ambulatory Pediatric Association Website.

4 Descriptions of Associated Milestones (A Subset of Pediatrics Milestones to be Reported on Semi-Annually) Patient Care (PC) PC1 Gather essential and accurate information about the patient. Organize and prioritize responsibilities to provide patient care that is safe, effective and efficient. Make informed diagnostic and therapeutic decisions that result in optimal clinical judgment PC7 Develop and carry out management plans PC8* Prescribe and perform all medical procedures. Medical Knowledge (MK) Locate, appraise, and assimilate evidence from scientific studies related to their patients health problems. Practice-Based Learning and Improvement (PBLI) PBLI1 Identify strengths, deficiencies, and limits in one s knowledge and expertise. Interpersonal and Communication Skills (ICS) ICS1 Communicate effectively with patients, families, and the public, as appropriate, across a broad range of socioeconomic and cultural backgrounds ICS2 Demonstrate the insight and understanding into emotion and human response to emotion that allows one to appropriately develop and manage human interactions. Professionalism (P) P4 A sense of duty and accountability to patients, society, and the profession. Systems-Based Practice (SBP) SBP2 Coordinate patient care within the health care system relevant to their clinical specialty. SBP4 Advocate for quality patient care and optimal patient care systems. *The PC8 milestone is not currently reported to ACGME. NOTE: Utilized Pediatric Milestones for new program application but would move to Pediatric Subspecialty Milestones upon program commencement.

5 Pediatrics Integrative Medicine Fellowship Sample Weekly Schedule Monday Tuesday Wednesday Thursday Friday 8:00-8:30am Morning Report 8:00-8:30 am Morning Report 8:00-8:30 am Morning Report 8:00-8:30 am Morning Report 8:00-9:00 am Grand Rounds 9:00 am -12 noon Offsite clinic AZCIM online curriculum research 8:30-12 noon Offsite clinic AZCIM online curriculum research 8:30-12noon Offsite clinic AZCIM online curriculum 11-12: weekly case review/ journal club/ teaching session 8:30 am-12 noon IM Pulm Clinic Dr. John Mark 770 Welch Road (first floor) 8:30 am-12 noon Integrative Medicine/ Pain clinic Dr. Brenda Golianu 321 Middlefield Suite 225 (2 nd floor) Noon Conference Noon Conference Noon Conference Noon Conference Noon Conference 1:00 pm-5:00 pm IM GI clinic Dr. Ann Ming Yeh 321 Middlefield Suite 225 (2 nd floor) 1:00 pm-5:00 pm Offsite clinic AZCIM online curriculum 1:00 pm-5:00 pm IM Rheumatology Clinic Dr. Dana Gerstbacher 730 Welch Road (2 nd floor) 1:00 pm-5:00 pm IM Pain clinic Dr. Brenda Golianu 321 Middlefield Suite 225 (2 nd floor) 1:00 pm-5:00 pm Offsite clinic AZCIM online curriculum IM GI CLINIC Dr. Ann Ming Yeh 321 Middlefield Suite 225 (2 nd floor)

6 Pediatric Integrative Medicine Fellowship Block Schedule (sample) Orientation Weeks 4 Clinical Weeks 38 Research Weeks 4 CME weeks 2 Vacation weeks 4 Total: 52 O = orientation, C=clinical (see weekly schedule for clinical weeks), R=research, V= vacation FIRST YEAR BLOCK DIAGRAM Month/4wk Week 1 Orientation C R C C C C V C C CME C Week 2 Orientation C C CME C R C C C R V C Week 3 Orientation C C C C R C C V C C C Week 4 Orientation C C C V C C C C C C C

7 Stanford Pediatric Integrative Medicine Fellowship Program Sample Weekly Conference Schedule Week Topic 1 Fellow Boot Camp TCM basics Acupuncture basics 2 Fellow Boot Camp Supplement Basics 3 Fellow Boot Camp Mind Body Basics 4 Fellow Boot Camp Nutrition Basics 5 Journal Club 6 Difficult Case Review 7 Non pharm approach to dyspepsia 8 IM approach to asthma 9 Vacation No conference 10 Difficult Case Review 11 IM approach to pain 12 Medical informatics 13 Plant based nutrition 14 Difficult Case Review 15 Journal Club 16 Acupressure intro 17 Mindfulness based stress reduction 18 Difficult Case Review 19 Heart Rate Variability and biofeedback 20 Vacation No conference 21 IM approach to rheum 22 Evidence based herbs and supps for URI 23 Difficult Case Review 24 IM approach to nausea 25 Journal Club 26 IM approach to ADHD 27 Difficult Case Review 28 Environmental medicine 29 Mayan herbs 30 Vacation No conference 31 Difficult Case Review 32 Probiotics for common GI conditions 33 Non pharm approach to headache 34 Mindfulness for physicians 35 Difficult Case Review 36 Journal Club 37 Acupuncture for pain management 38 Herbs and supplements for mood disorders 39 Vacation No conference 40 Difficult Case Review 41 Intro to homeopathy 42 Intro to osteopathic manipulation

8 Stanford Pediatric Integrative Medicine Fellowship Program 43 Difficult Case Review 44 Acupuncture for rheumatologic conditions 45 Journal Club 46 Intro to aruyveda 47 Intro to pediatric massage 48 Difficult Case Review 49 Intro to functional medicine 50 Infant massage 51 Journal Club 52 Program Annual Review

9 STUDY GUIDE FINAL EXAM February 3 23, 2014 February 24 May 25, 2014 *RESIDENTIAL WEEK - April 6-11, 2014 May 26 August 24, 2014 SUMMER BREAK - June 30 July 13, 2014 August 25 October 12, 2014 October 13 November 16, 2014 November 17, 2014 January 25, 2015 THANKSGIVING BREAK - November 26 December 1, 2014 January 26 April 12, 2015 *RESIDENTIAL WEEK - March 8-13, 2015 H&P/TX PLANS DUE - February 23 August 23, 2015 April 13 June 21, 2015 June 22 August 16, 2015 August 17 October 4, 2015 October 5 December 6, 2015 December 7, 2015 January 3, 2016 WINTER BREAK - December 21, January 4, 2016 January 4 24, 2016 Fellowship THANKSGIVING BREAK - November 25 30, 2015 GRADUATION ~ *RESIDENTIAL WEEK - February 21-26, 2016 WINTER BREAK - December 22, 2014 January 4, 2015 HP/TX DUE To receive graduation certificate, all requirements must be met by Janaury 24th 90-day post-fellowship access begins on January 25th. * CME Credit Available Schedule subject to change.

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