Updated December 2021
TRAUMA & ACUTE CARE SURGERY – PGY-2 & 3 Resident
A. Medical Knowledge
Goal: The resident will achieve a detailed knowledge of the pathophysiology of blunt and penetrating trauma and develop the skills necessary to treat the trauma patient.
Objectives: The resident should be able to…
1. Describe the mechanisms of injury of blunt and penetrating trauma.
2. Become familiar with the steps of the primary, secondary, and tertiary surveys.
3. Discuss the diagnosis and treatment of thoracic injuries, including:
a. Diaphragmatic injury
b. Aerodigestive injury
c. Cardiac tamponade and contusion
d. Open and tension pneumothorax
e. Plus the diagnosis and treatment discuss on PGY 1
4. Discuss the diagnosis and treatment of abdominal injuries, including:
a. Hepatic injury
b. Bowel Injury
c. Gastric injury
5. Discuss the diagnosis and treatment of central nervous system injury, including:
a. Spinal cord injury
6. Discuss the diagnosis and treatment of orthopedic injuries
a. Pelvic fracture and management.
7. Study and memorize the steps in the diagnosis and treatment of hemorrhagic shock.
8. Review the indications for and complications of blood product transfusions.
B. Patient Care Goals
Goal: The resident will provide patient care that is compassionate, appropriate, and effective care in the initial evaluation and management of the trauma patient.
Objectives: The resident should be able to…
1. Perform primary, secondary, and tertiary surveys of trauma patients.
2. Prompt performance of role designated by senior resident during the initial evaluation of trauma patient.
3. Perform a complete neurological evaluation of a trauma patient.
4. Accurately assign GCS score.
5. Maintain ATLS certification.
6. Manage ICU patients with graduated independence.
7. Participate with graduated independence in the emergency treatment of flail chest, cardiac tamponade, pneumothorax, and airway obstruction.
8. Perform, with graduated independence, the following procedures:
a. Chest tube placement
b. Diagnostic peritoneal lavage
c. Focused Assessment with Sonography for Trauma (FAST) exam
9. Perform with graduated independence emergent procedures, including:
a. Pericardiocentesis
b. Pericardial window
10. Perform, with graduated independence, surgical procedures in the operative management of thoracic and abdominal trauma.
C. Practice Based Learning and Improvement
1. Routinely analyzes the effectiveness of own practices and accepts feedback on performance from senior residents and faculty.
2. Improves patient care practices via the integration of appropriately gathered data and feedback.
3. Develop organizational and teaching skills required in basic management of a surgical service
4. Educate junior residents, medical students and other healthcare professionals in the practices of trauma surgery.
5. Reviews patient clinical status including laboratory and radiologic studies with junior residents and medical students for teaching purposes.
6. Understand principles of clinical research and application of biostatistics.
7. Exhibits an interest in and actively seeks scientific literature/data to support current practices in trauma surgery.
8. Presents patient complications and deaths at weekly morbidity and mortality conferences.
D. Interpersonal and Communication Skills
1. Continues to develop communication and interpersonal skills for the effective exchange of information with trauma patients and their families.
2. Exhibits confidence and ability in the education of patients and families in the basic management and rehabilitation of traumatic injuries.
3. Assist senior resident and faculty in the development of a plan of care for the trauma patient and accurately relay information regarding care plans to patients and families.
4. Develop skills in the management of surgical service. Manage service administrative duties as assigned by chief resident or faculty.
5. Continue to develop personal values and interpersonal skills to integrate with the trauma team and consulting services.
6. Effectively communicates significant information regarding patient status to senior resident in an appropriate and timely manner.
7. Develop the ability to sensitively and effectively deliver bad news to patients and their families.
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. Educate junior residents on and assist in all aspects of care of the trauma patient, including the initial evaluation, acute management, and long-term rehabilitation.
2. Demonstrate understanding of complex health care systems and effectively call upon appropriate resources as needed to optimize patient outcomes.
3. Direct the rehabilitation plan and timely discharge/placement of the trauma patient through partnerships with other health care professionals, including:
a. Social workers
b. Nurse practitioners
c. Physician assistants
d. Dieticians/Nutritionists
e. Physical therapists
f. Occupational therapists.
4. Demonstrate knowledge of cost-effective care practices and avoid unnecessary expenses when ordering laboratory and radiologic studies.
5. Advocates cost-effective care. Limited use of unnecessary diagnostic tests/studies and avoids duplication to minimize health care costs.
6. Communicate with consulting services and discuss their recommendations with other members of trauma team.
7. Manifests proficiency in the rational use of surgical literature and evidence-based medicine in the management of the trauma patient.
Goal: The resident will demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.
Objectives: The resident will be able to:
1. Possesses a sensitivity and awareness of the unique stresses placed on trauma patients and their families.
2. Exhibit unselfish regard for the welfare of patients. Is respectful of patients and their families especially during times of stress.
3. Demonstrate firm adherence to a code of moral and ethical values. Maintains composure in accordance with ethical principles even in stressful situations.
4. Recognizes the limits of his or her knowledge and asks for help when needed.
5. Demonstrates commitment to professional responsibilities and continuity of patient care.
6. Responds to pages and consultation requests promptly.
7. Demonstrate sensitivity to individual patient’s profession, life goals, and cultural background and they apply to vascular surgery.
8. Understand the concepts of autonomy, beneficence, non-maleficence, justice and respect for life.
9. Maintain patient confidentiality.