Introduction:

Goals/Objectives:
The PGY 1 resident will:

• Practice/review concepts of aseptic technique gowning/gloving/creation of

sterile field.

• Review Universal Protocol-‘time-out’.

• Review 2014 National Hospital Patient Safety Goals.

• Review and apply SBAR in simulation

• Review and Apply early diagnosis concepts for SIRS/Sepsis through Simulation

Intern Skills Testing Overview

Rotations: (40 minutes each)

 Aseptic technique ‘hands-on’ practice

o Gowning/gloving/set-up sterile field

 Patient Safety-Communication-Medication Safety

o Simulations focusing on 2014 National Hospital Patient Safety Goals

 Universal Protocol/SEPSIS/SIRS

o ‘Time-Out’ video

o Sepsis SIRS –power-point and group discussion


INSTITUTION: Mercy Health Saint Mary's
ROTATION: Family Medicine Service
PGY LEVEL: PGY1
ROTATION LENGTH: <4 Blocks>
ROTATION DESCRIPTION/OVERALL GOALS:To provide residents with an environment and opportunities for gaining professional and
Based medicine with particular emphasis on issues appropriate to the family practitioner.
INSTITUTIONAL RESOURCES: Epocrates, MHSM Health Sciences Library, MSU Health Sciences Library, Mock Codes, FMS Rounders
GOALS AND OBJECTIVES BY COMPETENCIES
PATIENT CARE (PC):
Goals
1. Acquires skill in gathering essential
and accurate data information, and
synthesizing it
Last Revision: 1/16/2015
FAMILY MEDICINE RESIDENCY
CLINICAL ROTATION GOALS AND OBJECTIV
Objectives Sub Instructional Strategies
(Knowledge/Skills/Attitude) Comp
1. Gathers data from patient, family, and PC-1 1. With indirect supervision
team PC-2 a. Acquires accurate and
PC-3 relevant history from the
patient that is customized and
PC-4 hypothesis driven
C-1 b. Obtains appropriate, verified
MK-2 and prioritized data from
secondary
sources (e.g., family,
records, and pharmacy)
c. Performs physical
examination in a systematic
manner adapting to the needs
of the patient
d. Tracks changes in physical
examination findings
e. Responds to urgent or
emergent situations and
recognizes when to seek

MEDICAL KNOWLEDGE (MK):
Goals
1. Demonstrates knowledge to treat
common medical conditions and to
order and interpret appropriate tests.
Last Revision: 1/16/2015
2. Integrates data from patient/family,
and team to determine
effectiveness of care
Objectives
(Knowledge/Skills/Attitude)
1. Fund of Knowledge: Reviews adequacy of
knowledge with current evidence and clinical MK-2
experience
assistance
f. Formulates differential
diagnoses
PC-1 1. With indirect supervision
PC-3 a. Provides appropriate
MK-2 preventative care and teach
patient regarding self-care
b. Makes appropriate clinical
care decisions based upon
the results of common
diagnostic testing, including
but not limited to routine
blood chemistries,
hematologic studies, arterial
blood gases, ECG, chest
radiographs, pulmonary
functions test, urinalysis, and
other bodily fluids
c. Manages patients with
common clinical disorders
seen in the practice of
inpatient medicine
d. Initiates management and
stabilize patients with
emergent medical conditions
Sub Instructional Strategies
Comp
MK-1 1. Understands the relevant
pathophysiology and basic
science for common medical
PC-1
conditions
PC-5 2. Demonstrates sufficient
PBLI-1 knowledge to diagnose and
treat common conditions that
require hospitalization
3. Discusses indications for and
basic interpretation of common
diagnostic testing, including,
but not limited to routine blood
chemistries, hematologic

