slide1 n.
Download
Skip this Video
Download Presentation
College of Medicine

Loading in 2 Seconds...

play fullscreen
1 / 25

College of Medicine - PowerPoint PPT Presentation


  • 65 Views
  • Uploaded on

Inpatient Internal Medicine-Pediatrics PACE Subcommittee Maria Cannarozzi, M.D. December 16, 2004. College of Medicine. “Disease in the context of a lifetime” Incorporate ILC topics via innovative learning experiences Emphasize pathophysiology common to both pediatrics and adult medicine

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'College of Medicine' - tracey


Download Now An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
slide1

Inpatient Internal Medicine-Pediatrics PACE Subcommittee

Maria Cannarozzi, M.D.

December 16, 2004

College of Medicine

objectives
“Disease in the context of a lifetime”

Incorporate ILC topics via innovative learning experiences

Emphasize pathophysiology common to both pediatrics and adult medicine

Unify two clerkships

Preserve mutual exclusivity

Objectives

USF College of Medicine

Internal Medicine-Pediatrics PACE Subcommittee

Maria Cannarozzi, M.D.

Sir William Osler

http://www.medicalarchives.jhmi.edu/sgml/osler.html

components
Nonintegrated vs Integrated

Weekly themes

Conferences

Integrated longitudinal curriculum

Components
clerkship curriculum
Nonintegrated

Patient encounters and ward experience

Case based conference

Integrated

Keynote conference

ILC

Clinical modules

ECG lecture series

Clerkship Curriculum
weekly themes
1 Cardiology – congestive heart failure/cardiac dyspnea

2 Pulmonary medicine – obstructive lung disease/respiratory failure

3 Endocrinology – diabetic ketoacidosis/HHNK physiology

4 Infectious Disease – sepsis/presentations of infection

5 Rheumatology – inflammatory joint pain/SLE/vasculitis

6 Gastroenterology – acute abdomen

7 Nephrology – acute renal failure/fluids and electrolytes

8 Hematology/Oncology – anemias/common malignancies

Weekly Themes
conferences
Keynote

Case Based Conference

ECG

Conferences
integrated longitudinal curriculum weekly task
-- Management issues of a simulated case of a sickle cell patient in aplastic crisis who follows the religion of Jehovah’s witness

-- Plan a vaccination strategy for influenza season with a limited supply

-- Managing the care of a patient with a newly diagnosed terminal illness –“breaking the news”

-- Management of a cancer patient with uncontrolled pain

-- Attending Tumor Board and presenting a patient/treatment plan

-- Spending time in the ER reviewing criteria for admissions for various/specific diagnoses

-- Spending a day working with nutrition services, specifically what is involved in preparation of various patient diets, including the formulation of TPN

-- Spend a day in hospital administration/hospital operations management in order to appreciate and become sensitive to issues related to administrative aspects of inpatient medical care

Integrated Longitudinal CurriculumWeekly Task
electronic portfolio
Electronic Portfolio
  • STUDENT LOGBOOK – PATIENT DATA/PROCEDURES
  • DOCUMENTATION OF WEB-BASED MODULE COMPLETION 
  • DOCUMENTION OF ILC TASK COMPLETION 
  • FACULTY AND RESIDENT PHYSICIAN EVALUATIONS 
  • WEEKLY QUIZ SCORES 
  • COMPREHENSIVE WRITTEN EXAMINATION SCORE
  • CLINICAL PERFORMANCE EXAMINATION SCORES

Student Portfolio

A closer look…

inpatient internal medicine pediatrics on line curriculum

Inpatient Internal Medicine-Pediatrics On Line Curriculum

Keynote Conference

Weekly Task

Clinical Modules

assessment
Ward evaluations from attending and residents

Weekly quizzes

ILC task completion

Module completion

ECG competency exam

Student log (diagnoses and procedures) completion

Comprehensive written exam

Case-based clinical performance examination

Assessment
further considerations
Eight weeks continuous ward service

Workload demands and time restraints

Ward team responsibilities vs independent learning

Balancing didactic education and clinical experience

Continual curriculum assessment and improvement

Further Considerations
ilc weekly task
ILC Weekly Task

Sir William Osler

http://www.medicalarchives.jhmi.edu/osler/oslerroom.htm

slide15
“Follow the antibiotic”

