rotation description form pgy2 critical care - weebly

Department of Pharmacy

ROTATION DESCRIPTION FORM – PGY2 CRITICAL CARE

Service Area Details (operational/clinical environment, description of service area)

The Medicine Intensive Care Unit (MICU) Introductory Experience rotation is an inpatient acute care experience designed to develop a PGY2 Critical Care resident's skills in participation in a multidisciplinary critical care environment. PGY2 Critical Care residents will be exposed to a variety of disease states and supportive care issues commonly encountered in critical care, as well as rare cases and patient care issues that are unique to a specialty center. The rotation is designed to be fast-paced and challenging for learners of all ability and experience levels. Learning will be accomplished with a mixture of self-directed exploration, active participation in the care environment, patient-based discussions, and scheduled topic discussions. PGY2 Critical Care residents will refine advanced pharmacotherapeutic skills in the identification and resolution of drug therapy problems in the critically ill medicine population. Beyond the expansion of a knowledge base in critical care medicine, emphasis for the rotation will be placed on the further development of critical thinking skills, time management abilities, and communication skills that will be essential to patient care practice in any setting. The goal of the PGY2 Critical Care resident is to be capable of functioning as an independent member of the multidisciplinary team in a proactive manner.

The MICU is a 30-bed ICU that serves as the primary care area for critically ill patients with non-surgical issues at UNC. The Medicine Intensive Care service often covers 30-35 patients, some boarded in other intensive care units within UNC. The service is divided into two rounding teams, each led by a Pulmonary / Critical Care attending and fellow and staffed by medical residents. Housestaff provides 24-hour coverage. The structure is multidisciplinary, with active participation by all members of the medical team. This includes nurses, respiratory therapists, dietitians, and case managers, in addition to physicians and pharmacists. PGY2 Critical Care residents will be assigned to a preceptor with one of the rounding teams and will be expected to be responsible for all of the patients on that team. Residents will be afforded a high level of autonomy, with the goal of functioning independently by the second half of the rotation. An active presence in the ICU is encouraged for all learners, and order verification will be an expectation during this rotation unless otherwise noted.

Description of Rotation Activities: - Patient Care Pre-rounds – residents are expected to collect and analyze appropriate patient information, and to be prepared to identify

Rotation Title Medicine Intensive Care Unit (MICU)

Level of Learner PY4 PGY1 PGY2, Critical Care Specialty (Introductory Experience)

Preceptor(s) Stacy Campbell-Bright, Brian Murray

Preceptor Contact [email protected]; [email protected]

mailto:[email protected]

mailto:[email protected]


potential medication-related issues and make recommendations. A sufficient amount of time should be allotted each morning to pre-rounds preparation to ensure completeness and familiarity with the information gathered. Potential recommendations may be discussed with the preceptor before rounds.

- MICU Core Lecture Series (attendance Highly Recommended) – residents are encouraged to attend a morning session intended for house staff education. Topics covered are informative but do not always pertain to pharmacy practice (ex. ventilator management, ARDS, acid/base). These sessions are 30 minutes in duration and generally occur immediately before rounds begin.

- Patient Care Rounds – residents are expected to attend patient care rounds, to be appropriately attentive and professional, and to make recommendations as appropriate for the patients that they are covering. Active participation during rounds will be encouraged throughout the month. The level of autonomy on rounds will be high – generally, a preceptor will observe rounds for at least the first half of the rotation. Residents will be expected to help facilitate the patient care plan determined on rounds – this will include order verification unless otherwise noted, and will also include making sure that medications are available to be administered, and implementing parts of the care plan or monitoring plan as necessary (entering verbal orders, ordering drug levels, calling central pharmacy, etc.)

- Patient Discussion – after rounds or in the afternoon, residents will discuss patients and their medical problems in depth with the preceptor. This will serve as a time to identify problems, discuss the differential diagnosis, develop a plan for pharmacotherapy and monitoring, follow up on interventions, and provide targeted education on specific disease states and supportive care issues that are pertinent to the patients currently on service. These discussions will serve as a key educational component of the rotation and should be expected to take place daily.

- Post-Rounds Follow-Up – residents will be expected to follow up on all recommendations and outstanding issues after rounds. Residents are expected to resolve these issues reliably and in a timely manner. It is also expected that residents will follow up on recommendations during rounds (was the recommendation accepted and why / why not? What was the outcome of the therapeutic intervention? Are further adjustments to the plan necessary given the patient’s current condition? Etc.) This is a critical part of patient monitoring in the ICU setting and will be a point of emphasis on this rotation.

