7+Neurosurgery+Educational+Goals+and+Objectives+2-4-16

Educational Goals and Objectives

The program aims to provide comprehensive education in both basic and clinical sciences pertinent to neurosurgery, alongside training in cognitive and technical skills It focuses on enhancing clinical knowledge, fostering professional maturity, and developing sound surgical judgment Additionally, the program includes specific rotation objectives and evaluations aligned with the six competencies established by the Accreditation Council for Graduate Medical Education.

Graduate Medical Education (ACGME) are noted below Specific technical and medical objectives to be gained within each rotation are described individually below

The educational experiences for reaching these objectives are:

 Supervised responsibility for patient management and operations

 Review of deaths, complications and errors

 Development of individualized program of reading and self-education

Evaluation of attainment of these goals is measured by faculty evaluation on clinical services, as well as evaluation by other professional staff (e.g., nursing).

The program conducts a comprehensive self-evaluation process that includes assessments from residents regarding the program and its rotations, along with evaluations from faculty and nursing staff on resident performance This evaluation process involves semi-annual self-assessments by residents, which are reviewed with the Program Director (PD), as well as electronic monitoring of case logs Additionally, residents participate in semi-annual reviews with the PD to discuss their case volume, breadth, and complexity, ensuring a thorough appraisal of their progress and development.

Department of Neurosurgery Residency Program | 6

The Six Core Competencies

Patient Care

Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.

Residents will showcase their manual dexterity according to their training level and will be capable of creating and implementing patient care plans This skill is cultivated through direct mentorship from senior residents and faculty during each clinical rotation, with their performance assessed in the final formative evaluation at the end of each rotation.

During surgical rotations, essential learning activities that enhance competency development encompass a variety of experiences These include both inpatient and outpatient patient care, as well as comprehensive pre-operative, operative, and post-operative care Residents are required to complete and review their operative logs, attend weekly academic conferences, participate in didactic sessions, and engage in quality improvement initiatives Additionally, case discussions during weekly resident conferences, bedside teaching, and inpatient teaching rounds are integral components Operating room instruction and participation in an evidence-based Journal Club further enrich the learning experience, while involvement in the pre-operative evaluation of surgical patients in an outpatient setting is also crucial.

Residents are expected to effectively communicate and demonstrate respect in their interactions with patients and families while obtaining comprehensive surgical histories and relevant medical records They should make informed decisions regarding diagnostic and therapeutic interventions, considering patient preferences, current scientific evidence, and clinical judgment Additionally, residents must formulate care plans that encompass pre-, intra-, and post-operative care, as well as counsel and educate patients and their families Utilizing information technology to enhance patient care decisions and education is essential, along with competently performing all necessary medical and invasive procedures Furthermore, residents are tasked with providing healthcare services focused on preventing health issues and maintaining overall health, while coordinating with a multidisciplinary care team to ensure effective, patient-centered care.

Assessment includes observation of performance in these areas: a Medical interviewing b Physical examination c Procedural skills, as demonstrated with simulators and patients d Clinical judgment e Ongoing care

Medical Knowledge

Residents are expected to learn basic medical knowledge about established and evolving biomedical, clinical, epidemiological and social-behavioral sciences, as well as the application of

The Department of Neurosurgery Residency Program emphasizes the importance of applying scientific knowledge to patient care Residents are trained to critically evaluate scientific information, enhancing their clinical skills through departmental lectures, conferences, morbidity and mortality discussions, and resident presentations.

Surgical rotations offer a variety of learning activities that enhance competency development, including weekly academic conferences focused on neuroradiology and neuropathology, presentations at related conferences, and hands-on educational experiences in clinics, hospitals, and operating rooms Participants engage in occasional intra- and extra-mural conferences, prepare for the American Board of Neurological Surgery (ABNS) primary examination, and attend Journal Club/EBM Conferences Maintaining an academic portfolio and participating in the annual Neuropathology and Neuroradiology Review Course at the Inova Neuroscience and Spine Institute further enrich their education Additionally, students benefit from hands-on neurosurgical simulations and self-directed study to deepen their understanding and skills in the field.

Residents are expected to exhibit strong investigatory and analytical thinking skills in clinical situations, apply foundational and clinically relevant sciences pertinent to their field, and possess a solid understanding of neuroanatomy Additionally, they should start developing the ability to create and execute diagnostic and treatment plans for brain and spinal cord diseases, while also demonstrating comprehensive knowledge in the diagnosis, preparation, operative treatment, and overall management of surgical patients.

Assessment encompasses various performance evaluation methods, including bi-annual mock oral examinations for PGY-6 and PGY-7 residents, daily attending rounds, written evaluations by faculty members, which include semi-annual reviews with the program director, and the development and maintenance of an academic portfolio.

Practice-Based Learning and Improvement

Residents are required to engage in practice-based learning and improvement to enhance patient care They must investigate and evaluate their patient management, integrate scientific evidence, and commit to continuous self-assessment and lifelong learning Identifying personal strengths and weaknesses is essential, as is setting improvement goals and undertaking relevant learning activities Residents should systematically analyze their practices using quality improvement methods and implement necessary changes to enhance their skills Additionally, they must locate and appraise scientific studies pertinent to their patients’ health issues, utilize information technology for optimal learning, and actively participate in educating patients, families, students, and other healthcare professionals This process is reinforced through critical evaluation.

The Department of Neurosurgery Residency Program emphasizes the importance of practice outcomes by regularly conducting morbidity and mortality conferences Residents engage in daily discussions regarding patient care plans and outcomes with faculty members, fostering a collaborative learning environment Additionally, literature reviews are assigned for in-depth discussions at the Journal Club, enhancing the educational experience and promoting evidence-based practices.

During surgical rotations, essential learning activities that enhance competency development include monthly Morbidity and Mortality (M&M) Conferences for case reviews, semi-annual performance evaluations with Program Directors (PD) that involve case log reviews, and weekly resident conferences for case discussions Additionally, participation in an Evidence-based Journal Club, presentations at various conferences, and hands-on neurosurgical simulations contribute to practical experience Engaging in case discussions at the annual Network for Psychiatric Nursing Research (NPNR) review course and participating in didactic sessions and daily teaching rounds further enrich the educational experience for residents.

Residents are expected to engage in practice-based improvement activities through systematic analysis of their experiences, while effectively locating and evaluating scientific evidence related to their patients' health issues They should gather and utilize data about their specific patient population and the broader community they serve Additionally, residents must apply their understanding of study designs and statistical methods to critically assess clinical studies and evaluate diagnostic and therapeutic effectiveness Proficiency in information technology is essential for managing data, accessing online medical resources, and enhancing their own education Furthermore, residents are encouraged to support the learning of students and fellow healthcare professionals, and they should be prepared to defend their scientific papers in a Journal Club setting.

Assessment encompasses various performance areas, including the ability to critically evaluate scientific evidence and maintain an academic portfolio Key activities involve presentations at Journal Club and Evidence-Based Medicine conferences, as well as at Neurosurgery School and Grand Rounds Familiarity with research methods, such as study designs and statistical techniques, is essential Additionally, a semi-annual review of self-evaluations with the Program Director allows for effective data collection and feedback assimilation Proficiency in information technology is expected, alongside serving as a role model for student education Finally, the evaluation of operative notes and discharge summaries by the Program Director or Assistant Program is a crucial component of the assessment process.

Interpersonal Relationships and Communication

Residents will develop effective communication skills with healthcare professionals, learn to counsel and educate patients and families, and ensure proper documentation of their practice activities These skills will be cultivated through daily interactions with faculty in both inpatient and outpatient settings, as well as through presentations at relevant conferences The proficiency in these areas will be assessed during clinical rotations and evaluated by nursing staff and patients or families Faculty will also monitor patient records to ensure adequate documentation practices.

During surgical rotations, key learning activities that enhance competency development include hands-on patient care experiences in both outpatient clinics and hospitals, participation in national professional meetings for networking, attending lectures on communication delivered by attending physicians, engaging in presentations during Journal Club and teaching rounds, and facilitating learning opportunities for medical students and mid-level providers.

