Endocrine Evaluation

Transcription

1 Endocrine Evaluation Level of Entrustment scale 1. Fellow cannot perform this activity 2. Fellow can perform this activity but requires direct supervision 3 Fellow can perform this activity but requires occasional direct supervision 4. Fellow can perform this activity independently 5. Fellow can act as instructor for this activity General Rotation Evaluation 1.Obtains a complete history from review of medical records clinical encounter 2.Performs a complete physical exam is able to identify physical findings pertinent to the endocrine system 3. Knows the appropriate use, interpretation limitations of radiologic, laboratory dynamic testing. Able to utilize tests in a clinically appropriate costeffective manner 4. Analyzes clinical data, prioritizes medical problems delivers cost-effective, quality patient care 5. Monitors clinical course, follow-up on test results modifies care plan 6. Engages accommodates patients families. Communicates in a clear, effective, culturally sensitive professional manner 7. Collaborates communicates effectively with other health care providers. Utilizes health information technology effectively. Maintains complete, accurate timely records 8. Seeks guidance /or consultation as appropriate. Improves performance based on self-reflection feedback s Patient Care PC1 PC1-A, PC1-C Patient Care PC1 PC1-B, PC1-C, learning Improvement, learning Improvement PC4b, MK2, SBP3,SBP4,PROF3 PC2 SBP1, SPB2, SBP3, SPB4,PROF3 PC2, PROF2, PROF4 PROF3, PROF4,ICS1 PC2, PC5, PBLI4, ICS2, ICS3, PROF2 PC2, PC3, PC5, SBP1, PBLI2, PBLI3 PC4b-C,, SBP3-A, SBP3-B, SBP4-B, PROF3- A PC2-A, SBP1-A, SBP2-A, SBP3-A, SPB3-B, SPB4-B, PROF3- A PC2-B, PROF2- A, PROF4-B PC5-A, PROF1- A, PROF3-C, PROF4-A, ICS1- A, ICS1-B PC2-C, PC5-B, PBLI4-A, PROF2- A, ICS2-A, ICS2- B, ICS3-A, ICS3- B, PC2-C, PC3-B, PC5-C, SBP1-A, SBP1-B, PBL1-A, PBLI2-B, PBLI3- A, PBLI3-B

2 9. Identifies, reports develops solutions to problems in knowledge base, clinical care, ethics /or patient safety 10. Transitions care between inpatient consult service outpatient clinical visits. Utilizes outpatient visits telephone management to minimize readmission. 11. Reviews utilizes current literature to guide diagnostic therapeutic decisions. Participates in professional development continuing medical education activities. 12. Provides care for patients with a broad spectrum of endocrine disorders Adrenal Disorders Bone, Mineral Parathyroid Disorders Diabetes Hypoglycemia Gonadal Disorders Growth Development Disorders Lipids Nutrition Obesity Pituitary Neuroendocrine Disorders Reproductive Endocrinology including Pregnancy Thyroid Disorder learning Improvement, practice learning Improvement, SPB2, PBLI1, PBLI2, PBLI3, PROF4 SBP2, SPB4 PC2, PBLI1, PBLI4,PROF2 SPB2-B, PBL1-A, PBL1-B, PBLI2-B, PBLI3-B, PROF4- A,PROF4-B, PROF4-C SBP2-A, SBP4-A, SBP4-B PC2-D, PBLI1-A, PBLI1-B, PBLI4- B,PROF2-B MK1-B MK1-D MK1-E MK1-G MK1-I MK1-F MK1-F MK1-F MK1-A MK1-H MK1-C

3 Thyroid US Biopsy Recommends neck ultrasound nodule aspiration consistent with evidence based guidelines Interprets thyroid imaging (i.e. address quality of imaging, thyroid parenchyma echotexture size of thyroid lobes, location size of nodule(s) sonographic features of nodule(s)) Performs documents thyroid ultrasound. Reports the following: a) Measurement of each thyroid lobe in 3 dimensions with description of thyroid parenchyma echotexture b) Measurement of isthmus in transverse view c) Measurement of each nodule of interest in 3 dimensions with description of location sonographic features (echogenicity, composition, presence of calcifications, margins, vascularity) Obtains informed consent for thyroid aspiration. Effectively reviews risks, benefits, alternatives any conflict of interest. Performs thyroid nodule aspiration: a) Place needle in nodules of interest accurately with ultrasound guidance b) Prepare the specimen for cytologic analysis c) Obtain samples adequate for diagnosis Interprets thyroid nodule aspiration results,, s PC4a, MK1,MK2 PC4a, MK1,MK2 PC4a, MK1,ICS3 PC4a, MK2, PROF3 Patient Care PC4a PC4a-C PC4a, MK1,MK2 PC4a-A, MK1-C, MK2-A, PC4a-C, MK1-C, PC4a-C, MK1-C, ICS3-A, ICS3-B PC4a-A, MK2-A, PROF3-A PC4a-C, MK1-C, Maintains an accurate updated procedure log Yes No Patient Care PC4a PC4a-b Interprets a minimum 5 Ultrasounds competently Yes No Patient Care PC4a PC4a-C Preforms a minimum 5 FNAs procedures competently Yes No Patient Care PC4a PC4a-C Insulin Pump Management Reviews insulin pump technology therapy with the patient including indications, pump features, risks, benefits, alternate therapies any conflict of interest Guides initiation of insulin pump therapy a) Determines glucose targets b) Calculates basal bolus rates c) Calculates correction sensitivity factors Interprets blood glucose logs modifies setting (i.e. adjusts basal/bolus rates, insulin-carbohydrate ratios, or glucose targets) or care plan Intreprets a minimum 5 logs/downloads competently Yes No, s, PROF3 PC4b-A, MK1-E, MK2-A,, PROF3-A