- Topic Discussion – 1-2 times a week in addition to POD, residents will participate in structured topic discussions with the preceptor. Topics will be chosen at the beginning of the month, but may change if necessary or as requested. Residents will be provided with some background reading, but are encouraged to add additional depth with a literature search. Residents will be required to lead at least one of these topic discussions during the month. Potential topics are listed elsewhere in this document. Number of topic discussions will depend on patient care needs and time available.

- Transitions of Care – residents are required to assist with transitions of care activities, including medication reconciliation for all patients prospectively identified as high- or intermediate-risk for readmission and any patients identified by the resident or the preceptor as needing follow-up of home medication regimen issues. Discharge counseling and communication with accepting teams for patients changing level of care will be expected for eligible patients. A “warm hand-off” will occur whenever a patient is transferred to a different level of care (step-down status or floor status) – this will entail a direct communication with the pharmacist on the accepting team,


highlighting reason for admission, active ongoing issues, the current pharmacotherapy plan, and issues that need follow-up. This communication should happen in a timely manner, no later than after rounds on the following day.

- Documentation of Patient Care Activities – Residents will at a minimum maintain the Pharmacy Sign-Out and document interventions on pharmacy consults, high-priority medications, and transitions of care per departmental policy. Residents may also utilize the Pharmacy Plan notes and I-VENT follow-up notes as desired and appropriate. Residents will also be responsible for documenting adverse drug events (ADE) or other medication-related issues in the Patient Occurrence Reporting System (PORS) as appropriate.

- Drug Information –residents will respond to drug information requests from the interdisciplinary team, during and after rounds, using appropriate literature resources or knowledge base. For complicated questions, time may be required to complete a thorough literature search and follow-up should be completed after rounds or the following day. Emphasis will be placed on the ability to determine the actual need in the drug information request, and the ability to appropriately evaluate available literature to formulate a response. Residents will be expected to respond in a timely manner, taking into consideration the acuity and complexity of the request.

- Critical Care Pharmacotherapy Inservice – each month, residents are required to deliver one 30-minute in-service to the MICU house staff during a morning session. The topic will be chosen by the resident and can take a variety of forms – common topics include sedation, vasopressor agents, neuromuscular blockade, toxicology, and antibiotics. A slide set or handout of some kind will be required. The preceptor will review the presentation for content and is responsible for providing feedback.

- Journal Club – residents will lead a journal club discussion on one recent and relevant article in the critical care literature. A handout is not required, but appropriate assessment of background literature and the methods of the study is expected.

- Co-precepting – if the opportunity is available, residents will also be involved in co-precepting of pharmacy students and/or PGY1 residents. This will include participation as a leader in patient discussion and topic discussion. Assistance with formal evaluation of PY4 students and PGY1 residents will be expected.

Hours of Rotation

Monday through Friday, 7AM – 5PM - Hours may vary slightly from day to day depending on rotational and off-rotation responsibilities - Patient care rounds will occur daily from 8AM – Noon - Time before rounds should be spent pre-rounding and identifying patient care issues to be addressed – learners should plan to arrive to

rotation with adequate time to prepare for patient care rounds and patient discussion - Activities after patient care rounds will vary from day to day but will include: patient discussion with preceptor, follow-up on patient care

issues, and planned / unplanned rotation-related learning opportunities (i.e. topic discussion, small group POD lecture)

Weekly/Monthly Activities

Required Meetings/Conferences Educational Activities


First Day Meeting This meeting will be held on the first day of rotation, and will serve as an opportunity to:

- Review the syllabus - Give an overview of the MICU and the rotation - Establish preceptor and resident expectations - Work on a calendar for the rotation

Weekly meeting with preceptor Residents will meet with their preceptor once per week (generally at the end of the week) to provide and receive feedback on the rotation and their performance

Wrap-up Meeting / Final Evaluation To be held within 3 business days of completion of the rotation – this meeting will provide an opportunity to offer final feedback, both from the resident and preceptor perspective, and to complete the resident’s final evaluation

Critical Care Conference (3rd Tuesday of each month, Noon – 1PM) A monthly multidisciplinary meeting aimed at continuing education of practitioners in critical care. Seminars will be presented by experts in a variety of specialty areas.

