PL-1 Residents The Pulmonary elective is available to first year residents in either a 2 or 4 week block rotation. The experience will include performing inpatient consultations, attending outpatient clinics and participating in procedures. The overall goal of the pulmonary elective is to acquire an in-depth knowledge and experience with commonly encountered pulmonary problems of infants and children. This elective also includes adequate time to pursue directed readings that focus on pathophysiology of disease processes. With this information as a background, the resident will acquire a good understanding of the management and long-term outcomes of common respiratory disorders in children should be obtained. Residents are required to attend and be active participants in all required clinics. When instructed, residents are required to complete consultations on hospitalized patients thoroughly so that they are prepared to present and discuss the patients on rounds with the attending. This includes locating pertinent chest X-rays in radiology and pulling pertinent literature from the library. Residents are required to follow the consult patients and communicate recommendations to the inpatient team. Before the rotation, please contact Dr. B. Louise Giles to obtain access to the Pulmonary UChicagoBox. Other references and guidance for reading can be obtained from service attending (or any of us you can find) at any time. Gaining facility with various internet search devices (Pub-Med, OMIM and others) is also recommended. A. Patient Care: 1. Demonstrate the ability to perform a comprehensive physical examination on children of all ages 2. Gather accurate, essential information from all sources, including medical interviews, physical examinations, medical records and the results of diagnostic procedures 3. Make informed recommendations about diagnostic and therapeutic options and interventions that are based on clinical judgment, scientific evidence, and patient preference 4. Develop effective patient management plans and integration of patient care 5. Pre-round daily to find and perform a comprehensive physical examination on all pulmonary inpatients and on-going consults. This should include reviewing pertinent chest x-rays and labs 6. Coordinate rounds with the pulmonary attending, the general service team covering pulmonary patients, and students on the pulmonary service 7. Communicate daily with general service teams, in person and by note in chart of changes in plan of care, discharge plans, etc. for pulmonary patients 8. Complete all pulmonary consults inclusive of X-ray review, acquisition of all pertinent information from narrative history and record review, and personally performed physical examination of the patient B. Medical Knowledge: 1. Demonstrate a clear understanding of asthma, from pathophysiology to prevention 2. Identify diagnostic strategies and understand basic management of patients referred for evaluation of the following: bronchopulmonary dysplasia, cystic fibrosis, obstructive sleep apnea, asthma, acute and chronic ventilatory support, muscular dystrophies, apparent life threatening events, apnea of prematurity and congenital central hypoventilation syndrome 3. Review the indications, limitations, risks and costs of pulmonary function testing 4. Demonstrate an understanding of the multimodal Respiratory Physiology (Sleep) Laboratory to Updated 02.2017 1
PL-1 Residents include utility, indications, limitations, risks, costs. 5. Define and recognize the common presenting signs and symptoms of respiratory disorders (stridor, respiratory failure, cough, exercise intolerance, apnea, wheezing, tachypnea, hemoptysis, cyanosis, clubbing) 6. Develop a working knowledge of the following topics during their time on the Elective through experience, didactic sessions or reading: Pulmonary Major topics: Cystic fibrosis BPD Asthma Pneumonia (recurrent) Lung growth and development Interstitial lung disease Pulmonary function testing and interpretation, Oximetry, Blood Gas analysis Respiratory failure (acid base, blood gas interpretation) Utility of flexible bronchoscopy Pulmonary Related topics: SIDS Evaluation and management of apparent life threatening events, including interpretation of polysomnographic studies. Congenital Central Hypoventilation Syndrome (CCHS) and related control of breathing problems, apnea, alveolar hypoventilation) Obstructive sleep apnea Hypersensitivity pneumonitis (ABPA, etc.) Aspiration Syndromes AIDS related pulmonary complications Tuberculosis Neuromuscular disorders leading to respiratory failure Congenital anomalies of lung and tracheobronchial tree Immunologic lung diseases Upper airway problems- congenital and acquired Pulmonary problems in bone marrow and other transplant recipients C. Practice-Based Learning and Improvement: 1. Arrange to tour the PFT lab and watch a patient have a full study performed, to become familiar with techniques and tests 2. Read and review PFT s as they become available for interpretation with the service attending 3. Present two informal seminars to the attending, fellow, and students on service on in-depth review of a pertinent topic, either from something of interest that has come up on clinical or consult service, or from the suggested reading list 4. Maintain a willingness to learn from error and use errors to improve health care delivery 5. Reflect on their own knowledge and performance, identify and target gaps in that knowledge 6. Develop an independent learning plan to address identifiable gaps in knowledge Updated 02.2017 2
