NOSM Enhanced Skills Resident Handbook

Transcription

1 NOSM Enhanced Skills Resident Handbook NOSM Enhanced Skills Resident Handbook

2 Contents Welcome to Your Residency... 3 Welcome Letter from Dr. Kathy Simpson... 4 NOSM Enhanced Skills Program Roles... 5 Program Stream Coordinators...5 Postgraduate Program Coordinator...5 Important Contact Information... 6 Ethics, Professional Responsibility and Standards of Conduct... 7 MyCurriculum... 8 Self-Directed Stream Curriculum... 9 Clinical Curriculum...9 Scholarly Activities...9 Assessment...9 Evaluation...9 Maternity Skills Stream Curriculum Clinical Curriculum...10 Assessments...10 Evaluation...10 Care of the Elderly Stream Curriculum Clinical Curriculum...11 Academic Rounds...11 Scholarly Activities...11 Assessments...11 Evaluation...12 Specific Policies Conference Funding Policy for Enhanced Skills Program How to Become Involved at NOSM Enhanced Skills RPC...13 Teaching NOSM Enhanced Skills Resident Handbook

3 Welcome to Your Residency Welcome to your residency at NOSM! Residency is an adventure and you are fortunate to be embarking on this new phase of your life in beautiful Northern Ontario. If you are not from here, we trust you will feel at home quickly as people across the North will welcome and appreciate you. We are looking forward to meeting you and are delighted that you have chosen Northern Ontario for this crucial stage of your education. We are here to help you achieve your goals during your residency. NOSM residency programs embrace resident-centered approaches with a balance of high support and high expectations. The clinical and academic work will be demanding, you will learn quickly and there will be support, back up and teaching. You will develop clinical independence with a safety net. Throughout your residency, NOSM staff, program directors, preceptors and your resident colleagues, as well as the NOSM Postgraduate Office are there to answer question, give guidance and provide the support you need. As you begin your residency, which will offer unique and diverse learning experiences across the North, I encourage you to be ambitious and self-directed so you can make the most of every clinical encounter and conversation with your preceptors, to hone your clinical skills and knowledge. Residency is complicated and challenging. Please read this manual carefully as it is designed to make life in residency go smoothly and help you to avoid pitfalls and problems. Your success in residency depends in large part on your motivation, your ability to be organized, and your attention to important details, in addition to your clinical know-how. I wish you the all the best in your residency training and look forward to getting to know you. Sincerely, Dr. Catherine Cervin 3 NOSM Enhanced Skills Resident Handbook

4 Welcome Letter from Dr. Kathy Simpson Welcome to the Northern Ontario School of Medicine Enhanced Skills Residency Program! We are glad you have chosen NOSM for your enhanced skills training. Whether you are pursuing additional skills for comprehensive family practice or a focused practice in family medicine, we hope the program provides you with the opportunity and experiences to meet your learning needs. You may identify additional learning objectives, within the clinical practice setting, the classroom, or in research, and we encourage you to connect with your Stream Coordinators, preceptors, and NOSM staff to explore all the options available to you. During your residency, Stream Coordinators, preceptors, NOSM staff, and Postgraduate Office, as well as myself in the Enhanced Skills Program Director role, are here to answer questions, give guidance and provide the support you need. I wish you continued success within the Enhanced Skills training. Sincerely, Kathy Simpson, MD CCFP Enhanced Skills Residency Program Director 4 NOSM Enhanced Skills Resident Handbook

5 NOSM Enhanced Skills Program Roles Enhanced Skills Program Director The Enhanced Skills Program Director oversees the functioning of all the PGY3 Enhanced Skills program, chairs the Enhanced Skills Residency Program Committee (RPC), and primarily supports the Stream Coordinators. Residents can contact the Program Director for discussion on overall program processes or general support during their training. Dr. Kathy Simpson Program Stream Coordinators Program Stream Directors for each of the separate Enhanced Skills streams (Self-Directed Skills, Maternity Skills, and Care of the Elderly) are responsible for communicating with residents to coordinate all training activities, in many cases acting as a guide for residents to achieve the program goals and objectives as well as residents personal learning objectives. Should problems arise, they should be available as a resource. Dr. Kathy Simpson, Self-Directed Stream Coordinator [Acting] simpsonk@tbh.net Dr. Peter Hutten-Czapski, Maternity Skills Stream Coordinator phc@srpc.ca Dr. Grant McKercher, Care of the Elderly Stream Coordinator g.mckercher@nbrhsc.on.ca Dr. Robert Anderson, Family Practice Anesthesia Coordinator randerson@nosm.ca Dr. Bill MacGregor, Family Medicine-Emergency Medicine Stream Coordinator macgregor@shaw.ca Postgraduate Program Coordinator The Postgraduate Program Coordinator acts as a manger of information flowing to, from, and within the residency program. They are the main point of contact for the program, performing complex administration duties in the support of the program. They engage in coordination, planning, information management, communication and project development for the program and its faculty members and residents. Program coordinators provide assistance and support to residents. Marie Parkkari Telephone: mparkkari@nosm.ca 5 NOSM Enhanced Skills Resident Handbook