2. Participates in group learning
PRACTICE BASED LEARNING & IMPROVEMENT (PBL):
Objectives
Goals
(Knowledge/Skills/Attitude)
1. Creates a goal-oriented plan for self- 1. Knowledge Management: Appraises and
directed learning. applies emerging information and best
evidence to decision making
2. Practice Experience: Assesses own
cognitive and behavioral needs; seeks
mentoring for improvement
Last Revision: 1/16/2015
studies, arterial blood gases,
ECG, chest radiographs,
pulmonary functions test,
urinalysis, and other bodily
fluids
MK-1 1. Attends educational conferences
Prof-2 of Family Medicine, Including:
SBP-2 a. Morning report on FMS
b. Grand Rounds
PBLI-1 c. Tuesday morning lectures
PBLI-2 d. Evidence-based Medicine
e. Quarterly Mortalities
f. Teaching rounds
g. Noon conferences
Sub Instructional Strategies
Comp
PBLI-1 1. Accesses medical information
PBLI-2 resources to answer clinical
questions and support
decision making
2. Implements plans for study
and research to promote
personal and professional
growth
3. With assistance, appraises
study design, and conducts
statistical analysis for clinical
research papers
4. Determines if clinical
evidence can be generalized
to meet individual patient
needs
SBP-2 1. Readily admits to error and
Prof-1 seeks corrective measures
Prof-2 2. Identifies areas in own practice
that can be changed to improve
PBLI-3 processes and outcomes of
care
3. Implements a plan for study
and scholarship that promotes
personal and professional
growth
 3. Lifelong Learning: Seeks mentoring for Prof-4 1. Discusses with faculty
improvement C-3 member efforts to organize
PBLI-2 time and to balance personal
and professional
SBP-4 responsibilities
2. Seeks and welcomes
feedback from all members of
the health care team
including faculty, nurses, peer
residents, students allied
health workers patients and
advocates
3. Actively participates in
teaching conferences

PROFESSIONALISM (PROF):

Objectives Sub Instructional Strategies

Goals
(Knowledge/Skills/Attitude) Comp
1. Demonstrates compassion, integrity, 1. For Self: Self assesses ability to be honest Prof-1 1. Documents and reports
respect for others and compliance with and straightforward Prof-2 clinical information truthfully
laws and regulations pertaining t o 2. Maintains good hygiene and
Prof-4
medical practice neat attire
3. Avoids tardiness
4. Addresses personal,
psychological, and physical
professional performance
limitations that may affect
professional performance
2. In Patient Care: Demonstrates compassion C-2 1. Maintains professional
and respect Prof-2 relationships with patients
family and staff
Prof-3
2. Demonstrates empathy and
SBP-3 compassion to all patients
3. Treats patients with dignity,
civility and respect,
regardless of race, culture,
gender, ethnicity, age or
socioeconomic status
4. Advocates for individual
patient needs
5. Maintains patient
confidentiality
6. Recognizes impact of
disparities in health and care
among populations
3. With Colleagues and Staff: Is respectful Prof-1 1. Responds promptly to clinical
and timely in patient care and team Prof-2 responsibilities including calls
Last Revision: 1/16/2015
 interactions Prof-4 and pages
C-3 2. Carries out timely interactions
with colleagues, patients and
their designated caregivers
3. Ensures prompt completion of
clinical, administrative and
curricular tasks
4. Recognizes and manages
conflicts of interest, e.g.,
providing care for family
members and professional
associates
5. Verbalizes distinction
between personal and
profession opinion or
obstinance
6. Shares constructive feedback
with health care team
7. Shows humility and admits to
errors, and seeks corrective
action
8. Assists colleagues in the
provision of duties

COMMUNICATION SKILLS:

Objectives Sub Instructional Strategies

Goals
(Knowledge/Skills/Attitude) Comp
1. Establishes therapeutic and 1. With the Patient and Family: Communicates C-1 1. With indirect supervision
empathetic relationships in a culturally across culture in a sensitive and effective C-2 a. Uses language that is
sensitive manner. manner readily understood by
Communicates with all members of a patient/family
health care team. b. Uses verbal and non-
verbal skills to create
rapport with patients and
families
c. Uses an interpreter to
engage patients,
including for patient
education
d. Provides timely and
comprehensive verbal
and written
communication to
patients and advocate
e. Demonstrates sensitivity
to patient diversity
including, but not limited

