Curriculum Template by agR7BS

VIEWS: 5 PAGES: 7

									  Goals and Objectives: General Nuclear Medicine and PET
                  (3 Year Curriculum- Nuclear Residency Program)

Description of Rotation
Residents who participate in the three year curriculum have typically had experience of
only one clinical year. Thus, the pace of their training, especially in the first year, is
relatively slow. In the first year, the rotation provides the fundamentals of nuclear
medicine practice, including the general principles of radiotracer imaging and the range
of diagnostic imaging studies and therapies performed in nuclear medicine. Hands-on
experience in the nuclear pharmacy and camera operation is supplemented by basic
science lectures.
For second year residents there will be continued exposure to the general principles of
radiotracer imaging and increased familiarity with diagnostic imaging and therapy
studies.
In the third year residents are expected to function largely independently (with
appropriate supervision) in prescribing, performing and assessing adequacy, interpreting
and reporting nuclear medicine imaging studies, including pediatrics, cardiac and PET
studies. The residents should by now have a well developed capacity for the integration
of functional/molecular/CT imaging for interpreting exams and planning radiation
therapy.

Patient Care
Goal
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.

Objectives
First Year Residents are expected to:
    1. Become familiar with the operations of a nuclear medicine clinic.
    2. Develop basic familiarity with the evaluation of a clinical request, planning and
       monitoring procedures, principles of interpretation and dictation after faculty
       review.
    3. Learn how to interview patients in nuclear medicine, including patients with
       special needs e.g. dementia.
    4. Learn to care appropriately for patients while they are in the Nuclear Medicine
       suite for nuclear imaging studies.
    5. Lear to obtain information from medical record and clinical physicians.

Second Year Residents are expected to:
   1. Begin to assume some clinical responsibility for and supervision of the operations
      of a nuclear medicine clinic, including quality control issues.
   2. Learn the contraindications for studies and modifications for special patients and
      be able to select appropriate procedures.
   3. Continue to develop skills to interview and examine patients.

Third Year Residents are expected to:


                                                                                           1
   1. In addition to all the above, become more sophisticated and independent in the
      care of patients in the nuclear medicine laboratory.
   2. Demonstrate more advanced skills in patient care (history, physical examination,
      treatment of complications).
   3. Demonstrate facility with hospital computer and PACS systems for patient care.
   4. In short, able to take responsibility for almost all routine patient management
      while the patient is in the nuclear medicine department.

Medical Knowledge
Goal
Residents must demonstrate knowledge of established and evolving biomedical, clinical,
epidemiological, and cognate (e.g. epidemiological and social-behavioral) sciences, and
the application of this knowledge to patient care.

Objectives
First Year Residents are expected to:
       1. Learn the basic concepts of nuclear medicine physics and radiobiology and
           comply with NRC rules.
       2. Learn the main imaging modalities, planar, SPECT and PET and appropriate
           radiopharmaceuticals.
       3. Learn the main non-imaging studies.
       4. Learn the basic aspects of quality control of images.
       5. Acquire fundamental knowledge of normal and abnormal scintigraphic
           appearance.
       6. Develop beginner skills to interpret nuclear medicine studies, formulate
           differential diagnoses and draft reports.
       7. Demonstrate facility with hospital computer and PACS systems.

Second Year Residents are expected to:
      1 Learn the fundamental aspects of radiotracer biodistribution and excretion.
      2 Increase depth of understanding of basic sciences, instrumentation,
         radiobiology, radiation protection, mathematics, statistics and
         radiopharmaceutical chemistry.
      3 Learn the guidelines for conducting and interpreting more complex studies,
         including co-registration and fusion studies.
      4 Learn to process and display basic nuclear medicine studies.

Third Year Residents are expected to:
       1. In addition to the above, acquire increasingly sophisticated knowledge of the
          imaging and non-imaging modalities and radiopharmaceuticals, scintigraphic
          appearance and radionuclide therapy.
       2. Perform quality control of images with minimal direction.
       3. Accurately dictate reports and communicate results with reduced supervision.
       4. Fully understand the indications for nuclear medicine studies, the various
          protocols and how to modify them, and a thorough knowledge of image
          interpretation.


