Hospital Consults PGY-3

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Hospital Consult Rotation Goals/Objectives PGY-3
Patient Care
Goal: To provide care for inpatients that is caring, sensitive, and effective in optimizing
diagnosis, management, patient education and outcomes.
Objectives:

1. Consistently be able to extract difficult-to-elicit but pertinent information from the primary
   team, the nurses, the patient and the chart (including previous dermatology notes if SLU
   dermatology patient) but can occasionally need guidance with subtle or complex findings. PC1
2. Consistently be able to obtain clinical findings for a floor and ICU inpatient but can
   occasionally need guidance with subtle or complex findings. PC1
3. Document a complete drug timeline in the chart for patients suspected of drug reaction. PC1
4. Consistently give a targeted and precise presentation with pertinent negatives. PC1
5. Consistently perform tests (KOH, Tzanck, scabies prep) proficiently and interpret results
   correctly. PC6
6. Consistently accurately interpret laboratory (bedside, blood work, biopsy, etc.) and imaging
   test results for inpatients. PC6
   , interpret laboratory (bedside, blood work, biopsy, etc.) and imaging
7. Usually interpret and apply dermatopathology findings to clinical care accurately, including
   for uncommon neoplasms and common inpatient inflammatory dermatoses. PC4
8. Consistently develop a comprehensive and weighted differential diagnosis. PC7
9. Usually educate patients and nursing staff with common and complex disorders with
   guidance. PC7
10. Consistently make management decisions for patients with common disorders, but can need
    guidance for patients with complex disorders. PC1
11. Consistently tailor counseling and management decisions for individual patient needs and
    preferences. PC1
12. Consistently seek appropriate specialist consultations. PC1
13. Choose the appropriate biopsy technique and location for different diagnoses. PC3
14. Consistently select appropriate medication and changes to medical therapy and usually select
    appropriate systemic medication for management of complex with consideration of feasibility in
    hospital setting. PC8
15. Reviews own biopsy slides. PC4
    Medical Knowledge
    Goal: To acquire knowledge in inpatient dermatology, demonstrate competence in knowledge
    of topics specified by the American Board of Dermatology and develop expertise in patient
    management.
    Objectives:
16. Usually demonstrate knowledge of the clinical and laboratory manifestations, expected course
    and management options of common, uncommon, and complex inpatient dermatologic disorders.
    MK1
17. List medications most likely to be causing common and uncommon drug eruptions. MK1

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3. Identify and usually manage urgent dermatological conditions appropriately. MK1
4. Usually demonstrate knowledge of the socio- behavioral aspects of common and complex
medical dermatologic disorders. MK1
5. Usually apply basic science knowledge to dermatologic disorders, and relate advances in
basic science to clinical practice in the inpatient setting. MK1
6. Identifies variable presentations of common disease MK2
7. Describes morphology with fluency MK2
Practice-Based Learning and Improvement
Goal: Develop skills in acquiring, analyzing, applying and teaching medical knowledge.
Develop the ability to self-analyze.
Objectives:

1. Actively seek appropriate resources to find dermatology information to answer clinical
   questions without being requested or assigned this task. PBLI
2. Apply a set of critical appraisal criteria to different types of research, including synopses of
   original research findings, systematic reviews, meta- analyses, and clinical practice guidelines.
   PBLI1
3. Critically evaluate information from others, including colleagues, experts, industry
   representatives, and patients. PBLI1
4. Identify in journal club or other educational venues when new evidence, guidelines, or
   information should change how they or the department function as a consult service (ordering
   tests, selecting therapies, etc.) PBLI1
5. Teach fellow residents, medical students and resident rotators about pertinent exam
   findings/disease processes at hospital rounds conference. PBLI2
6. Independently creates and implements a learning plan PBLI2
7. Seeks performance data episodically with adaptability and humility PBLI2
   Interpersonal Communication Skills
   Goal: To communicate with patients, their families, and other health professionals in a clear,
   concise, caring, and respectful manner.
   Objectives:
8. Consistently communicate effectively and build rapport with patients and families in routine
   inpatient encounters, but may occasionally require guidance in stressful encounters. ICS1
9. Usually recognizes non-verbal cues from patients, and uses non-verbal skills to convey
   empathy. ICS
10. Usually pace clinical interviews appropriately, spending extra time when indicated. ICS1
11. Consistently maintain composure in difficult patient and family encounters. ICS1
12. Consider patient beliefs in shaping the patient-physician relationship and therapeutic plan.
    ICS1
13. Adapt patient/family-related information gathering to social and cultural context. ICS1

