Sports/Ortho

NHCP 52 Area SMART CLINIC ROTATION INFORMATION

POC: Jeremy Ramsey CDR MC USN, Jeremy.k.ramsey.mil@mail.mil

Welcome to the Sports Medicine and Reconditioning Team (SMART) Clinic at NHCP where you will be seeing Active Duty Service Members with overuse and traumatic injuries. You will be able to hone your musculoskeletal exam skills, and have a glimpse of operational medicine. Have fun, learn a lot and ask questions!

First Day:

Arrive at SMART Clinic by 0730 and report to CDR Ramsey for orientation.  You may wear the alternative uniform of a Navy Blue Polo Shirt and Khaki shorts or pants. You may wear Khaki’s or NWU’s. You are expected to wear your hospital name badge at all times. Your orientation will include a short welcome by CDR Ramsey. The more familiar you are with the shoulder, back, hip, knee, and ankle exams prior to starting, the more meaningful your rotation will be.

Directions:

SMART CLINIC address:

52 Area: BLDG 520440 (On San Juan Road)

Recommend using  Google Maps or Waze . Use 52 Area BAS/ Clinic

Schedule:

Clinic starts at 0730 and ends at 1530 M-F with weekends off.  

Lunch:

             You will have 1 hour for lunch, usually 1200-1300, and there is a galley and exchange store on base where you may get lunch. A break room is available with a refrigerator and microwave. During your break you may leave the base but no alcohol is allowed. You may also workout in the gym and use the locker room to shower.

Continuity Clinic / Conferences:

             Inform CDR Ramsey of your clinic schedule during your orientation. You will always be able to leave so that you can get lunch and make it to clinic on time. You will not be expected to return after your continuity clinic. If any conferences arise during your rotation, please notify CDR Ramsey.

You may start out shadowing staff, if you want to repeat an exam, just let them know.  Once you feel ready, you can do independent evaluations and presentations.

WELCOME TO THE 52 AREA SMART CLINIC (SPORTS MEDICINE AND RECONDITIONING TEAM)

We are Specialty Clinic that sees musculoskeletal injuries that occur in our Active Duty Military Members. Most of the patients are Marines, some Navy, even fewer Army and Air Force. A large percent (approximately 2/3 –3/4) are patients from the School of Infantry command. Most of the SOI patients are students that have just graduated boot camp and are here for basic training. Some are fleet members that are in advanced infantry or staff academy courses (usually for moving up in rank). The rest of the patients are fleet members from other commands that are referred to us from their GMOs, typically from 41 Area (Las Flores) and northwards  - 43 Area (Las Pulgas), 53 Area (Horno), 62 Area (San Mateo) and 64 Area (Talega). We get patients on occasion from Army or Air Force recruitment stations.

The mission of the clinic is primarily to see SOI students in training and evaluate and treat their injuries. One of the important components of the evaluation will be to see if they can continue training or not. The treatment rendered will sometimes depend on that answer. Those patients that are not in training receive the same evaluation and similar treatment however they are usually not faced with any specific time constraints.

SOI students that are at Pendleton for basic training fall under 2 training categories: MCT (Marine Combat Training) or ITB (Infantry Training Battalion). MCT training is 29 training days, and ITB is 59. MCT training is roughly the same training as ITB for the first half. Where MCT graduate ITB continues on and does more specific infantry – type training. MCT graduates go onto different MOS schools to continue training as support marines for the infantry units (motor transport, cook, communications, etc). ITB graduates go onto either a fleet unit to be infantrymen, or continue to advanced infantry reconnaissance training (BRC – Basic Reconnaissance Company).  The BRC classes are few and far between, thus there is a training unit called MART (Marines Awaiting Reconnaissance Training) where they do nothing but PT, all day, twice a day 5 days a week.

SOI Students in Advanced courses come from different commands, sometimes from far away, and are here for courses such as “SSGT Course, GySGT Course, SGT Course, Sniper School, AITB, ISLC, IULC, MAIC, CIS, LAVTC”  to name a few. The acronyms are endless. These are typically 4-9 weeks long.

After assessing an injury, we need to determine if they can be treated acutely with therapy (usually athletic training) in the same day with no light duty, for a few days with no more than 2 days of light duty, or will need longer and subsequently need to drop out of their course. Students in basic training (MCT/ITB) that get dropped come to the LIMA REHAB Platoon. Advanced course students that drop out of their course go back to their parent command. Training courses usually will drop any student needing /missing more than 2 days of Physical Training (PT) / light duty (LD).

