Goals and Objectives PGY 3: VAPA

Goals and Objectives PGY 3: VAPA

Competency-based Goals and Objectives Goal 1. Expand knowledge in area of head and neck oncology.

Resident Objectives: Be able to accurately stage cancers of the head and neck. Develop an understanding of the role of chemotherapy and radiation therapy in the treatment of head and neck cancer. Begin to be able to formulate a treatment plan for head and neck tumors with supervision, and be able to effectively counsel patients regarding treatment options including risks associated with surgical treatment.

Progress in ability to counsel patients regarding head and neck cancer risk factors.

Be able to work-up and treat patients with thyroid and parathyroid diseases.

Be able to work-up and treat patients with salivary gland tumors.

Be able to recognize the histopathologic appearance of common head and neck neoplasms, including parotid and thyroid pathology.

Goal 2. Expand knowledge of common otologic complaints.

Resident Objectives: Be able to outline the assessment, work-up, and management of sudden sensorineural hearing loss. Progress in the ability to systematically evaluate the dizzy patient.

Be able to formulate operative and non-operative treatment plans for patients with chronic otitis media. ACGME Competency Goals Medical Knowledge Medical Knowledge Patient Care Patient Care Medical Knowledge Interpersonal and Communication Skills Practice-Based Learning and Improvement Patient Care Medical Knowledge Interpersonal and Communication Skills Practice-Based Learning and Improvement Medical Knowledge Patient Care Medical Knowledge Patient Care Medical Knowledge

ACGME Competency Goals Medical Knowledge Patient Care Medical Knowledge Patient Care Medical Knowledge Patient Care Patient Care

Demonstrate facility with counseling patients regarding the expected risks and benefits associated with surgery for chronic ear disease.

Be able to describe the pathophysiology of cholesteatoma. Develop the ability to recommend ‘for’ or ‘against’ hearing amplification based on audiometric considerations, and be able to effectively advise patients regarding appropriate amplification options.

Goal 3. Expand knowledge of common rhinologic disorders.

Resident Objectives: Progress in the ability to evaluate and treat patients with epistaxis, including nonoperative and operative management as well as counseling patients regarding risk reduction.

Be able to successfully evaluate patients with chronic sinusitis, and be able to counsel patients regarding medical and surgical treatment options.

Demonstrate increasing facility and diagnostic skill with rigid nasal endoscopy. Progress in the ability to successfully interpret sinus imaging studies.

Be able to competently counsel patients regarding the risks associated with sinonasal surgery.

Goal 4. Expand knowledge of voice and swallowing disorders

Resident Objectives: Be able to describe the anatomy, physiology, and pathophysiology of the larynx. Medical Knowledge Interpersonal and Communication Skills Practice-Based Learning and Improvement Medical Knowledge Patient Care Medical Knowledge Interpersonal and Communication Skills Practice-Based Learning and Improvement

ACGME Competency Goals Patient Care Medical Knowledge Practice-Based Learning and Improvement Patient Care Medical Knowledge Interpersonal and Communication Skills Practice-Based Learning and Improvement

Patient Care

Patient Care Medical Knowledge Patient Care Medical Knowledge Interpersonal and Communication Skills Practice-Based Learning and Improvement

ACGME Competency Goals Medical Knowledge

Take a history with focused questions that assist in the diagnosis of hoarseness and dysphagia. Be able to subjectively assess and describe hoarseness (i.e. GRBAS scale)

Describe the use of diagnostic tests for assessing hoarseness (e.g. CT scans, laryngeal endoscopy, stroboscopy). Be able on physical examination to assess dysfunction of vocal folds (i.e. paralysis). Patient Care Medical Knowledge Patient Care Medical Knowledge Patient Care

Be able to counsel parents about the pathophysiology of conditions associated with vocal fold paralysis. Patient Care

Interpersonal and Communication Skills

Understand the indications for vocal fold medialization (e.g. injection, thyroplasty, arytenoid repositioning) and alternative therapies. Be able to counsel parents about the risks and benefits of vocal fold medialization. Patient Care Medical Knowledge Professionalism Interpersonal and Communication Skills

Be able to safely and efficiently perform a flexible fiberoptic nasolaryngoscopy and stroboscopy. Be familiar with the principal lesions that can affect vocal fold function in adults (i.e. papilloma, polyp, nodule, cyst, cancer). Patient Care

Patient Care Medical Knowledge

Be able to identify the various methods for laryngeal framework surgery (e.g. thyroplasty, arytenoid adduction); their indications and their possible complications. Patient Care Medical Knowledge

Know the instrumentation used to resect laryngeal lesions (i.e. endoscopic scissors, graspers, lasers).

