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Ward Management Basics for the Senior Medical Student Entering Surgery: Part B

2012; Association of American Medical Colleges; Linguagem: Inglês

10.15766/mep_2374-8265.9255

2374-8265

Mara B. Antonoff, Jonathan D’Cunha,

Surgical Simulation and Training

OPEN ACCESSOctober 16, 2012Ward Management Basics for the Senior Medical Student Entering Surgery: Part B Mara B. Antonoff, MD, Jonathan D'Cunha, MD, PhD Mara B. Antonoff, MD University of Minnesota Medical School Google Scholar More articles by this author , Jonathan D'Cunha, MD, PhD University of Minnesota Medical School Google Scholar More articles by this author https://doi.org/10.15766/mep_2374-8265.9255 SectionsAbout ToolsDownload Citations ShareFacebookTwitterEmail Abstract Introduction: Significant recent attention has been directed toward developing preparatory courses to heighten the readiness of senior medical students as they transition to surgical residency. To this end, this resource includes comprehensive materials intended to prepare senior medical students for basic ward management of surgical inpatients. This resource may be used by course directors for surgery PGY-1 preparatory classes/bootcamps, for independent study by individuals planning to matriculate into surgical residencies, or as a review source for those already in surgical training. While these materials were designed to meet the needs of new surgical house staff, the contents are easily generalizable to other medical specialties, and would prove useful for any trainee managing hospital inpatients. Please note that this resource was divided into Parts A and B for MedEdPORTAL organizational purposes; however, all modules in Parts A and B are complementary and together create the complete package of Ward Management Basics for the Senior Medical Student Entering Surgery resource. Methods: The materials provided in this module are designed for use as part of a preparatory course for fourth-year medical students entering surgical specialties; all necessary materials including instructor's blueprints, powerpoint slides, and handouts are included. The resource is comprised of eight separate sections on the topics of: patient tracking, documentation, discharge, radiology, antibiotics, signouts, cross coverage, and ward management. A multiple-choice knowledge pre-/posttesttest is also included. The outcomes from this course have been extensively studied. Through pre- and postcourse surveys, knowledge tests, and technical examinations, we measured confidence and skill acquisition in specific job-related tasks. We subsequently followed course participants and matched peers into internship and collected performance evaluations from supervising senior residents, in order to determine if course graduates would display performance advantages in these same instructed tasks. Results: In 2010, 62 individuals were studied (22 course graduates, 16 PGY-1 nonparticipant controls at our home institution, and 24 nonparticipant peer controls at outside institutions). We found that course participants demonstrated marked improvement in task-specific confidence in all tasks from course beginning to end, and this was supported by improved scores on written and technical skill examinations. Further, course participants outperformed peers in all tasks 1 month into internship, with their performance advantage predictably dissipating into the third month of residency. Discussion: We found that competency-based preparation for surgical internship utilizing the curricular tools found within this resource resulted in objective gains in task-specific confidence and test performance at course conclusion, which, importantly, translated to improved performance upon residency matriculation. These data emphasize the significant impact of these curricular materials in formally preparing senior medical students for the care of surgical inpatient. Educational Objectives By the end of this session, learners will be able to: Define the intern role: what you should know about your patients and why.Discuss strategies for patient tracking: what clinical information needs to be followed and how to do it.Review necessary components of chart documents, including: history/physicals, consult notes, daily notes, preoperative evaluations, and postoperative checks.Review safe placement of orders in the medical record.Review appropriate order writing strategies.Practice and improve upon order writing skills, including admission orders, daily orders, and discharge orders.Review the process of discharging patients, including: planning, counseling, writing orders, and dictating a summary.Discuss sample discharge and interim summaries.Identify appropriate indications for radiologic tests in the preoperative workup and postoperative management of surgical patients.Discuss algorithm for selecting an appropriate imaging study.Discuss interpretation of imaging studies in surgical patients.Discuss common surgical infections.Provide an overview of coverage of gram positive, gram negative, and anaerobic organisms.Discuss hospital vs. community acquired infections.Discuss empiric coverage of infectious diseases.Explain the strategy of tailoring antibiotics to culture sensitivities.Provide rationale for duration of antibiotic coverage.Apply antibiotic selection skills to sample cases.Discuss the importance of an effective signout for patient safety.Identify the key components of successful signouts, citing evidence from the literature.Compare/contrast poor signout vs. effective signout.Review reasons for establishing signout guidelines and discuss guidelines from a sample institution.Discuss