Learning Objectives

Care of the Elderly

https://www.ualberta.ca/family-medicine

Skilled Clinician

• • 1. basic science knowledge

    2. clinical knowledge

    3. physical exam - complete, accurate, organized

    4. clinical decision making

    5. recognition and management of emergencies

    6. technical and procedural skills

Community Based

• • 1. communicates effectively with other health professionals

    2. recognizes roles of, and interacts effectively with other health professionals

    3. consults and delegates effectively

    4. identifies socioeconomic determinants of health of patients and communities

Resource to a Defined Practice Population

• • 1. documentation timely, accurate

    2. uses information technology effectively

    3. allocates finite healthcare resources wisely

    4. manages time effectively

    5. applies quality improvement principles effectively

    6. personal continuing education strategy

    7. evidence based practice/critical appraisal

    8. helps others learn

    9. contributes to development of new knowledge

    10. seeks and accepts advice, demonstrates awareness of personal limitations

    11. meets deadlines/commitments made; is punctual

Effective Doctor/Patient Relationship

• • 1. communicates effectively with patients, families

    2. understands when and how to advocate appropriately on behalf of patients and communities

    3. demonstrates integrity, honesty, compassion and respect for diversity

    4. applies ethical principles appropriately

Typical topics cover in this rotation

• • 1. Approach to frail, older persons, their family, and/or caregivers

    2. Functional assessment

    3. Delirium

    4. Depression

    5. Dementia

    6. Urinary incontinence

    7. Medication use in the elderly

    8. Rehabilitation, continuing care, and home care services

    9. Competency

    10. Osteoporosis/fractures

    11. Falls and immobility

    12. Constipation

To enable you to fulfill your teaching role for medical students, their objectives are quoted below for information.

1. Comprehensive geriatric assessments including:

• • • • cognitive, functional, psychosocial

      • medication review

      • pertinent problem lists

      • care plans with interdisciplinary team

2. Assess and evaluate:

• • • • Delirium

      • Dementia

      • Falls and immobility

      • Urinary incontinence

3. Understand transitions of care

Core Internal Medicine Staff Evaluation of Residents Guidelines

Observer

• • • Demonstrates reliability in keeping appointments and other behaviour appropriate for a clinical

    • shadowing experience, but neither independently nor consistently meets the performance level of the reporter.

Reporter

• • • Consistently good in interpersonal skills and reliably obtains and communications clinical findings.

    • Efficiently and accurately collects patient date.

    • Recognizes normal from abnormal.

    • Identifies and labels new problems.

    • Communicates collected data orally and in writing.

Interpreter

• • • Able to prioritize and analyze patient problems.

    • Prioritizes problems.

    • Follows up and interprets abnormal findings and tests.

    • Creates a differential diagnosis.

    • Prioritizes a differential diagnosis.

Leader

• • • Consistently proposes reasonable options which incorporate patients' preferences.

    • Determines when action is necessary.

    • Chooses the most appropriate diagnostic tests.

    • Chooses the most appropriate management strategy.

    • Customizes a plan according to patient circumstances and preferences.

Educator

• • • Consistent level of knowledge of current medical evidence & can critically apply knowledge to specific patients.

    • Identifies knowledge gaps and develops plans to address them.

    • Shares new knowledge with others.

    • Understands the use and limits of evidence in the care of patients.

Typical topics cover in this rotation:

• • 1. Approach to frail, older persons, their family, and/or caregivers

    2. Functional assessment

    3. Delirium

    4. Depression

    5. Dementia

    6. Urinary incontinence

    7. Medication use in the elderly

    8. Rehabilitation, continuing care, and home care services

    9. Competency

    10. Osteoporosis/fractures

    11. Falls and immobility

    12. Constipation

CanMEDS OBJECTIVES

Medical Expert

• • • Able to complete an appropriate history

    • Able to complete an appropriate physical examination

    • Able to generate an appropriate differential diagnosis

    • Establishes an appropriate management plan

    • Applies best available evidence to clinical practice

Communicator

• • • Demonstrates ability to communicate in a respectful, truthful, empathetic manner

    • Written records are legible, timely and problem based

    • Communicates effectively

Collaborator

• • • Appropriate interaction with other health care professionals

    • Understands the interdependent nature of the multidisciplinary health care team.

    • Consults effectively by asking and/or answering appropriate questions

Leader

• • • Manages time effectively; completes assigned tasks proficiently and on time.

    • Rational and cost effective use of investigative tests.

    • Demonstrates conflict resolution skills

    • Delegates work effectively where appropriate

Health Advocate

• • • Is an advocate for his or her patient

    • Considers cost and impact to the patient and family with choice of investigations, drugs, and therapy

    • Maximizes opportunities to promote preventative medicine in patient encounters

Scholar

• • • Demonstrates commitment to personal education

    • Understands the principles of critical appraisal. Demonstrates ability to critically appraise the medical literature.

    • Capitalizes on available teaching opportunities (teachable moments - includes attendance at rounds).

Professional

• • • Shows integrity and honesty

    • Shows compassion

    • Respectful of patients and other health care professionals

    • Seeks advice and is aware of limitations

    • Respects patient confidentiality

    • Dresses in a respectful and professional manner.

    • Punctual and meets deadlines

To enable you to fulfill your teaching role for medical students, their objectives are quoted below for information.

1. Comprehensive geriatric assessments including:

• • • • cognitive, functional, psychosocial

      • medication review

      • pertinent problem lists

      • care plans with interdisciplinary team

2. Assess and evaluate:

• • • • Delirium

      • Dementia

      • Falls and immobility

      • Urinary incontinence

3. Understand transitions of care