Log Book Clinical skill report booklet for residents of cardiology

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1 مااللها نا م 1

2 Shahid Beheshti University of Medical Sciences CARDIOLOGY DEPARTMENT Log Book Clinical skill report booklet for residents of cardiology 2

3 The Name of Allah This collection is designed at Shahid Beheshti University of Medical Sciences with the aim of advancing scientific and practical capabilities of Cardiology residents. I trust that we will achieve the main objective, promotion of the quality of training of residents, by application of its contents, proper use of it, and implementation of all programs set forth herein. Obviously, success will be guaranteed only by preservance and stamina, and by continually carrying out the instructions laid down in the booklet. Dr.Mohammad Asadpour Piranfar Head of Cardiology Department Shahid Beheshti University of Medical Sciences Tehran-Iran 3

4 Preface This collection which will be called Logbook is actually a clinical skill report booklet designed to record practical and scientific activities of cardiology residents of Shahid Beheshti University of Medical Sciences. It is used to either evaluate these activities by faculty or self evaluate by residents. This log book has been designed based on similar material used in well known medical universities and will help in dealing with the educational pitfalls during the residency program. We wish this will facilitate better educational outcomes among our residents. Dr. Mersedeh Karvandi Cardiologist-Echocardiologist Assistant of Cardiology Shahid Beheshti University of Medical Sciences 4

5 Faculty Members Department of Cardiology Name & Surname Academic Degree Name & Surname Academic Degree Mohammad Abazari MD Assistant professor Mersedeh Karvandi MD Assistant professor Shapour Alidaei MD Assistant professor Mohammad Khani MD Associate professor Saeed AliPour Parsa MD Assistant professor Homayoun Koohi Kamali MD Assistant professor Mohammad Assadpour Piranfar MD Associate professor Reza Miri MD Associate professor Manouchehr Behnia MD Assistant professor Mohammad Hassan Namazi MD Associate professor Mohammad Reza Beyranvand MD Associate professor Mohammad Parsa Mahjoob Assistant professor Neda Behzadnia MD Assistant professor Habibollah Saadat MD Associate professor Seyed Masoud Ghavam MD Assistant professor Roxana Sadeghi MD Assistant professor Mohammad Esmaeil Gheidari MD Associate professor Morteza Safi MD Associate professor Mohammad Yousof Heidari MD Assistant professor Babak Sharif Kashani MD Associate professor Mohammad Haji Aghajani MD Assistant professor Maryam Taherkhani MD Assistant professor Farhad Hajsheikholeslami MD Assistant professor Hossein Vakili MD Associate professor Head of Department of Cardiology Dr. Mohammad Asadpour Piranfar 5

6 Contents Preface.. 4 Peripheral angiography.42 CV line- Arterial line-swan-ganz..154 Faculty members...5 Fluoroscopy. 45 EPS-RF-ICD Content table..6 PCI...49 Cardiovascular surgery Objectives 7 Holter monitoring 53 Pericardial diseases T UTT T z 9 80 G 172 fi fi 11 TT T 12 T G 31 z 34 T T 148 T

7 Objectives The assistant will record his scientific experiments accurately and completely in the Logbook that led him to document his experiences, clear his shortages and help him to resolve them. The Logbook will help the professors to assess the educational process of each assistant. The Logbook will assist relevant authorities in assessing the success of the educational sector to create professional experiences for the residents. The Logbook will help estimating the ability of an educational department to provide scientific grounds for their assistants. Terms and conditions All cardiology residents should record their academic experiences in their Log Book. Each assistant should fill its own Logbook. All written data should be approved by the respective observing professors. Assistants should complete their logbook from the beginning of the training course, or from the beginning of the school year. The Department can any time demand the logbook for review or coping. Contents of the logbook is personal and confidential and only can be checked by the faculty, director, education officials of the university, staff and members of the examination center and the relevant educational authorities of the Ministry of Health and Medical Education. The observing professor should approve the procedures reported in the tables even if the assistant perform a procedure independently but with permission. The reports written in the logbook can be cited as abilities and experiences of its owner. A copy of the logbook should be provided to the department office at the end of the training course. 7