Residents are expected to foster and maintain therapeutic, ethically sound relationships with patients while employing effective listening skills and utilizing various forms of communication, including nonverbal cues and clear explanations They should collaborate efficiently within healthcare teams or professional groups, whether as a member or a leader, and demonstrate an understanding of cultural and gender differences to enhance patient care.

Assessment encompasses several key areas of performance, including active participation in teaching rounds and academic conferences, providing counseling and education to patients along with informed consent instructions, and involving patients in treatment decisions Additionally, it involves attentive listening to patients and collaboration with other healthcare team members, as well as conducting 360 evaluations by allied health professionals.

Professionalism

Neurosurgical residents are expected to uphold high ethical standards while being sensitive to the diverse age, gender, and cultural backgrounds of patients and healthcare professionals These principles are instilled through daily interactions with faculty during clinical rotations and through relevant conferences The achievement of these objectives is evaluated through faculty assessments during rotations and feedback from nursing staff Additionally, residents must show a commitment to continuity of patient care, which is measured by their involvement in outpatient clinics.

During surgical rotations, essential learning activities that enhance competency development include mandatory training on cultural competence and compliance standards, participation in educational programs from other medical schools, and mentorship from surgical faculty Additionally, opportunities for personal scientific presentations at regional and national conferences, performance in Mock Oral Examinations, and hosting resident applicants during neurosurgical match activities further contribute to skill enhancement and professional growth.

Department of Neurosurgery Residency Program | 10 h Journal Club/EBM conference presentations.

Residents are expected to uphold values such as respect, compassion, honesty, and integrity, prioritizing the needs of patients and society over personal interests They must be accountable to patients, the community, and the medical profession while committing to ongoing professional development and excellence Additionally, residents should adhere to ethical principles regarding clinical care, patient confidentiality, informed consent, and business practices It is also essential for residents to show sensitivity and responsiveness to the diverse cultures, ages, genders, and disabilities of their patients.

Assessment of performance encompasses several key areas: a commitment to the welfare of others, adherence to moral and ethical codes, and respect for patients and their families It also includes valuing fellow healthcare team members, providing timely consultations, and being sensitive to patients' cultural backgrounds Additionally, individuals are expected to be accountable for their actions, demonstrate reliability, and maintain punctuality in their duties.

Systems-Based Practice

Residents are required to understand and engage with health care systems effectively, coordinating patient care while working in inter-professional teams to enhance safety and identify system solutions They must cultivate knowledge in risk-benefit analysis and provide high-quality, cost-effective care, which is fostered through daily clinical practice, interdisciplinary rounds, lectures, and presentations Participation in patient safety and quality improvement initiatives is sometimes expected Faculty assessments during clinical rotations measure residents' progress in these areas, including their ability to collaborate with various specialists and health care professionals in patient management.

During surgical rotations, key learning activities that enhance competency development include participating in case reviews at Morbidity and Mortality (M&M) Conferences, attending departmental meetings alongside chief residents, engaging in Journal Club and Evidence-Based Medicine (EBM) conferences, conducting daily rounds and conferences, planning the discharge of complex patients through case management, and completing Epic training along with coding courses.

Residents are expected to recognize the impact of their patient care and professional practices on fellow health care professionals, the health care organization, and society as a whole Additionally, they should understand how these systemic elements influence their own practice.

The Department of Neurosurgery Residency Program emphasizes the importance of understanding the differences in medical practice and delivery systems, including strategies for controlling healthcare costs and resource allocation Residents are trained to practice cost-effective healthcare while maintaining high-quality care standards Collaborating with healthcare managers and providers is essential for assessing, coordinating, and enhancing healthcare services, which ultimately impacts system performance Additionally, residents are expected to demonstrate a strong awareness of quality improvement and safety measures in their practice.

Assessment of healthcare performance encompasses several key areas: delivering cost-effective care, comprehending the significance of documentation and coding, referring patients to suitable practitioners and agencies, coordinating ongoing care within the healthcare system, and ensuring timely and appropriate patient discharges.

PGY-1 Competencies

The resident should be able to:

1 Care for the neurosurgical patient including preoperative evaluation, postoperative care, writing pre and postoperative orders.

Understanding the fundamental pathophysiology of neurosurgical diseases is essential for enhancing basic neurosurgical knowledge This knowledge is crucial for the evaluation and management of patients facing complex neurosurgical issues Additionally, it is important to grasp the various surgical specialties involved in the care of patients with multiple injuries.

3 Be proficient in Basic procedures: start IV, placement of central lines, arterial lines, intubation, ICP monitor placement and ventriculostomy placement.

4 Able to perform: basic sterile technique, bedside procedures, assist on operating room procedures, progressed to more advanced procedures under supervision and assist on more complex surgical procedures.

Assessment: Observation in OR, Faculty evaluation

Effective communication is essential for professionals in healthcare, enabling clear interactions with patients, hospital staff, students, fellow residents, and attending staff By enhancing communication skills, healthcare providers can improve collaboration within the patient care team, demonstrating foresight and strategic planning in patient management Delivering concise and impactful presentations is also crucial for conveying important information efficiently.

Assessment: Nursing evaluation 360, patient evaluation, faculty evaluation and senior resident’s evaluations.

PGY-2

1 Function in the role of junior-level resident with its associated need to develop some responsibility and begin to achieve some independence.

In the role of a mid-level or sub-leader within neurosurgical teams, you will collaborate closely with senior residents and attending physicians to oversee patient care This involves coordinating evaluations and treatments, ensuring effective communication with other healthcare professionals and consultants for comprehensive patient management.

Assessment: faculty and senior resident evaluations, nursing 360 evaluations,

3 Demonstrate Mastery of basic neurosurgical pathophysiology and patient care (ward and ICU), basic understanding of surgical options.

Department of Neurosurgery Residency Program | GENERAL GOALS AND OBJECTIVES BY LEVEL 13

4 Teach and supervise basic procedures including line placement, intracranial pressure (ICP) monitor placement, ventriculostomy placement, lumbar puncture, lumbar drain placement, etc.

Assessment: Supervision/log card, faculty evaluation, feedback from peers and juniors.

5 Demonstrate the development of teaching and supervision skills

Assessment: Faculty evaluation, feedback from junior residents and students.

Enhance your communication skills with the patient care team to become a more effective team leader Foster strong interactions with fellow health care professionals while addressing problem-solving and dispute resolution Additionally, demonstrate a clear understanding of the roles played by various specialists and health care providers in the comprehensive management of patient care.

Assessment: 360 degree evaluation via web based evaluation program including review of the core competencies.

7 Improve mastery of adult learning skills.

Assessment: Evaluation of professional growth through feedback from faculty, mentor and peers Review of research portfolio and conference performance.

PGY-3

1 Function in the role of mid-level resident with its associated increase in responsibility and independence.

Assessment: faculty and 360 degree evaluations

2 Assume leadership of larger neurosurgical teams and supervise care of neurosurgical patients at various levels of acuity with input from surgical attendings, consultants and other health care professionals.

Assessment: Observation in operating room (OR), and simulation lab; faculty evaluations.

4 Surgery: teach and supervise advanced neurosurgeries, under the supervision of an attending

Assessment: Observation in OR, faculty evaluation, feedback from residents.

5 Demonstrate mastery of general neurosurgical knowledge.

Assessment: faculty evaluations, self-assessment.

6 Demonstrate advanced understanding of subspecialties including endovascular, complex spine, neuro-trauma, and functional surgery.

Assessment: Faculty evaluations, weekly quizzes and section conferences.

7 Further develop skills in problem solving and dispute resolution

8 Continue to improve the mastery of adult learning skills.

The assessment of professional growth involves gathering feedback from faculty, mentors, and peers, evaluating performance at conferences, and reviewing the academic portfolio This process includes an analysis of research contributions and the demonstrated ability to effectively plan for the optimal use of research or elective years.

PGY-4

The resident should be able to maintain previously acquired skills, while spending a year focused on research or an elective.

The PGY-4 year primarily focuses on research, resulting in reduced clinical responsibilities and obligations Consequently, the clinical goals and objectives for PGY-4 will closely align with those established for PGY-3 For more comprehensive information, please consult the details from the PGY-3 year and the PGY-4 Research Rotation.

