Download Goals and Objectives: UMN Rotation

UMMC NUCLEAR MEDICINE ROTATION DESCRIPTION
ROTATION OVERVIEW
The University Nuclear Medicine rotation takes place at University of Minnesota Fairview
Hospital (2nd Floor Nuclear medicine). This rotation requires a minimum of two months,
although some residents will have a third rotation at the University. Residents gain a wide range
of knowledge and skill in various aspects of nuclear medicine, PEC/CT, and molecular imaging.
During this rotation, residents receive training in the following subspecialties:
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
Nuclear Medicine
Molecular Imaging
Additional training in Nuclear Medicing and Molecular Imaging occurs in the VANM rotation.
Requirements are progressive and cumulative over time. That is, a resident in the 2nd or 3rd
month of the rotation is assumed to continue to meet all the goals and objectives of the 1st
month of rotation. The responsibilities and privileges that apply at the end of the 1st month
rotation will continue to apply in subsequent months.
DIDACTICS
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Complete minimum reading requirements specified in the Body of Knowledge, as
indicated in the Section Curriculum Desciption for Nuclear Medicine.
Participate in conferences and rounds as described in the UMNM Duty Sheet. All
residents will be responsible for presenting cases in conference.
Wednesday evening lecture series
Particpate in alternate Thursday Nuclear Medicine and Molecular Imaging
Conferences.
CLINICAL ACTIVITIES

Participation in wide range of diagnostic and image-guided procedures, as noted in
the specific objectives listed below under the core competencies.
ROTATION GOALS
Upon completion of the UMNM rotation, resident will:
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Demonstrate mastery of the Body of Knowledge, as defined in the Section
Curriculum Description for Nuclear Medicine.
Achieve “Competency” in each category evaluated by faculty evaluations through
RMS system.
Consistently meet the expectation outlined in the UMNM Duty Sheet.
This is generally a two-month rotation, but some additional objectives are listed below for
residents who take a third month in the UMNM rotation.
COMPETENCIES & OBJECTIVES
Goals are listed as bullets under each competency below. Each goal is followed by a list of
objectives for each year (unit) of the complete rotation, along with the appropriate assessment
tool for each objective. Evaluation codes, A, B, C, etc. refer to the Evaluation Methods and are
described in more detail in the Appendix.
A: Global Faculty Evaluation; B: Case/Procedure Logs; C: 360 Degree Evaluation;
D: Objective Test; E: Resident Learning Portfolio; F: Document participation in Department
Activities; G: Evaluation quality of reports; H: Direct Observation and I: Journal Club
PATIENT CARE
 DEVELOP A MANAGEMENT PLAN BASED ON RADIOLOGIC FINDINGS AND CLINICAL INFORMATION
MO
OBJECTIVE DESCRIPTION
EVALUATION
METHOD
1

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2
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Understands basic functions in Nuclear Medicine
including gamma camera quality control, design,
functional use, SPECT and gated principles
Understand basic Nuclear Pharmacy as it applies to
routine day to day in the Division of Nuclear Medicine
Understand Basic Nuclear Medicine procedures and
indications
Understand Basic Molecular Imaging Principles
Understand cardiac applications of Nuclear Medicine
including, stress perfusion, MUGA evaluation and PET
Viability
Understand Nuclear Endocrine (Thyroid, Adrenal,
Parathyroid) management, diagnosis and therapy
Understand Advanced PET/CT/MRI diagnosis of
Oncological and Neurological Nuclear Medicine
Understand Molecular Imaging Diagnosis as it relates to
patient care
A,B
A,B
MEDICAL KNOWLEDGE
(Residents should be knowledgeable, scholarly and committed to lifelong learning)
 RECOGNIZE AND DESCRIBE RELEVANT RADIOLOGIC ABNORMALITIES
MO
OBJECTIVE DESCRIPTION
1


