Radiology - University of Nevada School of Medicine by xiaopangnv


									Revised February 26, 2008

                       GOALS AND OBJECTIVES

Rotation Director:                 Dianne Mazzu, MD
                                   2020 Palomino Lane
                                   Las Vegas, NV 89106


Educational Purpose
Knowledge of the proper utilization of Radiologic services is an important component of
patient care for the Internist.

The Radiology elective rotation is available to Internal Medicine residents through the
UMC Radiology Department. It can be taken in a 2-week or 4-week block. The resident
will be given an assignment schedule and a self-study CD-Rom by Dr. Mazzu or
associate. The resident will be assigned to radiologist for the rotation and is excused only
for continuity clinic, medical review and noon conferences or department request (sick

The educational goals and objectives include the following general areas:

A.     Become familiar with the Radiologic tests and procedures available at UMC
       including Invasive Radiology.

B.     To learn the proper utilization of imaging modalities in diagnosis and

C.     To understand the clinical indications and contraindication of Radiologic tests and
       procedures at UMC.

D.     To understand Radiologic testing procedures cost effectiveness and risk versus
       benefit analysis.

Teaching Methods
The resident will work closely with the attending. The resident will review films with the
radiologist as they present to the department. In addition, the resident will engage in self-
study with a CD-ROM collection of standardized radiographic studies and findings, and
take an examination at completion.

Mix of Diseases
Patients present a vast array of acute and medical problems for which imaging studies
may be indicated.

Patient Characteristics
The patient population is diverse, male and female, of all ages from adolescent to
geriatric, representing most ethnic and racial backgrounds, from all social and economic
strata. The hospital serves primarily the indigent population of the city of Las Vegas.
There is a mix of medical, surgical, obstetric and trauma cases

Types of Clinical Encounters
There are few clinical encounters except those in which a diagnostic radiologist might
need to interact with a patient, i.e., procedural sedation.

Resident Supervision
Residents have constant on site supervision by an attending radiologist.

Procedures and Services
No procedures are performed

Didactic Teaching

       Noon Conference
       Residents rotating are required to maintain greater than 60 % attendance at noon
       conference. Noon conference occurs daily, Monday through Friday. These
       sessions cover the basic core curriculum, and other curriculum topics such as
       ethical issues, geriatrics, computer systems and informatics, health care systems,
       occupational and environmental health issues, and other topics of concern.

       Attending Rounds
       There are no rounds per se. Cases are reviewed individually with an attending

Core Reading Materials
      Self-study CD-ROM

Ancillary Educational Materials
       Subspecialty Texts of Neurology, Pulmonary Medicine, Nephrology,
       Endocrinology, Infectious Diseases, Rheumatology as well as General Medical
       References (Harrison’s Principles of Internal Medicine, Cecil’s Textbook of
       Medicine) are available 24 hours a day, seven days a week in the resident lounge.
       Savitt Medical Library On-Line
       Residents have access to the on-line services of Savitt Library (the main library of
       the University of Nevada - Reno) via their computer in the resident room, Suite
       300 of the 2040 W. Charleston Building. Access to this room is available 24
       hours a day, seven days a week.
       Full text is available for many peer-review journals including, but no limited to:

              ACP Journal Club
              Annals of Internal Medicine
              British Medical Journal
              Journal of the American College of Cardiology
              The Lancet
              New England Journal of Medicine

       Also available on-line:
              Harrison’s Principle’s of Internal Medicine, 14th ed.
              Merck Manual, 17th ed.
              Guide to Clinical Preventive Services, 2nd ed.
              The Cochrane Library
              Medline and Grateful Med Databases

Pathological Material and Other Educational Resources

Training Sites

       University Medical Center
       All of the diagnostic radiology experience occurs at University Medical Center
       (UMC) under the supervision of one of the full-time radiology attendings.

