Curriculum Block

Objectives

• The student will identify the major sensory and motor nerves in the extremity and apply this knowledge to examination of the extremities.
• Knee and Lower Leg: Meniscal tears; Osteochondritis dissecans/loose bodies; Cruciate and collateral ligament injuries (ACL, PCL, MCL, LCL).
• Hip and Upper Leg: Labral tears; FAI; Osteoarthritis.
• The student will differentiate physiologic from pathological growth.
• Identify non-accidental trauma and understand the urgency of immediate referral.
• For the following disorders the student will interpret the information provided and synthesize an appropriate basic management plan including:
• Rehabilitation prescription (physiotherapy, massage therapy, etc.).
• Brace, walking aid, and orthotic prescription.
• Drug therapy (oral and topical analgesics, nonsteroidal anti-inflammatories, injections, narcotics, etc.) with an understanding of serious side-effects and addiction potential.
• Indications for surgery and general surgical principles.
• Return to activity.
• Referral to other specialists when appropriate.
• Recognize the impact of the condition on the child and their parents regarding impairment of function, limitation of activities, and the potential of life with chronic pain requiring social and psychological support.
• Limping child (Developmental Dysplasia of the Hip (DDH), Perthes, Slipped Capital Femoral Epiphysis (SCFE))
• Apophyseal conditions (Osgood Schlatter Disease)
• Foot and Ankle: Ankle sprains; Achilles Tendon Injury; Bunions; Diabetic foot.
• The student will recognize the importance of compound fractures and their management.
• Describe the radiographic findings (of fractures).
• Outline potential complications of the (fracture) injury.
• Formulate an immediate and long-term management plan for the injury (fracture) including brace or cast; Indications for surgery and the general surgical principles; Rehabilitation prescription (physiotherapy, massage therapy, etc.).
• Recognize the impact of the condition on the individual regarding impairment of function, limitation of activities, and the possibility for chronic pain requiring social and psychological support.
• Hand and wrist (5th metacarpal fracture (boxer’s), Scaphoid fractures, Distal radius fractures).
• Forearm and elbow (Monteggia fracture)
• Humerus (Supracondylar humerus fracture)
• Foot and Ankle (Lisfranc fracture, 5th Metatarsal fracture (acute and stress), Ankle fracture).
• Lower extremity (Tibia fracture, Femoral neck fracture).
• For the following problems, the student will: Diagnose and recognize their importance. Analyze the situation and determine the urgency. Outline the management principles.
• Infection: Osteomyelitis; Joint sepsis.
• Acute Trauma
• The student will understand the principles and techniques of antisepsis in the operating room.
• Fractures (Growth plate fractures).
• Axial and soft tissue joint disorders: neck and back pain; Myelopathy/claudication; Disc herniation; Scoliosis; Spondylolisthesis.
• Club Foot.
• Flat feet (Tarsal coalition).
• Bone and soft tissue tumours: Benign (osteochondromas); Malignant (osteosarcoma); Metastatic (breast cancer).
• Patellofemoral disorders
• Lower extremity malalignment (in-toeing).
• Understand new history and physical examination techniques to formulate a differential diagnosis.
• Understand the judicious use of laboratory, radiographic, and other investigations to rule in and rule out each diagnosis.
• Compartment Syndrome, Cauda equina syndrome, Limb Ischemia
• Interpret the information provided and synthesize an appropriate basic management plan including:
• Drug therapy (oral and topical analgesics, nonsteroidal anti-inflammatories, injections, narcotics, etc.) with an understanding of serious side-effects and addiction potential.
• Rehabilitation prescription (physiotherapy, massage therapy, etc.)
• The student will be able to explain the techniques of joint aspiration and joint injections.
• The student will build on their basic science, physiology, and clinical examination skills as it pertains to the structure and function the bones, joints, muscle, and connective tissues.
• Brace, walking aid, and orthotic prescription.
• Communicate in an appropriate fashion to colleagues, other heath care professionals, patients, and family members.
• Demonstrate respect and appreciate the roles of other health care professionals.
• Practice appropriate medical resource management.
• Always behave as a professional with honesty, integrity, commitment, compassion, efficiency, competency, and altruism.
• The student will learn the relevant surgical anatomy for a variety of musculoskeletal conditions.
• Indications for surgery and general surgical principles.
• Return to activity.
• Referral to other specialists when appropriate.
• Recognize the impact of the condition on the individual regarding impairment of function, limitation of activities, and the potential of life with chronic pain requiring social and psychological support.
• Hand and Wrist: Tendon injury (Jersey finger, mallet finger, boutonniere deformity); Ulnar Collateral Ligament injury (Game keeper or skier’s thumb); Carpal Tunnel Syndrome; Dupuytren’s disease.
• Forearm and Elbow: Epicondylitis (tennis elbow - lateral, golfer’s elbow - medial); Olecranon bursitis; Biceps tendon injury.
• Shoulder and Upper Arm: Rotator cuff tear; Joint instability; Superior labral tear

