Physical Medicine and Rehabilitation
LOCATION: Ruby Memorial Hospital/Clinics and Encompass Rehabilitation Hospital, Morgantown, WV
PRECEPTOR: John Alm, DO
DURATION: 4 weeks
OFFERED: Continuously
MAXIMUM ENROLLMENT: 4
STATUS: Elective
OBJECTIVES:
Students would be assigned to rotate in outpatient PMR provider clinics and at the Acute Inpatient Rehabilitation Facility over at Encompass. Students will participate in supervised clinical encounters to learn history taking skills, physical exam skills, and documentation writing skills related to the neurological and musculoskeletal examination with focus on patient function. No call. No weekends. The goals of this rotation would be to: - Introduce the student to the field of Physical Medicine and Rehabilitation - Familiarize the student with introductory principles in the management of neurologic and musculoskeletal conditions including but not limited to spasticity management, functional changes in strength, prosthetics/orthotics & equipment evaluations, and gait evaluations. - Educate the student on what a functional history is and how to obtain an appropriate functional history for a patient encounter. - In addition, the student will also see outpatients independently and formulate rehabilitation assessment and plans with presentations.
The student will observe and participate in outpatient musculoskeletal procedures such as fluoroscopic spinal injections, trigger point and interarticular injections. - In the ambulatory setting, students will be introduced to detailed history for musculoskeletal disorders including spine pain, shoulder, and knee pain. - On the inpatient unit, evaluation and treatment of stroke, brain injury and spinal cord injury, s/p orthopedic procedures, and multi trauma. The student will learn appropriate utilization of physical therapy, occupation therapy, and speech language pathology. - Daily observation. - Student exposed to writing an appropriate therapy prescription. - Evaluate acute and chronic neuromusculoskeletal disorders with a rehabilitation plan. - Learn appropriate utilization of PT/OT/SLP. - Evaluate acute care patient for appropriateness for acute rehabilitation vs. disposition to SNF or home. - Determine functional prognosis of patients with diagnoses such as spinal cord injury, traumatic brain injury, stroke, orthopedic injuries, and acute and chronic spinal pain. - Basic knowledge of interventional spinal procedures for low back pain. - Present daily inpatient presentations with focus on the rehabilitation plan. - Know basic medical complications of patients in acute rehabilitation.
Patient Care:
Select and interpret appropriate physical examination findings, diagnostic tests, laboratory tests, and standard imaging studies to formulate a complete and accurate differential diagnosis. Provide patient care that is compassionate, safe, appropriate, and effective for the treatment of health problems. Collaborate with an inter professional team to provide preventive, acute, chronic, rehabilitative, and end-of-life care that is patient-focused and cost-effective.
Medical Knowledge:
Describe the alterations of structure and function or organ systems and tissues that characterize disease (e.g., genetic, developmental, environmental, nutritional, toxic, infectious, inflammatory, neoplastic, degenerative, traumatic, behavioral, etc.).
Practice-Based Learning:
Locate, appraise and assimilate evidence from scientific studies including basic, clinical, translational, and community (population) based research to develop the skills necessary for lifelong learning, as evidence by demonstrating independent and self-directed study. Utilize strategies to identify and analyze strengths, deficiencies, and limits in one's knowledge, collaboration skills, and professionalism.
Communication Skills:
Communicate effectively and demonstrate caring and respectful behaviors with patients and families across a broad range of health literacy, socioeconomic and cultural backgrounds.
Professionalism:
Demonstrate respect, compassion, integrity, and responsiveness in all interactions with inter-professional colleagues, patients and their families and society. Demonstrate a commitment to ethical principles, including provision or withholding of care, confidentiality, informed consent, and respect for patient privacy and autonomy. Demonstrate sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in culture, national origin, age, gender, race, religion, disabilities, sexual orientation, veteran status and health. Demonstrate honesty, timeliness, punctuality, integrity and accountability in the process of learning and completing professional and clinical responsibilities. Demonstrate a commitment to uphold and sustain the WVUSOM Code of Professionalism.
Systems-Based Practice:
Define the roles of healthcare professionals and demonstrate how inter professional collaboration improves patient safety, patient-centered outcomes, and system performance.
METHODS TO ACHIEVE OBJECTIVES:
Lectures/Handouts which may include but not limited to: Common musculoskeletal issues, Spine/Pain related topics, Common Medical Complications related to patients with Stroke, Brain Injury, and Spinal Cord Injury, as well as topics associated with pediatric populations. -Review of journal articles relevant to patient cases/encounters.
EXAMINATION PROCEDURES AND EVALUATION CRITERIA:
Formative Assessment:
Informal preceptor sessions with the student to review important physical examination evaluation maneuvers as appropriate to the patient's chief complaint or diagnosis through bedside teaching or discussion. Informal preceptor sessions with the student to review differential diagnoses for a clinical encounter and for the student to ask questions. Informal topic review or review of journal club articles as appropriate based on clinical topics observed during rotation. Preceptor sessions to review common complications of patients with impaired mobility and impaired activities of daily living.
Summative Assessment:
Patient case presentations or presentations on a particular topic related to patient cases.
PRIOR TO THE FIRST DAY OF THE ROTATION:
Contact Dr. Alm, john.alm@hsc.wvu.edu, at least 2 weeks before the start of the rotation for reporting procedures on the first day.