Download GOALS AND OBJECTIVES FOR NEPHROLOGY ROTATION

GOALS AND OBJECTIVES FOR NEPHROLOGY ROTATION
Overall Goal:
This rotation will improve the trainee’s understanding of the subspecialty of Nephrology
and enable them to safely manage patients with nephrological disorders. Trainees will
spend the majority of their time on the Nephrology consult service providing care to
patients with acute kidney injury, chronic kidney disease and metabolic and electrolyte
disorders.
The resident will be able to:
A. Medical Expert:
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Describe the pathophysiology, diagnosis, and management of: acute kidney injury,
proteinuria, hematuria, primary and secondary hypertension, fluid and electrolyte
and acid-base disorders, poisonings
Describe indications for hemodialysis, peritoneal dialysis, ultrafiltration,
hemoperfusion, renal transplantation
Describe the pharmacology of commonly used medications in patients with impaired
renal function and immunosuppressive agents
Take an appropriate and thorough history, perform a comprehensive physical
examination, and formulate an appropriate differential diagnosis and management
strategy related to renal diseases
Perform and interpret a microscopic urinalysis, be aware of the indications and
limitations of imaging studies in urological disease, be aware of the indications for
and interpretation of renal biopsy, and perform placement of central venous
catheters as appropriate to level of training
Manage complications of chronic kidney disease such as hypertension, anemia,
mineral metabolism abnormalities, electrolyte disturbances and volume overload
B. Communicator:
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Communicate in an effective manner, verbally and in written form, with other
members of the health care team
Develop good patient-physician relationships, characterized by understanding, trust,
respect, empathy, and confidentiality
Develop a patient-centered approach to healthcare. This approach will encourage
discussion, promote patients’ participation in decisions (such as choice of renal
replacement therapy), and acknowledge the importance of factors, which influence
the patient-physician relationship such as age, gender, ethnicity, cultural and
socioeconomic background, and spiritual values.
Demonstrate ability to discuss issues related to end-of-life care (such as decisions
to not use or to withdraw life-sustaining renal replacement therapies) with patients
and/or their families
Version date: September-2011
C. Collaborator:
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Recognize that high quality nephrology care is best provided by a team approach
Work effectively in an interdisciplinary team, demonstrating an understanding and
respecting the roles of other health disciplines
Appropriately utilize other healthcare organizations and allied healthcare
professionals in the efficient management of ambulatory nephrology problems and
delivery of nephrology services in a out-patient environment
D. Manager:
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Describe ways in which the structure, financing, and operation of the Ontario health
system affect the delivery of nephrology services in Southeastern Ontario
Demonstrate the ability to multi-task, prioritize responsibilities, and delegate
responsibilities at a level appropriate for the resident’s level of seniority
Use resources appropriately to optimize patient management in a cost-effective
manner
Provide appropriate supervision and guidance for junior residents/clerks on the
service
E. Health Advocate:
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Identify determinants of health which particularly relate to the practice of nephrology
(including patient socioecomic background, financial resources, employment status,
and social support)
Describe preventative strategies for minimizing or preventing renal disease in
common conditions and clinical situations (e.g. diabetes, contrast radiological
studies)
F. Scholar:
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Identify and correct knowledge deficits by means of self-assessment, literature
review, and consultation with other healthcare professionals
Evaluate medical literature using critical appraisal skills
Facilitate the learning of medical students and other residents
G. Professional:
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Be cognizant of ethical issues in the management of patients with end-stage-renal
disease, including issues surrounding resource allocation (such as dialysis and
transplantation) and end-of-life care (such as withdrawal of life-sustaining renal
replacement therapies)
Deliver exemplary patient care commensurate with level of training, demonstrating
appropriate personal and interpersonal professional behaviours
Demonstrate regular attendance for all scheduled rounds and conferences and be
punctual
Recognize their limitations and seek advice and consultation when needed
Version date: September-2011