Goals and Objectives for the Pulmonary Fellowship Programs Outpatient VA Hospital and University Hospital Clinic Rotations

Goal I: Patient Care

Fellows must demonstrate the ability to provide patient-centered care that is appropriate, compassionate, and effective for treatment of health problems and the promotion of health.

Objectives:  In the outpatient clinic setting:

    1. Fellows will gather essential and accurate information by performing complete and clinically-relevant history and physical exam.
    2. Fellows will understand how to order and interpret appropriate diagnostic tests.
    3. Fellows will make informed diagnostic and treatment decisions by analyzing and synthesizing information.
    4. Fellows will understand the limits of their knowledge and expertise.
    5. Fellows will develop and carry out care plans.
    6. Fellows will maintain comprehensive, succinct, timely, effective, and legible medical records.
    7. Fellows will effectively counsel patients and families.
    8. Fellows will use consultants and referrals appropriately.

Goal II: Medical Knowledge

Fellows will know, critically evaluate and use current medical information and scientific evidence for patient care.

Objectives: In the outpatient clinic setting:

    1. Fellows will be able to access information and evaluate the medical literature.
    2. Fellows must demonstrate habits consistent with life-long learning.
    3. Fellows will demonstrate mastery of the basic and clinical science elements for outpatient pulmonary disorders including:

                  a.  Asthma

                  b.  COPD

                  c.  Diffuse Parenchymal Lung Diseases

                              -Sarcoidosis

                              -Idiopathic Interstitial Pneumonias

                              -Collagen Vascular Disease Related Pulmonary Fibrosis

                              -Hypersensitivity Pneumonitis

                              -Wegener’s Granulomatosis

                              -Cryptogenic Organizing Pneumonia

                  d.  Pneumonia

                  e.  Lung Cancer

                  f.  Bronchiectasis

                  g.  Tuberculosis

                  h.  Cystic Fibrosis

                  i.  Obstructive Sleep Apnea

                  j.  Pulmonary Hypertension

                  k  Pleural Disease.

                  l. Hemoptysis.

 

    1. Fellows will demonstrate mastery of the evaluation and management of the following respiratory-related symptoms:

                  a.  Dyspnea

                  b.  Cough

                  c.  Chest Pain

 

    1. Fellows will become proficient in the interpretation of imaging studies obtained on their clinic patients.

 

Goal III: Interpersonal Communication Skills

Fellows must demonstrate interpersonal and communication skills that result in effective information exchange, and collaboration with patients, families, and health professionals.

Objectives: In the outpatient clinic setting:

    1. Fellows will demonstrate the ability to develop highly effective therapeutic relationships with patients and families.
    2. Fellows will exhibit communication that is characterized by socio-cultural effectiveness.
    3. Fellows will communicate respectfully and effectively with other health professionals.
    4. Fellows will be able to act in a consultative role to other physicians and health professionals.

Goal IV: Professionalism

Fellows will demonstrate a commitment to professionalism, ethical behavior, and a commitment to the development of cultural humility.

Objectives: In the outpatient clinic setting:

    1. Fellows will demonstrate integrity, honesty, and compassion, empathy, and altruism.
    2. Fellows will acknowledge errors and limitations.
    3. Fellows will demonstrate responsibility, accountability, dependability, commitment, and encourage continuity of care.
    4. Fellows will respect patient and family privacy and autonomy.
    5. Fellows will exhibit a commitment to the development of cultural humility.

Goal V: Practice-Based Learning and Improvement

Fellows will investigate and evaluate their patient care practices, appraise and assimilate scientific evidence, and use these processes to improve patient care.

Objectives : In the outpatient clinic setting:

    1. Fellows will exhibit evidence of self-evaluation.
    2. Fellows will demonstrate ongoing self-education and habits of life-long learning.
    3. Fellows will accept and incorporate feedback to improve practice.
    4. Fellows will apply these processes to improve patient care.

Goal VI: Systems-Based Practice

Fellows will practice quality health care that is cost-effective and advocate for patients within the health system.  In addition, the fellow will understand the quality improvement process and how to partner with health care managers and providers toward this goal.

Objectives: In the outpatient clinic setting:

 

    1. Fellows demonstrate care coordination and knowledge of medical practice and delivery systems in the two different clinic settings (VA and University).
    2. Fellows advocate for patients and for populations of patients.
    3. Fellows understand and practice cost-effective health care that does not compromise quality of care.