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General Surgery Residency

General Surgery Residency On-Line Handbook

Burn Surgery, PGY-1

Updated June 2019

ACUTE BURN SURGERY – Junior (PGY1) Resident 

A. Medical Knowledge 
Goal: The resident will achieve a detailed knowledge of the evaluation and management of burn patients.  
Objectives: The resident should be able to… 
1. Discuss the resuscitation techniques used to treat major acute burn patients.
2. Discuss the different types of burn injury based on depth: 
a) Superficial (first degree) burn
b) Superficial partial thickness (second degree) burn
c) Deep partial thickness (second degree) burn
d) Full thickness (third degree) burn 
3. Discuss the three zones of a burn wound:
a) Zone of Coagulation 
b) Zone of Stasis
c) Zone of Hyperemia
d) Anatomy of skin 
4. Discuss the properties of split thickness vs. full thickness skin grafts
5. Discuss the airway management and treatment of inhalational injuries.
6. Describe the resuscitation and management of electrical burn injuries.

7. Gain comfort with the care of critically ill patients

B. Patient Care Goals
Goal: The resident will provide care that is compassionate, appropriate, and effective for the treatment of burn patient. 
Objectives: The resident should be able to…
1. Observe and assist in burn wound debridement and preparation for skin grafting.
2. Observe and assist in performing split thickness skin grafts. 
3. Observe and assist in performing full thickness skin grafts. 
4. Observe and assist in the utilization of skin substitutes, biological dressings, allografts, and xenografts in the treatment of burn wounds.
5. Perform central line placement and intubations
6. Evaluate various types of shock.  

C. Practice Based Learning and Improvement 
Goal: The resident will investigate and evaluate his or her own patient care practices, appraise and assimilate scientific evidence, and improve patient care practices.
Objectives: The resident should be able to… 
1. Use reliable information resources to prepare for surgical cases and start to develop a knowledge base of the current practices in burn patients. 
2. Work to develop a personalized and effective approach to the care of the burn patient.   
3. Be receptive to feedback from both senior residents and faculty. 
4. Be proactive and integrate recommended changes to improve performance.
5. Educate medical students on the early management and resuscitation of acute burn patients and provide the rationale to support such care. 
6. Educate medical students and other healthcare professionals on the significance of infectious precautions in the burn unit and teach techniques used in infection control.
7. Know the different types of study designs (e.g. RCT, case-control, cohort) and their appropriate application in clinical research. 
8. Possess a basic understanding of biostatistics.  

9. Develop a knowledge base to enable resident to critically review current literature to identify both strengths and weaknesses in study design and methods. 

D. Interpersonal and Communication Skills 
Goal:  The resident will demonstrate interpersonal and communication skills that result in effective information exchange and teaming with patients, their families, and professional associates. 
Objectives: The resident should be able to… 
1. Develops communication and interpersonal skills for the effective exchange of information with burn patients and their families. 
2. Exhibits confidence and ability in the education of patients and families on the basic management and rehabilitation of acute burn injuries. 
3. Provide appropriate and accurate information regarding the plan of care to patients and families as discussed with senior residents and/or faculty. 
4. Demonstrate compassion for burn patients and their families. 
5. Develop personal values and interpersonal skills to integrate with other members of burn team. 

6. Effectively communicates significant information regarding patient status to senior resident or faculty in an appropriate and timely manner.

E. System Based Practice 
Goal: The resident will demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value. 
Objectives: The resident should be able to: 
1. Assist in the coordination of the rehabilitation of burn patients. 
2. Develop basic understanding of the resources available for coordination of patient care, including social workers, nurses, dieticians, and physical and occupational therapists. 
3. Establish relationships and create partnerships with other healthcare professionals to develop a rehabilitation plan and facilitate timely discharge of the burn patient. 
4. Collaborate with infection control practitioners to familiarize with infectious organisms common to the burn unit, antibiotic resistance patterns, and routes of transmission.  
5. Recognize significance of cost-effective medicine and avoid unnecessary expenses when ordering laboratory and radiologic studies. 
6. Request consultations from different services when appropriate, follow up on their recommendations, and communicate this information to senior residents. 
7. Advocate for burn patients within the health care system. 

8. Refer burn patients to the appropriate practitioners and agencies. 

F. Professionalism 
Goal: The resident will demonstrate a commitment to carrying our professional responsibilities, adherence to ethical principles, and sensitivity to diverse patient population. 
Objectives: The resident should be able to… 
1. Develops a sensitivity and awareness of the unique stresses placed on the burn patients and their families. 
2. Exhibits an unselfish regard for the welfare of patients. Is respectful to patients and their families especially during times of stress. 
3. Begins to develop and apply a code of moral and ethical values to daily medical practice.
4. Prompt completion of clinical responsibilities and tasks as instructed by senior residents and faculty.   
5. Demonstrate sensitivity to individual patient’s profession, life goals, and cultural background as they apply to burn patients. 
6. Be reliable, punctual, and honest with team members in regards to patient care. 
7. Understand the concepts of autonomy, beneficence, non-maleficence, justice and respect for life. 
8. Maintain patient confidentiality.