Resident Orientation EDucation

1
Resident Orientation EDucation

• IMC/VAMC Podiatric Residency Lecture Series
• 2010-2011
• Andrew Black DPM
• Co-Chief Resident

2
Overview

• Lectures
• Case Presentations
• Journal Club
• MM Discussions
• Workshops
• Guest Lecturers
• McGlamry Review
• Research

3
Goals

• 1. Understand assigned topics and be able to
  speak about them in an intelligent manner.
• 2. Understand assigned topics as applied to both
  clinical and surgical settings.
• 3. Pass board qualification exams successfully
  upon completion of residency.

4
Lecture Topics

• Assigned topics listed on the schedule, which are
  derived from the following
• ACFAS Clinical Practice Guidelines
• Forefoot and Hallux Valgus Surgery
• Reconstructive Rearfoot and Ankle Surgery
• Sports Medicine and Biomechanics
• Medical Management
• Surgical Anatomy
• Neoplastic Conditions
• Trauma
• Limb Salvage

5
Lecture Format and requirements

• Powerpoint Presentation (lectures will be
  distributed to all residents, so please use this
  as the standardized format so that we can all
  view the lecture at a later date without
  difficulty). REMEMBER TO CONVERT YOUR FILES IF
  NECESSARY!!
• Prepare your presentation to last 15 minutes
  (some topics may be slightly quicker and others
  slightly longer). Lets not get lost in the
  minutiaif you include it in your lecture, you
  dont have to read it to us all.
• At least 2 references from must be included from
  current literaturethis is mandatory for all
  lectures (remind the visiting students of this
  when they are assigned their lecture topic). If
  you are having trouble meeting this requirement
  for a given lecture, please email the Chief
  Resident at least 1 week prior to your
  presentation and well find the sources together.
• Incorporate ACFAS Clinical Practice Guidelines
  into lecture (see the lecture schedule for
  references to each of the CPGs.
• Sources should be referenced in AMA Style format1
• Try to present your lecture and compose yourself
  as you would at a larger scientific meetingthis
  is our chance to practice.

1. American Medical Association Manual of Style
A Guide for Authors and Editors. 9th ed.
Baltimore, MD American Medical Association1998.
6
Lecture Discussion Feedback

• Unless otherwise dictated by the attending
  physician present (i.e. let an attending ask
  questions whenever they feel like it), questions
  should be reserved for the discussion period
  following each presentation.
• This will help the lecturer to maintain flow and
  practice the presentation in a more professional
  manner.
• Many questions are asked prematurely and would
  have been answered during the course of the
  presentation in the order the lecturer
  determined.
• Following each lecture discussion, there will be
  a brief optional feedback session for the
  lecturer. Attendees may give positive comments
  and/or constructive criticism.
• Remember that feedback is key to progress!

7
Reference Format

• AMA Style Format
• Based on
• American Medical Association Manual of Style,
  9th ed., 1998.
• List the source at the bottom of each page AND at
  the conclusion of the lecture)
• Example below
• 26 of diabetics suffer from onychomycosis2

2. Gupta AK, et al. Prevalence and epidemiology
of toenail onychomycosis in diabetic subjects a
multicentre survey. Br J Dermatol.
1998139665-71.
8
AMA Style Format for Journals and Websites
Type of Entry Reference List
Article from journalsingle author Moldofsky H. Sleep, neuroimmune and neuroendocrine functions in fibromyalgia and chronic fatigue syndrome. Adv Neuroimmunol. 1995539-56.
Article from journal--more than one author(list all authors if six or less, otherwise list first three followed by "et al.") Raux H, Coulon P, Lafay F, Flamand A. Monoclonal antibodies which recognize the acidic configuration of the rabies glycoprotein at the surface of the virion can be neutralizing. Virology. 1995210400-408.
Monographic series Davidoff RA. Migraine Manifestations, Pathogenesis, and Management. Philadelphia, Pa FA Davis 1995. Contemporary Neurology Series, No. 42.
Online journals with volume and page information Simon JA, Hudes ES. Relationship of ascorbic acid to blood lead levels. JAMA serial online. 19992812289-2293. Available from American Medical Association, Chicago, Ill. Accessed August 24, 1999.
Online journals without volume and page information Gordon GF. Bypassing heart surgery. Alternative Medicine serial online. July 1999issue 30.
Online web site Terre Haute Center for Medical Education. The THCME Medical Biochemistry page. Available at http//web.indstate.edu/thcme/mwking/home.html. Accessed August 24, 1999.

.
9
AMA Style Format for Books
Type of Entry Reference List
Booksingle author Shepard TH. Catalog of Teratogenic Agents. 7th ed. Baltimore, Md Johns Hopkins Press 1992.
Bookmore than one author(list all authors if six or less, otherwise list first three followed by "et al.") Baselt RC, Cravey RH. Disposition of Toxic Drugs and Chemicals in Man. 4th ed. Foster City, Calif Chemical Toxicology Institute 1995.
Bookwith editors Armitage JO, Antman KH, eds. High-dose Cancer Therapy Pharmacology, Hematopoietins, Stem Cells. Baltimore, Md Williams Wilkins 1995.
Chapter from a book Degner LF, McWilliams ME. Challenges in conducting cross-national nursing research. In Fitzpatrick JJ, Stevenson JS, Polis NS, eds. Nursing Research and its Utilization International State of the Science. New York, NY Springer 1994211-215.

