Altruism

Performance Objective

Evaluation Method

Graduation Competency

1. Knowledge regarding ethical decision making: Students may have the opportunity to witness and participate in end of life discussions with patients and their families. Additionally, there should be ample opportunity for the student to observe and participate in the informed consent process.

a) Students will accept the individuality, values, goals, concerns and rights of the patient and the patient’s family.

b) Students will display professional behavior and function effectively as a member of the health care team. 

4, 5, 6, 7

1k, 2h, 4a, 4b, 5l, 6g

2. Compassionate patient care and respect for the privacy and dignity of their patients: Patients who are undergoing surgery face unique psychological and social stresses. It is imperative that the students exercise compassionate care and respect for patient privacy throughout the peri-operative period. It is important not to discuss operative findings in areas of the hospital where the discussion might be overheard by friends or families of the patient.

a) Students will complete required HIPPA training.

b) Students will observe and adopt the attitudes and attributes that promote effective patient and professional relationships, including honesty, integrity, and compassion.

8

1, 2, 4, 5, 6, 7

5b, 5j

3. Honesty and integrity in all interactions with patients' families, colleagues, and others with whom physicians must interact professionally: The student is expected to wear a clean white coat with name tag at all times except in the operative suite. All patients are to be addressed as Mr., Mrs., etc. Any discussion of diagnosis, management, or prognosis with the patient or family should be first cleared with the housestaff or attending physician.

a) Students will observe and adopt the attitudes and attributes that promote effective patient and professional relationships, including honesty, integrity, and compassion.

1, 2, 4, 5, 6, 7

1k, 2g, 2h, 4a, 4b, 5a, 5i, 5k

4. An understanding of, and respect for, the roles of other health care professionals, and of the need to collaborate with other in providing care for individuals and populations: Surgeons typically pride themselves on their ability to manage patients throughout all of the phases of their illness. However, medicine has a very sophisticated science, and collaboration with other health care professionals can be expected. Most medical students will not choose a surgical career, but students should consider that they will likely consult with and be consulted by surgeons throughout their professional careers.

a) Students will recognize appropriate consultation resources, both medical and non-medical, and demonstrate an awareness of available community resources. 

6

4b, 5a, 5e, 5i, 5k, 6a, 6b, 6c

5. The capacity to recognize and accept limitations in one's knowledge and clinical

skills: Surgical therapy typically produces extreme results. Positive outcomes are extremely rewarding but negative outcomes are immediate and devastating to the patient and humbling to the surgeon. The best application of the most current surgical therapy does not guarantee positive outcomes. This situation should result in reflection on the part of all members of the team. Sometimes, ideas arise after failure that results in progress in knowledge.

a) Students will attend scheduled M & M conferences.

6, 7

3a, 3b, 3d, 3e, 4a, 4b, 5c, 5f

Knowledge

Performance Objective

Evaluation Method

Graduation Competency

1. Knowledge of molecular, biochemical, and cellular mechanisms underlying the pathology of disease: The surgeon must have a comprehensive knowledge of basic science disciplines. The student will have the opportunity to correlate his or her preclinical basic science knowledge with the care of the surgical patient.

a) Students will demonstrate correlation of basic science knowledge with the care of the surgical patient. 

3, 4, 5, 6, 7

2a, 2b, 2d

2. Knowledge of pathologic changes in the structure and function of organ systems as a result of disease: Surgery is unique in the degree of clinical correlation that can be accomplished. The student can detect findings on a preoperative physical exam, view radiographs and then be able to see and directly palpate the patient's pathology. Responsibility for making this possible is shared among the students, residents, and surgical faculty.

a) Students will demonstrate basic knowledge of altered structure and function (pathology and pathophysiology) of the body and its major organ systems that are seen in various surgical diseases. 

3, 4, 5, 6, 7

2a, 2b

3. Knowledge of mechanisms of drug-action, pharmokinetic parameters, pharmacodynamics and pharmacotherapeutics: Students will have an opportunity to see a number of medications used in the perioperative period. This should be an excellent opportunity to review the pharmacology of many antibiotics, analgesics, anesthetics, etc.

a) Students will demonstrate understanding of pharmacological agents utilized in surgery.

3, 6, 7

1j, 2a, 2e

4. Skills for life-long learning: The hours are long for most surgeons. The call schedule has been modified in an attempt to provide students with adequate time for rest and study. Despite these modifications, it is expected that Surgery will be one of the most rigorous and demanding experiences of the student's medical school educational experience. One misconception that leads to problems is the some students believe that they should only study when away from the hospital. Instead, the student must develop a strategy that allows them to read and study during any free opportunity during the working hours. Developing this skill will also be useful to the student during residency training, and in future post-training practice.

a) Students will demonstrate study preparation by being prepared for questions during lectures, case presentations, clinics, and the OR.

b) Students will demonstrate willingness to take on learning issues presented to them by their preceptors. 