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7. When prompted, reflects on personal biases while attempting to minimize communication
barriers ICS1
8. Consistently communicate effectively with health care team members, including the nursing
staff, in ways that demonstrate appreciation for their skills and contributions in routine situations.
but may occasionally require guidance in difficult or contentious situations. ICS2
9. Consistently obtain and provide consultation and communicate effectively and efficiently
with supervisors, consultants, and primary teams in routine patient care situations, but may
occasionally need guidance in complex or nuanced situations. ICS2
10. Communicates concerns and provides feedback to peers and learners ICS2
11. Be consistently respectful of the opinions of colleagues, and work to resolve conflicts
through proper channels and communication. ICS2
12. Consistently ensure that patient records, including inpatient consultations and transitions of
care, are promptly and accurately documented for routine and complex situations. ICS3
13. Appropriately selects and uses direct (eg. telephone, in person) and indirect (e.g. progress
notes, texts and inbox messages) forms of communication based on context ICS3
Professionalism
Goal: Develop a commitment to excellence, integrity, and sensitivity in the care for inpatients
and in the interactions with other health professionals and staff.
Objectives:

1. Educate junior learners and ancillary staff members in, and model adherence to, institutional
   and departmental policies and procedures, proper use of social media (including appropriate
   transmission of patient photographs), equitable and empathic treatment of all patients, and
   maintaining patient confidentiality. PROF1
2. Adhere to state, institutional, and professional guidelines regarding physician relationships
   with industry. PROF1
3. Establish a list of priorities and effective time management that enable successful pursuit of
   professional and personal goals. PROF2
4. Consistently demonstrate empathy and compassion to patients of all ages, including difficult
   or challenging patients. PROF1
5. Demonstrate effective strategies to manage conflict when patient values differ from his or her
   own values. PROF2
6. Respect patient confidentiality, especially in hospital “common areas” (ie, elevators, waiting
   rooms, hallways, etc.). PROF2
7. Proposes a plan to optimize personal and professional well-being, with assistance PROF3
8. Proposes a plan to remediate or improve limits in one’s own knowledge/skills, with assistance
   PROF3
   Systems Based Practice
   Goal: Competently navigate the health care system using the resources available to provide
   effective yet cost-conscious patient care.

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Objectives:

1. Review local gaps in quality, and identify systems and human errors that contribute to gaps in
   quality within the hospital setting. SBP1
2. Participate in quality improvement activities. SBP1
3. Effectively navigate systems to overcome obstacles to optimal patient care (for example,
   facilitating access to care). SBP2
4. Identify target patient populations, differences in demographics, and utilize the appropriate
   agencies/resources to address specific needs of these populations. SBP2
5. Facilitate checklist- guided briefings (for example pre-procedure timeouts) in health care
   activities. SBP1
6. Articulate understanding of the intersection of thelegal system and health care system in the
   context of medical errors. SBP3
7. Consistently identify the social/governmental services necessary for vulnerable populations,
   including determination of eligibility for services and delivery of some aspects of care. SBP3
8. Consistently advocate for optimal patient care in the setting of interdisciplinary interactions.
   SBP2
9. Articulate awareness of common socio-economic barriers that impact patient care. SBP3
10. Articulate understanding of how cost-benefit analysis is applied to patient care (that is, via
    principles of screening tests and the development of clinical guidelines). SBP3
11. Identify the role of various health care stakeholders, including providers, commercial and
    government payers, and pharmaceutical industry and medical device companies, and their varied
    impact on the cost of and access to health care. SBP3
12. Identify and minimize unnecessary care, including tests, procedures, therapies, and
    ambulatory or hospital encounters. SBP1