Residency Orientation Southern Illinois University Springfield Janet Albers
Residency Orientation Southern Illinois University - Springfield Janet Albers, MD Anna Mies Richie, MD Harald Lausen, DO
New People New Place Different Backgrounds
Orientation Objectives • Recognize the Challenges – Different backgrounds • • Ethnicity Age Family Training – Medical knowledge – Clinical skills – Communication skills • Address the Challenges – Assessment evaluations • Strengths/weaknesses – Team Building – Individualize the curriculum for the resident
So much to do… So little time • One month – – – – – Become a Resident Become a ‘Family Physician’ Meet and Greet Certifications Assessment Policies & Procedures Practice Management Clinical Operations Computer Training Clinical Review and Education
As a Resident • • Responsibility Documentation Learning Teaching Presentations Recruitment Relationships
You had a calling to be a physician; there was an even higher calling to be a Family Physician. But what is a Family Physician?
Family Residents – SIU • We care for more children than pediatric residents • We deliver more babies and OB care than OB residents • We manage more hospital medicine patients than internal medicine residents
Patient Pyramid of Care 1 seen at an Academic Medical Center 5 hospitalized 9 see a consultant 250 see a Family Physician
Zoom • Zoom in and out of the patient encounter. • Approach the patient from all angles • Approach the patient plan from all angles. • Look at the patient from different angles.
Zoom • Zoom in and out of the patient encounter. • Approach the patient from all angles • Approach the patient plan from all angles. • Look at the patient from different angles.
Meet and Greet • People – – – Faculty (his/her area of expertise) Class Mentor, Individual Mentor Residents Dean Administrators/Staff Nurses • Places (scavenger hunt) – – Clinic 2 hospitals Call rooms Springfield
Certifications • • • ALSO NALS PALS ACLS BLS
Assessments • • • Medical School Performance Self Assessment Multiple Choice Exam Simulated Patient Visits Clinical Skills Competency Assessment
Self-Assessment • Interests • Strengths/Weaknesses – Clinical Disciplines – General Knowledge/Skills – Exam Skills – Office Skills & Procedures – Laboratory – Common Problem Management • Learning Style • Long-term Goals
Multiple-Choice Exam • • Problem-Solving/Clinical Judgment Basic Medical Knowledge of Discipline Diagnosis and Patient Management
Simulated Patient Encounters • • History and Physical Exam Diagnosis and Management Oral Presentation Problem-Solving/Clinical Judgment Knowledge of Discipline Patient Rapport/Professionalism Direct Feedback from Observers and Patients
Simulated Patient Encounters • Professional Development Lab • Two faculty observers – Physician and Behavioral Scientist • 2 cases – health maintenance exam – complete H &P with risk factor assessment and patient education skills. – geriatric patient accompanied by her daughter emphasizing interpersonal skills in a difficult interview situation.
OSCE Stations Obstetrics • perform vaginal delivery • review tracing • Annual exam history and perform pelvic/pap • Gyne questions • Peds • inpatient admission orders • MCQs • Ortho • knee exam and history • MCQs • Internal Medicine • Admit orders for Chest pain • Read ECG • MCQs • Geriatric Community Medicine • Patient Education role playing • General Surgery • Abdominal pain DDX • MCQs • Head to Toe Exam
Policies & Procedures • • • SIU/Hospitals Curriculum Evaluation Core Competencies Research Project Roles and Responsibilities Sick Time/Vacation/Education Residents as Teachers Duty Hours/Time Cards
Practice Management • • Billing & Coding Referrals Phone Triage Scheduling Reception Medical Records Clinical Performance EHR
Clinical Operations • • Community Agencies Anti-Coagulation Clinic SAC (Senior Assessment Clinic) Diabetic Education Group Classes Mental Health Off-Site Clinics – Gateway, Hope School, OB/Gyn clinics – Girard, Beardstown, and CCHC
Computer Training • • Electronic Health Record Hospital Computer Training x 2 Recording Procedures (New Innovations) PDA Passwords And more passwords
Clinical Review and Education • Shadowing • Hospital paperwork: H & Ps, SOAP notes, discharge summaries, admit orders • Fluids and Floor calls • ECG reading • OB stations • ICU/IM review • Clinic paperwork: referrals, scripts • Surgical Skills • Pediatric Physical Exam Skills • Ortho stations • Evidenced Based Medicine • Procedures/Ultrasound/Spirometry
OB stations • • • AROM – (water balloon and sock) Cervical Dilation/Effacement Delivery Suturing Episiotomies Triage Situations
Shadowing • Hospital – Family Medicine Teaching Service – Call with PGY-2/3 • OB floor – With PGY-2/3 • Clinic – With Faculty
Healthy Physician, Healthy Patient • Overall Wellness: physical and mental • Wellness Activity: – BP, Weight, BMI, Bone density • • • Burnout Sleep Deprivation Impairment/Substance Abuse Goal Setting Stress Level
Bonding/Teamwork • • • Dinners Cultural Competency ROPES Course Scavenger Hunt Ballint Group Pool party
Professionalism • • • Interpersonal Skills Core Competency Cultural Competency Videotaping Self-assessment Case Examples – role playing
2 nd and 3 rd Year Orientation • • • Triage Nursing Home Residents as. Teachers Senior Responsibilities Practice Management
Overview of a Day • AM – Hospital rounds • Noon – Orientation lecture » Clinic ops, practice management, clinical education • PM – Certifications, clinic shadowing, assessments or clinical education
Overview of the Month • • • Orientation Day Certifications – ACLS, ALSO, NALS, BLS In-service exam and self assessment OSCEs Scavenger hunt Simulated patient assessment Clinic operations, policy and procedures, practice mgmt Computer Training Hospital rounds daily Clinical learning activities – OB, Peds, ICU, Ortho, ECGs, IV fluids, surgical skills, paperwork • Clinic shadowing • Common Problems Presentation
What to do with the assessment data? • RESIDENT • FACULTY/MENTOR • CURRICULUM
SUMMARY • Time and resource intensive • First step of many steps • Valuable investment individual resident and program development
We continue to change the orientation as needed. If we always do what we’ve always done Then we’ll always get what we’ve always got. Wisconsin Factory Worker l
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