Critical Care POD (Tuesdays and Fridays, approximately 90min each) Targeted at the PGY1 level, these sessions, led by one of the critical care preceptors or PGY2 critical care resident, is attended by PGY1/PGY2 and PY4 learners. Readings will be assigned ahead of time and posted on the critical care group website, and we will have an active discussion of common disease states and supportive care issues in critically ill patients. Topics will be selected by survey each month and will be scheduled prior to the start of rotation.

Student Seminar (Wednesdays, 12-1) Session featuring PY4 students presenting on selected topics. Attendance at seminar is required for scheduled PGY1 residents.

Case Conference (Thursdays, 3-5) Educational sessions taught by residents and students, focusing on core learning objectives of a pharmacy residency program. Attendance at case conference is required for PGY1 residents.

In-service Presentation (see “Description of Rotation Activities”)

Journal Club (see “Description of Rotation Activities”)

Topic Discussions (see “Description of Rotation Activities”)

End Goals of Rotation (by the end of the rotation, what should the learner be able to do?

- Demonstrate in-depth knowledge of disease states and pharmacology commonly encountered in the Medicine ICU and in the supportive care of critically ill patients, including primary literature

- Formulate a daily patient problem list and present patients in a problem-oriented manner, highlighting each pharmacotherapy problem as well as differential diagnosis, drug therapy, monitoring parameters, and endpoints of therapy

- Develop a daily pharmacotherapy plan for each patient, including medication recommendations and necessary laboratory orders - Collect and critically assess all clinically relevant data to facilitate monitoring and management of pharmacotherapy plan, as well as

necessary interventions - Perform therapeutic drug monitoring for critically ill patients for the following medications: aminoglycosides, vancomycin, phenytoin,


digoxin, tacrolimus, cyclosporine, voriconazole, posaconazole, and others - Document daily therapeutic plans, interventions, goals, and monitoring appropriately - Communicate at an appropriate level with other healthcare professionals, including attending, fellows, and residents, interns, nurses,

respiratory therapists, dietitians, and other pharmacy colleagues in order to optimize drug therapy - Round with the medical team and make appropriate recommendations for monitoring and drug therapy with limited clinical oversight - Effectively collect and analyze appropriate pharmacotherapy literature to respond to drug information requests from the medical team,

patient, or family members - Implement plans and document activities appropriately per departmental policy - Function independently as the primary pharmacy presence for an ICU team - When appropriate, participate in the clinical precepting of PY4 pharmacy students and PGY1 residents

Core Topics Covered on this Rotation (Highlighted)

I. Organ-System Related A. Pulmonary

1. Acute respiratory distress syndrome/acute lung injury 2. Status asthmaticus 3. Acute COPD exacerbation 4. Pulmonary embolism 5. Pneumothorax and hemothorax 6. Drug-induced pulmonary diseases

B. Cardiovascular 1. Arrhythmias 2. Pulmonary edema/congestive heart failure exacerbations 3. Acute coronary syndromes 4. Hypertensive emergencies 5. Acute aortic dissection 6. Pericardial tamponade 7. Shock and related problems

a. cardiogenic b. septic c. hypovolemic/hemorrhagic d. anaphylactic e. neurogenic (spinal)

C. Renal

D. Neurology 1. Status epilepticus 2. Intracranial pressure management 3. Traumatic brain injury 4. Ischemic stroke 5. Subarachnoid hemorrhage 6. Intracerebral hemorrhage 7. Spinal cord injury 8. Critical illness polyneuropathy 9. Diabetes insipidus 10. Syndrome of inappropriate antidiuretic hormone 11. Cerebral salt wasting

E. Gastrointestinal

1. Acute upper and lower gastrointestinal bleeding 2. Severe pancreatitis 3. Fistulas 4. Ileus

F. Hepatic 1. Liver failure 2. Hepatorenal syndrome 3. Complications of cirrhosis


1. Acute renal failure 2. Acid-base imbalance 3. Fluid and electrolyte disorders 4. Rhabdomyolysis 5. Contrast-induced nephropathy 6. Drug-induced kidney diseases

H. Immunology

1. Acute transplant rejection 2. Graft-versus-host disease 3. Systemic inflammatory response disease (SIRS)

I. Endocrine 1. Relative adrenal insufficiency 2. Diabetic ketoacidosis/nonketotic coma 3. Thyroid storm/ICU hypothyroid states 4. Hypoglycemia & hyperglycemia