6 Important Contact Information Postgraduate Family Medicine Program Director Dr. Ric Almond Phone: (807) Fax: (807) Associate Dean, Postgraduate Education Dr. Catherine Cervin Phone: (705) Fax: (705) Director, Postgraduate Education Jennifer Fawcett Phone: (807) Fax: (807) Manager, Postgraduate Education Dr. Kristy Côté Phone: (705) Fax: (705) Administrative Assistant Jennifer Morris Phone: (807) Fax: (807) NOSM Enhanced Skills Resident Handbook

7 Ethics, Professional Responsibility and Standards of Conduct Professionalism is a core value for all health professionals and it is at the heart of your study and practice. Professionalism will be highlighted throughout your residency, in both academic and clinical settings, and embedded in the evaluation profess as one of those fundamental roles in the CanMEDS framework. The NOSM professionalism policy and code of conduct is in development and will be circulated when complete. The Canadian Medical Association Code of Ethics should be reviewed prior to residency and kept at the forefront of your mind when practicing. As a self-directed learning, you will experience a lifetime of professional rewards, shared with your patients. As a modern health professional, you must continually monitor your knowledge, skills and attitudes, seek out new knowledge and improve on areas of weakness in order to maintain the highest standard of care. Your patients deserve this care and you owe it to them and yourself. As an adult learner, you are an active participant in your own education. During your residency, you will refine your skills in setting learning objectives, choosing learning strategies, understanding your preferred learning style, and evaluating your own progress. You will have the opportunity to make suggestions both to individual preceptors and to the program to improve the training process. In our preceptor-based learning environment, you must always remember to respect all of your preceptors patients as if they were your own. As a professional learner, you should maintain and respect the code of ethics and conduct of the profession itself in all of your personal and professional activities. As you assume an ever-increasing role as a physician with authority, trust and respect, you must accept the responsibilities that are a condition of these privileges. This program was created for you by the people of Ontario with who you are entering into a social contract to provide both leadership and service in health care. The treatment of illness, the monitoring of wellness, the creation and promotion of preventive health measures, research and professional development are all factors of this contract. 7 NOSM Enhanced Skills Resident Handbook

8 MyCurriculum MyCurriculum is the Northern Ontario School of Medicine s online learning environment. MyCurriculum contains all the components and resources necessary for you to complete training in the PGY3 Enhanced Skills program. Once you connect to MyCurriculum, there are separate spaces for Self-Directed Enhanced Skills, Maternity Skills, and Care of the Elderly. In addition to providing you with information on academic rounds, MyCurriculum also contains the handbooks, manuals, administrative forms, and calendars to assist you. As of July 1, 2015, MyCurriculum was introduced to Enhanced Skills residents. There will be ongoing development and construction to enhance the information available for both residents and faculty. Any feedback or questions regarding the online learning environment should be directed to your coordinator. 8 NOSM Enhanced Skills Resident Handbook