Last Revision: 1/16/2015


2. About the Patient: Communicates with a
team, across transitions of care
3. Within the System: Documents in a
comprehensive, timely, and legible
manner
to, race, culture, gender,
sexual orientation,
socioeconomic status,
literacy, disability,
and religious beliefs
C-2 1. Delivers appropriate,
C-3 succinct, hypothesis driven
SBP-4 oral presentations
2. Formulates and explains
diagnoses
3. Demonstrates clear and
concise communication with
other caregivers to maintain
continuity during transitions
of care
4. Communicates plan of care to
all members of the health
care team
5. Communicates the role of
consultant to patient
C-4 1. With indirect supervision
SBP-4 provides legible, accurate,
complete, and timely written
communication that is
congruent with medical
standards
2. Justifies consult requests and
expectations

SYSTEMS BASED PRACTICE (SBP):

Objectives Sub Instructional Strategies

Goals
1. Identifies issues related to error, cost
and the need for interdisciplinary
collaboration in the delivery of health
care
Last Revision: 1/16/2015
(Knowledge/Skills/Attitude)
1. Collaboration: Incorporates family
members, other health professionals,
and advocates as care team members
Comp
SBP-2 1. Appreciate roles of various
SBP-4 health care providers, including
C-3 but not limited to consultants,
therapists, nurses ,home care
workers, pharmacists and
social workers
2. Discusses unique roles and
services provided by local
health care delivery systems.
3. Works as a member within the
interprofessional team to
ensure safe patient care.
4. Considers alternatives
solutions provided by other
team members
 2. Cost: Performs a cost-benefit analysis SBP-1 1. Discusses a cost-benefit
when planning patient care SBP-3 analysis when planning patient
care
a. Identifies costs for
common diagnostic or
therapeutic tests
b. Minimizes unnecessary
care including tests,
procedures, therapies, and
ambulatory or hospital
encounters
2. Discusses common socio-
economic barriers that impact
patient care
3. Discusses how cost-benefit
analysis is applied to patient
care, e.g., principles of
screening tests and
development of clinical
guidelines
3. Quality: Investigates impact on quality PBLI-3 1. Recognizes health system
of care of interprofessional practice SBP-2 forces that increase the risk for
error including barriers to
Prof-2
Recognizes system error and advocates for optimal care
system improvement 2. Reflects on and learns from
critical incidents, e.g., near
misses and preventable
medical errors
3. Discusses how plan of care
differs when decisions are
independently made and when
team is involved
4. Participates in QI or Safety
committees
SUPERVISION: Family Medicine residents will be supervised by senior residents and Family Medicine faculty in all patient care a
Family Medicine rotation.

EDUCATIONAL RESOURCES: <Books, self directed learning modules, readings, videos, etc.>

• Required experiences:
• IPASS
• On Call Series
• Safety Rounds
• Tuesday AM Didactics

• Suggested resources:
Last Revision: 1/16/2015
 • STFM National Curriculum
• Swanson’s
• Geriatric Lecture series
• Radiology Rounds
• Morning Openers

Last Revision: 1/16/2015

DRAFT 5/31/2013

Internal Medicine
In situ Simulation GOALS AND OBJECTIVES

INSTITUTION: Spectrum Health/Mercy Health-St Mary’s/GRMEP

PGY LEVEL: 1-3

Simulation Length: varied by scenario (30-60 minutes)

In situ Simulation DESCRIPTION: Twice per block offering of simulated medical emergency in an acute care setting that allows for a resident
member on an inter-professional team.

GOALS AND OBJECTIVES BY COMPETENCIES:

PATIENT CARE (PC)

Objectives
Goal
(Knowledge/Skills/Attitude)
1. Gathers and synthesizes essential and accurate information to 1. Obtains a patient history relevant to the scenario.
define each patient’s clinical problem(s). (PC1)

2. Assesses and manages an airway appropriate to the scenario. PGY1-2:1.Demonstrates and chooses appropriate airway managemen
(PC4) including basic and advanced airways.
PGY3: Mentors other practitioners in use of appropriate airway adjun
procedures.

MEDICAL KNOWLEDGE (MK)

Objectives
Goals
(Knowledge/Skills/Attitude)
1. Demonstrates adequate knowledge of the topic and equipment 1. Adequately addresses the cause of the ‘code’ situation
and applies it to scenario. 2. Demonstrates safe use of a defibrillation unit.
3. Orders and administers medications in a safe manner.