8 Recommendations It is recommended that assistants have the logbook with them in all conditions while they are present in the ward and to fill the tables immediately after performing any procedure. It is recommended that the data written in relevant tables be approved by the observing professor as soon as possible. Clinical components Cardiology specialty training course During the training course the assistants should have the possibility to visit outpatients consistently and independently and made diagnosis and treatment plan for them, while having a direct or indirect supervision of Academic Staff. Due to the importance of providing proper outpatient care, assistants should have the possibility to track their patients and evaluate their therapeutic actions. These measures should be under supervision of the faculty. During the training course the assistants should have the opportunity to provide emergency cardiac cares to the patients. These measures should be supervised directly or indirectly by the faculty. The training program should provide enough time and condition for the assistant to learn electrocardiography, echocardiography, exercise test, Holter monitoring, Tilt test, pacemaker, cardiac catheterization, invasive interventions, cardiac MRI interpretation, and interpretation of cardiac CT angiography and Thallium scan in the field of cardiology. 8

9 In order to gain the mentioned skills by an assistant it is needed to ensure the following conditions. Conducting at least 150 exercise testing and its analysis. Reporting and interpreting at least 100 Holter monitoring for electrocardiographic and cardiac rhythm changes. Performing and reporting at least 20 Tilt test. Performing at least 500 echocardiography and interpreting them. 20 of them should be recorded to be assessed by the faculty. Performing at least 50 cases of right and left catheterization and at least 200 cases of coronary angiography as first operator and interpreting the results and management of possible side effects. Participating in at least 25 invasive intervention like PCI. Temporary pacing for at least 25 cases. Participating in at least 25 PPM. Interpretation of at least 25 cardiac MRI, CTA, and Thallium scam. Participating in at least 25 EPS, RF ablation and ICD and interpretation of the results. Specialized Skills Assistant should know the applications, contra indications and side effects of the following techniques and skills and have the ability to perform them and interpret their results. Electrocardiography, chest radiography, echocardiography, exercise test, cardiac nuclear imaging, holter monitoring, cardiac imaging techniques, Head up tilt test and diagnostic and therapeutic invasive procedures such as catheterization, angiography, (percutaneous coronary intervention) PCI and... Echocardiography, including knowledge of cardiac anatomy, physiology and hemodynamic, principles of physics of echo and Doppler phenomenon, to be familiar enough with the echocardiography devices. 9

10 Assistant should be familiar with Transesophaheal Echocardiography and stress echocardiography, but to achieve the full skills it is needed to pass complementary courses. Invasive cardiology including ability to perform coronary angiography and left and right catheterization, and management of their side effects. Electrical cardioversion, cardiovascular resuscitation, pericardiocentesis, placing an arterial line and Swan-Ganz catheter, electrophysiology study, temporary pacing (pace maker) Applications, specifications and properties of different types of pacemakers and monitoring and programming them. It is necessary to participate in pacemaker clinic. Assistant should be familiar with PCI and PPM insertion and EPS procedures, but to achieve the full skills it is needed to pass complementary courses. Certification Each assistant is required to perform a research project as a thesis during the residency program under the supervision of one of the faculty members. Each assistant is required to participate in all examinations and tests conducted by the cardiology department during his academic course. Assistants are required to participate in the annual promotion examination and national board examination conducted every year by the Council Secretariat of Specialized Medical Training based on the approved regulations. 10

11 Resident Profile: Name and Surname: Birthplace: of pass on residency: University of MD: Father's Name: Birthday: Residency program start date: Year of Graduation: Address: Phone/Fax: Cell Phone: 11

12 About the Thesis Title in Persian: Title in English: Type of Research: Advisor: Supervisor: Approved Number: About thesis defense and score: Advisor Signature: Meeting time for defense: Score: Thesis accepted for publication in an approved journal: Yes NO Journal name: Advisor Signature: 12