J. Hematology 1. Coagulopathies 2. Drug-induced hematologic disorders 3. Drug-induced thrombocytopenia 4. Anemia of critical illness 5. Blood loss and blood component replacement

K. Psychiatry 1. ICU psychosis 2. Sleep disturbances 3. Neuroleptic malignant syndrome 4. Substance abuse /alcohol withdrawal syndromes

II. Specific Considerations A. Infectious Diseases

1. CNS infections 2. Complicated intra-abdominal infections 3. Infections in the immunocompromised host 4. Pneumonia

4. Drug-induced liver diseases G. Dermatology

1. Burns 2. Stevens Johnson syndrome 3. Toxic epidermal necrolysis 4. Erythema multiforme

III. Supportive Care A. Nutrition

1. Enteral nutrition 2. Parenteral nutrition 3. Nutrition considerations in special patient populations 4. Immune-modulation

B. Analgesia C. Sedation D. Delirium E. Neuromuscular blocking agents (rapid sequence intubation, ICU paralysis) F. Venous thromboembolism prophylaxis G. Stress ulcer prophylaxis H. Bowel regimens I. Devices

1. Intravascular devices 2. Mechanical ventilation 3. Continuous renal replacement therapies 4. Chest tubes 5. Sequential compression devices 6. Intra-arterial balloon pumps and LVADs 7. Ventriculostomies 8. Peripheral nerve stimulators 9. Bispectral index


5. Endocarditis 6. Sepsis 7. Wound infection 8. ICU fever

B. Pharmacokinetics and Pharmacodynamics C. Toxicological emergencies D. Pediatric and Neonatal Considerations (optional) E. Bioterrorism and Mass Casualty Events

RLS Goal Based Evaluation

Goal

/Objective Description Type of Goal Activity Targeting Goal

Outcome R1: Demonstrate leadership and practice management skills.

1.1 Exhibit essential personal skills of a practice leader.

1.1.1 Practice self-managed continuing professional development with the goal of improving the quality of one’s own performance through self-assessment and personal change.

Characterization Weekly meetings and final evaluation with preceptor

Preparation for patient care

activities, patient discussion, and topic discussion

Co-precepting of PY4 students and

PGY1 residents, including participation in evaluations

Self-directed learning, research and

responding to drug information requests

1.1.2 Demonstrate commitment to the professional practice of critical care pharmacy through active participation in the activities of local, state, and/or national professional organizations concerned with the health care of critically ill patients.

Characterization N/A

1.1.3 Demonstrate the ability to make considered but rapid decisions in intense Characterization Patient care rounds


situations where time is at a minimum. Post-rounds follow-up

Serve as primary responder for

medical emergencies in the MICU and secondary responder for medical

emergencies in the medical tower

1.2 Contribute to the critical care practice area’s leadership and management activities.

1.2.1 Use effective negotiation skills to resolve conflicts Application Patient care rounds

Post-rounds follow-up

1.2.2 Use group participation skills when leading or working as a member of a committee or informal work group.

Synthesis Patient care rounds

1.3 Exercise practice leadership.

1.3.1 Demonstrate a commitment to advocacy for the optimal care of patients through the assertive and persuasive presentation of patient care issues to members of the health care team, the patient, and/or the patient’s representative(s).

Characterization Patient care rounds


Transitions of care activities

1.3.2 Explain the nature of mentoring in pharmacy, its potential connection with achievement, and the importance of willingness to serve as mentor to appropriate individuals.

Comprehension Weekly meetings and final evaluation with preceptor

Co-precepting of PY4 students and

PGY1 residents

1.3.3 Demonstrate a caring attitude toward critically ill patients and their representative(s).

Characterization Patient care rounds

Transitions of care activitites

1.3.4 Explain the general processes of establishing and maintaining a critical care pharmacy residency program.

Comprehension N/A

Outcome R2: Optimize the outcomes of critically ill patients by providing evidence-based medication therapy as an integral part of an interdisciplinary team.

