PGY1&2 OBJECTIVES AND EVALUATION RADIATION ONCOLOGY RESIDENT IN PALLIATIVE CARE

Transcription

1 PGY1&2 OBJECTIVES AND EVALUATION RADIATION ONCOLOGY RESIDENT IN PALLIATIVE CARE Resident: Preceptor(s): Rotation Date: Training Site: A. Radiation Oncology Objectives for Competency in CanMEDS Roles Medical Expert The resident will demonstrate diagnostic and therapeutic skills necessary for ethical and effective patient care. They will obtain and apply relevant information to clinical practice. Communicator The resident will demonstrate the ability to establish a therapeutic relationship with the patient and family. This includes the ability to obtain and share pertinent information with the patient and the health care team. Collaborator The resident will demonstrate the ability to work effectively in a team environment, by contributing to interdisciplinary patient care activities and by consulting effectively with other physicians. Professional The resident will practice medicine ethically: with integrity, honesty and compassion, always demonstrating respect for others. Their duties will be discharged reliably and they will always strive for excellence. Scholar The resident will develop, implement and monitor a personal continuing education strategy which will include the ability to critically appraise the literature. The resident will develop teaching skills in order to facilitate the learning of their patients and peers. Manager The resident will utilize health care resources effectively to balance patient care and learning needs. Health Advocate The resident will recognize and respond to those patient care issues where health advocacy is appropriate.

2 Page 2 of 5 Evaluation of Resident Performance in the CanMEDS Competencies Please rate the resident s performance in the objectives listed below using the following scale: Needs to Unacceptable Fair Satisfactory Good Very Good Outstanding Not Assessed improve Several Consistent No deficiencies Many major Few significant Satisfactory deficiencies of good of No deficiencies deficiencies deficiencies performance consequence performance consequence **COMMENTS ARE REQUIRED FOR MARKS LESS THAN 4** OBJECTIVE: The resident will display effective CanMEDS Competencies Communicator The resident will display effective doctor patient communication skills Establishes a therapeutic relationship with the patient and family Encourages full participation of the patient and family in decision-making and management Obtains and synthesizes relevant history from patients/families/colleagues/other professionals Provides accurate, relevant information and explanations to the patient and family and checks whether the patient (family) understands Verbally presents the patient s problems clearly, concisely and correctly in the clinical setting, formal presentations, and in the written records Collaborator The resident will display good collaborative team skills Has a straightforward approach with staff and peers Assists others as required Takes on appropriate share of team assignments Contributes effectively within the interdisciplinary team Consults effectively with other physicians and health care professionals Professional The resident will carry out their duties in a professional manner Recognizes limitations and seeks advice and consultation when needed Exercises initiative within limits of knowledge and training Discharges duties and assignments dependably and in a timely and ethical manner Reports facts accurately, including own errors Maintains appropriate boundaries in work and learning situations Respects the diversity of race, age, gender, disability intelligence and socio-economic status Recognizes and manages issues/concerns associated with caring for dying patients Demonstrates an approach for addressing ethical issues in palliative care Scholar The resident will develop a plan for self-improvement Attends and contributes to rounds, seminars and other learning events Accepts and acts on constructive feedback Reads around patient cases and takes an evidence-based approach to management problem

3 Page 3 of 5 Health Advocate The resident is a health advocate Identifies situations where patient advocacy was required Acts as a patient advocate Manager The resident is aware of the need for time and resource management The resident displayed good organization skills The resident displayed good time management skills The resident utilizes health care resources effectively Utilizes appropriate hospital and community services in the care of the patient B. Radiation Oncology Objectives for Clinical Skills in Palliative Care Listed below are the palliative care specific clinical objectives for radiation oncology residents. It should be noted that not all objectives will be met on this rotation. Further learning takes place during related rotations, seminars and independent study. For site-specific medical expert objectives, please refer to Program Goals & Objectives. At the end of this rotation the resident will be able to: Utilize a patient-centered approach in the provision of care to palliative patients and their families Demonstrate effective knowledge, skills and attitudes in dealing with the complex interplay of physical, psychological, social and spiritual needs of palliative patients and their families Collaborate as an effective member of the interdisciplinary team Incorporate accepted standards of palliative care in his/her practice Recognize and manage his/her personal issues and concern associated with caring for dying patients Discuss ethical issues confronting palliative patients, their families and professional health care providers, including end-oflife decision-making, advance directives, care planning, competency, euthanasia and assisted suicide

4 Page 4 of 5 Evaluation of Resident s Clinical Performance in Palliative Care OBJECTIVE 1: The resident will display effective clinical skills. Medical Expert History and Physical Performs a focused, accurate and complete history Performs a focused, accurate and complete physical exam Pain and Other Symptoms Understands the pharmacology and role of opioids and adjuvant drugs used in pain management Understands opioid conversions, and dose titration Understands the role of non-pharmacological options in pain management Demonstrates knowledge of the mechanisms of pain and can differentiate clinically the different types of pain Demonstrates an orderly approach to pain management Demonstrates knowledge of the mechanisms and causes of nausea and vomiting, constipation, malignant bowel obstruction, dyspnea, and delirium in palliative patients Demonstrates an orderly approach to the management of nausea and vomiting, constipation, malignant bowel obstruction, dyspnea, and delirium in palliative patients Identifies psychosocial and spiritual issues and strategies for addressing them Identifies and manages emergencies that arise in palliative care patients e.g. pain crises, severe dyspnea, hypercalcemia, SCC, SVC syndrome Problem Solving and Clinical Judgment Has a good store of pertinent factual information Takes all data into account in problem formulation Shows good judgment when setting management priorities Demonstrates appropriate management of in-patients Demonstrates a systematic approach to clinical problem solving Implementing a Management Plan Writes orders that are clear, comprehensive and correct Is fully aware of the side effects of the therapies ordered Monitors therapy appropriately Makes effective use of other health professionals and community resources Treatment decision-making and clinical management Can recognize, anticipate, and manage palliative medical problems appropriately Can discuss the general principles of treatment Can recommend an appropriate management plan Is fully aware of the side effects of the therapies ordered Can recognize and manage common acute toxicities of pain therapy

5 Page 5 of 5 Strengths and Areas Needing Improvement: Strengths: Areas Needing Improvement **COMMENTS ARE REQUIRED FOR MARKS LESS THAN 4**: Overall Evaluation: Satisfactory Date: Marginal Preceptor s Signature: Unsatisfactory Preceptor s Name: (please print) Please discuss this directly with resident. Resident's Comments: Evaluation discussed with Preceptor: Yes No Resident s Signature: Date: Program Director s Comments: Program Director s Signature: Date: