Rotation Specific Objectives - Hip and Knee Reconstruction

 

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  • The following document is intended to guide you in some of the specific knowledge and skills you should develop on this rotation. This document is intended to augment but not replace the “Objectives of Training and Specialty Training Requirements in Orthopedic Surgery” and the “Specific Standards of Accreditation for Residency Programs in Orthopedic Surgery”. A copy of these documents is supplied in your residency handbook and is also available on the Royal College website.
  • The resident is expected to be able to describe the rotation specific objectives prior to or at the commencement of the rotation.
  • It is understood that a residency in Orthopaedics is a continuum. Senior residents will be able to meet the same objectives as junior residents as well as the senior objectives.

 

1. MEDICAL EXPERT

 

1.1. Cognitive & Diagnostic

1.1.1.   Junior Resident

1.1.1.1.  Be able to advise patients regarding the non-operative management of hip and knee arthritis; including indications, complications and effectiveness of such treatment

1.1.1.2.  Understand the indications, results and complications of surgery for hip and knee arthritis with respect to age, gender and activity level.

1.1.1.3.  Understand the principles of hip and knee reconstructive surgery for arthritis including osteotomy, arthrodesis and joint replacement

1.1.1.4.  Understand the recovery and rehabilitation following hip and knee replacement

1.1.1.5.  Understand the unique medical problems of the geriatric population

 

1.1.2.   Senior Resident

1.1.2.1.  Be competent in recognizing and assessing  painful or failed  hip and knee replacements, particularly with respect to infection

1.1.2.2.  Understand the details of hip and knee reconstructive surgery for arthritis including osteotomy, arthrodesis and joint replacement

1.1.2.3.  Understand the assessment, treatment and sequelae of complications associated with hip and knee reconstructive surgery

1.1.2.4.  Demonstrate detailed knowledge of the following areas:

1.1.2.4.1.  Complicated primary joint arthroplasty (eg dysplatic hip, valgus knee)

1.1.2.4.2.  Revision hip and knee replacement surgery

1.1.2.4.3.  Selection of appropriate implants

1.1.2.4.4.  The factors affecting implant survivorship and function, including design, biomaterials, fixation and wear properties

 

1.2. Technical

1.2.1.   Junior Resident

1.2.1.1.  Demonstrate proficiency in the following areas:

1.2.1.1.1.  Perform arthrotomies and aspirations of the hip and knee

1.2.1.1.2.  Pre-operatively plan and perform simple primary hip and knee arthroplasty with guidance

1.2.1.1.3.  Recognize and manage common post-operative complications in hip and knee reconstruction surgery

 

1.2.2.   Senior Resident

1.2.2.1.  Demonstrate proficiency in the following areas:

1.2.2.1.1.  Performing a difficult primary hip and knee replacement

1.2.2.1.2.  Pre-operatively plan and perform simple revision hip and knee replacements

1.2.2.1.3.  Perform osteotomies around the knee

 

 

2. COMMUNICATOR

 

2.1. Junior Resident

2.1.1.  Listen effectively and obtain an appropriate history from patients and their families.

2.1.2.  Gather information not only about the specific problem but also about the patient’s beliefs, expectations and concerns about their illness.

2.1.3.  Provide information to the patient in a humane manner with language that they can understand so that they may be involved in the decision making process regarding their care.

2.1.4.  Provide appropriate information to others involved in the care of the patient

 

2.2. Senior Resident

2.2.1.  Maintain appropriate records which are clear and accurate

2.2.2.  Provide effective consultation as requested and document the findings and care plan in a clear and effective manner

 

 

3. COLLABORATOR

 

3.1. Junior Resident

3.1.1.  Consult with other health care professionals as appropriate

3.1.2.  Describe the multidisciplinary approach to the arthritis patient and the role of each of the health care providers

 

3.2. Senior Resident

3.2.1.  Clearly deliver information to patients and other health care providers such that decisions around non-surgical and surgical therapies may be made

3.2.2.  Participate in the multidisciplinary care of the joint reconstruction patient

 

 

4. MANAGER

 

4.1. Junior Resident

4.1.1.  Understand the importance of the allocation of health care resources and how that effects wait list management

4.1.2.  Learn to apply evidence and management processes for cost-appropriate care

 

4.2. Senior Resident

4.2.1.  Understand population-based approaches to health care services

4.2.2.  Understand the management of a practice including finances and human resources

 

 

5. HEALTH ADVOCATE

 

5.1. Junior Resident

5.1.1.  Understand the determinants of health of populations, including barriers to access to care and resources

 

5.2. Senior Resident

5.2.1.  Understand the possibility of conflict of interest in performing the role as health advocate for a patient or community with that of being a manager or gate keeper

 

 

6. SCHOLAR

 

6.1. Junior Resident

6.1.1.  Understanding how to integrate new learning into practice

6.1.2.  Understand critical appraisal and the methods of doing a literature search

 

6.2. Senior Resident

6.2.1.  Pose an appropriate research question and describe the steps to answer that question

6.2.2.  Develop, implement and monitor a personal continuing education strategy

6.2.3.  Demonstrate knowledge of preferred learning methods in dealing with students, residents, and colleagues. Understand evaluation techniques and demonstrate the ability to help in the evaluation of more junior members of the team.

6.2.4.  Describe the process of performing a personal practice audit

 

 

7. PROFESSIONAL

 

7.1. Junior Resident

7.1.1.  Describe how to recognize unprofessional behavior in others and how to respond to it

7.1.2.  Understand the professional, legal and ethical codes of practice including physician’s relationship with industry.

7.1.3.  Understand the appropriate doctor patient relationship

 

7.2. Senior Resident

7.2.1.  Pose an ethical question related to research and discuss the resolution of that question

7.2.2.  Demonstrate professional behaviors in practice

7.2.3.  Understand the importance of privacy and how it relates to communication with and about patients