PL-1 Residents 7. Provide, request and accept/incorporate feedback into practice 8. Demonstrate a willingness to learn from errors and use errors to improve the system or processes of care 9. Use information technology or other available methodologies to access and manage information, support patient care decisions and enhance both patient and physician education 10. Demonstrate the ability to work with other learners to improve/enhance knowledge D. Interpersonal and Communication Skills: 1. Use interpreters effectively when necessary 2. Provide effective and professional consultation to other physicians and health care professionals and sustain therapeutic and ethically sound professional relationships with patients, their families, and colleagues 3. Use effective listening, nonverbal, questioning, and narrative skills to communicate with patients and families 4. Interact with referring physicians in a respectful, appropriate manner 5. Maintain comprehensive, timely, and legible medical records 6. Demonstrate the ability to give age-appropriate anticipatory guidance including discussions of health promotion and disease control and prevention 7. Demonstrate the ability to communicate with patients and families effectively without the use of medical jargon 8. Complete evaluations of attending, staff and rotation E. Professionalism: 1. Act in the best interest of your patients 2. Demonstrate respect, compassion, integrity, and altruism in relationships with patients, families, and colleagues 3. Demonstrate sensitivity and responsiveness to the gender, age, culture, religion, sexual preference, socioeconomic status, beliefs, behaviors and disabilities of patients and professional colleagues 4. Adhere to principles of confidentiality/scientific/academic integrity 5. Demonstrate conflict resolution F. Systems-Based Practice: 1. Advocate for families as they navigate health system complexity 2. Explain of different options for home monitoring and home ventilation (invasive and non-invasive) 3. Develop a multidisciplinary approach to the child and young adult with cystic fibrosis in conjunction with CF program 4. Demonstrate knowledge of billing and coding and their supportive documentation 5. Participate in problem case conferences 6. Identify access and utilize the resources, providers and systems necessary to provide optimal care 7. Discuss the limitations and opportunities inherent in various practice types and delivery systems, and the strategies to optimize care for the individual patient Updated 02.2017 3
PL-2 Residents The Pulmonary elective is available to senior residents in either a 2 or 4 week block rotation. The experience will include performing inpatient consultations, attending outpatient clinics and participating in procedures. The overall goal of the pulmonary elective is to acquire an in-depth knowledge and experience with commonly encountered pulmonary problems of infants and children. This elective also includes adequate time to pursue directed readings that focus on pathophysiology of disease processes. With this information as a background, the resident will acquire a good understanding of the management and long-term outcomes of common respiratory disorders in children should be obtained. Residents are required to attend and be active participants in all required clinics. When instructed, residents are required to complete consultations on hospitalized patients thoroughly so that they are prepared to present and discuss the patients on rounds with the attending. This includes locating pertinent chest X-rays in radiology and pulling pertinent literature from the library. Residents are required to follow the consult patients and communicate recommendations to the inpatient team. Before the rotation, please contact Dr. B. Louise Giles to obtain access to the Pulmonary UChicagoBox. Other references and guidance for reading can be obtained from service attending (or any of us you can find) at any time. Gaining facility with various internet search devices (Pub-Med, OMIM and others) is also recommended. A. Patient Care: 1. Demonstrate the ability to perform a comprehensive physical examination