Be able to articulate physical, chemical and biological
properties of radiopharmaceuticals used in Nuclear
Medicine and Molecular Imaging
Be able to describe daily QC of gamma cameras, SPECT
EVALUATION
METHOD
A,D
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2
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3
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acquisitions and processing, and gamma camera design
and function
Understand the imaging/pathologic correlation in nuclear
medicine procedures (i.e. bone, hepatobiliary, renal,
gastric emptying, thyroid imaging and function)
Be able to articulate the four basic aspects of Molecular
Imaging and Diagnosis
Be able to articulate PET/CT principles, clinical
applications, QC procedures and analysis of results
Be able to manage patients with Thyroid disease (i.e.
hyperthyroidism, Cancer, low/high dose therapies)
Be able to assist referring physicians in the staging and
management of Oncological Imaging (PET/CT, Nuclear
Medicine)
Understand more advanced antibody and metabolic
precursor Nuclear Medicine Techniques
Participate in education of medical students and first
year residents
 SYNTHESIZE RADIOLOGIC AND CLINICAL INFORMATION AND FORM AN IMPRESSION
MO
OBJECTIVE DESCRIPTION
1

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2,3
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Know the normal appearance and behavior of commonly
used radiopharmaceuticals.
Be able to identify abnormal findings on nuclear
medicine examinations
Know common artifacts which may alter the appearance
on procedures
Be able to formulate a consultative conclustion based on
the abnormal findings
Be able to more extensively formulate a consultative
conclusion based on the abnormal findings
A,D
A,D,H
EVALUATION
METHOD
A,D
A,D
 UTILIZE INFORMATION TECHNOLOGY TO INVESTIGATE CLINICAL QUESTIONS AND FOR CONTINUOUS
SELF-LEARNING.
MO
OBJECTIVE DESCRIPTION
EVALUATION
METHOD
ALL
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Demonstrate use of internet to find pertinent
information to add to current cases and teaching file
cases.
Demonstrate case based computer initiated biomedical
library and internet information access.
Be able to use the Leonardo and eSoft workstations in
Nuclear Medicine
Complete 8 RSNA self learning Physics Modules in
Radiation Biology, Radiation Protection, and Nuclear
Medicine and send documentation of completion to
A,D,H
Program Coordinator for entry into Resident Portfolio
(see Duty Sheet)
INTERPERSONAL/COMMUNICATION SKILLS
(Residents should communicate and teach effectively)
 SHOW SENSITIVITY TO AND COMMUNICATE EFFECTIVELY WITH ALL MEMBERS OF THE HEALTH CARE
TEAM
MO
1
OBJECTIVE DESCRIPTION
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2
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3
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A,C,G,H
Interactions with team members are in accordance with
the UMNM Duty Sheet.
Residents interact effectively and appropriately with both
patients and families.
Communicate effectively with referring physicians
A,C,G
Explain the role of the radiologist as a team member in
managing patients with medical conditions necessitating
nuclear medicine procedures
A,C,G
Understand how the physician is held accountable for
functions of other members of the nuclear medicine
team, as well as understanding the limits of that
accountability
 APPROPRIATELY OBTAIN INFORMED CONSENT
MO
OBJECTIVE DESCRIPTION
1