Patients NOT in a course can have up to 90 days consecutive light duty for any one injury. We do not write LD chits for patients outside of SOI. We can write for duty modifications; however the patient must bring our recommendations back to their BAS for a LD chit.

We often manage patients with chronic injuries that require a “Limited Duty Board”. Those members have sustained an injury that required > 90D LD and have a dedicated 6 month period to be treated for their injury. The main difference is that it requires paperwork on our part and filing in the IDES system to officially record their LIMDU period.

We have the following as our resources for treatment: ATC (Athletic Trainers- Certified), physical therapy, Chiropractic services.  We also prescribe medications, order Durable Medical Equipment (DME), and perform joint injections. We have the capacity for MSK ultrasound and PRP. We try to utilize our ATCs for our SOI students in training or for patients that only need 1-2 visits for a home exercise program. Most if not all fleet members that need formal therapy are usually referred to physical therapy. This allows the ATCs to be available for our SOI students at all times including the same or next day. Please do not order “ATC 2-3 per week x 4 weeks” for patients.

AFTER SEEING AND EVALUATING AND SOI LIMA CO REHAB STUDENT THEN MUST BE ASSIGNED A PT PHASE (0/1/2/3/4). CHECK WITH YOUR PRECEPTOR ABOUT THIS PART.

ORIENTATION GUIDELINE FOR LEARNERS

WELCOME TO THE 52 AREA SMART CLINIC (SPORTS MEDICINE AND RECONDITIONING TEAM)

Patients: Active Duty Military Members only, no dependents or retirees (some exceptions). Most of the patients are Marines, some Navy, even fewer Army and Air Force.

2/3- ¾ from School of Infantry command. The rest are referrals from the north end of base - 53 Area (Horno), 62 Area (San Mateo) and 64 Area (Talega). We get patients on occasion from Army or Air Force recruitment stations.

Mission: see SOI students in training and evaluate and treat their injuries. One of the important components of the evaluation will be to see if they can continue training or not. Secondarily we see referral from the north end of base.

SOI students

Basic Training: MCT (Marine Combat Training – 29 days) or ITB (Infantry Training Battalion – 59 days).

Advanced Infantry Training – graduate from ITB then go onto MART, BRC, and later on IULC, ISLC, MAIC, CIS, Sniper School, LAVTC, anywhere from 4 weeks to 3 months long.

Staff Academy – SGT, SSGT, GySGT Courses through the SNCOI Academy. Usually 9 weeks long

Injury Evaluation and Treatment for SOI students:

Full Duty – stay in course

Light Duty (up to 3 days) – stay in course

Light Duty > 3 days up to total of 90 days – drop from course

ATC acutes, established, phase PT evals (ask your preceptor what that means), physical therapy, Chiro, Ortho / podiatry, DME, occupational therapy are available as treatment options

ITB / MCT Students dropped from training come to rehab platoon (LIMA REHAB). Other students dropped from courses return to their parent command (some come from out of state!)

Rehab students are closely tracked and on a strict time scheduled to return to training. Out of training < 30D can go back where they left off. If > 30D will start over (some exceptions). If > 90D will either be RTFD, LIMDU or ADSEP / ELS. ALL REHAB STUDENTS WHEN EVALUATED MUST BE ASSIGNED A PT PHASE. CHECK WITH YOUR PRECEPTOR ABOUT THIS PART.

Fleet members

Eval and treat (same resources) without the 2D time constraint.

Can have up to 90 days cumulative LD (for specific injury)

LD > 90 days needs a LIMDU Board, usually 2 / career. Any obviously permanently disabling injury will need a PEB / MED BOARD

Use physical therapy services rather than ATCs for most cases

Sports Medicine Resident Binder (on resident share drive) * Please bring a blank CD if you would like a

copy for personal use*

AMSSM physical exam videos can be found at: https://amssm.blogspot.com/p/videos.html

EKG Interpretation in Athletes http://learning.bmj.com/learning/course-intro/.html?courseId=10042239

(sign in with your Athens account)

USU Sports Medicine Website https://www.usuhs.edu/fam/sports-med-presentations (Google drive

cannot be accessed on Government Computer)

American Academy of Family Practice http://www.aafp.org/home.html

AFP Journal (Musculoskeletal Care Topic)