                                                                                         2
       5. Learn the fundamentals of Computed Tomography performance and
          interpretation.
       6. Have a working knowledge of the application of PET/CT to radiation therapy.
       7. Acquire increasingly sophisticated knowledge and performance of procedures
          and demonstrate facility with independently running the nuclear laboratory
          (with reduced level of supervision).
       8. Know the relevant NRC regulations for diagnostic and therapeutic nuclear
          medicine practice


Practice- Based Learning and Improvement
Goal
Residents must demonstrate the ability to perform practice-based learning and
improvement that involves investigation and evaluation of their own patient care,
appraisal and assimilation of scientific evidence, and improvements in patient care.

Objectives
First Year Residents are expected to develop skills and habits to be able to:
    1. Learn to utilize available information technology for access to the most recent
       scientific data.
    2. Collect cases of interest, either due to unusual or classic presentations of disease
       or due to difficulties in diagnoses. Present these at the nuclear medicine
       correlation conferences.
    3. Participate in Journal Club where appraisal of scientific evidence and applicability
       to patient care are discussed.
    4. Participate in annual self-assessment exercise, identify strengths and limitation
       and develop own learning goals.

Second Year Residents are expected to:
   1. Utilize available information technology for access to the most recent scientific
      data. Independently seek out new data in printed and electronic formats.
   2. Continue to collect cases of interest, either due to unusual or classic presentations
      of disease or due to difficulties in diagnoses. Present these at the nuclear
      medicine correlation conferences, using more advanced analytic skills.
   3. Continue to participate in Journal Club where appraisal of scientific evidence and
      applicability to patient care are discussed.
   4. Participate in annual self-assessment exercise, identify strengths and limitation
      and develop own learning goals.

Third Year Residents are expected to:
   1. As well as all the above, regularly explore the contemporary literature for the
       most recent developments in nuclear medicine imaging.
   2. Collect cases of interest and present them at conferences, now using sophisticated
       skills to analyze the findings and incorporate into their own practice.

Systems Based Practice


                                                                                          3
Goal
Residents must be aware of systems-based practice, as manifested by actions that
demonstrate an awareness of and responsiveness to the larger context and system of
health care, and the ability to call effectively on system resources to provide care that is
of optimal value.

Objectives
First year residents are expected to:
    1. Gain basic knowledge of the role that the various nuclear medicine imaging
        procedures play in the work up of patients relative to other complementary
        /competing techniques.
    2. Understand appropriateness criteria and the relative strengths and weaknesses of
        the various procedures.

Second year residents are expected to:
   1. Demonstrate basic knowledge about the costs of imaging studies.
   2. Gain more advanced knowledge of the role that the various nuclear medicine
      imaging procedures play in the work up of patients relative to other
      complementary /competing techniques.

Third Year Residents are expected to:
   1. Fully understand the relative merits of the different nuclear medicine imaging
       studies and able to make recommendations to the clinical service concerning the
       best imaging studies for detecting suspected pathology.
   2. Play an active role in trying to control health care cost expenditures. This
       includes recommending equally effecting imaging studies that are less expensive,
       whenever appropriate.
   3. Be aware of the roles of the regulatory agencies such as the Nuclear Regulatory
       Commission (NRC) and Joint Commission on the Accreditation of Healthcare
       Organizations (JCAHO).


Professionalism
Goal
Residents must demonstrate professionalism, as manifested through a commitment to
carrying out professional responsibilities, adherence to ethical principles, and sensitivity
to a diverse patient population.

First year residents are expected to::
    1. Dress appropriately at all times.
    2. Begin to understand how to interact on a professional level with their patients.
    3. Demonstrate strong ethical principles. This includes good work ethic with prompt
        appearance on the service at appropriate times.
    4. Begin to establish professional relationships with the nuclear medicine
        technologists and student technologists with whom they interact.
    5. Not discriminate based on age, ethnicity, gender, disability or sexual orientation.