4 Continuous Glucose Monitoring Procedure Recommends Professional Personal CGM consistent with evidence based guidelines Reviews procedure with patients including CGM technology, risks, benefits, alternatives any conflict of interest Interprets Professional (retrospective, masked) CGM a) Evaluates adequacy of the download data/tracings b) Integrates logbook with CGM data c) Interprets reports CGM data d) Recommends therapeutic changes based on findings Interprets Personal ( real-time ) CGM a) Evaluates adequacy of the download data/tracings b) Integrates logbook with CGM data e) Interprets CGM data c) Recommends therapeutic changes based on findings Interprets a minimum 5 studies competently Yes No, s PC4b, MK1,MK2,PROF3 PC4b-A, MK1-E, MK2-A, PC4b-A, MK1-E, MK2-A,, PROF3-A Bone Densitometry (DXA) Procedure Recommends bone densitometry testing consistent with evidence based guidelines reviews alternate tests (Central vs. Peripheral DXA), risks, benefits, costs any conflict of interest Interprets Central DXA scan a) Recognizes proper patient positioning scan analysis (PA spine, hip, forearm, total body) including common errors b) Understs skeletal anatomy relevant to DXA c) Recognizes common artifacts on DXA scan images d) Compares contrasts use of different skeletal sites regions of interest for diagnosis e) Understs the stardized scores used in bone densitometry (T- Z-score) f) Knows the criteria for diagnosis of osteoporosis in premenopausal women, children, men - of different ethnic groups g) Understs fracture risk assessment combining BMD with other risk factors. h) Recognizes the clinical importance of precision error least significant change i) Recognizes which skeletal site to measure, how often to test j) Understs clinical relevance of changes in BMD Utilizes evidence-based guidelines to generate reports (i.e. applies stard nomenclature, avoids common errors, follows reporting treatment guidelines) Interprets a minimum 5 studies competently Yes No, s PC4b, MK1,MK2,PROF3 PC4b-A, MK1-D, MK2-A, PROF3-A PC4b-D, MK1- D, PC4b-D, MK1-D, PC4b-D, MK1-D,

5 Score/Scale for Scholarship 1) Fellow makes no effort to participate in scholarly activity 2) Fellow makes rudimentary effort to participate in scholarly activity 3) Fellow engages scholarly activities with significant guidance 4) Fellow engages scholarly activities with significant independence 5) Fellow is a role model for peers colleagues Scholarship Basic, clinical translational research investigations Safety or QI projects Publications (e.g. abstract, case reports, reviews, original research) Presentation (e.g. local, regional, national) Scale/Score (1-5),, System Based Practice,,, Practice Based Learning Improvement s MK3,PROF2 MK3,SBP2, PROF2, PBLI3 MK3,PROF2, MK3, PROF2, PBLI2 MK3-A, MK3-B, MK3-C, PROF2- A MK3-A, MK3-B, MK3-C, SBP2-B, PROF2-A MK3-B, PROF2- A MK3-C, PROF2- A, PBLI2-A

6 Scale/Score for Allied Health Professionals 1) Never 2) Rarely 3) Sometime 4) Often 5) Always Allied Health Professionals Engages accommodates patients/families in a culturally sensitive respectful manner Communicates with allied health providers in an effective professional manner Utilizes health information technology effectively Scale/Score (1-5) learning improvement, s PROF3, PROF4, ICS1 PROF3, PROF4,ICS2 PC5, PBLI4, ICS2, ICS3 PC5-A, PROF1-A, PROF3-C, PROF4-A,ICS1-A PC5-B PROF1-A, PROF4-A, ICS2- A, PC5-B, PBLI4-A, ICS2-B, ICS3-A, ICS3-B Collaborates within an interdisciplinary team of providers PC2, PC5, SBP1,PROF1 PC2-C, PC5-C, SBP1-A, SBP1-B, PROF1-A,

7 Scale/Score for Peer Evaluations 6) Never 7) Rarely 8) Sometime 9) Often 10) Always Peer Evaluations Engages accommodates patients families Communicates in a clear professional manner Utilizes health information technology effectively Scale/Score (1-5) learning improvement, s PROF3, PROF4, ICS1 PROF3, PROF4,ICS2 PC5, PBLI4, ICS2, ICS3 PC5-A, PROF1-A, PROF3-C, PROF4-A, ICS1-A PC5-B, PROF1-A, PROF4-A, ICS2-A PC5-B, PBLI4-A, ICS2-B, ICS3-A, ICS3-B Collaborates within an interdisciplinary team of providers PC2, PC5, SBP1,PROF1 PC2-C, PC5-C, SBP1-A, SBP1-B, PROF1-A, PROF1-B

8 Scale/Score for Patient Evaluations 1) Poor 2) Fair 3) Good 4) Very Good 5) Excellent Patient Evaluations Polite respectful during the visit Listen to my concerns Encouraged me to ask questions Used words I can underst Explained my medical problem treatment Showed interest in me as a person Scale/Score (1-5) s PROF1, PROF3, PROF4, ICS1 PROF1, CS1 PROF1, CS1 PROF1, CS1 ICS1 ICS1 PROF1-A, PROF4- A, ICS1-A PROF1-A, ICS1-A PROF1-A, ICS1-A PROF1-A, ICS1-B PC5-A, PROF1-A, ICS1-B PC5-A, PROF1-A, ICS1-A