2,3
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EVALUATION
METHOD
Demonstrate knowledge of principles of informed
consent, and appropriate documentation of such.
Consistently obtain appropriate informed consent with
appropriate documentation
EVALUATION
METHOD
A,C,G
A,C,G
 RECOGNIZE, APPROPRIATELY COMMUNICATE, AND DOCUMENT IN THE PATIENT RECORD URGENT OR
UNEXPECTED RADIOLOGIC FINDINGS
MO
ALL
OBJECTIVE DESCRIPTION
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Consult with Nuclear Medicine staff when unexpected
and care changing findings are discovered
Unexpected, abnormal and care changing findings
should be reported within 1 hour to ordering physician
or care team and recorded in the report of the
examination
Consult Interventional Radiology as soon as active GI
Bleeding is observed on a Nuclear Medicine GI Bleeding
examination
Know NRC rules for reporting “spills” and
“misadministration” of radionuclide’s
EVALUATION
METHOD
A,C,G,H
 PRODUCE RADIOLOGIC REPORTS THAT ARE ACCURATE, CONCISE, AND GRAMMATICALLY CORRECT.
MO
OBJECTIVE DESCRIPTION
EVALUATION
METHOD
1
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2
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Effectively communicate the radiological findings in both
oral and written format.
Reports exhibit internal consistency.
Use “Power Normal” reports as much as possible for
consistent and complete reporting of findings and
conclusions
Reports evolving further into radiological consultation
with concise but accurate differential diagnosis’ and
pertinent references
Understand the medicolegal aspects of reporting
A,C,G
A,C,G
 EFFECTIVELY TEACH RESIDENTS, MEDICAL STUDENTS AND OTHER HEALTH CARE PROFESSIONALS.
MO
OBJECTIVE DESCRIPTION
EVALUATION
METHOD
1
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2
3
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Produce three teaching files per rotation and give case
conferences as scheduled.
Prepare multidisciplinary conference cases, adding three
cases occurring during rotation to the appropriate saved
folder for potential teaching file cases
Teach previously mastered competencies to medical
students and more junior residents.
Effective in teaching medical students
Effective in teaching junior residents
Observes teaching by junior residents and grades
performance
Professional, clear, and effective presentations at
subspecialty conferences
A,C,G,H
A,C,G,H
A,C,G,H
PRACTICE-BASED LEARNING AND IMPROVEMENT
(Residents should investigate and evaluate patient care practices, and appraise and assimilate scientific
evidence in order to improve their practices)
 PARTICIPATE IN QI (QUALITY IMPROVEMENT)/QA (QUALITY ASSURANCE) ACTIVITIES
MO
OBJECTIVE DESCRIPTION
EVALUATION
METHOD
ALL
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Demonstrate understanding of Quality Assurance
process.
Actively participate in identifying errors, improving
quality of the image and its interpretation, and
forwarding the results the the Quality Assurance
Committee.
 RECOGNIZE AND CORRECT PERSONAL ERRORS
A,E
MO
ALL
OBJECTIVE DESCRIPTION
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Consistently use personal errors and feedback on errors
to improve performance.
Apply strategies for elimination of errors recognized by
Quality Assurance Committee.
Use printed and electronic resources to access
information that can further the individual’s knowledge
and further the care of the patient.
Identify personal errors and develop strategies for their
elimination
EVALUATION
METHOD
A,E
PROFSSIONALISM
(Residents should be altruistic and accountable, and adhere to principles of medical ethics by respecting
and protecting patient’s best interest)
 DEMONSTRATE A RESPONSIBLE WORK ETHIC WITH REGARD TO CONFERENCE ATTENDANCE AND WORK
ASSIGNMENTS
MO
ALL
OBJECTIVE DESCRIPTION
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Comply with UMNM Duty Sheet requirements for
conferences and teaching files.
Uphold work ethic described on the UMNM Duty Sheet.
Demonstrate respect for patient privacy and
confidentially.
 DEMONSTRATE ACCEPTABLE PERSONAL DEMEANOR AND HYGIENE
MO
OBJECTIVE DESCRIPTION
1
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2
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Comply with standards for professional appearance and
conduct as outlined in the UMNM Duty Sheet.
Assume greater responsibility, in interactions with
personnel in the work environment, for maintaining a
respectful work environment.
EVALUATION
METHOD
A,C,H
EVALUATION
METHOD
A,C,H
A,C,H
SYSTEMS-BASED PRACTICE
(Residents should understand healthcare practice)
 DEMONSTRATE KNOWLEDGE OF AND APPLY APPROPRIATENESS CRITERIA AND OTHER COST-EFFECTIVE
HEALTHCARE PRINCIPLES TO PROFESSIONAL PRACTICE
MO
1
OBJECTIVE DESCRIPTION
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Attend interdisciplinary conferences.
Demonstrate understanding of electronic medical
records.
Know the ACR standards of appropriateness criteria.
EVALUATION
METHOD
A,E,F
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2
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3
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Demonstrate understanding of and consistent practice of
radiation safety.
Weigh, on a daily basis, the pros and cons in terms of
health care costs, and appropriateness, of alternative
forms of diagnostic imaging work up on individual
patients
Correctly apply ACR standards/appropriateness criteria.
Develop understanding of cost effective algorithms for
patient care.
Demonstrate understanding of and consistent practice of
radiation safety.
Weigh, on a daily basis, the pros and cons in terms of
health care costs, and appropriateness, of alternative
forms of diagnostic imaging work up on individual
patients
Actively participate and prepare for interdisciplinary
conferences
A,E,F
A,E,F