PGY 5

1 Act as “leader/supervisor” on a neurosurgical team with close attending supervision.

Assessment: Faculty and 360 degree evaluations

In larger surgical teams, assume the role of a mid-level or sub-leader, providing support and coordination under the guidance of senior residents and attending physicians Ensure comprehensive patient care by facilitating appropriate evaluations and treatments from various healthcare professionals and consultants.

Assessment: faculty and senior resident evaluations, 360 evaluations

3 Demonstrate Mastery of increasingly complex neurosurgical pathophysiology and patient care (ward and ICU) scenarios, more advanced understanding of surgical options.

4 Teach and supervise basic procedures including line placement, ICP monitor placement,

Ventriculostomy placement, lumbar puncture, lumbar drain placement, etc Begin to instruct junior residents in basic operative procedures.

Assessment: Supervision, faculty evaluation, feedback from peers and juniors.

Enhance communication with the patient care team to function more effectively as a team leader Foster clear interactions with other healthcare professionals and show growing proficiency in problem-solving and resolving disputes.

Demonstrate an understanding of the role of different specialists and other health care professionals in overall patient management.

Assessment: 360 degree evaluation and faculty evaluation

7 Improve mastery of adult learning skills.

Assessment: Evaluation of professional growth through feedback from faculty, mentor and peers Review of academic/research portfolio and conference performance.

PGY-6

1 Act as “leader/supervisor” on a neurosurgical team with close attending supervision.

In a senior leadership role within designated surgical teams, collaborate closely with the chief resident and attending physicians to oversee patient care This involves coordinating evaluations and treatments by various healthcare professionals and consultants to ensure comprehensive and effective medical management.

Assessment: faculty and chief resident evaluations, nursing 360 evaluations,

3 Demonstrate Mastery of complex neurosurgical pathophysiology and patient care (ward and ICU), complete understanding of surgical options.

Instruct and oversee fundamental bedside and surgical procedures such as line placement, ICP monitor insertion, ventriculostomy, lumbar puncture, and lumbar drain placement, as well as moderately complex operations involving the spine, brain, and peripheral nerves.

Assessment: Supervision/log card, faculty evaluation, feedback from peers and juniors.

To enhance patient care, it is essential to exhibit strong leadership communication skills within the healthcare team and operate effectively as a team leader This involves fostering clear communication with fellow healthcare professionals while addressing problem-solving and dispute resolution issues Additionally, it is important to recognize and understand the roles of various specialists and healthcare providers in the comprehensive management of patient care.

7 Demonstrate mastery of adult learning skills.

Assessment: Evaluation of professional growth through feedback from faculty, mentor and peers Review of academic/research portfolio and conference performance.

PGY-7/Chief Year

EDUCATIONAL GOALS AND OBJECTIVES FOR ROTATIONS BY LEVELS

Each rotation in the residency program has specific Educational Goals and Objectives tailored to the assigned service level, with PGY-1 and PGY-2 residents classified as junior residents due to occasional interchange These goals and objectives are accessible at the start of each academic year on the Department of Neurosurgery website and are distributed to faculty and residents The updated curriculum can be reviewed on my e-value platform before new rotations commence The outlined goals and objectives focus on essential competencies, including knowledge, patient care, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practices Additionally, procedure benchmarks are established for each service and PGY level, detailing how residents will be evaluated across the six competencies.

PGY-1 Neurosurgery Clinical Rotation

Interpersonal and Communication Skills

Developing skills and sensitivity in counseling and educating patients and their families is essential in various clinical situations Establishing and maintaining therapeutic, ethically sound relationships with patients and families is crucial Collaborating effectively with healthcare team members and other professionals enhances patient care Prompt and thorough documentation of practice activities is necessary for quality assurance Presenting patient information and conference materials in a concise, organized, and logical manner demonstrates professionalism and expertise Engaging collaboratively with all personnel involved in surgical patient care is vital for optimal outcomes Being an active member of the surgical team and contributing to the educational efforts of the surgical residency through effective teaching and example is important Additionally, participating in the education of students on the service fosters a culture of learning and growth within the healthcare environment.

Department of Neurosurgery Residency Program | III EDUCATIONAL GOALS AND OBJECTIVES FOR

ROTATIONS BY LEVELS 20 j Exhibits honesty, reliability, good communication skills, and appropriate judgment.

5 Professionalism a Demonstrate respect, compassion and integrity; a responsiveness to the needs of patients and society that supersedes self-interest; accountability to patients, society and the profession; and a commitment to excellence and on-going professional development. b Demonstrate a commitment to ethical principles pertaining to provision or withholding of clinical care, confidentiality of patient information, informed consent, and business practices. c Demonstrate sensitivity and responsiveness to patients’ culture, age, gender, and disabilities. d Exhibit professionalism through timely completion of required administrative responsibilities (evaluations, recording hours, chart documentation, medical record dictations, etc.). e Maintain positive relationships. f Demonstrate accountability for actions and decisions.

6 Systems-Based Practice a Awareness and Responsiveness to the Health Care System: i Begin to understand how patient care and other professional practices affect other health care professionals, the health care organization, and the larger society Understand how these elements of the system affect their own practice. ii Begin to know how types of medical practice and delivery systems differ from one another, including methods and controlling health care costs and allocating resources. iii Incorporate the knowledge of ethical, legal, economic, and/or social factors into the activities of the entire surgical team for all components of surgical care. b Utilization of System Resources: i Begin to practice cost-effective health care and resource allocation that does not compromise quality of care. ii Advocate for quality patient care and assist patients in dealing with system complexities. iii Partner with health care managers and health care providers to assess, coordinate, and improve health care and understands how these activities can affect system performance.

1 Patient Care a Participation in weekly academic conferences b Evaluations by faculty (including mid-rotation feedback sessions) c Evaluations by senior residents d Attending rounds

2 Medical Knowledge a ABNS primary examination taken for practice b Written evaluation by faculty (including mid-rotation feedback sessions) and senior residents

ROTATIONS BY LEVELS 21 c Faculty evaluation weekly conferences d Attending rounds

Practice-Based Learning

a Faculty evaluation b Weekly M&M c Weekly attending rounds d Journal Club

4 Interpersonal Relationships and Communication a Faculty evaluations b Self-evaluations c 360 evaluations

5 Professionalism a 360 evaluations by nursing b By faculty (including monthly feedback sessions) c By other resident staff members

6 Systems-Based Practice a Awareness and Responsiveness to the Health Care System: i Begin to understand how patient care and other professional practices affect other health care professionals, the health care organization, and the larger society. Understand how these elements of the system affect their own practice. ii Begin to know how types of medical practice and delivery systems differ from one another, including methods and controlling health care costs and allocating resources. iii Incorporate the knowledge of ethical, legal, economic, and/or social factors into the activities of the entire surgical team for all components of surgical care. b Utilization of System Resources: i Begin to practice cost-effective health care and resource allocation that does not compromise quality of care. ii Advocate for quality patient care and assist patients in dealing with system complexities. iii Partner with health care managers and health care providers to assess, coordinate, and improve health care and understands how these activities can affect system performance.

PGY-1 residents are required to develop essential skills in basic suturing, tying, cranial plating, and assisting during operations and in simulation labs They must effectively assist in the operating room, demonstrating proficiency in suturing and tying Additionally, participation in more advanced cases is crucial for mastering exposure, tissue handling, and advanced suture techniques.

ROTATIONS BY LEVELS 22 d Insertion of central lines, arterial lines, external ventricular drains and intracranial pressure monitors. e Assist for craniotomy for extra-axial hematoma (subdural or epidural).

The neurosurgery PGY-2 resident is expected to demonstrate advancing competency in the pre- and post-operative care of general neurosurgical patients This includes performing specific procedures and serving as a role model for PGY-1 residents and students, showcasing foundational clinical and personal skills Utilizing an evidence-based medicine approach, the PGY-2 should integrate basic science with clinical knowledge in patient care Additionally, the resident is responsible for modeling effective communication and leadership within the healthcare team, which includes students and allied health professionals Typically, the PGY-2 will achieve ratings of 2-3 across various categories in the Milestones evaluations.

