Corry Memorial Hospital Internal Medicine Residency Program

Critical Care Educational Goals and Objectives

CRITICAL CARE EDUCATIONAL GOALS and OBJECTIVES

Competency	PGY 2	PGY 3
Patient Care (PC)	Obtain a detailed HPI emphasizing chronology of presentation and containing good descriptions of systems Resident will present without notes Resident’s presentation will include appropriate pertinent positive and negatives Resident will use appropriate non-patient sources of data cannot give a history Resident will tailor the physical examination to patient’s complaints Resident will be able to accurately identify and characterize the signs and stages of septic, cardiovascular, and hypovolemic shock	Resident will obtain a detailed HPI emphasizing chronology of presentation and containing good descriptions of systems Resident will present without notes Resident’s presentation will include appropriate pertinent positive and negatives Resident will use appropriate non- patient sources of data cannot give a history Resident will tailor the physical examination to patient’s complaints Resident will be able to accurately identify and characterize the signs and stages of septic, cardiovascular, and hypovolemic shock Resident will be able to identify and characterize cardiac murmurs and sounds Resident will be able to identify and characterized pulmonary auscultatory findings
Medical Knowledge (MK)	Be proficient in the diagnosis and therapeutic management including monitoring for the adverse effects of specific therapeutic management, including monitoring for the adverse effects of specific therapeutic interventions, for the following medical conditions/complaints: Cardiology-Shock (septic, cardiogenic, hypovolemic) chest pain, cardiopulmonary arrest, hypertensive emergency, artic dissection; Pulmonary – Respiratory failure, Acute and progressive dyspnea, pulmonary embolism, COPD, asthma, acute respiratory distress syndrome- Basic ventilator management; GI/hepatology -GI bleed, acute liver failure, complications of liver failure; Neurology -Altered mental status, seizures, stroke, intracranial hemorrhage; Hematology -Bleeding diathesis, DI, anticoagulation, VET treatment, HIT diagnosis and treatment, DVT prophylaxis in the ICU setting; Metabolic & Electrolyte disorders, Diabetic ketoacidosis, hyper/hypo-kalemia, hyper/hypo-natremia, hypo/hyper-calcemia, renal insufficiency Develop proficiency in the interpretation of: Oximetry and blood gases, Serum electrolytes, Chest X-rays, Results from thoracentesis, paracentesis, spinal fluid, EKGs Appropriately order and understand the indications and contraindications as well as complications associated with the following tests/procedures: Mechanical Ventilation, Gastrointestinal endoscopy, CT and MRI imaging of the head, chest, and abdomen, Bronchoscopy and bronchoalveolar lavage, Lung VQ scan, High-resolution CT, lower extremity Doppler	Resident understands the epidemiology, pathophysiology, and pharmacology of common critical illness including ARDS, multiple organ system failure, pulmonary embolus, shock, vegetative state and brain death, ketoacidosis and hyperosmolar coma, asthma and COPD, and psychosis/delirium in the ICU setting Resident will develop experience in the use of vasoactive drug Resident will demonstrate developing competency in the use ventilatory support
Practice-Based Learning & Improvement (PBLI)	Resident prioritizes diagnosis and treatment decisions based on patient’s severity of illness Develop clinical judgment in the strategies used to match treatment protocols with critical illness Present a minimum of one EBM review at topic review and presentation conference	Resident prioritizes diagnosis and treatment decisions based on patient’s severity of illness Resident will develop clinical judgment in the strategies used to match treatment protocols with critical illness Resident will present a minimum of one EBM review at topic review and presentation conference
Interpersonal & Communication Skills (ICS)	Resident communicates regularly with patients and his/her family Resident is respectful to patient Resident is concerned about the patient’s comfort Resident addresses patient care issues such as end of life decisions with moderate faculty input Resident functions as an effective team member Resident communicates effectively with other members of the health care team	Resident communicates regularly with patients and his/her family Resident is respectful to patient Resident is concerned about the patient’s comfort Effectively coordinates team to optimize patient care Able to deal with challenging patients and families Functions as an effective team leader
Professionalism (P)	Resident completes the H&P/consultation within 24 hours of contact, and writes a daily progress note Resident will follow through with scholarly assignments promptly Resident completes medical records on time Resident recognized and takes steps to correct his/her deficiencies Resident treats team members with respect, including nurses and other health care providers	Resident completes the H&P/consultation within 24 hours of contact, and writes a daily progress note Resident will follow through with scholarly assignments promptly Resident completes medical records on time Resident recognized and takes steps to correct his/her deficiencies Resident treats team members with respect, including nurses and other health care providers Sets a tone of respect and collegiality for the team
System-Based Practice (SBP)	Resident can effectively initiate the appropriate clinical pathways Resident can effectively initiate the appropriate consultative services Resident develops a multidisciplinary approach to medical intensive care Resident severs as a consultant to other services with moderate faculty input	Resident can effectively initiate the appropriate clinical pathways Resident can effectively initiate the appropriate consultative services Resident develops a multidisciplinary approach to medical intensive care Resident severs as a consultant to other services with moderate faculty input Resident critically evaluates all consultant evaluations including conflicting recommendation to develop an effective patient care plan

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