Goals

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Goals Objectives

• Defining the Goals and Objectives of an
  Orthopaedic Residency Program in the Language of
  the ACGME Competencies

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Introduction

• R. Dale Blasier, MD, FRCS(C)
• University of Arkansas for Medical Sciences
• Program Director (3 years)
• Specialist Site Visitor (8years)

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Topics

• What are Goals Objectives?
• Why do we need them?
• What are the components of
• Goals Objectives?
• How do we write them?
• What about the core competencies?
• What constitutes good Goals Objectives?

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What are Goals Objectives?

• Goals are the broad vision of what
• we want to accomplish.

Objectives are the little steps we use to get
there.
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Why do we need goals objectives?

• The old days
• Direction
• Documentation
• Compliance

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What do we want?

• Historically
• Patient Care and Medical Knowledge
• Presently
• Communication, professionalism, practice-based
  learning, systems-based practice
• The future
• Patient safety, Reduce medical errors, Pay for
  performance, Cultural competency

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Writing Goals Objectives

• Whats the overall goal?
• What does the resident need to do to meet that
  goal?
• How do we state it?
• How do we state it in the language of the
  competencies?

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Goals
Objectives

• Broad
• General
• Intangible
• Abstract
• Cant be
• validated

• Narrow
• Precise
• Tangible
• Concrete
• Can be
• validated

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What is the goal for a rotation?

• For a sports rotation
• The resident should learn enough about sports to
  be able to function at the level a general
  orthopaedic surgeon

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Writing Objectives

• Make a list of tasks
• Conglomerate the tasks into Objectives
• Categorize objectives by Core Competency
• Specify differences in objective for different
  PGY levels

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Tasks

• Examine patients
• Know the common conditions and their
  pathophysiology
• Dictate a note
• Order and interpret tests
• Act in the patients best interest
• Teach junior residents and students
• Present cases at conferences
• etc

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Building Objectives

• Subject
• Behavior
• Condition
• Degree

Whom we are talking about
Will perform some task
Under some condition
To some degree
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Building Objectives

• Subject
• Behavior
• Condition
• Degree

The PGY4 Resident
Will Perform some task
Under some condition
To some degree
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Building Objectives

• Subject
• Behavior
• Condition
• Degree

The PGY4 Resident
Will be able to diagnose the common sports
injuries
Under some condition
To some degree
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Building Objectives

• Subject
• Behavior
• Condition
• Degree

The PGY4 Resident
Will be able to diagnose the common sports
injuries
In the clinical setting
To some degree
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Building Objectives

• Subject
• Behavior
• Condition
• Degree

The PGY4 Resident
Will be able to diagnose the common sports
injuries
In the clinical setting
With reasonable accuracy
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The competencies

• Medical knowledge
• Patient Care
• Professionalism
• Communication
• Practice based learning
• Systems based practice

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Medical knowledge

• The resident will know the common and important
  sports conditions, their pathophysiology, and
  natural history seen in a typical sports practice
  with reasonable certainty.
• List the common ones

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Patient Care

• The resident will be able to perform HP, order
  interpret tests, make a diagnosis and recommend
  treatment in most cases.
• The resident will be familiar with non operative
  treatment and its limitations.
• The resident will know surgical treatment,
  anatomy, approach, use of special devices, post
  op care and management of complications for the
  common procedures.

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Professionalism

• The resident will maintain a professional
  demeanor, maintain confidentiality, adhere to
  high ethical principles, act in the patients
  best interest and be sensitive to gender, age,
  cultural, and disability issues of patients and
  other professionals.

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Communication

• The resident
• will demonstrate communication skills that result
  in an effective information exchange with
  patients, their families and caregivers, and
  other physicians and members of the health care
  team
• will maintain records which accurately and
  clearly document the evaluation and management of
  the patient, routinely.
• will educate students and junior residents in the
  clinical setting on an ongoing basis.

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Practice based learning

• The resident will participate in the assessment
  of outcomes review of current literature
  literature and make improvements to care on an
  ongoing basis.
• The resident will actively participate in
  conferences and rounds regularly.

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Systems based practice

• The resident will be aware of the effects of his
  own actions on other components of the system
  including administrators, other practitioners,
  payers and ancillary personnel.
• The resident will be aware of the costs
  associated with his own practice patterns and
  strive for efficiency.

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Goals Objectives

• Should exist for each rotation or service
• Should be clearly labeled
• Should be kept in the operating documents of the
  program
• Should be published
• Faculty and Residents should read them

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What constitutes good Goals Objectives?

• They really indicate direction
• Some thought went into them
• They make sense
• They are appropriate in scope
• They are attainable
• Your faculty and residents actually use them

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Caveats

• Dont make too many objectives
• Dont bind yourself
• Think about assessment
• Revisit your Goals Objectives periodically
  things change.

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Final thoughts

• Remember why we need Goals and Objectives
• Write them with care dont kill yourself
• Document them and disseminate them
• Refer to them
• Revise them

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Thank you!