Compassionate patient care involves demonstrating respectful behaviors towards patients and their families, while incorporating individual patient specifics into diagnostic and therapeutic decisions It is essential for PGY-3 residents to oversee the collection of accurate patient information, evaluate common neurosurgical conditions, and present differential diagnoses Informed decision-making should be based on patient preferences, current scientific evidence, and clinical judgment, leading to the development and execution of effective patient management plans Knowledge of medication indications and contraindications is crucial, as is the coordination of care among the resident team and students Additionally, mid-level residents must competently perform essential medical and invasive procedures while promoting health through preventive care and collaboration with other healthcare professionals Finally, demonstrating technical skills and sound judgment in operative neurosurgical procedures is vital for success in this role.

As a neurosurgical resident, it is essential to arrive in the operating room (OR) prepared for the cognitive demands of individual neurosurgical procedures You must be able to safely and effectively position patients for common surgical types while following the lead of senior surgeons through various operative steps Making timely and appropriate decisions during procedures is crucial, as is demonstrating manual dexterity suitable for a PGY-2 level Competence in common neurosurgical cases and an understanding of the benefits and limitations of standard techniques are vital Additionally, assisting attending staff with complex surgeries and performing basic procedures with minimal supervision are key responsibilities in your training.

To excel in neurosurgery, one must possess a comprehensive understanding of neurosurgical pathophysiology, critical care, and pharmacology, alongside the ability to develop and execute diagnostic and treatment plans for conditions affecting the brain, spine, and peripheral nerves Familiarity with advanced subspecialties such as trauma, tumors, and pediatric neurosurgery is essential, as is initial proficiency in common surgical procedures Effective patient care involves elucidating preoperative and postoperative concerns, coordinating comprehensive management, and demonstrating a strong knowledge base to educate junior residents Surgical competence is crucial for achieving desired outcomes, while integrating continuity of care principles enhances the overall treatment plan Additionally, understanding the natural history of surgical diseases and the implications of neurosurgical interventions is vital for improving patient outcomes, particularly in outpatient settings under the guidance of attending supervisors.

3 Practice-Based Learning and Improvement a Investigates And Evaluates Patient Care Practices: i Analyze practice experience using a systematic methodology.

Surgeons must gather and utilize data about their patient population and the broader community to enhance care They should be skilled in locating, evaluating, and integrating scientific evidence pertinent to their patients' health issues, applying knowledge of research designs and statistical methods to assess clinical studies on diagnostic and therapeutic effectiveness Engaging in systematic practice-based improvement activities is essential, alongside leveraging information technology for managing data and accessing online medical resources to further their education Additionally, experienced surgeons play a crucial role in mentoring junior residents and must embody the principle of lifelong learning in their surgical practice By analyzing personal practice outcomes, they can continuously refine their patient care approaches.

Effective interpersonal relationships and communication are essential in healthcare, requiring sensitivity in counseling and educating patients and their families across various clinical situations It is crucial to establish and maintain therapeutic, ethically sound relationships with patients and their families while leading health care teams and collaborating with other professionals Timely and accurate documentation of patient information is vital, as is the ability to present patient cases and conference materials in a clear, organized, and knowledgeable manner Engaging in collaborative interactions enhances patient care, and demonstrating leadership within the surgical team is key Additionally, contributing to the education of neurosurgical residents through effective teaching and setting a positive example is important, as is evaluating the performance and competence of all surgical residency team members.

Professionalism in healthcare involves demonstrating respect, compassion, and integrity while prioritizing the needs of patients and society over self-interest This includes accountability to patients, society, and the profession, along with a commitment to excellence and continuous professional development Ethical principles must guide the provision or withholding of clinical care, ensuring confidentiality of patient information, informed consent, and sound business practices Additionally, healthcare professionals should be sensitive and responsive to the diverse cultures, ages, genders, and disabilities of their patients Timely completion of administrative responsibilities, such as evaluations, chart documentation, and medical record dictations, further exemplifies professionalism in the field.

ROTATIONS BY LEVELS 25 e Maintain positive relationships. f Demonstrate accountability for actions and decisions.

Systems-based practice involves understanding the interconnectedness of patient care and professional practices within the health care system, highlighting how these elements impact other professionals, organizations, and society at large It is essential to recognize how various medical practices and delivery systems differ in their methods for controlling costs and allocating resources Additionally, integrating ethical, legal, economic, and social considerations into the surgical team's activities is crucial for comprehensive surgical care Practicing cost-effective health care while ensuring quality is vital, as is advocating for patients navigating complex systems Collaborating with health care managers and providers to assess and improve health care delivery can significantly enhance system performance.

1 Patient Care a Weekly basic science conference b Evaluations by faculty c Attending rounds

The assessment of medical knowledge is a comprehensive process that includes the Annual Board Exam (ABNS primary exam), regular written evaluations by faculty, and feedback sessions during mid-rotation Faculty evaluations occur during weekly conferences and attending rounds, while residents present cases at conferences to enhance their learning Practice-Based Learning is emphasized, alongside ongoing faculty evaluations and participation in monthly Morbidity and Mortality (M&M) meetings Additionally, residents engage in a Journal Club to stay updated with the latest medical literature.

5 Professionalism a Faculty critique of weekly general surgery conference b By faculty

ROTATIONS BY LEVELS 26 c By other resident staff members

6 Systems-Based Practice a Faculty evaluation b Input from mid-level practitioners, nurses, 360 evaluations

PGY-2 residents are expected to competently perform key surgical procedures with minimal supervision, including craniotomy for trauma, ventriculoperitoneal (VP) shunt placement, anterior cervical approaches for decompression and stabilization, posterior cervical approaches for decompression and stabilization, lumbar discectomy, and various peripheral nerve procedures.

Goals and Objectives for Mid-Level Resident

The neurosurgery PGY-3 resident is expected to show foundational skills in managing general neurosurgical patients both before and after surgery Utilizing an evidence-based medicine approach, the resident integrates basic science with clinical knowledge in patient care Additionally, they should observe and replicate effective communication and leadership models exhibited by senior team members Typically, the PGY-3 resident will achieve ratings of 2-3 across various categories in the Milestones evaluations.

Compassionate patient care involves demonstrating respectful behaviors towards patients and their families, incorporating patient preferences in decision-making, and developing appropriate care plans It is essential to gather accurate patient information, evaluate complex neurosurgical conditions, and present differential diagnoses while comparing treatment options Informed decisions should be made based on patient data, scientific evidence, and clinical judgment, progressing towards complex patient management plans Knowledge of medication indications and contraindications is vital, as is the coordination of care among residents and students Effective treatment includes performing essential medical procedures competently, promoting health, and overseeing interdisciplinary care Technical skills are crucial for new surgeons, including preparation for operative procedures, patient positioning, and maintaining the flow of operations Making timely decisions, demonstrating manual dexterity, and competence in complex cases are essential, along with assisting attending staff and performing standard procedures with increasing independence.

The PGY-3 resident must demonstrate comprehensive knowledge of neurosurgical pathophysiology, critical care, pharmacology, and hemodynamic data interpretation, while formulating and implementing diagnostic and treatment plans for brain, spine, and peripheral nerve diseases Proficiency in general neurosurgery subspecialties, including trauma, tumors, and complex spine procedures, is essential, along with the ability to manage preoperative and postoperative patient care effectively The resident should also exhibit familiarity with neurosurgical literature and integrate basic medical knowledge into patient care Teaching junior residents and students, as well as demonstrating surgical competence to achieve optimal outcomes, are critical responsibilities Additionally, the resident must understand the importance of continuity of care, both in terms of the natural history of surgical diseases and the impact of neurosurgical interventions on patient outcomes, while exhibiting independence in managing patient care in an outpatient setting under appropriate supervision.

Practice-Based Learning and Improvement involves a systematic investigation and evaluation of patient care practices, where healthcare professionals analyze their experiences and gather information about their patient population This process includes appraising and assimilating scientific evidence relevant to patient care by locating and evaluating studies that address patients’ health issues Practitioners apply knowledge of study designs and statistical methods to assess clinical studies and effectiveness of diagnostics and therapies Additionally, they engage in practice-based improvement activities, utilize information technology for managing data and accessing online medical resources, and support their own education as well as that of junior residents Emphasizing the significance of lifelong learning, they recognize its crucial role in enhancing surgical practice.

