Home >> Education >> Residency Program >> Clinical Rotations and Educational >> Pennsylvania Hospital Rotation

Educational Objectives
Pennsylvania Hospital Rotation

Medical Knowledge

1. Summarize the biomechanics of the hip and the knee as related to joint replacement surgery.
2. Summarize the clinical features and pathophysiology of:
   1. osteoarthritis
   2. rheumatoid arthritis
   3. crystal induced arthropathies
   4. septic arthritis
3. Summarize the basic concepts for a rehabilitation program in acute and chronic arthritides.
4. Summarize the pathophysiology of metabolic bone diseases including osteoporosis.
5. Describe the clinical presentation and pathophysiology of the following:
   1. adhesive capsulitis
   2. lesions of the rotator cuff
   3. subacromial bursitis
   4. subacromial impingement
   5. bicipital tendinitis
   6. epicondylitis (medial/lateral)
   7. wrist pain
   8. trigger finger
   9. sprains/ dislocations of the digits
   10. Depuytrens contracture
   11. ganglion
6. Describe in detail the physiologic changes that occur with bedrest regarding cardio-vascular changes, and changes in muscle, bone and joints.
7. Discuss normal cardiovascular response to exercise, including isometric and isotonic; upper and lower extremity endurance activities; supine versus standing positions; effect of exercise training on these parameters.
8. Differentiate muscle endurance and cardiorespiratory endurance and measurement tools for each.
9. Explain various measures of exercise intensity
10. Explain unique components of cancer rehabilitation
11. Discuss pathophysiology of multiple sclerosis and degenerative brain disorders.
12. Describe the physiological changes across organ systems that occur during aging.
13. Summarize pathophysiology of patients with motor neuron disease.
14. Assess the role of various social support systems in the rehabilitation management of the older adult.
15. Summarize pathophysiology of cerebrovascular accidents:
    1. mechanisms (embolic, thrombotic, hemorrhagic, lacunar)
    2. risk factors
    3. relationship of stroke syndromes to anatomy
    4. common types and sites of aneurysms
16. Explain dysphagia evaluation.
17. Discuss the mechanics of wheelchair propulsion by occupants and attendants.
18. Describe the range of wheelchairs available and their costs: self-propelled, attendant propelled and electric; indoor vs. outdoor.
19. Describe the environmental factors that may limit the usefulness of wheelchairs.
20. Discuss the need for different types of special seating: supportive, contoured, anti-pressure, static.

Patient Care

1. Summarize the diagnosis and treatment of:
   1. osteoarthritis
   2. rheumatoid arthritis
   3. crystal induced arthropathies
   4. septic arthritis
2. Summarize the treatment options for metabolic bone diseases including osteoporosis.
3. Discuss and formulate a differential diagnosis of:
   1. monoarticular arthritis
   2. polyarticular arthritis using X-ray findings, arthrocentesis data, and history and physical examination
4. Describe the clinical presentation and pathophysiology of the following:
   1. adhesive capsulitis
   2. lesions of the rotator cuff
   3. subacromial bursitis
   4. subacromial impingement
   5. bicipital tendinitis
   6. epicondylitis (medial/lateral)
   7. wrist pain
   8. trigger finger
   9. sprains/ dislocations of the digits
   10. Depuytrens contracture
   11. ganglion
5. Demonstrate the ability to perform gait analysis.
6. Demonstrate competence in managing the patients program in an acute and subacute inpatient rehabilitation program.
7. Formulate a rehabilitation treatment plan for a cancer patient, including unique components, the major primary rehabilitation issues and pain management.
8. Formulate a rehabilitation management strategy for the disabled older adult, to address normal physiological changes caused by the aging of the major organ systems.
9. Formulate a comprehensive rehabilitative prescription addressing common functional limitations for older adults with:
   1. coronary heart disease
   2. peripheral vascular disease
   3. chronic obstructive pulmonary disease
10. Develop management strategies in the rehabilitation and community settings for the older adult with cognitive impairments, mental illness, and developmental disability.
11. Describe prevention, evaluation and management of deep venous thrombosis and pulmonary embolus.
12. Write an appropriate therapeutic prescription plan for all rehabilitation disciplines including but not limited to occupational therapy, physical therapy, speech therapy, nursing, social service, and neuropsychology.
13. Summarize basic principles of non-malignant pain management in patients with fibromyalgia.
14. Summarize the clinical course and medical management issues in patients with motor neuron disease.
15. Formulate a rehabilitation management strategy for the disabled older adult to address the normal physiologic changes associated with aging of the major organ systems.
16. Formulate a comprehensive rehabilitation prescription addressing common functional limitations for older adults with:
    1. coronary heart disease
    2. peripheral vascular disease
    3. chronic obstructive pulmonary disease
17. Develop management strategies in the rehabilitation and community settings for the older adult with cognitive impairments or mental illness.
18. Explain dysphagia management, including assessment of nutritional needs of patients with CVA.
19. Assess and treat the medical, neurological and other complications that can occur after CVA.
20. Manage the effects of the CVA patients premorbid personality and social milieu.
21. Diagnose and manage as well as initiate strategies to prevent the complications of chronic bed rest including de-conditioning.
22. Demonstrate ability to prescribe a wheelchair for a patient: needs assessment, fabrication issues, and fitting.
23. Explain to a patient the risk and safety factors involved in wheelchair use.
24. Explain to a patient the availability of community resources for wheelchair provision, wheelchair repair and transportation needs

Interpersonal and Communication Skills

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

Professionalism

1. Demonstrate sensitivity and responsiveness to age, culture, disability and gender of patients and colleagues.
2. Consider effects of personal, social and cultural factors in the disease process and 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.