The statements or observations are to be directly observed by the trainer. Some of the information may be elicited during the course of discussion. The trainer should make an assessment based on these observations (or habits) and discussions. The competencies will not be achieved in one patient encounter or one performed procedure. It is expected the resident will build his/her competency over a period of time. A trainer may need to revisit competencies as the opportunity arises or create an opportunity to assess the resident. Competency may not manifest consistently so it is important for more than one trainer to provide an assessment. A significant learning episode may occur because the learner is inexperienced in a procedure or very junior. It may also occur with a more senior learner who demonstrates a significant deficiency. A brief note discussed with the learner should be made with this assessment. Correction or significant learning episode (SL) An episode of behavior/interaction/procedural task required correction or intervention. This was followed by a significant discussion and reflection on the episode. Improved handling of future episodes is discussed or planned. No previous experience or limited experience requiring a significant teaching episode. Limited understanding of basic science/background which required a significant teaching episode and further reading. BRIEF NOTE REQUIRED. MUST DISCUSS WITH LEARNER Training in Progress /continuous learning (T) Training remains in progress. No significant deviations from expected. Can perform a task but will benefit from further experience. Supervisor should still be fully available to help. Patient/non patient interaction is satisfactory but areas of improvement remain (eg. content/delivery of information). Basic science/ background is present and required targeted teaching but will benefit from continual exposure or reading. Displays competency or can perform task (C) Comfortable in interactions with patients and can listen and provide information/feedback as expected by the patient. Has a good relationship with professional colleagues. Is carrying out the behavior/ habits well with no prompting. Could be allowed to perform a procedure with minimal or no supervision. NOT APPLICABLE The competency is not applicable to the learner. Medical student/resident/fellow/staff.. CanMEDS Competency RADIOFREQUENCY ABLATION OF LIVER TUMORS Observer Date Version: PANTRY RFA LIVER 20MAY2014 Page 1
Added note Medical Expert SL T C SL T C SL T C SL T C SL T C Basic and Clinical Sciences Can explain the anatomy/histology of the LIVER INCLUDING BLOOD SUPPLY Can explain the pathophysiology of this procedure ie how does it work and what are its limitations Can discuss and apply the indications and contraindications Is able to discuss the alternative treatment options to RFA FOR LIVER TUMORS Can describe the pre-procedural workup and actively reviews the pre-procedure checklist Able to identify potential complications Able to discuss the post procedure imaging requirements and follow up procedure Can you discuss the outcomes expected Procedural Expert Positions grounding pads securely and correctly, sets up RFA lines maintain sterile technique. Activated RFA machine and sets appropriate energy. Maintains sterile technique during procedure Maintains a tidy and clean work area Version: PANTRY RFA LIVER 20MAY2014 Page 2
Safely manages sharps and is not a danger to themselves or other health professionals Maintains appropriate contact and reassurance with the conscious patient during a procedure Aware of radiation safety, uses imaging appropriately and judiciously Safely and proficiently landmarks target area using imaging guidance Able to proficiently and safely under imaging guidance insert the catheter into correct position Confirms correct position with appropriate imaging. Safely administers the correct RFA energy Post procedure ensures no bleeding or other complications at insertion or treatment site and clean Band-Aid is applied. Ensure documentation of procedure is completed and patient has been given post procedure instructions. Able to manage patients pain and post op requirements satisfactorily Communicator General Competencies Patient orientated Introduces by name, position and role to the patient and patients companions Version: PANTRY RFA LIVER 20MAY2014 Page 3
Is able to describe the procedure appropriately and clearly to the patient Is able to explain the complications and adverse events associated with the procedure to the patient Allows sufficient time for the patient to ask questions Obtains appropriate consent correctly Remains courteous and respectful during all patient interactions Health professional orientated Constructs accurate succinct and timely reports Contacts other health professionals on an urgent basis when indicated. Is able to pass on and receive instructions accurately Collaborator Has taken the time to identify and understand the roles of individuals in the department/ sub-department. (Staff can ask what does he/she do?) Accepts the advice of other health care professionals. Actively asks advice from technologists, nurses and other care providers in the department. Is punctual or informs colleagues when late. Explains/apologizes Stops and considers co-workers workloads and time pressures. Does not release frustrations onto colleagues. Version: PANTRY RFA LIVER 20MAY2014 Page 4
Is courteous to physician and non physician colleagues. Readily discusses clinical cases with referring physicians without complaining to the physician. Respects colleagues confidentiality ie does not discuss confidential or sensitive information in a public place. Manager Took ownership of a patient/clinical case scheduling or logistical problem and tried to resolve it. Supervised peers and other trainees effectively and with courtesy. Supervised other health care professionals in the department effectively and with courtesy. Managed his/her time appropriately to maintain workflow in the department. Recognized deficiencies in care provision with in the department and acted on it appropriately. Health Advocate Has an understanding of the different concerns of a patient based on their community, religious or cultural background. Demonstrates this. Responded sympathetically to the concerns of a patient taking into consideration their community, religious or cultural background Tries to perform the best test Discussed or has identified issues which would improve patient care. Has suggested or instituted a Quality improvement (audit) project in the subspecialty Version: PANTRY RFA LIVER 20MAY2014 Page 5
Scholar Regularly researched information regarding cases performed or issues arising at the viewer side and discussed or presented findings to staff. Has discussed how he/she will address any deficiencies uncovered in the rotation. This will be in collaboration with the staff as a joint plan. Taught other health care professionals including, Technologists, Nurses, Residents, Medical Students. -His/her approach to teaching was positive and non punitive. Professional Was courteous with all individuals he/she met in the department. Maintained patient confidentiality. Did not ridicule staff or patients directly or indirectly. Acted appropriately when encountered unacceptable/unprofessional behavior. Maintained an appropriate and professional interaction with patients. Version: PANTRY RFA LIVER 20MAY2014 Page 6