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=17

American Medical Society for Sports Medicine http://www.amssm.org/

American College of Sports Medicine http://acsm.org/

American Osteopathic Academy of Sports Medicine http://www.aoasm.org/

American College of Emergency Physicians Sports Medicine https://www.acep.org/how-we-

serve/sections/sports-medicine/musculoskeletal-exam-series/

Achar, SA. “The 5-Minute Sports Medicine Consult” 3 rd Edition

O’Connor FG. “ACSM’s Sports Medicine: A Comprehensive Review”

Magee DJ. “Orthopedic Physical Assessment” 6 th Edition

Sawark JF. “Essential’s of Musculoskeletal Care” 5 th Edition

McKinnis LN. “Musculoskeletal Imaging Handbook: A Guide for Primary Practice”

Thompson JC. “Netter’s Concise Orthopedic Anatomy” 2 nd Edition

Gulick D. “Sports Notes: Field and Clinical Examination Guide”

Gulick D. “Ortho Notes: Clinical Examination Pocket Guide”

Eiff MP. “Fracture Management for Primary Care” 3 rd Edition

Burke L. “Clinical Sports Nutrition” 5 th Edition

Safran MR. “Instructions For Sports Medicine Patients” 2 nd Edition

Curriculum Description – The goal of these guidelines is to provide a framework within which the Family Medicine resident can gain a working knowledge of the many aspects of musculoskeletal disease and gain the skills necessary to provide care for his/her patients. The specialty of Family Medicine is vitally interested in all aspects of musculoskeletal problems. Its practitioners must have knowledge of even the most intricate problems so that appropriate decisions are made regarding the ultimate care of the patient.

Appropriate history-taking and competency in physical examination and diagnosis of musculoskeletal problems are essential parts of Family Medicine training. Many musculoskeletal problems are within the scope of Family Medicine.  Family Physicians should be able to competently diagnose and treat these problems. The Family Physician may not provide definitive care in all instances, depending on training and experience, but must have the knowledge to refer appropriately and educate the patient’s family. The ultimate goal of this curriculum is optimal patient care by the Family Physician, either with or without a consultant.

Curriculum Goals:

The ACGME has outlined six core competencies for all residents in training. The primary goal of the musculoskeletal care experience is for residents to develop the following 6 competencies in the context of evaluating and treating children and adults who present with musculoskeletal injuries or illnesses.

1. Patient care that is compassionate, appropriate, and effective for the treatment and promotion of health.

2. Medical Knowledge about established and evolving biomedical, clinical, and cognate sciences, as well as the application of this knowledge to patient care.

3. Practice-based learning and improvement that involves the investigation and evaluation of care for their patients, the appraisal and assimilation of scientific evidence, and improvements in patient care.

4. Interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and other health professionals.

5. Professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to patients of diverse backgrounds.

6. Systems-based practice, as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care.

Required Rotations:

PGY-1 – Sports Medicine (2 weeks) and Orthopedics (2 weeks.) Each PGY-1 will spend 2 weeks at the Camp Pendleton 13 area and 52 area SMART clinics and 2 weeks in the NHCP Orthopedics Department.

PGY-3 – Sports Medicine (4 weeks.)  Each PGY-3 will spend 4 weeks at the Camp Pendleton 13 area and 52 area SMART clinics.

Other Learning Activities:

Other experiences that contribute to achieving the goals and objectives of this section include Family Medicine continuity clinic in the PGY-1, 2 and 3 years, ER rotations at NHCP in the PGY-1 year and Palomar Trauma Center in the PGY-3 year, the annual Orthopedics Symposium, the annual Joint Injection/Aspiration Workshop, and assigned journal readings during rotations.  In addition, opportunities for elective rotations during the PGY-2 and 3 years in Sports Medicine, Orthopedics and Rheumatology are available at NHCP, CP SMART clinics, NMCSD and civilian hospitals in San Diego.

ACGME Program Requirements:

Residents must have two months experience in the care of patients with orthopedic and musculoskeletal problems, including experience in sports medicine.

The curriculum should include non-articular rheumatic disorders, infectious, suppurative and degenerative arthritic conditions, acquired and congenital abnormalities of bones and joints, musculoskeletal and connective tissue disorders, evaluation and management of common sprains, fractures and dislocations, preventive care, rehabilitation and restorative function. Clinical experience should include acute evaluation of musculoskeletal trauma and acute pain syndromes.