.
10
Surgical Case Presentations

• Choose from challenging cases, unusual cases,
  pediatric cases, or any case that you think has a
  significant educational value.
• This may include cases where you have learned
  what doesnt worklets all learn from each
  others mistakes.
• When presenting surgical cases, DO NOT mention or
  allude to the name of the attending physician
  unless he or she specifically asks you to.
• The surgical case presentation format should
  include
• Powerpoint Presentation
• 10-15 minutes
• Digital clinical images
• Digital X-rays
• Digital MRI and CT
• Digital Camera at VAMC (or use your own)
• You may want to include a brief reference to
  current literature related to your topicthis is
  very useful to all residents and is encouraged.
  Please do not create a lengthy topic review as
  part of your case presentation.
• Plan in advance to prepare your case
  presentations so that you are able to collect
  information, photos, x-rays, etc as you work up a
  specific case rather than months later.
• You may want to bring a digital camera with you
  to any scheduled cases that sound like they have
  potential for educational value.

11
Surgical Case Presentation Format
-HIPPA- Delete all patient identifiers.

• CC One liner
• HPI Brief summary
• Physical Exam Include all pertinent
• Pertinent Labs Include all pertinent
• Imaging The more the merrier
• Options to consider Ask listeners to give some
  ideas
• Treatment What actually happened
• Outcome Plan in advance so that you can contact
  the attending if necessary for detailed follow
  upit is best if you can review details rather
  than hes/shes doing well.
• Review of current literature applicable to your
  subjectdo not make this a lecture on its own,
  just review brief pertinent information.
• References Use same format as lecture

12
Journal Club

• Selections from the Latest Literature, including
  but not limited to
• Journal of Foot Ankle Surgery
• Foot Ankle International
• Journal of the American Podiatric Medical
  Association
• Journal of Bone Joint Surgery (Am, Br)
• Diabetes
• Diabetes Care
• Will take place in the form of a single journal
  article each week presented by rotating
  residents.
• Bring a copy for each resident the week prior to
  your presentation or by email.

13
Journal Article Presentation Outline

• Title
• Author
• Type of Study (prospective, Retrospective, Double
  Blind, etc)
• Size of the study
• Question of the Study (Purpose)
• MAJOR points or answers
• Materials and methods (BRIEF)
• Critiques (good Vs. Bad, What Could be changed?)
• How will this change/affect the way I practice?

Please be prepared with a typed outline for
everyone
14
IMC Grand Rounds

• VA residents will bring one case per month to
  Grand Rounds to present.
• Follow Case Presentation guidelines as above.
• These cases will be backup.

15
MM (Morbidity and Mortality Conference)

• MM Conference is an opportunity to routinely
  discuss complications related to patient care.
• These discussions will be conducted by PGY-3s.
• The discussions during these meetings should not
  include the name of attendings unless they
  specifically request that you share their
  information.
• This is an opportunity for us to learn from
  adverse results and to try to identify ways to
  avoid repeating them in the future.
• If guest attendings are present, they may be
  asked to participatebut again, please respect
  the privacy of all attendings.

16
Skills Workshops

• The goal of these workshops is to assist the
  residents with a fundamental understanding and
  competency with basic surgical skills and
  advanced diagnostic/treatment modalities.
• An opportunity to introduce residents to new or
  difficult surgical techniques in a practice
  setting.
• Workshops are mandatory for all residents and
  will be conducted by guest attending.
• Assist with mastery of basic surgical skills
• Dates to be announced
• Suggestions for workshops are encouraged, if you
  have an idea please contact the Chief Resident as
  soon as possible.

17
Guest Lectures

• Required for ALL Residents
• Additional talks may be added
• Time Dates TBA- Typically 3rd Wednesday
• Topics may include, but are not limited to
• Infectious Disease
• Trauma
• Pediatrics
• Neurology
• Dermatology
• Practice Management
• Plastic Surgery

18
McGlamry Review

• REQUIRED for PGY-12 Residents
• Last Wednesday of each month
• VAMC in BLDG 9
• 6-630 p.m.
• Assigned Chapters
• Discuss content of chapters or view Presents
  Lecture during this time
• Turn in every chapter outline

19
Research

• CPME 320
• All residents are required to submit a research
  proposalthis does not include case
  presentations.
• This is traditionally an area where podiatry is
  lacking and most residents too.
• In order to help each other stay on track, we
  would like to have more formal discussion with
  residents throughout the year about research
  ideas and how to structure a proposalthis will
  likely be the topic of a TBA guest lecture part
  way through the year.

20
References

• 1. American Medical Association Manual of
  Style A Guide for Authors and Editors. 9th ed.
  Baltimore, MD American Medical Association1998.
• 2. Gupta AK, et al. Prevalence and
  epidemiology of toenail onychomycosis in diabetic
  subjects a multicentre survey. Br J Dermatol.
  1998139665-71.
• Banks AS, Downey MS, Martin DE, Miller SJ, eds.
  McGlamry's Comprehensive Textbook of Foot and
  Ankle Surgery. 3rd edition. Philadelphia, PA
  Lippincott, Williams Wilkins 2001.
• CPME 320.
• 5. Veterans Affairs Medical Center Podiatric
  Residency Training Program Policy Manual.