2.1 Establish collaborative professional relationships with other members of the interdisciplinary critical care team.

2.1.1 Implement a strategy that establishes cooperative, collaborative, Synthesis Patient care rounds


communicative, and effective working relationships with other members of the interdisciplinary critical care team


Respond to drug information

requests from the medical team and nursing staff

2.2 Prioritize the delivery of care to critically ill patients.

2.2.1 Devise a plan for deciding which critical care patients to focus on if given limited time and multiple patient care responsibilities.

Synthesis Patient care pre-rounds and patient care rounds


Patient discussion with preceptor

Serve as primary responder for

medical emergencies in the MICU

2.3 Act in accordance with a covenantal relationship with the patient.

2.3.1 Formulate a strategy to guide care for a critically ill patient and interaction with the patient’s family that reflects the acceptance of a covenant with the patient for that patient’s care

Synthesis Patient care pre-rounds and patient care rounds



Transitions of care activities

2.4 Collect and analyze pertinent patient information

2.4.1 Collect and organize all patient-specific information needed to identify, prevent, and resolve medication and specialized nutrition support-related problems in order to provide appropriate evidence-based recommendations in critically ill patients with complex conditions.

Analysis Pre-rounds, patient care rounds

Post-rounds follow-up and patient monitoring

Patient discussion and topic discussion with preceptor

2.4.2 Assess the information base created for a critically ill patient for adequacy to identify problems and design a therapeutic regimen.

Evaluation Pre-rounds, patient care rounds




2.4.3 Determine the presence of any of the following problems in a critically ill patient's current medication or specialized nutrition support therapy:

Analysis Pre-rounds, patient care rounds



2.4.4 Prioritize a critically ill patient’s health care needs. Analysis Pre-rounds, patient care rounds



2.5 Design evidence-based therapeutic regimens for critically ill patients.

2.5.1 Specify therapeutic goals for a critically ill patient incorporating the principles of evidence-based medicine that integrate patient-specific data, disease and medication-specific information, ethics, and, when possible, quality-of-life considerations.

Synthesis Pre-rounds and patient care rounds


2.5.2 Design a regimen that meets the evidence-based therapeutic goals established for a critically ill patient; integrates patient-specific information, disease and drug information, ethical issues and, when possible, quality-of-life issues; and considers pharmacoeconomic principles

Synthesis Pre-rounds and patient care rounds


2.6 Design evidence-based monitoring plans for critically ill patients.

2.6.1 Design an evidenced-based monitoring plan for a critically ill patient’s therapeutic regimen that effectively evaluates achievement of the patient-specific goals.

Synthesis Pre-rounds, patient care rounds



Post-rounds follow-up and patient

monitoring

Documentation activities as described

2.7 Recommend regimens and monitoring plans for critically ill patients.

2.7.1 Recommend an evidence-based therapeutic regimen and corresponding monitoring plan in a way that is systematic, logical, accurate, timely, and secures consensus from the critical care interdisciplinary team.

Application Patient care rounds

Patient discussion and topic discussion with the preceptor


2.8 When appropriate, implement selected aspects of critical care patients’ regimens and/or monitoring plans.

2.8.1 When appropriate, order a therapeutic regimen for a critically ill patient according to the health system’s procedures.



2.8.2 When appropriate, follow organizational procedures to implement (e.g., order tests) the monitoring plan.



2.9 Evaluate critically ill patients’ progress and redesign regimens and monitoring plans.

2.9.1 Accurately assess the critically ill patient’s progress toward the therapeutic goal(s) and the absence of adverse drug events.

Evaluation Pre-rounds, patient care rounds



2.9.2 Redesign an evidence-based therapeutic plan for a critically ill patient as necessary based on evaluation of monitoring data and therapeutic outcomes.

Synthesis Pre-rounds, patient care rounds

Post-rounds follow-up and patient


monitoring


2.9.3 Collect outcomes data based on the patient’s response to therapy. Application Pre-rounds, patient care rounds



2.10 Collect outcomes data based on the patient’s response to therapy.

2.10.1 When given a patient who is transitioning out of the critical care setting, communicate pertinent pharmacotherapeutic information to the receiving health care professionals.

Application Transitions of care activities as described

Documentation activities as

described

2.11 Document direct patient care activities appropriately.

2.11.1 Appropriately select direct patient-care activities for documentation. Analysis Documentation activities as described

Outcome R3: Demonstrate excellence in the provision of training, including preceptorship, or educational activities for health care professionals and health care professionals in training.