13 Tables 13

14 Cath-Lab 14

15 Coronary Angiography Patient s Name Proposed Treatment Possible Complications Tasks for Complications 15

16 Coronary Angiography Patient s Name Proposed Treatment Possible Complications Tasks for Complications 16

17 Coronary Angiography Patient s Name Proposed Treatment Possible Complications Tasks for Complications 17

18 Coronary Angiography Patient s Name Proposed Treatment Possible Complications Tasks for Complications 18

19 Coronary Angiography Patient s Name Proposed Treatment Possible Complications Tasks for Complications 19

20 Coronary Angiography Patient s Name Proposed Treatment Possible Complications Tasks for Complications 20

21 Coronary Angiography Patient s Name Proposed Treatment Possible Complications Tasks for Complications 21

22 Coronary Angiography Patient s Name Proposed Treatment Possible Complications Tasks for Complications 22

23 Coronary Angiography Patient s Name Proposed Treatment Possible Complications Tasks for Complications 23

24 Coronary Angiography Patient s Name Proposed Treatment Possible Complications Tasks for Complications 24

25 Coronary Angiography Patient s Name Proposed Treatment Possible Complications Tasks for Complications 25

26 Coronary Angiography Patient s Name Proposed Treatment Possible Complications Tasks for Complications 26

27 Coronary Angiography Patient s Name Proposed Treatment Possible Complications Tasks for Complications 27

28 Coronary Angiography Patient s Name Proposed Treatment Possible Complications Tasks for Complications 28

29 Coronary Angiography Patient s Name Proposed Treatment Possible Complications Tasks for Complications 29

30 Coronary Angiography Patient s Name Proposed Treatment Possible Complications Tasks for Complications 30

31 Coronary Angiography in CABG Patients Patient s Name Proposed Treatment Possible Complications Tasks for Complications Superscriptio n 31

32 Coronary Angiography in CABG Patients Patient s Name Proposed Treatment Possible Complications Tasks for Complications 32

33 Coronary Angiography in CABG Patients Patient s Name Proposed Treatment Possible Complications Tasks for Complications 33

34 Catheterization in Valvular and Congenital Heart Diseases Patient s Name Proposed Treatment Possible Complications Tasks for Complications 34

35 Catheterization in Valvular and Congenital Heart Diseases Patient s Name Proposed Treatment Possible Complications Tasks for Complications 35

36 Catheterization in Valvular and Congenital Heart Diseases Patient s Name Proposed Treatment Possible Complications Tasks for Complications 36

37 Catheterization in Valvular and Congenital Heart Diseases No. Patient s Name Proposed Treatment Possible Complications Tasks for Complications 37

38 Catheterization in Valvular and Congenital Heart Diseases Patient s Name Proposed Treatment Possible Complications Tasks for Complications 38

39 Catheterization in Valvular and Congenital Heart Diseases Patient s Name Proposed Treatment Possible Complications Tasks for Complications 39

40 Catheterization in Valvular and Congenital Heart Diseases Patient s Name Proposed Treatment Possible Complications Tasks for Complications 40

41 Catheterization in Valvular and Congenital Heart Diseases Patient s Name Proposed Treatment Possible Complications Tasks for Complications 41

42 Peripheral Angiography Patient s Name Proposed Treatment Complications 42

43 Peripheral Angiography Patient s Name Proposed Treatment Complications 43

44 Peripheral Angiography Patient s Name Proposed Treatment Complications 44

45 Fluoroscopy Patient s Name Proposed treatment score 45

46 Fluoroscopy Patient s Name Proposed treatment score 46

47 Fluoroscopy Patient s Name Proposed treatment score 47

48 Fluoroscopy Patient s Name Proposed treatment score 48

49 PCI Patient s Name Procedure 49

50 PCI Patient s Name Procedure 50

51 PCI Patient s Name Procedure 51

52

53 Holter Monitoring Exercise Testing HUTT 52

54 Holter Monitoring NO. Patient s Name Patient s complaint QTc Holter findings Abnormal holter results HRV Commentary 53

55 Holter Monitoring NO. Patient s Name Patient s complaint QTc Holter findings Abnormal holter results HRV Commentary 54

56 Holter Monitoring NO. Patient s Name Patient s complaint QTc Holter findings Abnormal holter results HRV Commentary 55

57 Holter Monitoring NO. Patient s Name Patient s complaint QTc Holter findings Abnormal holter results HRV Commentary 56

58 Holter Monitoring NO. Patient s Name Patient s complaint QTc Holter findings Abnormal holter results HRV Commentary 57

59 Holter Monitoring NO. Patient s Name Patient s complaint QTc Holter findings Abnormal holter results HRV Commentary 58

60 Holter Monitoring NO. Patient s Name Patient s complaint QTc Holter findings Abnormal holter results HRV Commentary 59

61 Holter Monitoring NO. Patient s Name Patient s complaint QTc Holter findings Abnormal holter results HRV Commentary 60