                                                                                               4
Second year residents are expected to:
   1. Dress appropriately at all times.
   2. Understand how to interact on a professional level with their patients,
      demonstrating great sensitivity toward their patient’s anxiety, and placing
      appropriate and compassionate patient care above self-interest at all times.
   3. Demonstrate strong ethical principles. This includes good work ethic with prompt
      appearance on the service at appropriate times.
   4. Establish professional relationships with the nuclear medicine technologists and
      student technologists with whom they interact and progressively develop team
      leader skills.
   5. Demonstrate sensitivity to the needs of the diverse patient population, including
      but not limited to cancer and dementia patients.
   6. Not discriminate based on age, ethnicity, gender, disability or sexual orientation.

Third Year Residents are expected to:
   2. In addition to the professionalism demonstrated in the prior years, act
       professionally with a responsible work ethic and respect for all members of the
       team by “running” the service, directing all aspects of the nuclear medicine
       laboratory efficiently and smoothly throughout the day.

Interpersonal and Communication Skills
Goal
Residents must demonstrate interpersonal and communication skills that result in
effective information exchange and collaboration with patients, their families, and other
health professionals.

Objectives
First Year Residents are expected to (to be):
    1. Learn the appropriate format for a nuclear medicine report.
    2. Learn the rudiments of dictation, using clear and concise language after reviewing
       the images with a faculty member.
    3. Learn the need and style for oral communication of results to referring physicians.
    4. Begin to understand how to communicate with a variety of persons e.g. students,
       technologists, clerical and administrative personnel, etc.

Second Year Residents are expected to:
   1. Able to dictate reports using clear and concise language after reviewing the
      images with a faculty member. Gradually the resident will be expected to
      compose the report with progressively less assistance.
   2. Able to verbally communicate the results of any performed study concisely and
      clearly to referring physicians.
   3. Develop an ability to communicate calmly and teach patients about nuclear
      medicine imaging studies. Demonstrate appropriate patience and empathy in this
      communication.
   4. Play an active role in communicating with and instruction of medical students


                                                                                            5
      rotating on the service.
   5. Demonstrate appropriate communication skills with technologists with whom
      they interact.
   6. Demonstrate appropriate communication skills with clerical and administrative
      personnel with whom they interact.

Third Year Residents are expected to:
    1. Demonstrate proficiency in all the above skills, as well as gain mastery of report
       dictation. Dictate study findings clearly and concisely in the body of the imaging
       study report and to summarize those findings effectively in an impression at the
       end of the dictation with minimal direction.
   2. Able to communicate effectively with technologists, patients and any clinical
       physicians with whom they interact during the course of a work day. This
       includes leadership skills and demonstration of empathy/understanding for both
       patients and their primary caretakers.

Teaching Methods
Formal, didactic lectures on relevant subject material
Small group teaching on individual cases
Conferences and Journal Club
Teaching files on service, teaching files on internet
Written material in textbooks; scientific articles provided by faculty
Hands-on laboratory (first year)
Self education is expected
Assessment Method (residents)
Focused direct observation by the faculty (written quarterly evaluations)
Assessment of residents’ draft reports
Assessment of presentations
In-house examination
In-training ABNM examination
Assessment by clerical and technologist team members
Self-assessment tool
Resident logs (diaries)

Assessment Method (Program Evaluation)
Annual formal program evaluation
Quarterly meetings with the Program Director
Frequent informal discussions with the Associate Program Director

Level of Supervision
During the first six months supervision by the faculty is direct. During the second six
months, residents take on greater responsibility. During the second year, the residents
take on greater duties including supervision of radiology residents, quality control of
images, appropriateness review. During the third year, responsibility on the nuclear
medicine service continues to grow, but all dictated reports are reviewed by the faculty.


                                                                                            6
The faculty decides as a group whether the resident has sufficient knowledge and skills to
be promoted to “Supervisory Fellow” at which time responsibility is given to “run” the
service (with reduced supervision by the faculty).

Educational Resources
Textbooks in the Fellow Library
Taubman Medical Library
Electronic Teaching File
Access to Internet, Medline Search and PubMed

5/29/07




                                                                                         7

								
To top