FMED 410/410s Physical Medicine & Rehabilitation

Transcription

1 Kansas City University f Medicine and Bisciences Cllege f Ostepathic Medicine Department f Family Medicine FMED 410/410s Physical Medicine & Rehabilitatin Curse Descriptin: This clerkship will prvide students with expsure t many areas f rehabilitatin either in an acute inpatient unit r thrugh utpatient services. Students will be expsed t a variety f experiences and may be able t custmize the clerkship depending upn interests. Experiences may include physical therapy, ccupatinal therapy, speech therapy, recreatinal therapy, psychlgy, wund care, and ther rehabilitatin related cmpnents. 5 semester credits Repeatable Credit: n Prerequisites: Successful cmpletin f FMED 301 and FMED 302 Expectatins: Emphasis will be placed n: Histry and physical examinatin f the rehabilitatin patient Knwledge f rehabilitatin principles relative a patient s presentatin Applicatin f OPP and OMT t the management f the patient s disease prcess Knwledge f current evidence-based medicine within the field f PM&R Curse Structure The rtatin will cnsist f daily interactin with patients within either the rehabilitatin unit and/r an utpatient practice specializing in physical medicine and rehabilitatin. The student will be expected t participate in daily inpatient runds, utpatient encunters, team treatment discussins, jurnal clubs and didactic lectures. The student may be assigned specific readings by the preceptr relevant t patients seen in the practice. Cmpetencies & Objectives The KCUMB educatinal prgram has identified specific brad areas that students shuld develp during their training. These help ensure that the students are able t demnstrate and/r develp specific skills. This verarching cmpetencies and bjectives specifically addressed in the Elective in Physical Medicine and Rehabilitatin curse are dented in bld: 1. Demnstrate basic knwledge f stepathic philsphy and practice and stepathic manipulative treatment; 2. Demnstrate medical knwledge thrugh ne r mre f the fllwing: Passing f curse tests, standardized tests f the NBOME, end f clerkship tests, research activities, presentatins, and participatin in directed reading prgrams and/r jurnal clubs; and/r ther evidence based medical activities; 1

2 3. Demnstrate interpersnal and cmmunicatin skills with patients and ther health care prfessinals; 4. Demnstrate knwledge f prfessinal, ethical, legal, practice management, and public health issues applicable t medical practice; 5. Demnstrate the ability t effectively treat patients, prvide medical care that incrprates the stepathic philsphy, patient empathy, awareness f behaviral issues, the incrpratin f preventive medicine, and health prmtin. 6. Demnstrate the ability t critically evaluate their methds f clinical practice, integrate evidence-based medicine int patient care, shw an understanding f research methds, and imprve patient care practices. 7. Demnstrate an understanding f health care delivery systems, prvide effective and qualitative patient care with the system, and practice csteffective medicine. Curse Objectives: Ostepathic Philsphy and Practice/Ostepathic Manipulatin Demnstrate understanding and implementatin f the integratin f manipulative treatment int the verall management f the patient relative t the patient s presentatin. Patient Care Demnstrate the apprpriate histry and physical examinatin skills f a patient n a Rehabilitatin service. Demnstrate understanding f the prper dcumentatin f a rehabilitatin unit admit histry and physical examinatin and utpatient SOAP nte, inclusive f a differential diagnsis and a treatment plan. Demnstrate the cnsideratin f sequelae relevant t the rehabilitatin patient and their diagnsis. Demnstrate the ability t rder and interpret labratry and imaging studies relevant t a rehabilitatin patient presentatin. Medical Knwledge Demnstrate the understanding f the rehabilitatin team members and their functin Demnstrate understanding f the nrmal musculskeletal examinatin Demnstrate the understanding f the cntinued fllw up f a rehabilitatin patient Demnstrate knwledge f ptential sequelae the rehabilitatin patient may face. Prfessinalism Demnstrate prfessinalism in perfrming the duties as assigned within the elective rtatin. Interpersnal and Cmmunicatin Skills Demnstrate apprpriate use f cmmunicatin skills during patient encunters. Practice-Based Learning and Imprvement Demnstrate the understanding f effectively and efficiently prviding care t the rehabilitatin patient Systems-based Practice 2

