Goals

Objectives

Progression

Patient Care

The senior resident is assigned primary responsibility for the pediatric service, but obtains considerable experience in the operative management and care of patients with complex spine disease requiring instrumentation, brachial plexus reconstruction, pituitary tumors, epilepsy surgery, and intracranial tumors.  Through this year the senior resident demonstrates greater skill and knowledge with such cases and is generally able to function in a primary role in by the end of this experience.

Develop sophisticated skills in the diagnosis and treatment of neurosurgical diseases and disorders.  Should be able to function independently at the end of this experience in the following areas: craniotomies for tumors, approaches to various anterior circulation aneurysms, spinal instrumentation in the cervical and lumbar areas, and proficiently assist in various pediatric cases

Tools: Biannual evaluations, Surgery Bx Tool, event reporter, quality improvement initiatives

Medical Knowledge

Residents will practice evidence-based medicine, participate in teaching medical student anatomy labs, and help guide informal educational rounds for the residents..  Additionally, they will utilize the joint resources of the NLM’s search engine, <http://www.pub-med.gov>, and the connected journals of the Yale School of Medicine Library.

Progress is expected in knowledge of medical literature as demonstrated in teaching rounds, conferences, primary examination and patient care.

Tools:  Primary examination, residents presentations

Practice Based Learning & Improvement

Residents will track their own procedures, complications and outcomes electronically.  Conference presentations designed to increase a resident’s depth of knowledge in critical topics will be regularly assigned.  These items along with publications, grant applications and reviews will be a added to the residents portfolios

Progress will be assessed by faculty evaluations both in regards to patient care and the OR.

Tools:  Portfolio updates, publications

Interpersonal  & Communication
Skills

Residents will work effectively in this complex environment of patients, families, and multiple levels of health care professionals.
Senior residents will help guide junior level residents in the development of their presentation skills. They will present and receive critical information upon arrival and departure for duty hours.  They will prepare and present regularly at major departmental teaching conferences.  The senior resident will also lead weekly to bi-weekly clinical care review sessions with the nursing manager in the NICU and floor.

While training is provided by the institution in sexual harassment, diversity, and HIPPA, respect and humanistic interactions with patients are essential.  Effective communication is critical to learning and patient safety.

Tools:  360 evaluations, event reporter, Press-Ganey, patient questionnaires

Professionalism

This will be a critical theme in most interactions in this institution additionally conferences and lectures will periodically address ethics as the major topic.

Progress will be noted from recurrent evaluations.

Tools: 

Systems-Based Practice

Neurosurgery requires interacting in a large complex system.  Faculty and more senior residents will mentor junior residents in these areas and discuss as significant topic in most major patient based conferences.

Progress will be noted from recurrent evaluations

Tools:  biannual evaluations, 360 evaluations

Progressive Responsibility:  The senior resident takes a more administrative and educational role with medical students and more junior residents.  Chief call responsibilities are divided with the senior resident and during those times he/she is expected to operative within that capacity.  There is close faculty pairing and mentoring with the senior resident during this time.