Department of Neurology

Ambulatory Neurology - Nashville Veterans Administration Hospital

Ambulatory Neurology - Nashville Veterans Administration

The educational objectives of the adult outpatient Neurology services at Nashville Veterans Administration Hospital for the first year Neurology resident to acquire the knowledge, skills, and attitudes to perform a thorough neurological exam and to diagnosis and manage ambulatory patients presenting with a broad range of neurological illnesses. The resident will assume an ascending level of responsibility (with appropriate faculty supervision) based upon maturation of knowledge, skills and attitudes applicable to the educational goals of this experience. The specific educational goals for this experience include:

· A practical experience in obtaining an orderly and detailed history from the patient, in conducting a thorough neurological examination, and in organizing and recording data [patient care, medical knowledge]

· An understanding of the indications for and the limitations of clinical neurodiagnostic tests and their interpretation [patient care, medical knowledge, systems-based practice]

· The ability to correlate information derived from neurodiagnostic studies with the clinical history and examination in formulating a differential diagnosis and management plan [patient care, medical knowledge]

· Participation in the evaluation of and decision making for patients with disorders of the nervous system requiring surgical management [patient care, medical knowledge]

· Participation in the management of patients with psychiatric or neuro-psychiatric disorders [patient care, medical knowledge, interpersonal and communication skills]

· To better understand the principles of bioethics and the provision of appropriate and cost-effective evaluation and treatment of patients with neurologic disorders [practice based learning and improvement, professionalism, systems-based practice]

· Participation in end-of-life palliative care including adequate pain relief and psycho-social support and counseling for family members about these issues [patient care, professionalism, interpersonal and communication skills]

Resident Responsibilities
Neurology Residents and off-service Interns

· Attend four half-day clinics per week. [patient care, medical knowledge, practice based learning and improvement, interpersonal and communication skills, professionalism, systems-based practice]

· Fully evaluate patients prior to presenting a formulated assessment and plan to the attending. [patient care, medical knowledge, practice based learning and improvement, interpersonal and communication skills, professionalism, systems-based practice]

· Once staffed with the attending, implement formal plans as well as document a complete note. Notes must be entered via CPRS in a timely fashion. [patient care, interpersonal and communication skills, professionalism, systems-based practice]

· The resident will staff his/her regularly scheduled continuity clinic in addition to the four half-day clinics assigned during this rotation.

· Residents should never hesitate to contact the senior resident or attending physician if there are questions regarding patient care and/or responsibilities.

· At the conclusion of service time complete comprehensive evaluations on the attending, senior resident, intern, and student performances [practice-based learning and improvement]

· Residents are expected to leave morning clinics at 10:50 on Tuesdays, 11:50 on other weekends in order to attend didactice conferences.

Attending Faculty Responsibilities

· Residents present cases with their diagnosis and therapeutic plans [patient care, medical knowledge, practice based learning and improvement, interpersonal and communication skills, professionalism, systems-based practice]

· Attendings review the history, physical findings, diagnostic impression, and treatment plan with the resident. [patient care, medical knowledge, practice based learning and improvement, interpersonal and communication skills, professionalism, systems-based practice]

· Identify teaching points from the clinical cases [medical knowledge, practice-based learning and improvement]

· Assign appropriate reading and research to residents and students. [medical knowledge]

· Conduct follow-up discussions at the beginning or end of clinic. [medical knowledge]

· Faculty members are encouraged to schedule brief presentations by students and residents, reviewing assigned topics. [medical knowledge, practice-based learning and improvement, interpersonal and communication skills]

· Encourage and monitor senior residents to junior residents and junior residents to student teaching. [practice-based learning and improvement]

· If patients remain to be seen after residents are expected to leave for conference (10:50 on Tuesday, 11:50 on other weekdays), attendings are expected to see these patients alone.