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Educational Objectives
PVAMC Inpatient/Consultation Rotation

Medical Knowledge

1. Demonstrate knowledge of musculoskeletal and peripheral neuromuscular anatomy including surface anatomy and function.
2. Sumarize the pathophysiology of congenital and acquired neuromuscular and musculoskeletal disorders.
3. Summarize the 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
   5. Develop the use of a formal outcome measurement system (e.g., FIM-Functional Independence Measure) to document severity of disability and measure medical rehabilitation outcomes.
4. Summarize the basic concepts of a rehabilitation program in acute versus chronic arthritides.
5. Summarize the pathophysiology of metabolic bone diseases including osteoporosis, osteomalacia and similar diseases.
6. Describe a normal gait pattern, timing of muscle activation during different phases of gait, and location of center of gravity.
7. Summarize the 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
8. Summarize the various communication disorders after brain injury:
   1. Aphasia
   2. Dysarthria
   3. Apraxia
   4. Aprosodias
9. Identify relevant information for prognostication after CVA's.
10. Develop the use of a formal outcome measurement system (e.g., FIM- Functional Independence Measure) to document severity of disability and measure medical rehabilitation outcomes.

Patient Care

1. Perform a detailed functional history and physical examination.
2. Perform a thorough examination of soft tissues, all joints, peripheral neurologic examination, and identify bony landmarks.
3. Sumarize the treatment of congenital and acquired neuromuscular and musculoskeletal disorders.
4. Formulate differential diagnosis of neuromuscular and musculoskeletal disorders from history and physical.
5. Summarize indications for joint arthroplasties, their alternatives and postoperative management and precautions (hip, knee, shoulder, elbow).
6. Summarize the uses and contraindications of superficial heat and cold, ultrasound, and iontophoresis.
7. Summarize and operationalize impairment, disability and handicap as it pertains to a particular patient.
8. Grade and prescribe treatment for decubitus ulcers.
9. Summarize the treatment of metabolic bone diseases including osteoporosis, osteomalacia, and similar diseases.
10. Summarize the principles of orthoses for both upper and lower extremities
11. Explain the advantages, disadvantages and complications of various assistive devices as well as the energy cost of ambulation with them.
12. Demonstrate the ability to determine adaptive equipment needs.
13. Demonstrate the ability to write medical, physiatric and adaptive equipment orders.
14. Demonstrate the skills required to provide physiatric and medical management of patients with chronic complex medical and rehabilitation needs.
15. Demonstrate the ability to utilize proper and timely intervention from medical/surgical services and other subspecialties in physiatric patient management.
16. Formulate a therapeutic prescription and team treatment plan which includes occupational therapy, physical therapy, speech therapy, psychology, social work and nursing at admission and for ongoing treatment.
17. Demonstrate the ability to assume a leadership role in weekly team conferences.
18. 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

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.