5, 6, 7

6, 7

3a, 3b, 3c, 3d, 3e, 3f, 4a, 4b, 5c, 5e, 5f, 5g

Skillfulness

Performance Objective

Evaluation Method

Graduation Competency

1. The ability to perform both a comprehensive and organ system specific examination: The surgeon must assess the patient's entire state of health prior to performing an operative procedure. Therefore, the student will gain experience with a comprehensive physical examination during the rotation. Additionally, the student may have an opportunity to learn a very detailed examination of specific organ systems. This will vary according to the specific nature of the student's rotations.

a) Students will demonstrate the ability to interview patients and elicit a relevant and complete history, using appropriate verbal and non-verbal techniques to facilitate communication and pursue relevant inquiry.

b) Students will be able to obtain a logical, organized and thorough history.

c) Students will be able to obtain supplemental information from other sources such as significant others, institutions, pharmacies, and previous physicians whenever necessary.

d) Students will be able to demonstrate an understanding of the physiological mechanisms underlying the findings in the clinical examination.

e) Students will be able to demonstrate the methods, purpose and clinical significance of the physical examination particularly as it pertains to surgery.

f) Students will be able to demonstrate the proper techniques of physical examination with attention to patient comfort, hygiene and privacy.

g) Students will be able to demonstrate a logical, comprehensive and organized physical examination, with the ability to adapt it to a particular clinical situation. 

h) Students will understand the significance of, and be able to detect the presence of the most important physical examination abnormalities. 

1, 5, 6

1a, 1b, 1c, 1d, 1e, 1f, 1g, 1i, 1k, 1l, 2a, 2b, 2c, 2e, 2f, 2g, 2h, 4a, 4b, 5b, 5j

2. The ability to perform routine technical procedures (E.G., nasogastric tube insertion, venipuncture, intravenous catheterization, urinary catherization, suturing, skin stapling): Students frequently fail to recognize the opportunity to perform procedures on patients in the Operating Room. Doing procedures in this environment minimizes patient discomfort and allows the student to learn to do a procedure under supervision.

a) Students will demonstrate basic skills in performing routine technical procedures commonly required on a surgical service. 

b) Students will demonstrate understanding and consistent performance of basic sterile technique. 

1, 2, 6

1d, 1i, 3a, 3b, 4a, 4b

3. The ability to interpret the results of commonly used diagnostic tests with recognition of their limitations: Frequently, a surgeon will be required to make decisions based on inconclusive tests. The student should inquire frequently as to why specific tests have been ordered.

a) Students will demonstrate understanding and basic skills required to order and interpret commonly used labs and studies. 

1, 4, 5, 6, 7

1d, 1e, 2a, 3c, 4a, 4b, 5a, 5b

4. Knowledge of the most frequent clinical laboratory, radiologic, and pathologic manifestations of common maladies: The surgical pathologists are frequently willing to review the pathologic evaluation of tissue that has been removed at surgery. The radiology faculty and housestaff are consistently available to review perioperative imaging studies.

a) Students will demonstrate understanding of the most frequent lab, x-ray and pathology findings of common surgical diseases. 

4, 5, 6, 7

1a, 1b, 1c, 1d, 1e, 2a, 3a, 3b, 3c, 3d

5. The ability to reason deductively in solving clinical problems: The residents and faculty will be able to explain to the student how they have arrived at diagnoses and developed plans.

a) Students will develop a differential diagnosis and treatment rationale for patients with symptoms that commonly require surgical referral. 

1, 3, 5, 6, 7

1a, 1b, 1c, 1d, 1e, 1f, 2a, 2b, 2d, 2h, 4a, 4b, 5a, 5b, 5c

6. The ability to construct appropriate diagnostic and management strategies for patients with common surgical conditions: This applies to both the conditions that the student actually encounters in patient and those only read about in textbooks.

a) Students will demonstrate basic knowledge of strategies to identify, assess, and manage common surgical conditions.

b) Students will demonstrate basic knowledge of strategies to assess risk, and to prevent, identify, and treat post-operative complications.

1, 3, 5, 6, 7

1a, 1b, 1c, 1d, 1e, 1f, 1h, 1i

7. Knowledge about relieving pain and ameliorating suffering: This will be particularly true in the post-operative period. There are a variety of ways to relieve post-operative pain, and the student should be familiar with these options.

a) Students will demonstrate the basic knowledge required to assess, and treat pain, and ameliorating suffering. 

b) Students will attend scheduled lectures on pain management.

1, 3, 5, 6, 7

1j, 1k, 2a, 4a, 4b

8. The ability to communicate effectively with patients, their families, and members of the healthcare team: The unique aspect of surgical care is that often the surgeon must establish a relationship quickly in a stressful situation. Effective communication is important in guiding a patient, and his or her family, through these situations. The students will witness and participate in this process.

a) Students will demonstrate the basic skills required to communicate effectively both orally and in writing, with patients, patient’s families and colleagues. 

1, 4, 5, 6, 7

1h, 4a, 4b, 5b, 5e, 5i, 5j, 5k, 6b

Dutiful

Performance Objective

Evaluation Method

Graduation Competency

The ability to retrieve, manage and utilize biomedical information for solving problems and making decisions relevant to the care of individuals: The surgeon must synthesize clinical, laboratory, and radiologic information to solve problems with or without surgical intervention. The student will be an active participant on the surgical team.

a) Students will recognize the importance of cost-effective health care, quality assurance, and practice guidelines in today’s health care market.

6, 7

1d, 1e, 3c, 4a, 4b, 5a, 5b