Rotations by levels enhance patient care practices by enabling practitioners to analyze their personal outcomes for improvement They engage in systematic methodologies for practice-based enhancements and utilize information technology to manage data and access online medical resources, thereby supporting their ongoing education Additionally, these rotations facilitate the learning and development of junior-level residents, fostering a collaborative learning environment.

Effective interpersonal relationships and communication are essential in healthcare, requiring the ability to counsel and educate patients and their families with sensitivity across diverse clinical scenarios Establishing and maintaining ethically sound therapeutic relationships is crucial, as is the ability to collaborate effectively as a leader within the healthcare team Timely and accurate documentation of practice activities is necessary, along with presenting patient information and conference materials in a clear and organized manner Engaging collaboratively with all personnel involved in surgical patient care enhances outcomes, while exhibiting leadership within the surgical team fosters a productive environment Contributing to the educational initiatives of the neurosurgical residency through effective teaching and role modeling is vital, as is the evaluation of the performance and competence of residency team members.

Professionalism in healthcare involves demonstrating respect, compassion, and integrity while prioritizing the needs of patients and society over self-interest It requires accountability to patients, society, and the profession, alongside a commitment to ethical principles such as informed consent and confidentiality Healthcare professionals must be sensitive to the diverse cultures, ages, genders, and disabilities of their patients Timely completion of administrative responsibilities, such as evaluations and medical record documentation, is essential to uphold professionalism Maintaining positive relationships and demonstrating accountability for actions and decisions further reinforces the commitment to excellence and ongoing professional development in the field.

Systems-based practice emphasizes the importance of understanding how patient care and professional practices influence other healthcare professionals, organizations, and society as a whole It is essential for practitioners to recognize how these systemic elements impact their own clinical practices Furthermore, differentiating between various medical practices and delivery systems is crucial, as they employ distinct methods for managing healthcare costs and resource allocation Additionally, incorporating ethical, legal, economic, and social considerations into the surgical team's activities is vital for ensuring comprehensive and responsible surgical care.

To optimize system resources, it is essential to implement cost-effective healthcare practices that maintain high-quality care Advocating for quality patient care and guiding patients through complex healthcare systems is crucial Collaborating with healthcare managers and providers to assess, coordinate, and enhance healthcare services will significantly impact overall system performance.

1 Patient Care a Weekly basic science conference b Evaluations by faculty c Attending Rounds

2 Medical Knowledge a Annual written board exam (ABNS primary exam) taken for practice b Written evaluation by faculty c Faculty evaluation weekly conferences d Attending rounds e Presentations at conferences

3 Practice-Based Learning a Faculty evaluation b Monthly M&M c Weekly attending rounds d Journal Club

5 Professionalism a Faculty critique of weekly general surgery conference b 360 evaluations by nursing c By faculty d By other resident staff members

PGY-3 residents must demonstrate the ability to independently perform a range of advanced procedures, often with minimal supervision They are expected to guide junior residents through various cases, showcasing their leadership and expertise Key procedures include radiosurgery, ventriculoperitoneal (VP) shunt placement, anterior and posterior cervical approaches for decompression and stabilization, interventional procedures for spinal conditions, lumbar discectomy, peripheral nerve procedures, thoracic and lumbar instrumentation and fusion, as well as spinal surgeries such as Chiari decompression, laminectomy for dysraphism, tumors, and syringomyelia, and pediatric VP shunt procedures.

The neurosurgery resident rotation in neuroradiology and neuropathology offers an intensive opportunity to delve into essential disciplines for a successful clinical neurosurgery career Residents will collaborate with fellowship-trained clinical neuroradiologists, gaining hands-on experience in image interpretation within a high-volume clinical setting Additionally, time spent with the Pathology Department alongside neuropathologists will enhance their understanding of neurological conditions Throughout the rotation, residents will lead case presentations at Brain Tumor and Neuroradiology conferences, while also being expected to contribute to academic productivity through publications.

PGY-4 Neurosurgery Research Rotation

Goals and Objectives for Mid-Level Resident

During the PGY-4 year, neurosurgery residents will engage in a dedicated research project of their choosing, focusing on either basic science or clinical studies, potentially supplemented by an approved enfolded clinical fellowship Preparation for this project starts in PGY-1 through PGY-3, where residents participate in quarterly meetings with their assigned research mentor The program director (PD) emphasizes the importance of developing essential skills, including statistics, basic science knowledge, and collaboration with Institutional Review Boards (IRB), to ensure the resident's success in their research endeavors.

During the PGY-3 year, meetings with the Program Director and research year advisor will be crucial for ensuring progress towards the PGY-4 research year project Once the research year commences, monthly meetings with the research advisor will help track advancements and contribute to a successful year Key objectives include enhancing the research skills necessary for an academic neurosurgeon and laying the groundwork for a long-term career in neuroscience research Aiming for short-term achievements, the goal is to produce at least two publications within six months of completing the PGY-4 year.

PGY-4 residents are expected to independently perform essential procedures such as radiosurgery and ventriculoperitoneal (VP) shunt placements with minimal supervision Additionally, they should guide junior residents through various cases, demonstrating their leadership and expertise in clinical practice.

This article outlines various surgical approaches and interventional procedures for spinal conditions, including anterior and posterior cervical decompression and stabilization techniques It covers lumbar discectomy and peripheral nerve procedures, as well as thoracic and lumbar instrumentation and fusion Additionally, it discusses spinal surgeries such as Chiari decompression and laminectomy for conditions like dysraphism, tumors, and syringomyelia The article also highlights pediatric procedures, specifically the VP shunt.

Interpersonal and Communication Skills

In the realm of patient care, it is essential to demonstrate skill and sensitivity in counseling and educating patients and their families across various clinical situations Establishing and maintaining therapeutic, ethically sound relationships with patients and families is crucial Effective leadership within the healthcare team and collaboration with other professionals enhances patient outcomes Prompt and accurate documentation of practice activities is vital for continuity of care Presenting patient information and conference materials in a concise, organized, and knowledgeable manner ensures clarity and understanding Engaging collaboratively with all personnel involved in surgical patient care is important for comprehensive treatment Additionally, exhibiting leadership within the surgical team and contributing to the educational efforts of the neurosurgical residency through effective teaching are key responsibilities Lastly, evaluating the performance and competence of all members of the surgical residency team fosters a culture of continuous improvement and excellence in patient care.

5 Professionalism a Demonstrate respect, compassion and integrity; a responsiveness to the needs of patients and society that supersedes self-interest; accountability to patients, society and the profession; and a commitment to excellence and on-going professional development. b Demonstrate a commitment to ethical principles pertaining to provision or withholding of clinical care, confidentiality of patient information, informed consent, and business practices.

In the context of rotations by levels, it is essential to demonstrate sensitivity and responsiveness to the diverse backgrounds of patients, including their culture, age, gender, and disabilities Professionalism is exhibited through the timely completion of administrative responsibilities such as evaluations, recording hours, chart documentation, and medical record dictations Maintaining positive relationships with colleagues and patients is crucial, as is demonstrating accountability for one's actions and decisions.

6 Systems-Based Practice a Awareness and Responsiveness to the Health Care System: i Explain how patient care and other professional practices affect other health care professionals, the health care organization, and the larger society ii Discuss how these elements of the system affect their own practice. iii Differentiate how types of medical practice and delivery systems differ from one another, including methods and controlling health care costs and allocating resources. iv Incorporate the knowledge of ethical, legal, economic, and/or social factors into the activities of the entire surgical team for all components of surgical care. b Utilization of System Resources: i Practice cost-effective health care and resource allocation that does not compromise quality of care. ii Become an advocate for quality patient care and assist patients in dealing with system complexities. iii Partner with health care managers and health care provides to assess, coordinate, and improve health care and understands how these activities can affect system performance.