Sports Medicine must be a clear and separate curriculum within the two-month/200 hours of experience and must include non-orthopedic aspects of sports medicine with emphasis on care of athletes of all ages, both genders, and persons active or anticipating exercise activities. The care of the athlete includes performance of pre-participation sports physicals, assessment of common injuries, knowledge of treatment and rehabilitation. Both curricula must include performance of procedures common in the evaluation and care of orthopedic and sports medicine patients and participation in the rehabilitation required for these patients. These include interpretation of radiographs, aspiration and injection of joints, splinting and casting.

Administrative Information:

Last review: 18 November 2021

Family Medicine/Sports Medicine Coordinator: CDR Jeremy Ramsey

Orthopedics Coordinator: LCDR Ryan Scully

Length of rotation: 4 weeks

Number of months to be completed: 2

Maximal time away allowed from rotation: 7 days

Number of half days in FM clinic: PGY1 – 1 per wk (FRI AM); PGY2 (elective) – 4 per week (MON AM/PM, WED/FRI AM; PGY3 – 4 per week (WED PM, THUR AM, FRI AM/PM)

Preferred clinic times: Mornings

A.M. Report attendance required: Yes, while working in NHCP Orthopedics

 Thursday afternoon conference attendance required: Yes

FM call required: Yes

Responsible for hospitalized FM panel patients: Yes

Responsible for OB panel patients: Yes

Selected Rotation Specific Objectives by ACGME Competency Category:

The following is a listing of selected knowledge, skills and attitudes (K.S.A.s) that residents are expected to gain competency in during their rotations on the Sports Medicine and Orthopedics. It is understood that not all the K.S.A.s will be attained on a single rotation, but they will be developed and attained throughout the 3 years of residency; specific K.S.A.s that are not developed on the Sports Medicine and Orthopedics rotations will be developed during the other rotational experiences.

The rotation specific objectives will be reviewed with each resident prior to rotating on Sports Medicine and Orthopedics in order to clarify which objectives the resident is trying to attain. The resident will hold on to the curriculum, and use it as a reference point for areas to focus on during the rotation. At the end of the rotation, the rotation specific objectives will be reviewed with their advisor, and those attained will be checked. This review will be kept in the resident’s file, in order to document the resident’s progress.

Musculoskeletal Objectives

Patient Care:

Gather essential and accurate information about their patients:

PGY-1

____Perform an adequate musculoskeletal exam

____Identify fractures

Perform competently all medical and invasive procedures considered essential for the area of practice: Proficiency will be determined by several factors including understanding of indications, total attempted, total completed, skill level, confidence and outcome of procedure. PGY-1

____Stabilization of fractures

____Management of sprains and strains

____Relieve a subungual hematoma

____Arthrocentesis, joint injections, common injections for bursitis, common injections for tendinopathy

____Plaster and fiberglass casts (short and long leg, short and long arm, thumb spica, cast problems)

PGY-2

____Complete a pre-participation/clearance physical

____Write an exercise prescription

____Arthrocentesis, joint injections, common injections for bursitis, common injections for tendinopathy

PGY-3

____Reduction of an anterior shoulder dislocation

____Reduction of a radial head dislocation

____Arthrocentesis, joint injections, common injections for bursitis, common injections for tendinopathy

Medical Knowledge:

Residents must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological and social-behavioral sciences, as well as the application of this knowledge to patient care.

The resident should gain understanding of pathophysiology, presentation, initial evaluation, inpatient management and appropriate follow-up of patients who have the following included (but not limited to) conditions:

PGY-1

____Orthopedic emergencies

____Neck pain

____Back pain

____Rotator cuff injury

____Shoulder dislocation

____AC joint separation

____Epicondylitis

____Carpal tunnel syndrome

____Ganglion cyst

____de Quervain’s tenosynovitis

____Tuft (distal phalanx) fracture

____Subungual hematoma

____Patellafemoral pain syndrome

____Stress fracture/shin splints

____Compartment syndrome

____Plantar fasciitis

____Felon, paronychia and ingrown toenail

____Indications, limitations, contraindications and informed consent for office-based   musculoskeletal procedures (i.e. joint injections, joint aspirations, injections for bursitis, injections for tendinopathy)

PGY-2

____Concussion

____Impingement

____Scaphoid fracture

____Tenosynovitis

____Iliotibial band syndrome

____Tendon rupture

____Use of supplements/performance enhancers

____Indications, limitations, contraindications and informed consent for office-based   musculoskeletal procedures (i.e. joint injections, joint aspirations, injections for bursitis, injections for tendinopathy)

