FINAL PROJECT


This individual project is the final project and is due April 8 by 5 PM PDT.

 

Develop a curriculum plan for your learners in which the competencies of Interpersonal and Communication Skills, Practice Based Learning and Improvement, Systems Based Practice, and Professionalism are taught and assessed. Include all the components of a curriculum such as Goals, Learning Objectives, content to be included, teaching and learning strategies, and evaluation of learners and the course. 

 

Barbara Heywood,M.D.

 

                                                   Curriculum for Laryngology

 

Course:This is a 3 month rotation for the R2 level resident. The clinic meets every Thursday morning from 9:00am until noon in the ENT clinic where outpatients are examined and treated. It is a single resident and a single staff. The purpose of the program is to learn about the voice, in particular to changes in voice parameters in relation to disease states. Special stroboscopic equipment is used that enlarges the view of the vocal folds and the wave pattern is seen in slow motion or stopped. The quality of the voice is assessed by the computer programs. A speech pathologist is present in the clinic to help with diagnosis and therapeutic recommendations

 

Goals: The resident will learn to diagnose and treat laryngeal disease with stroboscopic equipment and provide the most up-to-date care for the patients. He/She will learn to work with speech pathologists as a team member.

 

Learning Objectives;

Knowledge By the end of this 3 month rotation,

1) The resident can list the common causes of voice problems and their treatment options

2) The resident will be able to analyze the true vocal cord findings on the examination of both anatomical and physiologic changes.

3) The resident will be able to discuss the voice profile in relation to jitter, shimmer, and related voice parameters.

4) The resident will be able to compare and contrast the different findings on the video in both children and adults and provide a differential diagnosis.

5) The resident will substantiate his findings with current literature.

6) The resident will evaluate his knowledge base and set his goals of the home reading schedule.

7) The resident will code the diagnosis correctly for every visit.

8) The resident will code the CPT code for one chart at each clinic day.

 

Attitudes

1) The resident will give clear instructions and support to the patient during the examination.

2) The resident will communicate with the speech pathologist in arriving at a diagnosis and a treatment plan.

3) The resident will discuss the treatment options with the patient and encourage their input. The decisions will be based on the patient's requests and any differences with be discussed with sensitivity to the patient's preferences.

4) The resident will communicate effectively with the referring physicians by letter.  

 

Psychomotor Skills

1)The resident will be able to obtain a complete history of the chief complaint, past medical history, family history and social history. 

2) The resident will be able to perform a complete stroboscopic exam.

3) The resident will be able to use both the rigid and flexible scopes and know when each is indicated.

4) The resident will demonstrate management of the equipment, completion of the video collection, and printing of the report.

5) The resident will demonstrate use of the voice evaluation program by accurate recordings and analysis.

 

Content

The subject matter relates to the diagnosis and treatment of voice disorders.

Required reading:

Videostroboscopic Exam of the Larynx,M Hirano, Singular Publishing 1993

Text book of Laryngology, Merati A, Bielamowicz S, Plural publishing  2007

 

Reference texts:

Professional Voice - The Science and the Art of Clinical Care, Sataloff R, Plural Publishing 3red edition, 2005

Voice Quality Measurement, Kent R, Singular Publishing 2000

 

 

Teaching Stategies: Mentoring with an apprenticeship type model. This includes role-modeling, immediate feedback and case presentations.

The case presentations include small group discussions.

 

Learning Strategies: The resident will learn by mentoring, readings from textbooks and computer searches. The resident also learns by reviewing videos of patient cases. The resident will self - reflect on own learning needs and prepare a reading schedule. The resident learns coding, billing and referrals by repeatedly completing the forms.

 

Evaluation of Learners Written mid-rotation formative evaluations at 6 weeks  and summative at 3 months. These include a rating scale.

Informal evaluation is given on a daily basis as immediate feedback in discussion of the patients.

Evaluation of Course

The residents evaluate the course at the end of 3 months.

The staff self-reflect and evaluate the course material and skills at the midpoint rotation and make changes for the rest of the course. The course is evaluated by the staff on a yearly basis in conjuction with the yearly program evaluation.

 

Evaluation of Competencies

Knowledge- This is evaluated daily on an observational bases by the staff. The resident is tested on a written exam once a year on the nationwide in-training exam. 

 

Systems Based Practice- Referrals to and from  Speech Pathologists at the hospital, Voice Teachers at schools, Speech Therapists at nursing home and assisted living facilities for stroke and accident victims and referrals to Speech Therapists at grade and high schools. These forms are all examined and discussed with the resident.

Proper CPT coding for the procedures and visits and the correct ICD-9 coding of the diagnosis are reviewed by the physician and by the clinic biller. If incorrect these are sent back to the clinic for review.

Notes to referring physicians are checked on the computer. 

 

The 3 month evaluation contains a rating scale for both knowledge and systems based practice.