1 Patient Care a Weekly basic science conference b Evaluations by Faculty (including mid-rotation feedback sessions) c Attending Rounds

2 Medical Knowledge a Annual written board exam (ABNS primary exam) taken for credit b Written evaluation by faculty (including mid-rotation feedback sessions) c Faculty evaluation weekly conferences d Attending Rounds e Presentation at Surgical Case Conferences

3 Practice-Based Learning a Faculty evaluation b Monthly M&M c Weekly attending rounds d Journal club

ROTATIONS BY LEVELS 36 a Faculty evaluations b Self-evaluations c 360 evaluations

5 Professionalism a Faculty critique of weekly general surgery conference b 360 evaluations by nursing c By faculty (including mid-rotation feedback sessions) d By other resident staff members

At the PGY-5 level, residents are expected to perform a range of complex procedures with minimal supervision and to guide junior residents through various cases It is essential for PGY-5 residents to be familiar with ACGME competencies and procedural skills, striving for mastery in key areas They should focus on gaining personal experience in procedures such as craniotomies for pain and trauma, functional procedures, radiosurgery, and transsphenoidal surgeries for tumors Additional skills include performing ventriculoperitoneal shunts, anterior and posterior cervical approaches for decompression and stabilization, interventional spinal procedures, lumbar discectomies, peripheral nerve procedures, thoracic and lumbar instrumentation and fusion, and pediatric craniotomies for brain tumors Moreover, they should be adept in spinal procedures for both adult and pediatric deformity correction, Chiari decompression, and craniotomies for epilepsy in both populations.

PGY-6/Neurosurgery Clinical Rotation

As a Senior Resident and Substitute Chief in neurosurgery, the PGY-6 resident must exhibit comprehensive mastery in managing general neurosurgical patients and demonstrate the ability to independently handle pre-operative, intra-operative, and post-operative care for various neurosurgical procedures Leadership within the neurosurgical team is crucial, and the resident is expected to apply an evidence-based medicine approach that integrates fundamental science with clinical expertise Additionally, this resident should evaluate and model effective communication and leadership skills for junior team members, fostering a collaborative and educational environment.

PGY-6 will rate between 3-5 on each category of the Milestones evaluations The resident should be able to:

Compassionate patient care involves demonstrating respectful behaviors towards patients and their families while incorporating patient preferences in decision-making for diagnostic and therapeutic interventions It is essential to gather accurate patient information, evaluate complex neurosurgical conditions, and present differential diagnoses, comparing treatment options to make informed decisions based on patient data and current scientific evidence Effective treatment and health promotion require performing essential medical procedures competently, preventing health issues, and coordinating care among healthcare professionals Technical skills in patient care encompass demonstrating knowledge and judgment in neurosurgical procedures, arriving prepared for operations, and ensuring patient safety during surgeries A chief resident should exhibit manual dexterity, competence in complex and common neurosurgical cases, and an understanding of operative techniques, while also assisting attending staff and performing standard procedures with significant independence.

A PGY-6 resident must demonstrate comprehensive knowledge of neurosurgical pathophysiology, pharmacology, and critical care, enabling the formulation and implementation of effective diagnostic and treatment plans for brain, spine, and peripheral nerve diseases Proficiency in advanced neurosurgery subspecialties, including trauma, tumors, and complex spine procedures, is essential, alongside a solid understanding of preoperative and postoperative patient care concerns The resident should be familiar with neurosurgical literature and capable of teaching junior residents, while also exhibiting surgical competence to achieve optimal patient outcomes Furthermore, the ability to integrate continuity of care principles into the overall treatment plan is crucial, as is the independence to manage pre-operative assessments and post-operative care in an outpatient setting under appropriate supervision.

Practice-based learning and improvement involves a systematic approach to investigating and evaluating patient care practices by analyzing experiences and utilizing data about both individual patients and the broader population It requires the appraisal and assimilation of scientific evidence relevant to patient care, including locating and evaluating studies related to specific health issues Surgeons must apply their understanding of study designs and statistical methods to assess the effectiveness of diagnostics and treatments Additionally, engaging in practice-based improvement activities and leveraging information technology for managing data and accessing medical resources are essential Finally, experienced surgeons should facilitate the learning process for junior residents, fostering a collaborative educational environment.

Lifelong learning is essential in surgical practice, emphasizing the need for continuous professional development To enhance patient care, surgeons must analyze their personal practice outcomes and engage in systematic improvement activities Utilizing information technology is crucial for managing data, accessing online medical resources, and supporting the education of new surgeons Additionally, experienced surgeons should facilitate the learning and development of junior residents to ensure a high standard of care and knowledge transfer in the surgical field.

Effective interpersonal relationships and communication are essential in healthcare, where professionals must demonstrate sensitivity and skill in counseling patients and their families across various clinical scenarios Establishing and maintaining therapeutic and ethically sound relationships is crucial, as is the ability to lead healthcare teams and collaborate with other professionals Timely and accurate documentation of practice activities is necessary, alongside the presentation of patient information and conference materials in a clear, organized, and knowledgeable manner Input from all team members involved in surgical patient care should be utilized to enhance outcomes Surgical team leadership is vital, as is contributing to the educational development of neurosurgical residents through teaching and mentorship Additionally, evaluating the performance and competence of all surgical residency team members ensures a high standard of care and continuous improvement within the team.

Professionalism in healthcare involves demonstrating respect, compassion, and integrity while prioritizing the needs of patients and society over self-interest It requires a commitment to ethical principles, including confidentiality, informed consent, and responsible business practices Healthcare professionals must be sensitive to the diverse cultures, ages, genders, and disabilities of their patients Timely completion of administrative responsibilities, such as evaluations and medical record documentation, is essential to exhibit professionalism Maintaining positive relationships and demonstrating accountability for actions and decisions further underscores the importance of professionalism in delivering high-quality patient care.

Systems-based practice involves understanding the interconnectedness of patient care and professional practices within the health care system, highlighting their impact on fellow health care professionals, the organization, and society at large It is essential for practitioners to recognize how these systemic elements influence their own practice, shaping their approach to patient care Additionally, it is important to differentiate between various types of medical practices and delivery systems, as they employ distinct methods for controlling health care costs and allocating resources effectively.

Incorporating ethical, legal, economic, and social factors into surgical care activities is essential for the entire surgical team Practicing cost-effective healthcare ensures resource allocation without compromising quality, while advocating for patient care helps patients navigate complex systems Collaborating with healthcare managers and providers is crucial for assessing, coordinating, and improving healthcare, ultimately enhancing system performance.

1 Patient Care a Weekly basic science conference b Evaluations by faculty (including mid-rotation feedback sessions) c Attending rounds

The assessment of medical knowledge involves several key components, including the Annual Board Certification Exam (ABNS primary exam), which is taken for credit Additionally, written evaluations by faculty, including mid-rotation feedback sessions, contribute to a comprehensive review process Weekly faculty evaluations during conferences, attending rounds, and presentations at Surgical Case Conferences further enhance the assessment of a physician's medical knowledge and skills.

3 Practice-Based Learning a Faculty evaluation b Monthly M&M c Weekly attending rounds d Journal Club

5 Professionalism a Faculty critique of weekly general surgery conference b 360 evaluations c By faculty (including mid-rotation feedback sessions) d By other resident staff members

PGY-6 residents are expected to perform a range of surgical procedures independently and with minimal supervision, while also guiding junior residents as lead surgeons They should strive to gain proficiency in essential ACGME competencies and procedural skills, including craniotomies for various conditions such as brain tumors, trauma, and vascular lesions, as well as endovascular procedures for cerebrovascular and neuro-oncologic issues Additionally, they must master extracranial vascular procedures, functional surgeries, radiosurgery, and transsphenoidal approaches for sellar tumors Other critical skills include performing ventriculoperitoneal shunts, cervical decompression and stabilization surgeries, lumbar discectomies, and peripheral nerve procedures PGY-6 residents should also be adept in spinal instrumentation and fusion, pediatric craniotomies, and spinal procedures for both adults and children, including Chiari decompression and deformity correction.

