Pulmonary

During this rotation, residents should develop an approach to the following :

• COPD

• Asthma

• Interstitial Lung Disease

• Lung masses/nodules

• Sleep disordered breathing

• Pleural Effusions

• Respiratory Failure

• Hemoptysis

• ABG interpretation

• PFT interpretation

• CXR interpretation

• Use of oxygen and non-invasive ventilatory support

By the end of this rotation, residents will be graded as “progressing as expected” in each of the following and in the Global Rating.  The expected level of performance in the PGY1 year is Interpreter level,  PGY2 is Manager Level, PGY3 is Educator Level (See Program Information - Overall Goals and Objectives). 

1. Medical Expert

• Data Collection and Clinical Reasoning: The resident appropriately collects and synthesizes clinical information to formulate a primary diagnosis and appropriate differential diagnosis.

• Clinical Decision Making: The resident is able to make appropriate and cost-effective investigation and management decisions based on the context of the case and best available evidence.

2. Communicator

• Patient and Family Communication: The resident communicates with and about patients and family in a patient-centered manner.

• Documentation and Verbal Presentation: The resident appropriately documents and verbally presents cases for new admissions, progress notes, handover of care, and discharge summaries (succinctly organized, prioritized, summarized).

3. Collaborator

• Interdisciplinary Team: The resident works well in a team, shares work, and interacts with allied healthcare providers and other consultants effectively.

4. Leader

• Efficiency: The resident prioritizes tasks and manages time effectively.

5. Health Advocate

• Patient Advocacy: The resident advocates for patients by obtaining/expediting investigations, consults, or access to other resources during inpatient care or during transition to the outpatient setting.

6. Scholar

• Personal and Team-based Learning:  The resident demonstrates an effective personal learning strategy (reading around cases, appropriate use of resources) and shares knowledge with other team members.

7. Professional

• Scope of Practice:  The resident is trustworthy and responsible, knows limitations (asks for help appropriately), and responds well to feedback.

Assessment

We use the following In-Training Evaluation Report (ITER): 

• Pulmonary Wards

Entrustable Professional Activities (EPAs)

This rotation may be done during Transition to Discipline, Foundations, or Core.  Depending on stage of training, this is an ideal learning environment for the following EPAs: 

• TD1: Performing histories and physical exams, documenting and presenting findings, across clinical settings for initial and subsequent care

• TD2: Identifying and assessing unstable patients, providing initial management, and obtaining help

• TD3: Performing the basic procedures of internal medicine

• FD1: Assessing, diagnosing, and initiating management for patients with common acute medical presentations in acute care settings

• FD2: Managing patients admitted to acute care settings with common medical problems and advancing their care plans

• FD3: Consulting specialists and other health professionals, synthesizing recommendations, and integrating these into the care plan

• FD4: Formulating, communicating, and implementing discharge plans for patients with common medical conditions from acute care settings

• FD5: Assessing and providing targeted treatment for unstable patients and consulting as needed

• FD6: Discussing and establishing patients’ goals of care

• FD7: Identifying personal learning needs while caring for patients and addressing those needs 

• CD1: Assessing, diagnosing and managing patients with complex or atypical acute medical presentations

• CD2: Assessing, diagnosing, and managing patients with complex chronic diseases

• CD3: Providing internal medicine consultation to other clinical services

• CD5: Performing the procedures of Internal Medicine

  • Thoracentesis

• CD7: Discussing serious and/or complex aspects of care with patients, families, and caregivers

  • Breaking Bad News

• CD8: Caring for patients who have experienced a patient safety incident (adverse event)

• CD10: Implementing health promotion strategies in patients with or at risk for disease

  • E.g. Smoking cessation in Asthma/COPD, lung cancer screening

Rotation Supervisor

Dr. Chrystal Chan

ctc1@ualberta.ca

Medical Education Program Coordinator

mednresp@ualberta.ca