Vascular Objectives

Rotation-Specific Objectives for Neurosurgical Residents on Vascular Surgery Services: PGY1 Rotation

As PGY1s, residents have the option of choosing a Vascular Surgery elective for 2 blocks.

MEDICAL EXPERT

Knowledge:

By the end of the rotation the resident will be able to:

• Demonstrate a clear understanding of the anatomy, physiology, and pathophysiology of the circulatory system in health and disease, including arterial wall and cell biology, hemodynamics, and ischemia-related organ dysfunction.
• Elicit a history and physical exam that is relevant, concise, accurate and appropriate to the patient's problem(s).
• Demonstrate an understanding of the natural history of vascular disease and management of risk factors, and how non-surgical treatment, percutaneous and/or surgical intervention can alter this.
• Demonstrate a clear understanding of the diagnostic and therapeutic procedures available in medical imaging for vascular disorders such as plain radiograms, diagnostic angiography, Doppler ultrasound and duplex imaging, CT, MRI, therapeutic angiographic procedures, and thrombolysis.
• Demonstrate an understanding of pre-operative risk assessment and approaches to minimize such risks.
• Understand the principles of patient positioning, preparing and draping for common vascular surgery procedures.

Technical skills:

By the end of the rotation the resident will be able to:

• Adhere to aseptic technique in performing operative and bedside procedures
• Recognize the appearance of normal & abnormal tissues in the operating room
• Perform:
  • exposure, isolation and control of the femoral vessels
  • Saphenous vein harvesting
  • Varicose veins, saphenofemoral dissection, stripping and ligation
  • Lower leg fasciotomies
  • Insertion of central venous lines
• Assist competently in:
  • Intra-abdominal vascular procedures
  • Extracranial carotid artery surgery
  • Revascularization procedures of the extremities
  • Amputations

COMMUNICATOR

By the end of the rotation the resident will be able to:

• Obtain thorough, focused histories from patients, family members and other care-givers
• Present patient histories and physicals with management plans to the attending surgeons in the ambulatory clinic
• Write appropriate admission notes, consultation notes, operative notes, and daily progress notes in a timely fashion
• Dictate accurate and timely operative reports and discharge summaries
• Convey pertinent information from the history and physical examination in different circumstances (over the phone, during ward rounds and conferences)
• Explain procedures at a level appropriate for patients and their families to understand in order to gain informed consent

COLLABORATOR

By the end of the rotation the resident will be able to:

• Describe the process of discharge planning for vascular surgery patients
• List the mechanisms of patient care coordination with the other members of the team
• Participate effectively and appropriately in an interprofessional healthcare team.
• Collaborate with community agencies (as required) and other professionals.

LEADER

By the end of the rotation the resident will be able to:

• Manage multiple tasks on time (i.e. follow up on reports, prioritize tasks appropriately)
• Utilize health care resources safely, effectively
• Describe the mechanisms for effective practice management

HEALTH ADVOCATE

By the end of the rotation the resident will be able to:

• Demonstrate familiarity with important determinants of health affecting patients (e.g. smoking, obesity, drug or alcohol dependence) and address preventative measures with patients

SCHOLAR

By the end of the rotation the resident will be able to:

• Prepare for teaching rounds, ward rounds and operating room cases with adult learning principles and evidence-based medicine
• Critically evaluate patient outcomes and participate actively in morbidity rounds and mortality rounds on the vascular surgery service

PROFESSIONAL

During the rotation the resident will:

• Appreciate the emotional and ethical issues surrounding the care of patients with vascular disorders and the need to involve family members and other health care-givers in certain situations
• Recognize her/his limits, make independent decisions when appropriate, but keep senior residents, fellows and attending surgeons informed
• Understand the need for ongoing systems of peer review, maintenance of competence, and evaluation of outcomes in the surgical management of patients with vascular disorders