on children of all ages 2. Gather accurate, essential information from all sources, including medical interviews, physical examinations, medical records and the results of diagnostic procedures 3. Make informed recommendations about diagnostic and therapeutic options and interventions that are based on clinical judgment, scientific evidence, and patient preference 4. Develop effective patient management plans and integration of patient care 5. Pre-round daily to find and perform a comprehensive physical examination on all pulmonary inpatients and on-going consults. This should include reviewing pertinent chest x-rays and labs 6. Coordinate rounds with the pulmonary attending, the general service team covering pulmonary patients, and students on the pulmonary service 7. Communicate daily with general service teams, in person and by note in chart of changes in plan of care, discharge plans, etc. for pulmonary patients 8. Complete all pulmonary consults inclusive of X-ray review, acquisition of all pertinent information from narrative history and record review, and personally performed physical examination of the patient B. Medical Knowledge: 1. Demonstrate a clear understanding of asthma, from pathophysiology to prevention 2. Identify diagnostic strategies and understand basic management of patients referred for evaluation of the following: bronchopulmonary dysplasia, cystic fibrosis, obstructive sleep apnea, asthma, acute and chronic ventilatory support, muscular dystrophies, apparent life threatening events, apnea of prematurity and congenital central hypoventilation syndrome 3. Review the indications, limitations, risks and costs of pulmonary function testing 4. Demonstrate an understanding of the multimodal Respiratory Physiology (Sleep) Laboratory to Updated 02.2017 1
PL-2 Residents include utility, indications, limitations, risks, costs. 5. Define and recognize the common presenting signs and symptoms of respiratory disorders (stridor, respiratory failure, cough, exercise intolerance, apnea, wheezing, tachypnea, hemoptysis, cyanosis, clubbing) 6. Develop a working knowledge of the following topics during their time on the Elective through experience, didactic sessions or reading: Pulmonary Major topics: Cystic fibrosis BPD Asthma Pneumonia (recurrent) Lung growth and development Interstitial lung disease Pulmonary function testing and interpretation, Oximetry, Blood Gas analysis Respiratory failure (acid base, blood gas interpretation) Utility of flexible bronchoscopy Pulmonary Related topics: SIDS Evaluation and management of apparent life threatening events, including interpretation of polysomnographic studies. Congenital Central Hypoventilation Syndrome (CCHS) and related control of breathing problems, apnea, alveolar hypoventilation) Obstructive sleep apnea Hypersensitivity pneumonitis (ABPA, etc.) Aspiration Syndromes AIDS related pulmonary complications Tuberculosis Neuromuscular disorders leading to respiratory failure Congenital anomalies of lung and tracheobronchial tree Immunologic lung diseases Upper airway problems- congenital and acquired Pulmonary problems in bone marrow and other transplant recipients C. Practice-Based Learning and Improvement: 1. Arrange to tour the PFT lab and watch a patient have a full study performed, to become familiar with techniques and tests 2. Read and review PFT s as they become available for interpretation with the service attending 3. Present two informal seminars to the attending, fellow, and students on service on in-depth review of a pertinent topic, either from something of interest that has come up on clinical or consult service, or from the suggested reading list 4. Maintain a willingness to learn from error and use errors to improve health care delivery 5. Reflect on their own knowledge and performance, identify and target gaps in that knowledge 6. Develop an independent learning plan to address identifiable gaps in knowledge Updated 02.2017 2
PL-2 Residents 7. Provide, request and accept/incorporate feedback into practice 8. Demonstrate a willingness to learn from errors and use errors to improve the system or processes of care 9. Use information technology or other available methodologies to access and manage information, support patient care decisions and enhance both patient and physician education 10. Demonstrate the ability to work with other learners to improve/enhance knowledge D. Interpersonal and Communication Skills: 1. Use interpreters effectively when necessary 2. Provide effective and professional consultation to other physicians and health care professionals and sustain therapeutic and ethically sound professional relationships with patients, their families, and colleagues 3. Use effective listening, nonverbal, questioning, and narrative skills to communicate with patients and families 4. Interact with referring physicians in a