62 Exercise Testing Patient s Name Indication for Testing Result of Testing Possible Complications Proposed Treatment 61

63 Exercise Testing Patient s Name Indication for Testing Result of Testing Possible Complications Proposed Treatment 62

64 Exercise Testing Patient s Name Indication for Testing Result of Testing Possible Complications Proposed Treatment 63

65 Exercise Testing Patient s Name Indication for Testing Result of Testing Possible Complications Proposed Treatment 64

66 Exercise Testing Patient s Name Indication for Testing Result of Testing Possible Complications Proposed Treatment 65

67 Exercise Testing Patient s Name Indication for Testing Result of Testing Possible Complications Proposed Treatment 66

68 Exercise Testing Patient s Name Indication for Testing Result of Testing Possible Complications Proposed Treatment 67

69 Exercise Testing Patient s Name Indication for Testing Result of Testing Possible Complications Proposed Treatment 68

70 Exercise Testing Patient s Name Indication for Testing Result of Testing Possible Complications Proposed Treatment 69

71 Exercise Testing Patient s Name Indication for Testing Result of Testing Possible Complications Proposed Treatment 70

72 Exercise Testing Patient s Name Indication for Testing Result of Testing Possible Complications Proposed Treatment 71

73 Exercise Testing Patient s Name Indication for Testing Result of Testing Possible Complications Proposed Treatment 72

74 Exercise Testing Patient s Name Indication for Testing Result of Testing Possible Complications Proposed Treatment 73

75 HUTT Patient s Name ECG findings&(qtc) Result of Test & Complications Proposed Treatment 74

76 HUTT Patient s Name ECG findings&(qtc) Result of Test & Complications Proposed Treatment 75

77

78 Temporary pacemaker Permanent pacemaker Pace maker clinic 76

79 Temporary Pacemaker (TPM) NO. Patient s Name Complications Over Time Remaining TPM Tasks for Complications 77

80 Temporary Pacemaker (TPM) NO. Patient s Name Complications Over Time Remaining TPM Tasks for Complications 78

81 Temporary Pacemaker (TPM) NO. Patient s Name Complications Over Time Remaining TPM Tasks for Complications 79

82 Permanent pacemaker NO. Patient s Name 80

83 Permanent pacemaker NO. Patient s Name 81

84 Permanent pacemaker NO. Patient s Name 82

85 Pacemaker clinic Patient s Name Primary diagnosis Analysis results Proposition Obsrving professor 83

86 Pacemaker clinic Patient s Name Primary diagnosis Analysis results Proposition Obsrving professor 84

87 Pacemaker clinic Patient s Name Primary diagnosis Analysis results Proposition Obsrving professor 85

88 Pacemaker clinic Patient s Name Primary diagnosis Analysis results Proposition Obsrving professor 86

89 Pacemaker clinic Patient s Name Primary diagnosis Analysis results Proposition Obsrving professor 87

90

91 Echocardiography 88

92 TTE Patient s Name Proposed Treatment 89

93 TTE Patient s Name Proposed Treatment 90

94 TTE Patient s Name Proposed Treatment 91

95 TTE Patient s Name Proposed Treatment 92

96 TTE Patient s Name Proposed Treatment 93

97 TTE Patient s Name Proposed Treatment 94

98 TTE Patient s Name Proposed Treatment 95

99 TTE Patient s Name Proposed Treatment 96

100 TTE Patient s Name Proposed Treatment 97

101 TTE Patient s Name Proposed Treatment 98

102 TTE Patient s Name Proposed Treatment 99

103 TTE Patient s Name Proposed Treatment 100

104 TTE Patient s Name Proposed Treatment 101

105 TTE Patient s Name Proposed Treatment 102

106 TTE Patient s Name Proposed Treatment 103

107 TTE Patient s Name Proposed Treatment 104

108 TTE Patient s Name Proposed Treatment 105

109 TTE Patient s Name Proposed Treatment 106

110 TTE Patient s Name Proposed Treatment 107

111 TTE Patient s Name Proposed Treatment 108

112 TTE Patient s Name Proposed Treatment 109

113 TTE Patient s Name Proposed Treatment 110

114 TTE Patient s Name Proposed Treatment 111

115 TTE Patient s Name Proposed Treatment 112

116 TTE Patient s Name Proposed Treatment 113

117 TTE Patient s Name Proposed Treatment 114

118 TTE Patient s Name Proposed Treatment 115

119 TTE Patient s Name Proposed Treatment 116

120 TTE Patient s Name Proposed Treatment 117

121 TTE Patient s Name Proposed Treatment 118

122 TTE Patient s Name Proposed Treatment 119

123 TTE Patient s Name Proposed Treatment 120

124 TTE Patient s Name Proposed Treatment 121

125 TTE Patient s Name Proposed Treatment 122

126 TTE Patient s Name Proposed Treatment 123

127 TTE Patient s Name Proposed Treatment 124

128 TTE Patient s Name Proposed Treatment 125