3 Demnstrate the integratin f evidence based medicine in develping a treatment plan fr the rehabilitatin patient. Detailed Objectives Ostepathic Philsphy and Practice/Ostepathic Manipulatin Demnstrate cmpetency in the applicatin f manipulative treatment mdalities apprpriate fr patients in need f rehabilitatin because f a disease prcess r injury; addressing the structural mdel, respiratry-circulatry mdel, neurlgical mdel, metablic mdel, and the behaviral mdel Demnstrate fundamental integratin and implementatin f relevant stepathic manipulative medicine treatment techniques during encunters with the rehabilitatin patient. Demnstrate the ability t integrate stepathic principles and practice int management f all rehabilitatin patient presentatins. Patient Care Perfrm evaluatin and apprpriate dcumentatin f gait, tne, reflexes, sensatin, crdinatin and statin. Demnstrate apprpriate dcumentatin and interpretatin f patient histry including quality f life functins, physical exams, allied health (lab prcedures, radigraphy, etc), scial, ccupatinal, and familial data. Demnstrate, evaluate and apprpriately dcument range f mtin and manual muscle examinatin fr extremities and spine. Understand the need fr readjusting individualized patient treatment plans based n acute and lng term gals, and pssible treatment reactins and interactins. Demnstrate a fundamental understanding f the presentatin and management f additinal cmplaints r diseases that culd be encuntered: neurgenic bwel, neurgenic bladder, hetertpic ssificatin, autnmic dysreflexia, spasticity, amputatin, trachestmy management. During this elective rtatin, the student is expected t develp cmpetencies in the fllwing clinical skills. The expected level f student engagement in the skills being develped: Observe (O), Assist (A), Master (M). Ordering and interpretatin f basic labratry tests and diagnstic studies (O, A) Clinical indicatins and cmpnents f electrdiagnstic testing (O, A) Ordering and interpretatins f apprpriate radigraphic studies (O, A) Mental status and cgnitin assessment tls and their use (O, A) Physiatric prescriptins and hw they are written (O, A) Crrect use f reflex hammer, phthalmscpe, tscpe, sphygmmanmeter; stethscpe tngue depressr; tuning frk ( M) Assess nrmal gait and perfrm elementary analysis f gait (M) Perfrm & dcument apprpriate OMM examinatin (A, M) Medical Knwledge Understand the rles f the physiatrist and the interdisciplinary management f the disabled patient (rehabilitatin nurse, physical therapist, ccupatinal therapist, speech r hearing therapist, dietician, rthtic/prsthetic technicians, and vcatinal rehabilitatin, etc). 3

4 Demnstrate a basic understanding f physical examinatin deficiencies and their classificatin as impairments, disabilities r handicaps. Understand pathphysilgy and treatment fr spinal crd injury; and demnstrate fundamental understanding f spinal crd injuries and rehabilitative requirements. Demnstrate fundamental understanding f stke syndrmes and rehabilitative requirements. Demnstrate a fundamental understanding f the presentatin and management f additinal cmplaints r diseases that culd be encuntered: neurgenic bwel, neurgenic bladder, hetertpic ssificatin, autnmic dysreflexia, spasticity, amputatin, trachestmy management. Prfessinalism Demnstrate prfessinalism by being prmpt t required cmpnents f the rtatin, and being dressed prfessinally. Demnstrate prfessinalism in the interactins with all members f the rehabilitatin team. Interpersnal and Cmmunicatin Skills Understand the imprtance f cmmunicating with the patient and family regarding the educatin fr acute and lng term gals f the treatment plan. Practice-Based Learning and Imprvement Demnstrate a fundamental understanding f cst effective medical management t include primary preventin, healthcare delivery and patient scial-ecnmic status. Systems-based Practice Demnstrate apprpriate use f clinical practice guidelines where apprpriate fr the rehabilitatin patient s diagnsis. General Infrmatin abut Clerkship The student is expected t have the apprpriate physical diagnstic tls necessary t perfrm a thrugh neurmusculskeletal examinatin. Assignments: 1. Review clinical practice guidelines fr the management f cncussin/mild traumatic brain injury, Management f patients with strke: rehabilitatin, preventin and management f cmplicatins, and discharge planning. A natinal clinical guideline and early acute management in adults with spinal crd injury: a clinical practice guideline fr health-care prfessinals. 2. Attend all didactic sessins, jurnal clubs (inclusive r presentatin f ne current PM&R research article). Recmmended Resurces. 1. DeLisa, JA; Gans, BM; Welsh, NE; Bchenek, WL; Frntera, WR. Physical Medicine and Rehabilitatin: Principals and Practices, 4th ed. Lippinctt, Williams & Wilkins, Tan, JC. Practical Manual f Physical Medicine and Rehabilitatin: Diagnstics, Therapeutics and Basic Prblems, 2nd ed. Mseby,

