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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