Starting with the order entered by a physician, physically track the process of an IV antibiotic or blood product being administered. Identify and record the following items (do not allow your presence to influence the people you are observing):

The name and role of every person who reads the order, or touches the medication/blood product

The manner in which the medication/blood product is prepared and stored

How the order and medication/blood product are verified to match

How the medication/blood product is transported to the ward

The name and role of everyone on the ward who processes or delivers the medication/blood product to the person who administers it

The supplies needed to administer the medication/blood product to the patient

The verification process for ensuring the medication/blood product given to the patient is correct

The manner in which the medication/blood product is administered including equipment, rates, and site of entry

Any counseling or information the patient/patient’s relative received by anyone involved in the entire process regarding the medication/blood product

The time for the entire process to occur

What benefit/drawbacks does the patient/patient’s relative expect from the medication/blood product

Sir William Osler

http://www.medicalarchives.jhmi.edu/osler/oslerroom.htm

slide16
Answer the following questions:

Identify 10 possible moments at which unintended error may occur

What information do you think should be provided to the patient or their relative regarding the administration of the medication/blood product (be specific)?

What is the manufacturer’s listed cost of the medication/blood product? How much does the hospital pay for it?

Sir William Osler

http://www.medicalarchives.jhmi.edu/osler/oslerroom.htm

keynote conference agenda for week 2 pulmonary medicine

USF HEALTH SCIENCES CENTER

Keynote Conference Agenda for Week 2: Pulmonary medicine

Representative Faculty:

 Pulmonologist, general internist, general pediatrician, basic sciences physiologist, pharmacologist

keynote conference agenda for week 2 pulmonary medicine1
Topic: Obstructive pulmonary disease – asthma/COPD

Objectives:

Discuss pathophysiology of obstructive lung disease, including anatomic features, etiologies, risk factors, clinical presentations and management.

Discuss how these physiologic processes differ in the adult and pediatric population i.e. bronchospastic hyperreactive airways vs. structural changes caused by environmental toxins (cigarette smoke) or congenital disorders (cystic fibrosis).

Discuss how patients of varying ages might present.

Discuss management strategies for patients of varying ages and why these strategies might differ.

Topic: Respiratory failure in the child and adult

Objectives:

Discuss primary pathologic mechanisms of respiratory failure i.e. hypoxia and hypoventilation – how these might occur and which are more prevalent in pediatric vs. adult populations

Discuss presentation of respiratory failure i.e. warning signs, different age presentations

Discuss the detailed pathophysiology of a selected type of respiratory failure: i.e. hypoxia secondary to diffusion abnormality. Why does this occur in the pediatric vs. adult patient? How do we treat it?

Discuss age-appropriate management strategies for selected respiratory disorders.

Keynote Conference Agenda for Week 2: Pulmonary medicine
pulmonary function test
Pulmonary Function Test
  • Spirometry
    • Slow maneuvers
    • Forced maximal maneuvers
  • Lung Volumes
    • Plethysmography
    • Inert gas washout/dilution
    • Planimetry
  • Diffusion Capacity
  • Pulmonary Mechanics
    • NIP, MVV, MEP
case 3
A 72-year-old woman with long standing tobacco use (150 pack years) undergoes PFT testing for evaluation of increasing dyspnea. Case # 3
slide21

Spirometry Results

Flow volume loop

Effort loop

Severely blunted exp curve

Both are smooth in contour

question
What is the most likely diagnosis?

Asthma

Asbestosis

Neuromuscular weakness

COPD

Question
ad