PGY-3

____Frozen shoulder

____Radial head dislocation

____Trigger finger

____Boutonnierre deformity

____Mallet finger

____Internal derangement of the knee (ACL/PCL/meniscus)

____Ingrown toenail

____Tendonopathies

____Radiculopathies

____Slipped capital femoral epiphysis

____Epiphyseal injury

____Osgood-Schlatter disease

____Limping child

____In-toeing child

____Indications, limitations, contraindications and informed consent for office-based   musculoskeletal procedures (i.e. joint injections, joint aspirations, injections for bursitis, injections for tendinopathy)

Practice-Based Learning and Improvement:

PGY-1

1.      Evidence-Based and Informed Practice

__Utilize hospital’s evidence-based medicine resources (Up To Date; FPIN; Ovid; Medical Letter; Prescribers Letter; Other resources on Clinical Portal) to obtain current information on patient management

__Demonstrates how to access, categorize, and analyze clinical evidence

2.      Reflective Practice and Commitment to Personal Growth

__Accepts responsibility for personal and professional development by establishing goals

__Accepts feedback

__Acknowledges there are always opportunities for self-improvement

         __Designs and implements a learning plan, with prompting

PGY-2/3

1.      Evidence-Based and Informed Practice

__Articulates clinical questions and elicits patient preferences and values in order to guide care

__Locates and applies the best available evidence, integrated with patient preference, to the care of complex patients

2.      Reflective Practice and Commitment to Personal Growth

__Designs and implements a learning plan, with prompting

__Independently creates and implements a learning plan

Interpersonal and Communication Skills:

PGY-1

1.      Patient-and Family-Centered Communication

__Uses language and nonverbal behavior to demonstrate respect and establish rapport

__Recognizes easily identified barriers to effective communication (eg. Language disability, deafness, etc)

__Identifies the need to individualize communication strategies (eg. Speaking in a way that the patients and their family can understand)

2.      Interprofessional and Team Communication

__Interactions with other physicians and health care professionals are respectful and collaborative with the patients’ interests held foremost

__Uses language that values all members of the health care team (360° evaluations will be completed during the rotation)

3.      Communication within Health Care Systems

­­__Accurately and timely records information in the patient record (timely completion of chart, response to patients’ message, and submission for attending co-signature)

__Learns institutional policy and safeguards patient personal health information (HIPAA compliant, PII, PHI, etc.)

__Communicates through secure messaging systems, encrypted emails, etc.

PGY-2/3

1.      Patient-and Family-Centered Communication

__Establishes a therapeutic relationship in straightforward encounters using active listening and clear language

__Organizes and initiates communication, sets the agenda, clarifies expectations, and verifies understanding

__Sensitively and compassionately delivers medical information, managing patient/family values, goals, preferences, uncertainty, and conflict

2.      Interprofessional and Team Communication

__Clearly and concisely requests a consultation

__Communicates information effectively with all health care team members

__Checks understanding of consult recommendations

__Communicates concerns and provides feedback to peers and learners

3.      Communication within Health Care Systems

__Demonstrate organized diagnostic and therapeutic reasoning through notes in the patient records

__Uses appropriate channels to offer clear and constructive suggestions for system improvement while acknowledging system limitations.

Professionalism:

PGY-1

1.  Professional Behavior and Ethical Principles

__Describes professional behavior and potential triggers for personal lapses in professionalism

__Takes responsibility for personal lapses in professionalism

__Demonstrate knowledge of ethical principles

__Demonstrate compassion, integrity, and respect for others

2.  Accountability/Conscientiousness

__Residents will be on-time to all work-related events, will complete all administrative work within hospital/departmental policies and will present themselves with and appropriate/professional appearance/demeanor at all times.

__Responds promptly to requests and reminders to complete tasks and responsibilities

3.  Self-Awareness and Help-Seeking Behaviors

__Recognizes status of personal and professional well-being, with assistance

__Recognizes limits in the knowledge/skills of self, with assistance

PGY-2/3

1.      Professional Behavior and Ethical Principles

__Demonstrates professional behavior in routine situations

__Demonstrates professional behavior in complex or stressful situations

__Analyzes straightforward situations using ethical principles

__Analyzes complex situations using ethical principles

2.      Accountability/Conscientiousness

__Performs tasks and responsibilities in a timely manner with appropriate attention to detail in routine situations

__Proactively implements strategies to ensure that the needs of patients, teams, and system are met

3.      Self-Awareness and Help-Seeking Behaviors

__Independently recognizes limits in knowledge/skills of self and team and demonstrates appropriate help-seeking behaviors

