Narrative

Narrative Description of Program Goals and Objectives

GENERAL OVERVIEW:

The broad goals of the curriculum include acquisition of both general competencies and specific competencies related to the practice of medicine in general and otolaryngology in particular. General competencies require the resident to perform at the level of expertise of a new practitioner of medicine and involves 1) patient care, 2) medical knowledge, 3) practice based learning and improvement, 4) interpersonal and communication skills, 5) professionalism, and 6) systems based practice. These general competencies and specific otolaryngological competencies will be developed through 1) conference development; (2) research awareness; (3) development of clinical expertise; (4) installation of an awareness for the need for continuing education; (5) development to practice competently in the broad field of Otolaryngology; (6) to pass the American Board of Otolaryngology certifying examinations, (7) incorporation of the institutional common resident curriculum information into the otolaryngology curriculum, and (8) incorporation of current socioeconomic, practice management, and compliance issues into the curriculum.

PATIENT CARE:

Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. Residents are expected to:

1. Communicate effectively and demonstrate caring and respectful behaviors when interacting with patients and their families.
2. Gather essential and accurate information about their patients
3. Make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment
4. Develop and carry out patient management plans
5. Counsel and educate patients and their families
6. Use information technology to support patient care decisions and patient education
7. Perform competently all medical and invasive procedures considered essential for the area of practice
8. Provide health care services aimed at preventing health problems or maintaining health
9. Work with health care professionals, including those from other disciplines, to provide patient-focused care

MEDICAL KNOWLEDGE:

Residents must demonstrate knowledge about established and evolving biomedical, clinical, and cognate(e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care. Residents are expected to:

1. Demonstrate an investigatory and analytic thinking approach to clinical situations
2. Know and apply the basic and clinically supportive sciences which are appropriate to their discipline

PRACTICE-BASED LEARNING AND IMPROVEMENT:

Residents must be able to investigate and evaluate their patient care practices, appraise and assimilate scientific evidence, and improve their patient care practices. Residents are expected to:

1. Analyze practice experience and perform practice-based improvement activities using a systematic methodology
2. Locate, appraise, and assimilate evidence from scientific studies related to their patients' health problems
3. Obtain and use information about their own population of patients and the larger population from which their patients are drawn
4. Apply knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness
5. Use information technology to manage information, access on-line medical information; and support their own education 
6. Facilitate the learning of students and other health care professionals

INTERPERSONAL AND COMMUNICATION SKILLS:

Residents must be able to demonstrate interpersonal and communication skills that result in effective information exchange and teaming with patients, their patients families, and professional associates. Residents are expected to:

1. Create and sustain a therapeutic and ethically sound relationship with patients
2. Use effective listening skills and elicit and provide information using effective non-verbal, explanatory, questioning, and writing skills
3. Work effectively with others as a member or leader of a health care team or other professional group

PROFESSIONALISM:

Residents must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population. Residents are expected to:

1. Demonstrate respect, compassion, and integrity; a responsiveness to the needs of patients and society that supersedes self-interest; accountability to patients, society, and the profession; and a commitment to excellence and on-going professional development
2. Demonstrate a commitment to ethical principles pertaining to provision or withholding of clinical care, confidentiality of patient information, informed consent, and business practices
3. Demonstrate sensitivity and responsiveness to patients' culture, age, gender, and disabilities

SYSTEMS-BASED PRACTICE:

Residents must demonstrate an awareness of an responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value. Residents are expected to:

1. Understand how their patient care and other professional practices affect other health care professionals, the health care organization, and the larger society and how these elements of the system affect their own practice
2. Know how types of medical practice and delivery systems differ from one another, including methods of controlling health care costs and allocating resources
3. Practice cost-effective health care and resource allocation that does not compromise quality of care
4. Advocate for quality patient care and assist patients in dealing with system complexities
5. Know how to partner with health care managers and health care providers to assess, coordinate, and improve health care and know how these activities can affect system performance.

The development of the general competencies will be facilitated by participation and completion of the Common Curriculum of the Wake Forest Baptist Medical Center available to all residents, see Appendix H. Assigned module are to be completed with appropriate testing scores prior to beginning the senior resident year. The medical knowledge goals and schedule of expected acquisition are defined under Goals and Objectives by year and service.

The objective of the conferences is to establish valid information in conference format for presentation and discussion, and introduce new information applicable to the basic and clinical sciences related to Otolaryngology. The objective of the research activities within the department is to develop an environment wherein new questions are invited and past concepts are challenged through organized scientific methods; wherein hypotheses, methods, data gathering, analyses and conclusions are achieved in a logical fashion. This type of milieu, in which faculty and residents are so engaged, also has an objective of continuing new thoughts and challenges within each individual=s mind, and enhancing the development of new thoughts by future generations, thereby instilling an attitude of inquiry and teaching.

The overall goal or objective of developing clinical competence is a basic requirement for a training program in Otolaryngology. The resident, upon completion of the program, must realize that competence at a given moment in time-upon completion- does not result in continuing competence without continued achieving of the other goals of research awareness, clinical expertise, continuing education, and adherence to basic ethical standards and practice guidelines. Clinical abilities include: appropriate diagnostic methods, appropriate medical and surgical treatment, and possible future identification of disorders currently undefined. The fund of knowledge and the abilities common to competency at one point in time, if they remain static, may be related to incompetency in the future.

Instilling in the resident the need for continuing education after leaving a regimented curriculum is a key programmatic goal. Introduction to the American Academy of Otolaryngology's continuing education courses and the requirement to take these courses, with attendance at societal meetings and presentation by the residents of studies performed by them, are the elements developed to achieve the goal of awareness and activity in continuing education.

The goal of passing the certifying examinations by the American Board of Otolaryngology, which admittingly does not evaluate competence, but does evaluate to fund of knowledge and the abilities that can allow for competence, is developed through regular questioning by the faculty on a day-to-day basis, participation in the continuing education materials of the Academy and the annual examination and practice drills in an oral examination format which allow for the development within the resident of thought processes and organized approaches to problem solving.