5 3. Natinal Guideline Clearing Huse ( 4. Chila, A. Fundatins fr stepathic medicine (3rd ed.), Lippinctt Williams & Wilkins, DiGivanna, E. An Ostepathic Apprach t Diagnsis and Treatment, Lippinctt, Williams & Wilkins Evaluatin This elective clerkship is graded Satisfactry/Unsatisfactry. POLICIES Dress Cde Students are expected t wear clean, pressed, white lab cats, required identificatin badges and dress in a prfessinal manner n all clinical experiences. Prfessinal dress fr males includes a shirt, tie and slacks. Fr female students, this includes a prfessinal dress r skirt (knee length r lnger), r slacks and prfessinal shirt. Men and wmen shuld wear scks r stckings at all times. N pen-ted shes r sleeveless shirts are allwed during the perfrmance f patient care. With the exceptin f the surgical suite, tennis shes are nt allwed. Hspital Rules & Regulatins Each hspital/health care system has individual rules and regulatins. Medical students must familiarize themselves with and adhere t these prtcls during training. At n time shuld a medical student alter, remve r therwise tamper with medical recrds. Specific rules and regulatins with respect t student entries in medical recrds must be clarified during rientatin r n the first day f the clinical experience. Students must respect and fllw all plicies regarding the use f hspital facilities, husing, and equipment. All hspital equipment including library materials, pagers, and keys must be returned befre leaving a clinical experience. Students are financially respnsible fr any damage t r lss f hspital prperty. As a result, it is strngly recmmended that students btain and retain a receipt as prf that prperty was returned and/r damage was nt incurred. Special Accmmdatins Students needing special accmmdatins need t ensure that BOTH the clinical training site AND KCUMB are aware f the need fr the accmmdatin. T allw KCUMB and the clinical training site ample time t make accmmdatins, it is recmmended that the student make cntact as sn as pssible. Wrk/Call Schedule 5

6 The wrk and call schedule during clinical experiences is at the discretin f the cre site hspital, service and/r preceptr. Students generally fllw the same schedule as their preceptr, hwever, if the preceptr is n vacatin, r scheduled away frm the ffice/hspital, additinal arrangements must be made fr cmpletin f the clinical experience. If this ccurs, cntact yur KCUMB Student Administratr immediately. Additinal call time may be required n evenings, weekends r hlidays. Students shuld clarify wrk and call schedules during rientatin. Wrk/call scheduling impsed by KCUMB, the cre site hspital, clinical experience service r preceptr must be fllwed withut exceptin. Federal laws restricting intern/resident wrk hurs d nt apply t medical students. Medical Ethics All medical students are expected t cnduct themselves in a prfessinal manner demnstrating an awareness and cmpliance with the ethical, mral and legal values f the stepathic medical prfessin. In bserving the principles and practices f medical ethics, students will: Place primary cncern n the patient s best interests Be available t patients at all reasnable times as expected by the preceptr/cre site Perfrm medical activities nly within the limitatins f a medical student s capabilities and within the guidelines determined by the site and/r preceptr Strictly maintain patient and institutinal cnfidentiality Physical Examinatins During the third and furth-year clinical experiences, students are rutinely expected t see and examine intimate parts f patient bdies. It is necessary that all intimate examinatins f patients be apprpriately structured, supervised, and cnsented in the interests f all parties, including the patient, student and attending physician. Students must wear their KCUMB picture identificatin badge and intrduce themselves t patients as a medical student. Patient cnsents fr a student t perfrm an intimate examinatin must always be vluntary. Cnsent fr an intimate examinatin must be either verbal and/r written. Irrespective f the gender f the examining student and the patient being examined, a chaperne, defined as anther medical prfessinal, preferably the preceptr is required during all intimate examinatins. A chaperne is nt an accmpanying persn i.e. friend r relative f the patient. A chaperne, similarly, is nt anther medical student. Students are highly encuraged t recrd the date, time, and the results f the examinatin as well as the name f the chaperne in the medical recrd. PROCEDURES Absence frm Clerkship Experiences Any absence must be reprted t bth the cre site and Preceptr and the KCUMB Student Administratr prir t the start f an assigned shift. Failure t reprt an absence t the cre site r preceptr and the KCUMB Student Administratr will be cnsidered abandnment f duties and the student will face apprpriate disciplinary actin. (Fr additinal infrmatin see Clinical Clerkship Manual). 6

7 Faculty Cntact Infrmatin Jhn Dugherty, DO 7