__Proposes a plan to remediate or improve limits in the knowledge/skills of self or team, with guidance

Systems-Based Practice:

­­PGY-1

1.    Patient Safety and Quality Improvement

__Demonstrates Knowledge of common patient safety events

__Reports patient safety events through institutional reporting systems (PSR report)

__Demonstrates knowledge of basic quality improvement methodologies and metrics (PDSA cycle)

2.      System Navigation for Patient-Centered Care

__Identifies key elements for safe and effective transitions of care and hand-offs

__Coordinates care of patients in routine clinical situations effectively using the roles of the interprofessional team members

__Performs safe and effective transitions of care/hand-offs in complex clinical situations (transfer patients to the ER for expedited work-up, discussing with inpatient team about potential admission)

3.  Physician Role in Health Care Systems

__Describes basic health payment systems

__Identifies components of the complex health care system (eg. Hospital, skilled nursing facility, etc.)

4.  Advocacy

__Identifies that advocating for a patient population is a professional responsibility

PGY-2/3

1.  Patient Safety and Quality Improvement

__Identify system factors that lead to patient safety events

__Participates in analysis of patient safety events (simulated or actual)

__Reports patient safety events through PSR system

__Participates in local quality improvement initiatives

2.  System Navigation for Patient-Centered Care

__Coordinates care of patients in routine clinical situations effectively

__Coordinates care of patients in complex clinical situations effectively

__Performs safe and effective transitions of care/hand-offs

3.  Physician Role in Health Care Systems

__Demonstrates use of information technology required for medical practice (eg, electronic medical record, documentation required for billing and coding)

__Engages with patients in shared decision making, informed by each patient’s payment models

4.  Advocacy

__Identifies that advocating for a patient population is a professional responsibility

Specific Expectations of Residents:

PGY-1,2,3

1.  Record all procedures in New Innovations in a timely manner and assign a supervising physician

2.  Complete rotational evaluation on New Innovations within 2 weeks of completion of rotation.

3.  Complete curriculum review within 2 weeks of completing the rotation with resident advisor; denote on the curriculum areas where competency was attained

4.  Required attendance at:

a.   Morning report

b.  Academic conferences

5.  Routine call responsibilities

6.  Coverage on OB panel patients and deliveries

7.  Family Medicine clinic as scheduled.

Evaluation: 

Resident Evaluation:

- Daily evaluation:

The Sports Medicine/Orthopedics attending should provide daily and weekly oral feedback to the residents on progress and performance. Attendings will also provide feedback on the quality of written communication by critically reviewing resident chart entries

- Mid-rotation feedback:

With Sports Medicine/Orthopedics attending at completion of week 2. Resident must ensure time is scheduled with staff.  Written feedback required if resident is failing at mid-rotation evaluation or at any other time

- Final Evaluation:

All attendings should be sent an evaluation by the resident via New Innovations. Evaluations should be completed within two weeks after rotation.

Methods of Evaluation:

Portfolio:

The following items will be entered in the residents training record by the GME coordinator:

-Procedures documented in New Innovations

-Resident New Innovation evaluation

-Rotation-specific objectives completed

Staff Evaluation: (the staff is evaluated by the resident)

-Residents evaluate staff using the annual New Innovations staff evaluation

Rotation Evaluation: (the rotation is evaluated by the resident)

-Resident assesses quality of the rotation by completing the New Innovations standard rotation evaluation form. Evaluations should be completed within two weeks after rotation.

Testing:

- Resident knowledge will be assessed on yearly in-service examinations.

Recommend reading list:

- It is expected that residents will read, at a minimum, Up To Date or other web-based articles on the conditions of the patients they are following. They will check off in the knowledge portion of the goals and objectives those conditions they have seen. They should check off each of the specific conditions they have gained knowledge in, and they should have checked off all the knowledge specific objectives by the time they have completed residency.

References:

1. Program Requirements for Graduate Medical Education in Family Medicine; effective July, 2014.

2. AAFP’s Residency Solutions: Recommended Curriculum Guidelines for Family Medicine Residents: http://www.aafp.org/online/en/home/aboutus/specialty/rpsolutions/eduguide.html.

3. AMSSM physical exam videos can be found at: https://amssm.blogspot.com/p/videos.html