3.1 Provide effective education or training to health care professionals and health care professionals in training.

3.1.1 Explain the differences in effective educational strategies for health care professionals and for various levels of health care professionals in training.

Comprehension Patient care rounds

Critical Care POD

Journal club

In-service to medical house staff

Patient discussions and topic discussions with preceptor

3.1.2 Design an assessment strategy that appropriately measures the specified objectives for education or training and fits the learning situation.

Synthesis In-service to physician group


Critical Care POD

Topic discussion

Co-precepting PY4 students and PGY1 residents

3.1.3 Use skill in the four preceptor roles employed in practice-based teaching (direct instruction, modeling, coaching, and facilitation).

Application In-service to physician group

Journal club

Critical Care POD

Topic discussion with preceptor (resident will lead at least one)

Co-precepting of PY4 student or PGY1

resident

3.1.4 Use skill in case-based teaching. Application Patient discussion and topic discussion with preceptor

Co-precepting of PY4 student or PGY1

resident

In-service to house staff

Critical Care POD

3.1.5 Use public speaking skills to speak effectively in large and small group situations.

Application In-service to house staff

Critical Care POD

Journal club

Topic discussion with preceptor

Outcome R4: Demonstrate the skills necessary to conduct a critical care pharmacy research project.

4.1 Conduct a critical care practice research project using effective project management skills.


4.1.1 Identify a topic of significance for a critical care pharmacy research project.

Synthesis

4.1.2 Formulate a feasible design for a critical care pharmacy research project. Synthesis

4.1.3 Secure any necessary approvals, including IRB and funding, for one’s design of a project.

Synthesis

4.1.4 Implement a critical care pharmacy research project as specified in its design.

Synthesis

4.1.5 Effectively present the results of a critical care pharmacy research project. Synthesis

4.1.6 Successfully employ accepted manuscript style to prepare a final report of a critical care pharmacy research project.

Synthesis

4.1.7 Accurately assess the impact, including sustainability if applicable, of the residency project.

Evaluation

Outcome R5: Participate in the management of medical emergencies.

5.1 Participate in the management of medical emergencies

5.1.1 Exercise skill as a team member in the management of medical emergencies as exhibited by certification in the American Heart Association Advanced Cardiac Life Support and, if applicable, Pediatric Advanced Life Support.

Application Serve as primary responder for medical emergencies in the MICU

Serve as secondary responder for

medical emergencies in the medical tower

Outcome E1: Evaluate medication profiles

1.3 Evaluate critically ill patients’ medication orders and/or profiles.

1.3.2 Assess a critically ill patient’s medication profile for appropriateness following existing standards of practice and the organization’s policies and procedures.

Evaluation Pre-rounds

Patient care rounds

Order verification

Outcome E3: Practice Leadership

3.1 Exhibit additional personal skills of a practice leader

3.1.1 Speak clearly and distinctly in grammatically correct English or the alternate primary language of the practice site.

Complex Overt Response Patient care rounds

Patient discussion

3.1.2 Use listening skills effectively in performing job functions. Application Patient care rounds


Post-rounds patient care activitites

3.1.3 Use correct grammar, punctuation, spelling, style, and formatting conventions in preparing all written communications.

Application Documentation of patient care activities

3.1.4 When communicating, use an understanding of effectiveness, efficiency, customary practice and the recipient's preferences to determine the appropriate type of, and medium and organization.

Analysis Patient care rounds

Outcome E5: Teaching skills

5.2 Exercise teaching skills essential to pharmacy faculty.

5.2.2 Prepare and deliver didactic instruction on a topic relevant to the specialized area of pharmacy residency training.

Synthesis Topic discussion

Inservice

CC elective lecture

Case conference

5.2.3 Develop and deliver cases for workshops and/or exercises for laboratory experiences.

Application CC elective Lecture

Case conference

Inservice

Topic discussion

5.2.4 Serve as a preceptor or co-preceptor utilizing the four roles employed in practice-based teaching (direct instruction, modeling, coaching and facilitation).

Application Co-precepting

Topic discussion

5.2.5 Develop a teaching experience for a practice setting (e.g., introductory or advanced pharmacy experience).

Analysis Co-precepting

5.2.6 Design an assessment strategy that appropriately measures the specified educational objectives for the class session, module, course, or rotation.

Synthesis Case conference

Co-precepting

CC elective lecture

rotation description form pgy2 critical care - weebly

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