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Educational Objectives
Electromyography (EMG) Rotation

Medical Knowledge

1. Discuss causes of dislocations of the shoulder and hip; identify the structures at risk.
2. Read bone X-rays and CTs; identify the indications for referral for electromyography
3. Describe in detail the physiologic changes that occur with bedrest, specifically, cardiovascular changes and changes to muscle, bone and joints.
4. Describe cervical spine anatomy and biomechanics.
5. Discuss normal cardiovascular response to exercise, including isometric versus isotonic, upper and lower extremity and spine versus standing (including RPP, pulse, blood pressure response, mVO₂, and VOmax); discuss effect of exercise training on these parameters.
6. Discuss pathophysiology and etiology of restrictive and obstructive lung diseases.
7. Describe various amputations, their limitations, advantages and energy of ambulation and walking speeds.
8. Describe phantom limb pain and residual limb pain.
9. Describe the sequelae of peripheral vascular disease, including clinical syndromes, diagnostic tools and anatomy.
10. Discuss the pathological processes after traumatic brain injury, including primary and secondary injury and late sequelae.
11. Summarize the mechanisms accounting for late functional recovery after brain injury (cerebral plasticity).
12. Summarize the types of motor disorders after brain damage including spasticity, rigidity, paresis, paralysis, myoclonus, ataxia, dysmetria, apraxia, and movement disorders.
13. Assess visual and perceptual problems seen in patients with brain disorders.
14. Evaluate the comatose patient and be able to differentiate the states of akinetic mutism, locked-in syndrome and vegetative state.
15. Identify relevant information for prognostication after traumatic brain injury.
16. Summarize various outcome measurement instruments employed in the fields of stroke and traumatic brain injury rehabilitation.
17. Interpret basic findings on computerized tomography scans and magnetic resonance imaging scans such as contusions, intracerebral hemorrhages, infarctions, encephalomalacia, hygromas, hydrocephalus, and atrophy.
18. Discuss anatomical and functional aspects of the cardio-pulmonary system, with emphasis on reconditioning and strengthening.
19. Formulate and support short-term and long-term prognoses for patients with traumatic and non-traumatic neurological conditions.

Patient Care

1. Discuss treatment of dislocations to the shoulder and hip.
2. Discuss treatment of restrictive and obstructive lung diseases.
3. Describe an appropriate treatment program for phantom limb pain and residual limb pain.
4. Using X-ray findings, arthrocentesis data, and history/physical examination, discuss and formulate a differential diagnosis of:
   1. monoarticular arthritis
   2. polyarticular arthritis
5. Discuss pathophysiology, diagnosis and treatment of osteoarthritis.
6. Describe fracture from X-ray study including open/closed, displacement, angulation, and override common names. Identify common fixation devices. Describe complications from common fractures and clinical presentation:
   1. midshaft humerus - radial nerve
   2. distal humerus - tardy ulnar pals
   3. colles - carpal tunnel
   4. prox fibula - peroneal nerve
   5. ankle - tarsal tunnel
   6. CRPF
   7. pelvic-L-S plexus 2o retroperitoneal hematoma/sciatic nerve
   8. hip-sciatic nerve
7. Summarize diagnosis and treatment of:
   1. cervical strain or sprain
   2. fracture
   3. herniated disc
   4. cervical spondylosis
   5. cervical spinal stenosis
   6. vertebral artery syndrome
   7. referred pain syndrome
8. Prescribe appropriate cardiac rehabilitation program with proper precautions.
9. Summarize appropriate pain management techniques for cancer patients.
10. Formulate an appropriate treatment plan (including interventions, goals, and disposition) for patients most commonly seen in consultation:
    1. traumatic brain injury
    2. stroke
    3. trauma
    4. spinal cord injury
    5. orthopedic-related medical condition
    6. cardio-pulmonary related medical condition
11. Summarize medical management techniques for motor disorders after brain damage including spasticity, rigidity, paresis, paralysis, myoclonus, ataxia, dysmetria, apraxia and movement disorders.
12. Summarize the diagnosis and treatment of the various medical complications that often occur after brain injury including:
    1. seizures
    2. hydrocephalus and shunt infection and failure
    3. hygromas
    4. cardiac arrhythmias and myocardial infarction
    5. neuroendocrine disorders
    6. heterotopic ossification
    7. gastrointestinal disorders
    8. neurogenic bladder
13. Assess and manage neurobehavioral and cognitive-perceptual dysfunction after brain damage:
    1. pharmaceuticals and environmental management of the agitated patient
    2. pharmaceuticals for enhancing alertness and cognition
    3. behavioral modification
    4. neuropsychological testing
    5. basis for cognitive rehabilitation
    6. effects of premorbid personality and social milieu
14. Evaluate sensory dysfunction and prescribe a treatment program for a patient with:
    1. thalamic pain
    2. hyperesthesia
    3. hemianesthesia
15. Evaluate and develop treatment strategies for patients with sexual dysfunction after brain injury.
16. Take a substance abuse history and suggest treatment strategies for a patient with brain injury who has such a history.
17. Design and implement a behavioral modification program for a patient with dysfunctional behaviors.
18. Implement the use of the 75-25 diagnostic rules to plan for patient discharge, with emphasis on determining the appropriate post-acute level of care.

Interpersonal and Communication Skills

1. Serve as leader of the rehabilitation team on rounds and during interdisciplinary team conferences.
2. Present information to patients & other care team members in an effective manner.
3. Establish trust and maintain positive rapport with patients, caregivers & family members.
4. Demonstrate effective listening skills.
5. Promote teamwork in the clinical setting.
6. Complete dictations and chart notes in a legible and timely manner.

Professionalism

1. Demonstrate sensitivity and responsiveness to age, culture, disability and gender of patients & colleagues.
2. Consider effects of personal, social and cultural factors in the disease process & patient management.
3. Demonstrate reliability, punctuality, integrity and honesty in all interactions with patients and colleagues.
4. Accept personal responsibility for own actions & decisions.
5. Apply sound ethical principles in practice (e.g., informed consent, confidentiality, veracity, provision or withholding of care).

Practice-Based Learning and Improvement

1. Demonstrate skill in supervising junior residents and medical students in information gathering, decision-making, and patient management.
2. Evaluate and/or modify own practice based on feedback from others.
3. Use information technology to appraise & assimilate evidence from scientific studies to enhance patient care outcomes.
4. Identify appropriate assessment & measurement tools to evaluate functional status or outcomes of interventions.

Systems-Based Practice

1. Summarize the physicians role in advocating for patient care needs.
2. Summarize the physicians role in disease management across various levels of the health care system in a cost effective manner.
3. Demonstrate how to access various community resources on behalf of the patient.
4. Demonstrate integrity and responsibility in interactions with insurance and/or disability-oriented agencies.