Assessments

• Orthopedic Surgery Clerkship

• Orthopedic Surgery

Tags

Clerkship Orthopedic Surgery Rotation Orthopedics 1.1 Gather essential and accurate information about patients and their health through history-taking, physical examination, and the use of laboratory data, imaging, and other tests. 1.2 Organize and prioritize responsibilities to provide care that is safe, effective, and efficient 1.3 Interpret laboratory data, imaging studies, and other tests required for the area of practice 1.4 Make informed decision about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment 1.5 Develop and carry out patient management plans 1.6 Perform or assist with medical, diagnostic, and surgical procedures considered essential for the area of practice. 1.7 Counsel and educate patients and their families to empower them to participate in their care and enable shared decision-making 1.8 Provide appropriate referral of patients including ensuring continuity of care throughout transitions between providers or settings, and following up on patient progress and outcomes 1.9 Provide health care services to patients, families, and communities aimed at preventing health problems or maintaining health 2.2 Apply biomedical scientific principles fundamental to health care for patients and populations. 2.3 Apply principles of clinical sciences to diagnostic and therapeutic decision-making, clinical problem-solving, and other aspects of evidence-based healthcare 2.4 Apply principles of epidemiological sciences to the identification of health problems, risk factors, treatment strategies, resource allocation, and disease prevention/health promotion efforts for patients and populations 2.5 Apply principles of socio-behavioural sciences to the provision of patient care, including assessment of the impact of psychosocial and cultural influences on health, disease, care-seeking, care concordance, care adherence and barriers to and attitudes toward care. 3.1 Solicit and respond to feedback from peers, teachers, supervisors, patients, families, and members of health care teams regarding one’s knowledge, skills, attitudes and professional behaviours 3.2 Integrate feedback, external measures of performance and reflective practices to identify strengths, deficiencies, and limits in one’s knowledge, skills, attitudes and professional behaviours 3.4 Identify and perform learning activities that address one’s gaps in knowledge, skills, and/or attitudes 3.6 Locate, appraise, and incorporate evidence from research related to patients’ health problems and the provision of healthcare 3.7 Use information technology and information systems to optimize patient care 3.8 Obtain and use information about individual patients and their caregivers, populations of patients, or communities with which patients identify to improve care 3.9 Continually identify, analyze, and implement new knowledge, guidelines, standards, technologies, products, or services that have been demonstrated to improve outcomes 4.1 Communicate effectively with patients, families, and the public, as appropriate, across a broad range of socioeconomic and sociocultural backgrounds 4.2 Participate in the education of patients, families, students, trainees, peers and other health professionals 4.3 Demonstrate sensitivity, honesty, and compassion in difficult conversations, including those about death, end of life, adverse events, bad news, disclosure of errors, and other sensitive topics 4.4 Demonstrate insight and understanding about emotions and human responses to emotions that allow one to develop and manage interpersonal interactions, including the ability to manage one’s own interpersonal responses 4.5 Maintain comprehensive, timely, and legible medical records 5.1 Demonstrate accountability to patients, society, and the profession 5.10 Manage conflicts of interest and dual relationships. 5.11 Demonstrate trustworthiness and reliability that makes colleagues feel secure when one is responsible for the care of patients 5.12 Present oneself professionally to patients, families, and members of the health care team 5.2 Demonstrate compassion, integrity, and respect for others 5.3 Demonstrate altruism, appropriately balancing patient needs and self-interest/self-care 5.4 Demonstrate respect for patient confidentiality, privacy and autonomy 5.5 Demonstrate sensitivity and responsiveness to a diverse patient population, including all dimensions of diversity such as those that are included in human rights legislation and federal and provincial law. 5.6 Demonstrate a critical understanding of personal, professional and institutional power and privilege and utilize anti-oppressive practice to create patient experiences where marginalization and oppression are minimized. 5.7 Demonstrate the application of ethical principles to commonly encountered ethical issues such as the provision or withholding of care, confidentiality, informed consent, and including compliance with relevant laws, policies, and regulations 5.8 Balance personal values and beliefs with professional and societal ethics 5.9 Maintain appropriate boundaries with patients and other professionals 6.4 Apply concepts of global health and social medicine to the health of individual patients and populations using the ecology, economy, equity framework 6.5 Work effectively in various health care delivery settings and systems relevant to a variety of clinical specialties 6.6 Coordinate patient care within the health care system relevant to a variety of clinical specialties 6.7 Incorporate cost, risk-benefit analysis and resource stewardship in patient and/or population-based care. 6.9 Perform administrative and practice management responsibilities commensurate with one’s role, abilities, and qualifications 7.1 Work with other health professionals to establish and maintain a climate of mutual respect, dignity, inclusion, ethical integrity, and trust 7.2 Use the knowledge of one’s own role and the roles of other health professionals to appropriately assess and address the health care needs of the patients and populations served 7.3 Communicate with other health professionals in a responsive and responsible manner that supports the maintenance of health and the provision of healthcare in individual patients and populations 7.4 Demonstrate the ability to consult with and to other health professionals 7.5 Work with physicians and other colleagues in the health care professions to promote understanding, manage differences, and resolve conflicts 7.6 Participate in different team roles and appropriately apply leadership skills to establish, develop, and continuously enhance team function. 8.2 Practice flexibility and maturity in adjusting to change with the capacity to alter one’s behaviour 8.3 Develop the ability to use self-awareness of knowledge, skills, and emotional limitation to seek help appropriately 8.4 Demonstrate awareness and acceptance of different points of view 8.5 Recognize that ambiguity is part of clinical health care and respond by utilizing appropriate resources in dealing with uncertainty Clinical Clerkship [I02.358.399.450.110]