PGY-7/Chief Year: Neurosurgery Clinical Rotation

PGY-1 Trauma (3 months)

b Written evaluation by faculty (including mid-rotation feedback sessions). c Faculty evaluation, weekly conferences d Attending rounds e Presentation at Surgical Case conferences

3 Practice-Based Learning and Improvement a Faculty evaluation b Weekly M&M c Weekly attending rounds d Journal Club

5 Professionalism a Faculty critique of weekly general surgery conference b 360 evaluations by nursing c By faculty (including mid-rotation feedback sessions) d By other resident staff members

At the PGY-7 level, residents are expected to perform essential neurosurgical procedures with minimal supervision, demonstrating proficiency in ACGME competencies They should lead junior residents in surgical cases and actively seek to enhance their skills through hands-on experience Key procedures include craniotomies for brain tumors, vascular lesions, pain, and trauma, as well as endovascular interventions for cerebrovascular and neuro-oncologic conditions, extracranial vascular procedures, functional surgeries, and radiosurgery Mastery of these skills is crucial for their professional development and patient safety.

This article discusses various surgical procedures categorized by their levels, including transsphenoidal approaches for sellar and parasellar tumors using both microscopic and endoscopic techniques It covers the implementation of ventriculoperitoneal (VP) shunts, anterior and posterior cervical approaches for decompression and stabilization, and interventional procedures for spinal conditions Additionally, it highlights lumbar discectomy, peripheral nerve procedures, and thoracic/lumbar instrumentation and fusion Pediatric surgeries such as craniotomy for brain tumors and VP shunts are also addressed, alongside spinal procedures for both adults and children, including Chiari decompression, laminectomy for dysraphism, tumors, and syringomyelia, as well as deformity correction Lastly, the article emphasizes craniotomy for epilepsy treatment in both adult and pediatric patients.

IV SAMPLE YEAR OF ROTATIONS FOR PGY-1 NEUROSURGERY RESIDENT

The PGY-1 neurosurgery resident focusing on trauma must master the initial diagnostic approach and post-traumatic management of patients, utilizing evidence-based medicine Under supervision, residents should gain proficiency in performing minor procedures and enhance their communication skills with healthcare professionals and patients' families.

Compassionate patient care involves demonstrating respectful behaviors towards patients and their families, incorporating patient preferences in decision-making, and developing effective care plans for trauma patients To ensure appropriate patient care, it is essential to gather accurate patient information, understand triage decisions, evaluate critically ill patients, and present differential diagnoses Additionally, healthcare providers must base diagnostic and therapeutic interventions on patient information, scientific evidence, and clinical judgment, while adhering to established policies and procedures Knowledge of medication indications and contraindications is crucial, as is the ability to assist senior residents in patient management Effective treatment and health promotion include supporting essential medical procedures, preventing health issues, and collaborating with multidisciplinary teams to provide comprehensive care for critically ill patients, particularly in managing conditions such as elevated intracranial pressure.

Department of Neurosurgery Residency Program | IV SAMPLE YEAR OF ROTATIONS FOR PGY-1

As a neurosurgery resident, you will assist in coordinating the evaluation and perform craniotomies for intracranial mass lesions It is essential to demonstrate the necessary technical skills, including knowledge and judgment in trauma care, and to arrive prepared for the cognitive demands of managing trauma patients You will develop manual dexterity and engage in the evaluation, triage, and treatment of multiple injured patients under the supervision of senior residents and attending surgeons Your responsibilities will include conducting primary and secondary surveys, formulating treatment plans, and managing trauma patients in the surgical ward You will also learn to provide medical opinions to colleagues, handle non-operative management of complex conditions such as multiple trauma and organ failure, and understand the comprehensive care required for critically ill patients Gaining experience in trauma rooms and outpatient clinics will enhance your ability to make timely decisions regarding operative procedures and ensure continuity of care Additionally, you will develop competence in interpreting radiologic studies, directing the evaluation of acutely injured patients, and outlining indications for essential surgical interventions while establishing emergency airways when necessary.

Develop the ability to assess and manage patients with increased intracranial pressure through timely surgical intervention Understand the various categories of shock—cardiogenic, hypovolemic, septic, tamponade, and tension pneumothorax—by explaining their etiology and pathophysiology Emphasize the importance of multi-disciplinary care for trauma and critical care patients Gain knowledge about surgical infections, complications associated with acute surgical diseases, and their management Cultivate a knowledge base adequate for teaching students in a clinical setting Familiarize yourself with surgical literature, particularly in trauma and acute general surgery, while relating fundamental medical knowledge to patient care and demonstrating the ability to evaluate and apply relevant scientific information.

Neurosurgery residents must exhibit surgical competence through advanced skills and extensive knowledge to achieve desired patient outcomes They should integrate principles of surgical continuity of care into comprehensive treatment plans for trauma and critically ill patients A thorough understanding of the natural history of surgical diseases, along with the positive and negative consequences of surgical interventions, is essential in influencing surgical outcomes Additionally, residents must consider ethical, legal, economic, and social factors in all aspects of patient care within the trauma and critical care team.

Practice-based learning and improvement involve a systematic approach to investigating and evaluating patient care practices by analyzing experiences and utilizing data from both individual and broader patient populations It emphasizes the appraisal and assimilation of scientific evidence pertinent to patient health issues, requiring practitioners to locate, evaluate, and integrate findings from relevant studies while applying knowledge of study designs and statistical methods Additionally, it encourages the execution of practice-based improvement activities, leveraging information technology for effective data management and access to online medical resources, which also supports the ongoing education of new surgeons The process further includes facilitating the learning of medical students and junior residents, highlighting the significance of lifelong learning in enhancing surgical practice Ultimately, it aims to improve patient care by enabling practitioners to analyze their outcomes and implement systematic methodologies for continuous improvement.

Effective interpersonal relationships and communication are essential in trauma and critical care settings This involves demonstrating skill and sensitivity while counseling and educating patients and their families Establishing and maintaining therapeutic, ethically sound relationships is crucial, as is working collaboratively with healthcare teams and other professionals Prompt and accurate documentation of practice activities is necessary to ensure continuity of care Presenting patient information and conference materials in a clear, organized, and knowledgeable manner enhances understanding Additionally, incorporating input from all team members involved in surgical patient care and contributing to the educational efforts of surgical residency programs through effective teaching and example are vital for improving overall patient outcomes.

NEUROSURGERY RESIDENT 50 h Evaluate the performance and competence of all members of the surgical residency team.

Professionalism in healthcare requires a deep commitment to respect, compassion, and integrity, prioritizing the needs of patients and society over self-interest This includes adhering to ethical principles regarding clinical care, patient confidentiality, informed consent, and business practices It is essential to be sensitive to patients' diverse cultures, ages, genders, and disabilities while also fulfilling administrative responsibilities promptly, such as evaluations and medical documentation Building and maintaining positive relationships is crucial, alongside demonstrating accountability for one's actions and decisions.

Systems-based practice involves recognizing the interconnectedness of patient care and professional practices within the healthcare system It is essential to understand how these practices impact other healthcare professionals, the organization itself, and society as a whole This awareness fosters a collaborative environment that enhances overall patient outcomes and promotes a more effective healthcare delivery system.

Understanding the impact of various system elements on medical practice is essential for healthcare professionals It is crucial to recognize the differences in medical practice types and delivery systems, particularly in terms of methods for controlling healthcare costs and allocating resources Practicing cost-effective healthcare while ensuring high-quality care for trauma and critically ill patients is vital Advocating for quality patient care and helping patients navigate complex healthcare systems is equally important Collaborating with healthcare managers and providers to assess, coordinate, and enhance healthcare services can significantly improve overall system performance.

PGY1 residents are required to effectively diagnose and manage trauma and critically ill patients They participate in numerous procedures, including complex wound closures, central line placements, and chest tube insertions, while also demonstrating expertise in managing both penetrating and blunt neck injuries Additionally, they assist senior residents and attending physicians during laparotomies for both blunt and penetrating trauma cases.

PGY-1 Critical Care (3 months)

The management of critically ill surgical patients with multiple medical issues requires a comprehensive care plan that includes triaging patients effectively and understanding the dynamics among physicians, nurses, and administrators in the ICU Surgeons play a pivotal role in critical care, necessitating the ability to adapt treatment interventions based on evolving clinical and laboratory data Initial evaluations and ongoing monitoring of neurologic or behavioral abnormalities, such as seizures, coma, and delirium, are essential for patient care in the ICU It is also crucial to establish medical and surgical criteria for patient admissions and discharges Identifying potential organ and tissue donors involves following specific hospital protocols for family communication Understanding the normal physiological responses to stressors like sepsis and trauma is vital, alongside a thorough knowledge of pharmacotherapeutics for critically ill patients, which includes vasopressors, antibiotics, and other supportive medications Nutritional support and the management of postoperative fever, including diagnostic approaches and treatments, are key components of care Additionally, distinguishing between septic and hypovolemic shock, as well as analyzing the treatment of seizures and acute mental status changes, is critical in ensuring optimal patient outcomes.