2. Applies ACLS algorithms to the scenario. PGY1:

1. Performs CPR per AHA guidelines.
2. Correctly identifies EKG rhythms during scenario.
DRAFT 5/31/2013

3. Identifies indications for and performs defibrillation, cardioversion,

pacing in a safe manner.
4. Orders and/or administers medication according to the applicable A
algorithm.
PGY2:
1. Correctly identifies EKG rhythms during scenario and applies ACLS
algorithm.
2. Identifies and performs defibrillation in a safe manner.
PGY3:
1.Initiates appropriate ACLS algorithm and mentors team members as
needed on ACLS protocols.
2. Follows ACLS algorithms and administers medications in a safe man

PRACTICE BASED LEARNING & IMPROVEMENT (PBL)

Objectives
Goals
(Knowledge/Skills/Attitude)
1. Monitors practice with goals for improvement (PBLI1) 1. PGY1-3:Utilizes feedback during scenario and debriefing to impro
practice and takes responsibility for actions
2. PGY1-3: Completes a post-simulation evaluation of simulation
experience.

PROFESSIONALISM (PROF)

Objectives
Goals
(Knowledge/Skills/Attitude)
1. Respectfully interacts with members of the inter-professional PGY 1-2:
team. (PROF1) 1. Communicates in a professional and respectful manner througho
scenario.
2. Actively participates in scenario and debriefing.
PGY3:
1. Effective Team leader
2. Facilitates debriefing
3. Coordinates and assists with scenario creation

2. Accepts responsibility and follows through on tasks. (PROF2) PGY1-3: 1.Accepts feedback for improvement and accountability for a
during scenario and debriefing

INTERPERSONAL COMMUNICATION SKILLS (ICS)

DRAFT 5/31/2013

Objectives
Goals
(Knowledge/Skills/Attitude)
1. Demonstrates interpersonal and communication skills that result PGY1-3:
in the effective exchange of information and collaboration with 1. Role models and teaches collaborative communication as team lead
patients and the inter-professional team. (ICS2) 2. Communicates effectively as a team member.
3. Uses closed loop communication and SBAR

SYSTEMS BASED PRACTICE (SBP)

Objective
Goals
(Knowledge/Skills/Attitude)
1. Works effectively within an inter-professional team. (SBP1) PGY3:
1. Identifies roles of team members specific to scenario.
2. Applies safety behaviors: call-backs, closed loop communicati
and SBAR to scenario.
3. Performs time-out as required in the simulation.

2. Transitions patients effectively within healthcare delivery system. PGY 2-3:

(SBP4) 1. Identifies need for transfer and arranges appropriate consult
DRAFT 5/31/2013

Expectation for successful completion:

• PGY 1: will attend 5 per academic year

o Will act as Team Member for atleast 3

o Will act as Team Leader min. of 2

• PGY 2 and 3: will attend 5 per academic year

o Will act as Team Leader for amin. of 3

o Will act as Team member for min. of 2

• This will be verified in New Innovations Evaluation Forms that have been completed by GRMEP Educators or Faculty

INSTRUCTIONAL STRATEGIES: Simulation with high-fidelity manikin; review (debriefing) of case post-simulation

ASSESSMENT METHODS: Evaluation Completed in New Innovations by GRMEP educators/Faculty Facilitators; Structured debriefing

SUPERVISION: Scenario is led by GRMEP educators and IM chief residents

EDUCATIONAL RESOURCES: AHA ACLS student manual; 2013/2014 JCHAHO National Hospital Safety Goals; IM milestones; Attachment 1: Sc

Rev1/21/2014vls; Rev1/03/2014vls; 12/03/2013vswendroski

Attachment 1: IM Mock Code Curriculum

PGY 1 PGY 2 PGY 3

Scenarios: Scenarios: Scenarios:
• Airway Obstruction/Management • Megacodes: • Acute Care:
• Asthma • Brady>Asystole • Megacodes
• Anaphylaxis • TACHY>PEA • Sepsis
• VT/VF pulseless • ROSC with Transfer • GI bleed
• Brady-arrythmia • Stroke
• Stable>Unstable Tachy-arrythmias • Stemi
Skills: Skills: Skills:
• Airway management- • Airway management- • Airway managemen
Basic/Advanced Advanced • BLS/ACLS Protocols
• BLS/ACLS Protocols • BLS/ACLS Protocols • Safe use of Defib an
• Defibrillation • Safe use of Defib and pacer • Safety Behaviors/te
• Safety Behaviors/communication • Safety Behaviors/team communication
communication • Transitions in Care
• Transitions in Care
Roles: Roles: Roles:
• Team member • Team member • Team Leader
• Team leader • Team Leader • Mentor Lower Levels
• Mentor Lower levels • Coordinate scenarios
• Assist with Debrief