Patient Care Medical Knowledge Understand the available radiographic and endoscopic methods of assessing swallowing. Patient Care

Goal 5. Increase knowledge of sleep medicine.

Resident Objectives: ACGME Competency Goals Increase competence in the assessment of patients with suspected sleep apnea. Patient Care Medical Knowledge

Progress in the ability to interpret polysomnographic data in adults. Patient Care Medical Knowledge

Be able to effectively counsel patients regarding the consequences of untreated sleep apnea, and regarding appropriate treatment options.

Medical Knowledge Interpersonal and Communication Skills Practice-Based Learning and Improvement

Goal 6. Increase knowledge in the area of facial trauma and reconstruction.

Resident Objectives: Be able to perform a thorough physical examination in the facial trauma and reconstruction patient with a command of positive signs to be sought and their significance. Be able to effectively counsel facial trauma and reconstruction patients regarding treatment options, potential complications, and expected post-operative course.

Goal 7. Expand knowledge of head and neck infectious disorders.

Resident Objectives: Be able to successfully evaluate and recognize cases of deep neck infection, and be able to outline an appropriate treatment plan. Be able to describe the pathophysiology of necrotizing fasciitis, and the treatment of this disorder. Demonstrate an understanding of the clinical presentation of mycobacterial infection in the head and neck, including organisms involved and appropriate management. Be able to describe the stages of orbital infection in complicated sinusitis, and outline appropriate treatment options.

Goal 8. Expand ability to perform surgical procedures

Resident Objectives: Be able to competently and efficiently perform mid-level procedures with attending assistance such as: o Laryngology Microlaryngeal excision of papillomas, polyps, leukoplakia Injection laryngoplasty ACGME Competency Goals Patient Care Medical Knowledge

Patient Care Medical Knowledge Interpersonal and Communication Skills Practice-Based Learning and Improvement

ACGME Competency Goals Patient Care Medical Knowledge Patient Care Medical Knowledge Patient Care Medical Knowledge Patient Care Medical Knowledge

ACGME Competency Goals Patient Care

o Otology/Neurotology Tympanoplasty Straightforward simple mastoidectomy o Head and Neck Submandibular gland excision Excision of congenital cysts Resection of small carcinomas (e.g. tongue, floor of mouth) Uvulopalatopharyngoplasty o Rhinology Septoplasty Turbinate reduction Selected endoscopic sinus surgery (concha bullosa, polypectomy, partial ethmoidectomy, maxillary antrostomy) o Facial Plastic and Reconstructive Surgery Closed nasal reduction Open nasal reduction (straightforward) Closure of complex facial lacerations Local flaps

Goal 9. General knowledge

Resident Objectives: Develop competence in the interpretation of head and neck imaging studies through regular review of all patient imaging and attendance at radiology rounds Gain an understanding of the set-up and use of the image-guidance system. Learn to set-up and use the facial nerve integrity monitor. Demonstrate competence in the safe and appropriate use of various lasers. Learn the nuances of correctly coding surgical procedures, consultations, and outpatient visits (CPT and ICD-9). Be able to appropriately document patient care to support coding levels and to comply with insurance payor regulations (e.g. Medicare). ACGME Competency Goals Patient Care Medical Knowledge Patient Care Patient Care Patient Care Patient Care Systems-Based Practice Patient Care Systems-Based Practice

Develop an understanding of and sensitivity to the impact of cultural, economic and ethnic factors in the doctor-patient relationship and the delivery of healthcare.

Systems-Based Practice

Develop an understanding of one’s own abilities and limitations including awareness of signs of fatigue. Become an intelligent user of the academic literature in otolaryngology. Demonstrate the ability to apply knowledge of study designs and statistical methods to appraise clinical studies. Perform literature searches as needed to continuously improve the level of medical knowledge. Professionalism

Professionalism Practice-Based Learning and Improvement