129 TTE Patient s Name Proposed Treatment 126

130 TTE Patient s Name Proposed Treatment 127

131 TTE Patient s Name Proposed Treatment 128

132 TTE Patient s Name Proposed Treatment 129

133 TTE Patient s Name Proposed Treatment 130

134 TTE Patient s Name Proposed Treatment 131

135 TTE Patient s Name Proposed Treatment 132

136 TTE Patient s Name Proposed Treatment 133

137 TTE Patient s Name Proposed Treatment 134

138 TEE Patient s Name Proposed Treatment Complication During TEE 135

139 TEE Patient s Name Proposed Treatment Complication During TEE 136

140 TEE Patient s Name Proposed Treatment Complication During TEE 137

141 Stress Echocardiography Patient s Name Proposed Treatment Complication During SE 138

142 Stress Echocardiography Patient s Name Proposed Treatment Complication During SE 139

143 Stress Echocardiography Patient s Name Proposed Treatment Complication During SE 140

144

145 Cardiopulmonary resuscitation 141

146 Cardiopulmonary Resuscitation Patient s Name Treatment CPR Length Result 142

147 Cardiopulmonary Resuscitation Patient s Name Treatment CPR Length Result 143

148 Cardiopulmonary Resuscitation Patient s Name Treatment CPR Length Result 144

149

150 Cardiac Imaging 145

151 Cardiac MRI interpretation Patient s Name Indication Interpretation 146

152 Cardiac MRI interpretation Patient s Name Indication Interpretation 147

153 Cardiac CT Angiography Patient s Name Indication Interpretation 148

154 Cardiac CT Angiography Patient s Name Indication Interpretation 149

155 Thallium scan Patient s Name Indication Interpretation 150

156 Thallium scan Patient s Name Indication Interpretation 151

157

158 Pericardiocentesis CV line pericardiocentesis Arterial line Swan-Ganz 152

159 Pericardiocentesis Patient s Name Possible cause of tamponade Echocardiography Result Possible Complications Tasks for Complications * Score from A to D by the observer 153

160 CV Line- Arterial line- Swan-Ganz Patient s Name File Indication Possible Complications Tasks for Complications * Score from A to D by the observer 154

161 EPS RF Ablation ICD 155

162 EPS-RF Ablation- ICD Patient s Name Indication Interpretation & diagnosis * Score from A to D by the observer 156

163 EPS-RF Ablation- ICD Patient s Name Indication Interpretation & diagnosis * Score from A to D by the observer 157

164 EPS-RF Ablation- ICD Patient s Name Indication Interpretation & diagnosis * Score from A to D by the observer 158

165

166 Cardiovascular Surgery 159

167 Cardiovascular Surgery Patient s Name Indication for surgery Type of Surgery Cardiac Surgeon 160

168 Cardiovascular Surgery Patient s Name Indication for surgery Type of Surgery Cardiac Surgeon 161

169 Cardiovascular Surgery Patient s Name Indication for surgery Type of Surgery Cardiac Surgeon 162

170

171 Inpatient and outpatient management 163

172 Pericardial diseases Patient s Name Primary diagnosis Diagnostic plan& results Final diagnosis 164

173 Pericardial diseases Patient s Name Primary diagnosis Diagnostic plan& results Final diagnosis 165

174 Myocardial diseases Patient s Name Primary diagnosis Diagnostic plan& results Final diagnosis 166

175 Myocardial diseases Patient s Name Primary diagnosis Diagnostic plan& results Final diagnosis 167

176 Valvular diseases Patient s Name Primary diagnosis Diagnostic plan& results Final diagnosis Score * 168

177 Valvular diseases Patient s Name Primary diagnosis Diagnostic plan& results Final diagnosis Score * 169

178 Coronary diseases Patient s Name Primary diagnosis Diagnostic plan& results Final diagnosis 170

179 Coronary diseases Patient s Name Primary diagnosis Diagnostic plan& results Final diagnosis 171

180 Great vessels diseases Patient s Name Primary diagnosis Diagnostic plan& results Final diagnosis 172

181 Great vessels diseases Patient s Name Primary diagnosis Diagnostic plan& results Final diagnosis 173

182 Congenital heart disease Patient s Name Primary diagnosis Diagnostic plan& results Final diagnosis 174

183 Congenital heart disease Patient s Name Primary diagnosis Diagnostic plan& results Final diagnosis 175

184 Scientific activities 176

185 Scientific Conferences and Activities Title Activity Venue and Organizer Director name and approval 177

186 Scientific Conferences and Activities Title Activity Venue and Organizer Director name and approval 178

187 Scientific Conferences and Activities Title Activity Venue and Organizer Director name and approval 179

188 Scientific Conferences and Activities Title Activity Venue and Organizer Director name and approval 180

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