Management of intravenous fluids should consider expected stress responses, including metabolic, hormonal, cardiovascular, and renal effects, particularly when using medications like Phenobarbital and Dilantin, which are not suitable during acute events It is essential to understand the correlation between elevated stress hormone levels and alterations in glucose metabolism Additionally, differentiating between low cardiac output and hypotensive or hypertensive states requires an analysis of preload, pump function, and afterload Specific fluid compositions must be discussed, alongside the implications of fluid losses Common indications for initiating ventilatory support should also be outlined, while reviewing respiratory physiology and the specific pathologies associated with ventilation and perfusion deficits.

Neurosurgery residents must analyze and compare ventilator mechanics, including ventilation modes and triggering mechanisms They should define information from invasive and non-invasive monitoring devices, detailing what is measured, accuracy, costs, and hemodynamic principles for devices like arterial catheters, central venous catheters, and pulse oximetry Understanding acid-base disturbances in critically ill patients is crucial, as is the ability to identify and correct complex acid-base issues, including intravenous fluid choices for electrolyte replacement Preoperative assessments should predict a patient's need for critical care based on existing health conditions and specific postoperative requirements Additionally, residents must grasp tissue oxygen supply and demand, calculating oxygen delivery and consumption, and analyzing factors affecting oxygen delivery such as cardiac output and hemoglobin saturation They should also evaluate and treat bleeding disorders like disseminated intravascular coagulopathy and thrombocytopenia, along with understanding the implications of anticoagulant therapies and liver disease Finally, knowledge of endocrine disorders in critical care, including hypothyroidism, hyperthyroidism, and adrenal dysfunctions, is essential for effective therapy management.

PGY-1 Neurosurgery Service D (3 months)

Practice-based Learning

a Faculty evaluation b Weekly M&M c Weekly attending rounds d Twice weekly multidisciplinary teaching rounds

5 Professionalism a 360 evaluations b By faculty (including mid-rotation feedback sessions) c By other resident staff members

6 Systems-Based Practice a Trauma Surgery Case conference b Multidisciplinary teaching rounds c Department of Surgery M&M

PGY-1 Neurology Rotation (3 months)

The goals of this training program focus on enhancing technical proficiency through structured index procedures, ensuring residents achieve competence in essential skills Participants will learn to conduct thorough history and physical examinations while honing their clinical judgment and decision-making abilities Emphasis is placed on non-operative clinical reasoning, effective data gathering, and maintaining organized case logs Additionally, residents will be trained to develop and implement comprehensive patient care plans, fostering a well-rounded approach to medical practice.

NEUROSURGERY RESIDENT 54 h Develop skills to effectively manage time and tasks.

This article outlines key objectives for medical professionals, including conducting a thorough neurological examination and gaining foundational knowledge in diagnosing and managing conditions such as status epilepticus, ischemic stroke, and intracranial hemorrhage Additionally, it emphasizes the importance of compassionately explaining diagnoses and treatment rationales to patients and their families Lastly, it highlights the need to demonstrate proper technique in performing lumbar punctures.

The primary goals of this training include enhancing familiarity with various neurological conditions, their differential diagnoses, and relevant treatments Trainees will gain an understanding of common neurological disorders, such as stroke, multiple sclerosis, and epilepsy, while also learning about the neurological manifestations associated with prevalent medical illnesses Additionally, participants will explore the neuropharmacology of medications used to treat these conditions, ensuring a comprehensive grasp of effective therapeutic approaches.

The primary objectives of this article are to provide an understanding of emergency management for neurological patients, focusing on the diagnosis, treatment, and triage of conditions like hemorrhagic and ischemic strokes, status epilepticus, and Guillain-Barre Syndrome Additionally, it aims to familiarize readers with essential procedures such as lumbar puncture for diagnostic and therapeutic purposes Furthermore, the article will explore relevant neurodiagnostic techniques, including Electroencephalogram (EEG) and Electromyography (EMG), as well as imaging methods vital for effective patient care.

3 Practice-Based Learning and Improvement

The goals of this initiative include understanding the organization and management of clinical databases and registries, critically assessing effective treatments and technologies, and demonstrating the ability to investigate and evaluate patient care by appraising scientific evidence to continually enhance care quality Additionally, it emphasizes the effective use of information technology to document and gather medical information, supporting ongoing education and improvement in patient care practices.

The objectives of this article include demonstrating the ability to learn and comprehend evidence related to management alternatives, maintaining secure patient logs during neurology service, and appreciating the importance of risk-benefit analysis in clinical decision-making.

As a neurosurgery resident, it is essential to comprehend team organization and objectives while actively participating in and executing tasks aligned with your level of responsibility Effective communication with patients and their families is crucial, alongside fostering collegial relationships with physicians, consultants, nurses, technicians, and administrative staff Utilizing strong listening skills and employing various communication techniques—such as nonverbal cues, clear explanations, thoughtful questioning, and proficient writing—are vital for successful information exchange in a collaborative healthcare environment.

The primary objectives include gathering comprehensive data from the referring provider, patient, and electronic medical record, and presenting it systematically to the attending physician Effective and compassionate counseling for the patient and family is essential, along with consulting other specialists as needed, both verbally and in writing Additionally, all findings must be meticulously documented in the electronic medical record, ensuring a clear and organized summary of the information.

To achieve excellence in healthcare, it is essential to demonstrate initiative and a strong sense of responsibility while exercising empathy and responsiveness to the needs of patients and colleagues Upholding a commitment to quality care is crucial, alongside exhibiting ethical behavior in all interactions with patients and professional peers.

The primary objectives include taking responsibility for patient care, diagnosis, and treatment under suitable supervision, while also ensuring compassionate communication with patients and their families It is essential to prepare for and address patient care needs effectively Additionally, demonstrating a strong work ethic and professional demeanor in interactions with both patients and colleagues is crucial for maintaining the standards of a physician.

The primary objectives are to showcase the ability to function efficiently within diverse healthcare delivery systems while providing comprehensive care to patients of all ages Additionally, it is essential to exhibit a solid understanding of risk-benefit analysis to ensure high-quality, cost-effective patient care.

The primary objectives include the implementation of practice guidelines to enhance clinical management, effectively utilizing consultation and referral mechanisms for optimal patient care, and employing accurate medical data to improve communication and management of patients Additionally, demonstrating a foundational understanding of community resources is essential to address both the short-term and long-term needs of patients.

Tiêu đề	Educational Goals And Objectives For The Department Of Neurosurgery Residency Program
Chuyên ngành	Neurosurgery
Thể loại	curriculum

Định dạng
Số trang	58
Dung lượng	483 KB

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Educational Goals and Objectives

The Six Core Competencies

Patient Care

Medical Knowledge

Practice-Based Learning and Improvement

Interpersonal Relationships and Communication

Professionalism

Systems-Based Practice

PGY-1 Competencies

PGY-2

PGY-3

PGY-4

PGY 5

PGY-6

PGY-7/Chief Year

EDUCATIONAL GOALS AND OBJECTIVES FOR ROTATIONS BY LEVELS

PGY-1 Neurosurgery Clinical Rotation

Interpersonal and Communication Skills

Practice-Based Learning

PGY-2 Neurosurgery Clinical Rotation

PGY-3 Neurosurgery Clinical Rotation

PGY-4 Neurosurgery Research Rotation

PGY-5 Neurosurgery Clinical Rotation

Interpersonal and Communication Skills

PGY-6/Neurosurgery Clinical Rotation

PGY-7/Chief Year: Neurosurgery Clinical Rotation

PGY-1 Trauma (3 months)

PGY-1 Critical Care (3 months)

PGY-1 Neurosurgery Service D (3 months)

Practice-based Learning

PGY-1 Neurology Rotation (3 months)