9 Self-Directed Stream Curriculum Clinical Curriculum Residents in the Self-Directed Stream follow a highly individualized curriculum by selecting clinical experiences to meet their individual learning needs. The Self-Directed Stream Coordinator communicates at least monthly in ensure all clinical placements are appropriate to meet learning objectives. The clinical curriculum documents available on MyCurriculum Self-Directed Enhanced Skills are available as resources for residents to focus their clinical placements to meet their learning needs. Scholarly Activities Completion of scholarly project or teaching is not a requirement of the program however residents may pursue teaching or research in the context of their PGY3 experience with financial support from the program. Assessment Residents in the Self-Directed Stream are assessed on performance on their clinical placements with midpoint and/or end-of rotation In-Training Assessment Reports (ITARs) and are completed by preceptors in the One45 online assessment system. Evaluations are due 10 days after the end of the rotation, but it is strongly recommended that the resident meet with the preceptor before the end of the rotation to discuss the rotation and evaluation and ensure its completion. It is the responsibility of the resident to ensure that all evaluations are completed in a timely manner and to ensure that the evaluations are distributed to the correct preceptors. For rotations longer than 4 weeks, the preceptor will also be given a mid-evaluation to complete. Monthly meetings with the Self-Directed Stream Coordinator are also used to document the progress of the resident in meeting and revising their individual learning objectives. Meeting are arranged at mutually convenient times by the resident and Stream Coordinator. Evaluation Rotation Evaluations are completed by residents and focus on the learning setting and how elements of the learning environment contributed to meeting the stated and residents person learning objectives. Clinical faculty evaluations are also completed by residents and focus on the teaching by the preceptor. Faculty evaluations are confidential the data is collected, compiled and analyzed by an Evaluation Coordinator in Faculty Affairs, who then creates a report for the individual faculty member. Reports are only generated when a minimum of 3 completed evaluations are received by Faculty Affairs to protect resident anonymity. Rotation and clinical faculty evaluations are also generated days before the end of the rotation, but do not require mid evaluations for rotations longer than 4 weeks. Residents will receive notice when their preceptor has completed their evaluation online, but will not be able to review the form until they have completed all of their evaluations for that specific rotation. 9 NOSM Enhanced Skills Resident Handbook

10 Maternity Skills Stream Curriculum Clinical Curriculum Residents in the Maternity Skills Stream complete a standard of 6 months of clinical placements. Four months of High Risk Obstetrics provide residents with an opportunity for high volume and high acuity obstetrics, and exposure to a variety of high risk pregnancies. Two months of FP Obstetrics with Caeserean clinical placement schedules a resident with a Family Physician/General Practitioner who provides maternity care and occurs in settings where there are no pediatricians or obstetricians. This placement provides residents with the opportunity to integrate operative obstetrics into regular family practice. Residents who requested 2 months of additional clinical placements may select rotations such as OB ultrasound or neonatology. All clinical curriculum documents are found on MyCurriculum. Assessments Residents in the Maternity Skills Stream are assessed on performance on their clinical placements with mid-point and/or end-of rotation In-Training Assessment Reports (ITARs) and are completed by preceptors in the One45 online assessment system. Evaluations are due 10 days after the end of the rotation, but it is strongly recommended that the resident meet with the preceptor before the end of the rotation to discuss the rotation and evaluation and ensure its completion. It is the responsibility of the resident to ensure that all evaluations are completed in a timely manner and to ensure that the evaluations are distributed to the correct preceptors. For rotations longer than 4 weeks, the preceptor will also be given a mid-evaluation to complete. Residents are required to maintain a logbook to capture all maternity skills procedures. The procedural logbook is specific for assessing enhanced maternity skills trainees to support privileging applications. The Maternity Skills Stream program allows some flexibility in the format of the logbook to suit individual needs and to facilitate documentation. The logbook should identify the procedures, the level of responsibility, and other items listed in the appendix of the Stuart Iglesias, MD and Peter Hutten-Czapski, MD article, Joint position paper on training for rural family practitioners in advanced maternity skills and cesarean section, published in the Canadian Journal of Rural Medicine 1999;4(4): The Maternity Skills Stream Coordinator reviews the logbooks at the end of training. Evaluation Rotation Evaluations are completed by residents and focus on the learning setting and how elements of the learning environment contributed to meeting the stated and residents person learning objectives. Clinical faculty evaluations are also completed by residents and focus on the teaching by the preceptor. Faculty evaluations are confidential the data is collected, compiled and analyzed by an Evaluation Coordinator in Faculty Affairs, who then creates a report for the individual faculty member. Reports are only generated when a minimum of 3 completed evaluations are received by Faculty Affairs to protect resident anonymity. Rotation and clinical faculty evaluations are also generated days before the end of the rotation, but do not require mid evaluations for rotations longer than 4 weeks. Residents will receive notice when their preceptor has completed their evaluation online, but will not be able to review the form until they have completed all of their evaluations for that specific rotation. 10 NOSM Enhanced Skills Resident Handbook