*This was developed from the Medical Knowledge MICU clinical rotation curriculum

Rev1/13/2015vls;12/03/2013vswendroski
 Post Simulation Faculty Evaluation of Resident -FM 06/09/2014
Other
(Mock Code) The resident functioned effectively as:

Patient Care
(Mock Code) The resident identifies the patient correctly using two identifiers.

Comments:

(Mock Code) The resident obtained a relevant patient history.

Comments:

(Mock Code) The resident discussed treatment options including risks, benefits, and complications
with the patient and family members.

Comments:

(Mock Code) The resident was able to demonstrate competency for procedures required in the
scenario.

Comments:

Medical Knowledge

(Mock Code) The resident demonstrated adequate knowledge of the topic and equipment; and was
able to apply it effectively to the scenario.

Comments:

(Mock Code) The resident was able to apply the ACLS/PALS algorithms to the scenario.

Comments:

(Mock Code) The resident identifies medication appropriately with correct labeling and also identifies
through patient history which medications may put a patient at risk. (anticoagulants or look
alike/sound alike).

Comments:
Practice Based Learning

(Mock Code) The resident was able to apply critical thinking skills, including prioritization and time
management to the scenario.

Comments:

Interpersonal and Communication Skills

(Mock Code) The resident was able to communicate effectively and contribute to the management
plan.

Comments:

Professionalism
(Mock Code) The resident communicated in a professional and respectful manner.

Comments:

(Mock Code) The resident was able to accept responsibility/accountability for their actions.

Comments:

(Mock Code) The resident actively participated in the simulation and debriefing.

Comments:

System Based Practice

(Mock Code) The resident functioned within an interdisciplinary team to enhance patient safety
through the use of closed looped communication, call-backs, and SBAR.

Comments:

(Mock Code) The resident transferred the patient to the appropriate level of care based on the
scenario following institutional policies and procedures.

Comments:

(Mock Code) The resident performed a “time out” during the simulation if required.

Comments:
 Post Simulation Faculty Evaluation of Resident -IM 06/09/2014
Other
(Mock Code) The resident functioned effectively as:

Patient Care
(Mock Code) The resident identifies the patient correctly using two identifiers.

Comments:

(Mock Code) The resident obtained a relevant patient history.

Comments:

(Mock Code) The resident discussed treatment options including risks, benefits, and complications
with the patient and family members.

Comments:

(Mock Code) The resident was able to demonstrate competency for procedures required in the
scenario.

Comments:

Medical Knowledge

(Mock Code) The resident demonstrated adequate knowledge of the topic and equipment; and was
able to apply it effectively to the scenario.

Comments:

(Mock Code) The resident was able to apply the ACLS/PALS algorithms to the scenario.

Comments:

(Mock Code) The resident identifies medication appropriately with correct labeling and also identifies
through patient history which medications may put a patient at risk. (anticoagulants or look
alike/sound alike).

Comments:
Practice Based Learning

(Mock Code) The resident was able to apply critical thinking skills, including prioritization and time
management to the scenario.

Comments:

Interpersonal and Communication Skills

(Mock Code) The resident was able to communicate effectively and contribute to the management
plan.

Comments:

Professionalism
(Mock Code) The resident communicated in a professional and respectful manner.

Comments:

(Mock Code) The resident was able to accept responsibility/accountability for their actions.

Comments:

(Mock Code) The resident actively participated in the simulation and debriefing.

Comments:

System Based Practice

(Mock Code) The resident functioned within an interdisciplinary team to enhance patient safety
through the use of closed looped communication, call-backs, and SBAR.

Comments:

(Mock Code) The resident transferred the patient to the appropriate level of care based on the
scenario following institutional policies and procedures.

Comments:

(Mock Code) The resident performed a “time out” during the simulation if required.

Comments: