ICU Objectives

Rotation-Specific Objectives for Neurosurgical Residents on ICU Rotation

Neurosurgery residents at the University of Toronto are required to spend 3 blocks on an ICU service as part of their PGY2 training. They will rotate to one of the teaching hospitals within the University, most often Sunnybrook Health Sciences Centre, Toronto Western Hospital/Toronto General Hospital, and St Michael's Hospital. The following is a description of the rotation-specific objectives for neurosurgery residents undertaking their ICU rotation:

MEDICAL EXPERT

KNOWLEDGE: At the completion of their rotation, the PGY2 resident will be able to:

• To interpret blood gases and assess acid-base status
• Interpret an electrocardiogram and recognize important life-threatening findings.
• Demonstrate awareness of the ethical principles pertinent to critically ill patients especially end of life care, and issues around withdrawing and withholding life support.
• Demonstrate familiarity with airway management and indications for intubation.

CLINICAL SKILLS: At the completion of their rotation, the PGY2 resident will be able to:

• Provide basic ventilator orders for most patients
• Use inotropes and vasopressors appropriately
• Perform basic airway management (bag/mask ventilation and uncomplicated intubation)
• Place central line with appropriate technique
• Place arterial line with appropriate technique
• Understands principles of ACLS and can apply them in a patient resuscitation.

COMMUNICATOR: At the completion of their rotation, the resident will be able to:

• Prepare written documentation regarding patient interactions in a timely and accurate fashion, including, consultations and progress notes.
• Establish communication with the patient and family that supports a trusting and open relationship.
• Respond appropriately to patients, families, and colleagues, who express anger, hostility, or a complaint.
• Communicate in a clear, concise and collegial manner with other health care professionals.
• Communicate to a group of peers or allied health personnel in a clear and understandable way at weekly conferences
• Communicate effectively with nursing managers and administrators, when necessary. 

COLLABORATOR: At the completion of their rotation, the resident will be able to:

• Effectively and respectfully collaborate with other physicians, health care professionals, and community agencies to contribute effectively to interdisciplinary team activities.
• Listen to concerns expressed by others providing care and assist in resolving these concerns if appropriate.

LEADER: At the completion of their rotation, the resident will be able to:

• Demonstrate time management for clinical activity, learning needs and personal activities.
• Prioritize clinical activities in a manner to optimize patient care and the functioning of the clinical service.
• Triage patients and identify emergencies that require prompt and immediate management.
• Delegate responsibilities where and when appropriate.

HEALTH ADVOCATE: At the completion of their rotation, the resident will be able to:

• Identify the important determinants of health that affect their patients.
• Intervene on behalf of patients or the community with respect to the social, economic and biologic factors that may impact on the patients’ health.
• Effectively advocates for practices that enhance health and well-being.
• Demonstrate sensitivity to the needs of patients and their families as they are affected by age, gender, cultural and ethnic perspectives.

SCHOLAR: At the completion of their rotation, the resident will be able to:

• Maintain and enhance professional activities through ongoing learning.
• Critically evaluate medical information and its sources, apply this appropriately to practice and communicate this at weekly rounds.

PROFESSIONAL: At the completion of their rotation, the resident will be able to:

• Deliver the high quality care with integrity, honesty and compassion.
• Fulfill medical, legal, ethical and professional obligations of the specialist.
• Meet deadlines, be punctual, monitor patients, and provide follow-up.
• Demonstrate an understanding of the principles of ethics and apply these in clinical situations.
• Demonstrate self-assessment, seek and accept advice when necessary.