respectful, appropriate manner 5. Maintain comprehensive, timely, and legible medical records 6. Demonstrate the ability to give age-appropriate anticipatory guidance including discussions of health promotion and disease control and prevention 7. Demonstrate the ability to communicate with patients and families effectively without the use of medical jargon 8. Complete evaluations of attending, staff and rotation E. Professionalism: 1. Act in the best interest of your patients 2. Demonstrate respect, compassion, integrity, and altruism in relationships with patients, families, and colleagues 3. Demonstrate sensitivity and responsiveness to the gender, age, culture, religion, sexual preference, socioeconomic status, beliefs, behaviors and disabilities of patients and professional colleagues 4. Adhere to principles of confidentiality/scientific/academic integrity 5. Demonstrate conflict resolution F. Systems-Based Practice: 1. Advocate for families as they navigate health system complexity 2. Explain of different options for home monitoring and home ventilation (invasive and non-invasive) 3. Develop a multidisciplinary approach to the child and young adult with cystic fibrosis in conjunction with CF program 4. Demonstrate knowledge of billing and coding and their supportive documentation 5. Participate in problem case conferences 6. Identify access and utilize the resources, providers and systems necessary to provide optimal care 7. Discuss the limitations and opportunities inherent in various practice types and delivery systems, and the strategies to optimize care for the individual patient Updated 02.2017 3
PL-3/4 Residents The Pulmonary elective is available to senior residents in either a 2 or 4 week block rotation. The experience will include performing inpatient consultations, attending outpatient clinics and participating in procedures. The overall goal of the pulmonary elective is to acquire an in-depth knowledge and experience with commonly encountered pulmonary problems of infants and children. This elective also includes adequate time to pursue directed readings that focus on pathophysiology of disease processes. With this information as a background, the resident will acquire a good understanding of the management and long-term outcomes of common respiratory disorders in children should be obtained. Residents are required to attend and be active participants in all required clinics. When instructed, residents are required to complete consultations on hospitalized patients thoroughly so that they are prepared to present and discuss the patients on rounds with the attending. This includes locating pertinent chest X-rays in radiology and pulling pertinent literature from the library. Residents are required to follow the consult patients and communicate recommendations to the inpatient team. Before the rotation, please contact Dr. B. Louise Giles to obtain access to the Pulmonary UChicagoBox. Other references and guidance for reading can be obtained from service attending (or any of us you can find) at any time. Gaining facility with various internet search devices (Pub-Med, OMIM and others) is also recommended. A. Patient Care: 1. Demonstrate the ability to perform a comprehensive physical examination on children of all ages 2. Gather accurate, essential information from all sources, including medical interviews, physical examinations, medical records and the results of diagnostic procedures 3. Make informed recommendations about diagnostic and therapeutic options and interventions that are based on clinical judgment, scientific evidence, and patient preference 4. Develop effective patient management plans and integration of patient care 5. Pre-round daily to find and perform a comprehensive physical examination on all pulmonary inpatients and on-going consults. This should include reviewing pertinent chest x-rays and labs 6. Coordinate rounds with the pulmonary attending, the general service team covering pulmonary patients, and students on the pulmonary service 7. Communicate daily with general service teams, in person and by note in chart of changes in plan of care, discharge plans, etc. for pulmonary patients 8. Complete all pulmonary consults inclusive of X-ray review, acquisition of all pertinent information from narrative history and record review, and personally performed physical examination of the patient B. Medical Knowledge: 1. Demonstrate a clear understanding of asthma, from pathophysiology to prevention 2. Identify diagnostic strategies and understand basic management of patients referred for evaluation of the following: bronchopulmonary dysplasia, cystic fibrosis, obstructive sleep apnea, asthma, acute and chronic ventilatory support, muscular dystrophies, apparent life threatening events, apnea of prematurity and congenital central hypoventilation syndrome 3. Review the indications, limitations, risks and costs of pulmonary function testing 4. Demonstrate an understanding of the multimodal Respiratory Physiology (Sleep) Laboratory to Updated 02.2017 1