triage of the issues that come up during a call night.Identify resources available to the surgical intern on call.Provide strategies for efficient and safe management of cross-cover patient issues.Establish a list of situations in which documentation should take place on a cross-cover patient.Review the importance of effective signout at the beginning and end of a call night. Sign up for the latest publications from MedEdPORTAL Add your email below FILES INCLUDEDReferencesRelatedDetails FILES INCLUDED Included in this publication: 8 Basic Ward Management Part B Knowledge Test with Key.doc B 1a Patient Tracking Instructor Blueprint.doc B 1b PatientTracking.ppt B 1c Order writing scoring rubric.doc B 2a Documentation Instructor Blueprint.doc B 2b Review Order Writing Exercise 1.ppt B 2c Documentation.ppt B 2d Sample H & P.doc B 2e Sample Consult.doc B 2f Order writing scoring rubric.doc B 3a Discharge Instructor Blueprint.doc B 3b Discharge.ppt B 3c Sample interim and discharge summaries.doc B 3d Discharge orders scoring rubric.doc B 4a Radiology Instructor Blueprint.doc B 4b Radiology Lecture Outline.doc B 5a Antibiotics Instructor Blueprint.doc B 5b Antibiotics Lecture Outline.doc B 6a Signouts Instructor Blueprint.doc B 6b Signouts.ppt B 6c Review of Sample Signout Guidelines.ppt B 6d Sample Signout Guidelines—UMN Surgery Transitions of Care Guidelines.doc B 7a Cross Cover Instructor Blueprint.doc B 7b Cross Cover.ppt Instructors Guide Part B.doc To view all publication components, extract (i.e., unzip) them from the downloaded .zip file. Download editor’s noteThis publication may contain technology or a display format that is no longer in use. CitationAntonoff MB, D'Cunha J. Ward Management Basics for the Senior Medical Student Entering Surgery: Part B. MedEdPORTAL. 2012;8:9255. https://doi.org/10.15766/mep_2374-8265.9255 Related Ward Management Basics for the Senior Medical Student Entering Surgery: Part B Ward Management Basics for the Senior Medical Student Entering Surgery: Part A University of Minnesota Surgical Clerkship Simulation Skills Curriculum and Instructor Guide Operative and Technical Skills for the Senior Medical Student Entering Surgery Special Patient Populations for the Senior Medical Student Entering Surgery Copyright & Permissions© 2012 Antonoff and D'Cunha. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-No Derivatives license.KeywordsPreparationInpatient ManagementPGY-1Ward ManagementChart DocumentationIntern Disclosures None to report. Funding/Support None to report. Prior Presentations Antonoff MB, D'Cunha J. Beyond the surgical bootcamp: evaluation of a competency-based curriculum for senior medical students entering surgical internship. Presented at: 2010 Resident Research Day, University of Minnesota; June 15, 2010; Minneapolis, MN. Antonoff MB, Maddaus MA, D'Cunha J. Beyond the surgical bootcamp: evaluation of a competency-based curriculum for senior medical students entering surgical internship. Presented at: 6th Annual Academic Surgical Congress; February 3, 2011; Huntington Beach, CA. Green CA, Antonoff MB, Maddaus MA, D'Cunha J. Impact of a competency-based curriculum for senior medical students entering a surgical internship. Presented at: University of Minnesota Medical School Research Day; March 14, 2011; Minneapolis, MN. Antonoff MB, Maddaus MA, D'Cunha J. PGY-1 preparatory curriculum design: tailoring content to the modern trainee. Presented at: Association for Surgical Education Annual Meeting; March 22, 2011; Boston, MA. Antonoff MB, D'Cunha J. Competency-based preparation of senior medical students for surgical internship: impact upon task-specific confidence and competence. Presented at: Surgical Education Research Fellowship Forum, Association for Surgical Education Annual Meeting; March 23, 2011; Boston, MA. Antonoff MB, D'Cunha J. Development of PGY-1 surgery preparatory course curricula: identification of key curricular components. Presented at: Association of Program Directors in Surgery Annual Meeting; March 25, 2011; Boston, MA. Antonoff MB, Maddaus MA, D'Cunha J. PGY-1 preparatory curriculum design: tailoring content delivery to the modern trainee. Presented at: 2011 Resident Research Day, University of Minnesota; June 14, 2011; Minneapolis, MN. Antonoff MB, Swanson JA, Green CA, Maddaus MA, D'Cunha J. The prospectively evaluated significant impact of a competency-based preparatory course for senior medical students entering surgical residency. Presented at: 2011 Resident Research Day, University of Minnesota; June 14, 2011; Minneapolis, MN. Antonoff MB, Green CA, Swanson JA, Maddaus MA, D'Cunha J. Prospective Analysis Of The 2-Year Outcomes From A Competency-Based Preparatory Course For The PGY-1 Resident: Modeling Standards For The Future. Presented at: 7th Annual Academic Surgical Congress; Feb 14–16, 2012; Las Vegas, NV. Green CA, Antonoff MB, Swanson, JA, Maddaus MA, D'Cunha J. Preparing Medical Students for Residency Training: Cumulative Analysis of a Model Preparatory Course. Presented at: 11th Annual Alfred F. Michael Student Research Colloquium, University of Minnesota; February 28, 2012; Minneapolis, MN. Antonoff MB, Berdan EA, Kirchner VA, Krosch TC, Holley CT, Maddaus MA, D'Cunha J. Who's covering our loved ones: surprising barriers in the sign-out process. Presented at: Association for Surgical Education Annual Meeting; March 24, 2012; San Diego, CA. Green CA, Antonoff MB, Swanson JA, D'Cunha J. Preparing Medical Students for Residency Training: 2-year Cumulative Analysis of a Model Preparatory Course. Presented at: Department of Surgery Research Day, University of Minnesota; June 11, 2012; Minneapolis, MN. tabs.loading