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III PROFESSIONAL SKILLS
3.1 Statistics and Research methods
Statistics
Definitions: mean, mode, median, standard deviation
Tests: one and two sample tests Multiple sample tests Contingency tables and Chi2 analysis Linear regression and correlation
Concepts: Sensitivity, specificity, incidence, and prevalence Positive predictive value, negative Predictive value, Odds, ratio, sample size analysis
Experimental design: Prospective, retrospective, randomization, Protocol development
Writing a paper
Funding
3.2 Critical Appraisal
Reading the Literature Studying a study: How to determine if a study is valid. Peer reviewed Relevance of topic Study design Statistical analysis Types of statistical error Appropriate application of literature to clinical practice
Use of Medline and other information sources
3.3 Ethics
Basic principles of ethics Autonomy, beneficence, non-maleficence, justice
Ethical systems Teleological, deontological Different value systems: cultural, religious
Discussing/framing and ethical argument
Common areas of ethical conflict in anesthesia Duty to report colleagues
Informed consent Surgical, anesthetic Patient refusal limited consent (models of autonomy vs. beneficence) Age (children) Mental competence, substitute decision making Coercion vs. persuasion
Duty of Care The physician-patient “contract” The patient dangerous to the physician (AIDS, Hep B, violence) Confidentiality
Allocation of resources
End of life Brain death With-holding/withdrawing treatment Advance Directives/Living Wills No blood, DNR
Research Ethics Informed consent
3.4 Legal Issues
Consent Informed consent Disclosure of risk Laws re consent Substitute decision-makers
Malpractice: Torts, Duty of Care, definition of negligence
Law suits: How to handle the threat of a lawsuit, CMPA The usual course of a law suit Avoiding law suits Responsibility of the resident vs. the staff anaesthetist when the resident disagrees with the staff’s actions
Confidentiality
Hospital bylaws
Statutory reporting
Coroner’s Act
3.5 Continuous Quality Improvement
Concepts: QA, QI, TQM, CQI Determinants of quality Types of activity Outcome investigation Quality improvement tools Risk management
Role in daily practice
Conducting a QI project: Structure, process, and outcome Evaluation of QI results
Structure of a hospital QI plan, the QI committee Role of departmental head Role of individual departmental members
3.6 Teaching & Communication Skills
Presentation skills Giving rounds (& larger lectures) Preparing slides & overheads Oral exams Teaching Principles of professional education One-to-one teaching with students and junior housestaff Small group teaching How to give feedback Principles of evaluation
Learning skills Concept of CME: continuous learning Legal aspects: continued competence, RCPSC, CPSO, courts Organizing material (file systems, etc.) Organizing study and reading in residency What to read Use of literature searchers, the Net
Communication with Patients and families Effective interviewing and information-giving skills Determining how information is received Breaking bad needs Colleagues, nurses, hospital employees Conveying a sense of urgency
Managing disagreement
3.7 Management of Professional Life
a) Management of Personal Time to maximize Professional Achievement and Job Satisfaction
An effective program for continuing medical education
Making a contribution to your practice environment Defining personal professional interests in addition to Clinical service. (Teaching, research, administrative, technical/equipment/quality assurance, etc.) Time management to leave quality time for personal and family life
Techniques of Stress management Recognition of Stress-Related Situations Occupational Hazards Substance Abuse
c) Duties and Responsibilities of a member of Active Staff of a Hospital
Legal responsibilities as outlined in the Public Hospitals Act Responsibilities to the College of Physicians and Surgeons Hospital Governance including Medical Staff by-laws and Rules Privileges and relationship to the Hospital Board Professional Conduct and Collegiality Responsibilities to Chief of Department or Chief of Medical Staff Participation in Department and Hospital Medical Management d) Responsibilities and Duties of Chief of Department of Anesthesia
Duties to Hospital Board for Provision of: Excellence patient care Department budget and fiscal long-range planning Quality Assurance
Responsibility for Department Infrastructure Human Resources Management Rules of work and equity of work distribution Daily OR Management Scheduling on a twenty four hour basis Financial group management Equipment planning and maintenance Department patient care policies Peer group leadership Strategic planning
Advocacy role for the Department within the Hospital Interface between external professional bodies, government and public Organizations and the Department.
3.8 Professional “Structure”
Role of CPSO, Licensing requirements Role of CMPA Legal obligations of resident to hospital and university OHIP: structure, fee schedule, review committee OMA CAS Standard setting RCPSC Certification, standard setting CSA |
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