11 Care of the Elderly Stream Curriculum Clinical Curriculum Clinical Residents in the Care of the Elderly Stream have a 12-month clinical curriculum which includes 12 weeks for electives. Resident may complete clinical requirements in block format or longitudinally with approval from the Care of the Elderly Stream Coordinator. Rotation goals and objectives are found on MyCurriculum Care of the Elderly Stream. Rotation Geriatric Assessment (In-Patient) Emergency/Acute Care Consultation Out-Patient Community Assessment Psychogeriatric Service Geriatric Rehabilitation Research Long-Term Care Electives Duration 8 weeks 4 weeks 8 weeks 8 weeks 8 weeks 4 weeks Longitudinal 12 weeks Academic Rounds The NOSM Care of the Elderly Stream will be hosting rounds for both faculty and residents interested in the Care of the Elderly in the fall of Residents will have the opportunity to both attend and present at rounds. Other rounds opportunities for Care of the Elderly residents include: NOSM Palliative Care Rounds University of Calgary Geriatric Rounds and Care of the Elderly Academic Days University of Toronto Baycrest Health Sciences Rounds University of Toronto Family and Community Medicine, Care of the Elderly certificate course Any round/sessions available at local site/hospital Scholarly Activities Requirement to complete scholarly project as part of training within the Care of the Elderly Program. The resident may choose to conduct research on an issue specific to the Care of the Elderly, collaborate in interdisciplinary research, or engage in research dissemination or knowledge translation. Additional details on the requirements can be found on MyCurriculum. Assessments Residents in the Maternity Skills Stream are assessed on performance on their clinical placements with mid-point and/or end-of rotation In-Training Assessment Reports (ITARs) and are completed by preceptors in the One45 online assessment system. Evaluations are due 10 days after the end of the rotation, but it is strongly recommended that the resident meet with the preceptor before the end of the rotation to discuss the rotation and evaluation and ensure its completion. It is the responsibility of the resident to ensure that all evaluations are completed in a timely manner and to ensure that the evaluations are distributed to the correct preceptors. For rotations longer than 4 weeks, the preceptor will also be given a mid-evaluation to complete. 11 NOSM Enhanced Skills Resident Handbook

12 Daily field notes are used by residents to record feedback received from clinical preceptors on a regular basis. The daily field note is important for capturing the longitudinal long-term care experiences, as well as other clinical placement scheduled longitudinally. Field notes are completed using the One45 assessment system. Residents in the Care of the Elderly Stream meet quarterly with the Care of the Elderly Stream Coordinator to review individual progress in the program. As part of the meeting, residents are encouraged to be self-aware and self-assess to support self-directed learning. Evaluation Rotation Evaluations are completed by residents and focus on the learning setting and how elements of the learning environment contributed to meeting the stated and residents person learning objectives. Clinical faculty evaluations are also completed by residents and focus on the teaching by the preceptor. Faculty evaluations are confidential the data is collected, compiled and analyzed by an Evaluation Coordinator in Faculty Affairs, who then creates a report for the individual faculty member. Reports are only generated when a minimum of 3 completed evaluations are received by Faculty Affairs to protect resident anonymity. Rotation and clinical faculty evaluations are also generated days before the end of the rotation, but do not require mid evaluations for rotations longer than 4 weeks. Residents will receive notice when their preceptor has completed their evaluation online, but will not be able to review the form until they have completed all of their evaluations for that specific rotation. Upon the completion of residency training in the Care of the Elderly Stream, the Stream Coordinator will arrange an exit interviews with graduates. This informal meeting is arranged 4 to 6 months after the residents has completed training. The interview is focused on providing constructive feedback on the effectiveness of the Care of the Elderly training program. 12 NOSM Enhanced Skills Resident Handbook

13 Specific Policies While in Enhanced Skills Training, there may be specific policies that are particularly important for your review: Information on Restricted Registration Clinical Service (RRCS) (formerly called Moonlighting ) Postgraduate Education Residency Retricted Registration Policy. Continuing Medical Education Funds Location of Home Base Leaves/Vacation External Rotations Conference Funding Policy for Enhanced Skills Program [coming soon] How to Become Involved at NOSM The Postgraduate Education Office Resident Handbook provides a list of committees with active participation. Calls for resident participant on committees and working groups will come up throughout the academic year through the Resident Bulletin: The Script, and/or from Chief/Senior Residents in your program. Enhanced Skills RPC Specific to the Enhanced Skills Programs, all residents in the Self-Directed, Maternity Skills, and Care of the Elderly streams may attend the Enhanced Skills Residency Program Committee (RPC). The RPC meetings quarterly via teleconference. Dates of meetings can be found on within the program calendars on MyCurriculum. Teaching Teaching undergraduate medical students is a staple of Postgraduate training at NOSM however you may also be interested in teaching residents in other training programs, such as the Family Medicine program. Please connect with your Stream Coordinator or Postgraduate Program Coordinator to explore teaching opportunities. 13 NOSM Enhanced Skills Resident Handbook