University Of Calgary Postgraduate Medicine

ICU Rotation - 4 Weeks

Objectives:

Learning Objectives

Given the large number of potential medical and surgical clinical problems that a resident may be exposed to in the intensive care unit, educational efforts are focused on ten of the most common and life-threatening clinical presentations. This is by no means an exhaustive list, and therefore, it is the responsibility of the resident to demonstrate effective adult learning strategies when faced with a patient presenting with a clinical problem not directly covered by this curriculum.

Ten Clinical Presentations

  1. Acute Respiratory failure
  2. Shock
  3. Cardiac dysrhythmias
  4. Cardiac arrest
  5. Derangements of serum electrolytes and osmolality
  6. Acid/base disorders
  7. Decreased level of consciousness and seizures
  8. Drug intoxication and withdrawel
  9. Sepsis
  10. Traumatic Injury

Medical Expert

  1. Recognize and describe the above clinical presentations
  2. Describe, and in the relevant clinical setting demonstrate, the appropriate initial and ongoing investigations pertinent to the presentation.
  3. Demonstrate successful completion of any of the skills listed in Part 2 that may be applicable to the presentation. In addition, the resident will need to demonstrate effective interpretation of any relevant results that are obtained from these procedures.
  4. Describe, and in the relevant clinical setting demonstrate, the appropriate initial and ongoing management required for the presentation. In addition, interpret and act on the patient's response to these therapeutic interventions
  5. Describe the potential complications associated both with the clinical presentations and with the therapies that are typically used in each setting.
  6. Describe prognosis, taking into consideration patient co-morbidities.

Health Advocate:

Demonstrate clinical decisions and professional attitudes that are consistent with the patient's best interests.

Communicator Role:

  1. Demonstrate the ability to succinctly, coherently and accurately communicate information to the members of the entire health care team, patients and their families via both written (chart/consult notes) and verbal (daily rounds, patient presentations and family meetings) methods.
  2. During interactions with the patient and their families, create a relationship based on trust, honesty and openness through effective listening and communication skills.
  3. Develop an appreciation for different methods of obtaining code level status, withdrawal of care and end-of-life issues by attending and participating in family conferences with different critical care medicine attending physicians.

Collaborator Role:

Demonstrate respect for and interact effectively with all members of the health care team.

Leader Role:

  1. Effectively cares for and manages appropriate clinical workload
  2. Manages and utilizes resources effectively where appropriate (e.g. appropriate investigations)
  3. Displays appropriate time management skills (e.g. prioritizing tasks, performing interventions in a timely manner, work at a pace appropriate for level of training.)
  4. Demonstrates the ability to use their time effectively by appropriately prioritizing tasks, delegating as required
  5. Recognize the finite nature of health care resources and, in the setting of patient-centered care, will prioritize investigations and treatments appropriately.
  6. Demonstrates ability to lead health care team (eg. code/resuscitation scenario.)

Scholar Role:

  1. Demonstrates ability to use point of care resources in order to optimize clinical decision making.
  2. Demonstrates appropriate evidence based medicine skills to start the practice of family medicine.
  3. Demonstrate the principles of life-long learning by actively reading around patients' clinical issues, attending all scheduled educational activities and participating actively in daily bedside rounds.
  4. Incorporate the principles of evidence-based medicine into their patient management strategy.

Professional Role:

  1. Exhibits appropriate professional behaviours in practice (honesty, integrity, commitment, compassion, respect, and altruism)
  2. Is punctual for work related activities and show enthusiasm for learning
  3. Follows through on assigned tasks, transfer of patient care, and informs supervisors of errors or concerns.
  4. Demonstrates a willingness and openness to receiving feedback
  5. Demonstrates a recognition of own limitations.
  6. Demonstrates early life/work balance.
  7. Demonstrates a professional demeanor in all interactions with patients, their families and members of the health care team.