Competency-based Goals and Objectives
Radiology Rotation
         Learning Venues              Evaluation Methods              Level Specificity

1. Radiology Reading Suite            A. Radiologic testing                R-1=1
2. Fluoroscopy; CT Scanner; Follow-up B. Attending evaluation
IR Procedures
3. Self Study-CD Rom                  C. Self Evaluation                   R-2=2

4. Hospital Wards                         D. Radiologic Tech                R-3=3

Competency: Patient Care                    Learning         Evaluation        Level
                                            Venues           Methods
Understand preparation of patients for      1, 4             A, B              1, 2, 3

Discuss with patients the risk and           1, 2, 4      B, D                2, 3
benefits of the radiologic procedure.

Competency: Medical Knowledge                Learning     Evaluation   Level
                                             Venues       Methods
Interpret radiographs, X-Ray, CT and         1, 2, 3      A, B            1, 2, 3
Evaluate indications for invasive            1, 2, 3      A, B            1, 2, 3
procedures-arteriography, Mylograms,
Tissue biopsies
Understand risk and benefit of               1, 2, 3      A, B, C             2, 3
Radiologic procedures
List all hazards of radiation                1, 2, 3      A, B, E      2, 3
Understand preparation of patients for       1, 2, 3      A, B, D, E   1, 2, 3
radiologic procedures

Competency: Interpersonal and                Learning     Evaluation   Level
Communication Skills                         Venues       Methods

Communicate with radiologist and             1, 2, 4      B, E         1, 2, 3
radiology staff effectively
Communicate clearly with patients            1, 2, 4      B, D, E      1, 2, 3
concerning Radiologic testing
Understand patient preferences for testing   1, 2, 3      B, C, D      1, 2, 3
Maintain patient confidentiality             1, 2, 4      B, C, D, E   1, 2, 3

Competency: Professionalism                  Learning     Evaluation   Level
                                             Venues       Methods

Attend scheduled rotation assignments        1, 2, 4      B, E         1, 2, 3
Maintain patient confidentiality             1, 2         B, E         1, 2, 3

Competency-Practice: Based learning          Learning     Evaluation   Level
                                             Venues       Methods

Understand the complications of test         1, 2, 3, 4   A, B, C      2, 3
performed unnecessarily
List three ways your utilization of          1,2,3        B,C          1,2,3
radiology services will change/improve

Competency-Systems: Based Practice           Learning     Evaluation   Level
                                             Venues       Methods

Determine the most cost-effective ways       1, 2, 3, 4   A, B, C      2, 3
to diagnose four common problems

utilizing Radiologic resources
*Chest Pain
*Pulmonary Embolism
*Diabetic Foot-infection
*Abdominal Pain

       A. Of Residents
       At the completion of each rotation, all clinical faculty are required to complete the
       standard ABIM resident evaluation form. All clinical faculty are encouraged to
       provide face-to-face feedback with the residents. The night-float resident is
       evaluated by one of the three service attendings. In addition, residents may
       receive interim feedback utilizing the ABIM’s Praise and Early Warning cards.

       B. Of Rotation and Preceptor
       All residents are encouraged to evaluate the rotation, and the clinical faculty
       member, at the completion of the rotation. This evaluation form is included at the
       end of this document. These evaluations are then converted to type and shared
       anonymously with the clinical faculty.
       The program director also discusses the rotation with the residents to ensure
       rotation quality and satisfaction.

                       Radiology Rotation Resident Check List

1. Evaluation reviewed at mid-month and end of rotation by the supervising faculty
member and resident.

2. Completed assigned readings

3. Attended all assigned activities (excluding scheduled time away, required clinics and

4. Completed required case report abstracts and/or posters if assigned by the supervising
faculty member.

5. Demonstrated understanding of the basic principals of radiologic diagnosis.

6. Received verbal feedback from attending at end of rotation.

Intern/Resident Signature_________________________          Date___________________

Supervising Attending Signature ___________________         Date__________________

All items must be completed for rotation credit and checklist returned to the
Department of Medicine by the rotation’s end.


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