PL-3/4 Residents include utility, indications, limitations, risks, costs. 5. Define and recognize the common presenting signs and symptoms of respiratory disorders (stridor, respiratory failure, cough, exercise intolerance, apnea, wheezing, tachypnea, hemoptysis, cyanosis, clubbing) 6. Develop a working knowledge of the following topics during their time on the Elective through experience, didactic sessions or reading: Pulmonary Major topics: Cystic fibrosis BPD Asthma Pneumonia (recurrent) Lung growth and development Interstitial lung disease Pulmonary function testing and interpretation, Oximetry, Blood Gas analysis Respiratory failure (acid base, blood gas interpretation) Utility of flexible bronchoscopy Pulmonary Related topics: SIDS Evaluation and management of apparent life threatening events, including interpretation of polysomnographic studies. Congenital Central Hypoventilation Syndrome (CCHS) and related control of breathing problems, apnea, alveolar hypoventilation) Obstructive sleep apnea Hypersensitivity pneumonitis (ABPA, etc.) Aspiration Syndromes AIDS related pulmonary complications Tuberculosis Neuromuscular disorders leading to respiratory failure Congenital anomalies of lung and tracheobronchial tree Immunologic lung diseases Upper airway problems- congenital and acquired Pulmonary problems in bone marrow and other transplant recipients C. Practice-Based Learning and Improvement: 1. Arrange to tour the PFT lab and watch a patient have a full study performed, to become familiar with techniques and tests 2. Read and review PFT s as they become available for interpretation with the service attending 3. Present two informal seminars to the attending, fellow, and students on service on in-depth review of a pertinent topic, either from something of interest that has come up on clinical or consult service, or from the suggested reading list 4. Maintain a willingness to learn from error and use errors to improve health care delivery 5. Reflect on their own knowledge and performance, identify and target gaps in that knowledge 6. Develop an independent learning plan to address identifiable gaps in knowledge Updated 02.2017 2
PL-3/4 Residents 7. Provide, request and accept/incorporate feedback into practice 8. Demonstrate a willingness to learn from errors and use errors to improve the system or processes of care 9. Use information technology or other available methodologies to access and manage information, support patient care decisions and enhance both patient and physician education 10. Demonstrate the ability to work with other learners to improve/enhance knowledge D. Interpersonal and Communication Skills: 1. Use interpreters effectively when necessary 2. Provide effective and professional consultation to other physicians and health care professionals and sustain therapeutic and ethically sound professional relationships with patients, their families, and colleagues 3. Use effective listening, nonverbal, questioning, and narrative skills to communicate with patients and families 4. Interact with referring physicians in a respectful, appropriate manner 5. Maintain comprehensive, timely, and legible medical records 6. Demonstrate the ability to give age-appropriate anticipatory guidance including discussions of health promotion and disease control and prevention 7. Demonstrate the ability to communicate with patients and families effectively without the use of medical jargon 8. Complete evaluations of attending, staff and rotation E. Professionalism: 1. Act in the best interest of your patients 2. Demonstrate respect, compassion, integrity, and altruism in relationships with patients, families, and colleagues 3. Demonstrate sensitivity and responsiveness to the gender, age, culture, religion, sexual preference, socioeconomic status, beliefs, behaviors and disabilities of patients and professional colleagues 4. Adhere to principles of confidentiality/scientific/academic integrity 5. Demonstrate conflict resolution F. Systems-Based Practice: 1. Advocate for families as they navigate health system complexity 2. Explain of different options for home monitoring and home ventilation (invasive and non-invasive) 3. Develop a multidisciplinary approach to the child and young adult with cystic fibrosis in conjunction with CF program 4. Demonstrate knowledge of billing and coding and their supportive documentation 5. Participate in problem case conferences 6. Identify access and utilize the resources, providers and systems necessary to provide optimal care 7. Discuss the limitations and opportunities inherent in various practice types and delivery systems, and the strategies to optimize care for the individual patient Updated 02.2017 3