Resident Orientation EDucation

1. Resident Orientation EDucation IMC/VAMC Podiatric Residency Lecture Series 2010-2011 Andrew Black DPM Co-Chief Resident

2. Overview • Lectures • Case Presentations • Journal Club • M&M Discussions • Workshops • Guest Lecturers • McGlamry Review • Research

3. Goals 1. Understand assigned topics and be able to speak about them in an intelligent manner. 2. Understand assigned topics as applied to both clinical and surgical settings. 3. Pass board qualification exams successfully upon completion of residency.

4. Lecture Topics • Assigned topics listed on the schedule, which are derived from the following: • ACFAS Clinical Practice Guidelines • Forefoot and Hallux Valgus Surgery • Reconstructive Rearfoot and Ankle Surgery • Sports Medicine and Biomechanics • Medical Management • Surgical Anatomy • Neoplastic Conditions • Trauma • Limb Salvage

5. Lecture Format and requirements • Powerpoint Presentation (lectures will be distributed to all residents, so please use this as the standardized format so that we can all view the lecture at a later date without difficulty). REMEMBER TO CONVERT YOUR FILES IF NECESSARY!! • Prepare your presentation to last 15 minutes (some topics may be slightly quicker and others slightly longer). Let’s not get lost in the minutia—if you include it in your lecture, you don’t have to read it to us all. • At least 2 references from must be included from current literature—this is mandatory for all lectures (remind the visiting students of this when they are assigned their lecture topic). If you are having trouble meeting this requirement for a given lecture, please email the Chief Resident at least 1 week prior to your presentation and we’ll find the sources together. • Incorporate ACFAS Clinical Practice Guidelines into lecture (see the lecture schedule for references to each of the CPG’s. • Sources should be referenced in AMA Style format1 • Try to present your lecture and compose yourself as you would at a larger scientific meeting—this is our chance to practice. 1. American Medical Association Manual of Style: A Guide for Authors and Editors.9th ed. Baltimore, MD: American Medical Association;1998.

6. Lecture Discussion & Feedback • Unless otherwise dictated by the attending physician present (i.e. let an attending ask questions whenever they feel like it), questions should be reserved for the discussion period following each presentation. • This will help the lecturer to maintain flow and practice the presentation in a more professional manner. • Many questions are asked prematurely and would have been answered during the course of the presentation in the order the lecturer determined. • Following each lecture discussion, there will be a brief optional feedback session for the lecturer. Attendees may give positive comments and/or constructive criticism. • Remember that feedback is key to progress!

7. Reference Format • AMA Style Format • Based on: American Medical Association Manual of Style, 9th ed., 1998. List the source at the bottom of each page AND at the conclusion of the lecture) Example below: 26% of diabetics suffer from onychomycosis2 2. Gupta AK, et al. Prevalence and epidemiology of toenail onychomycosis in diabetic subjects: a multicentre survey. Br J Dermatol. 1998;139:665-71.

8. AMA Style Format for Journals and Websites .

9. AMA Style Format for Books .

10. Choose from challenging cases, unusual cases, pediatric cases, or any case that you think has a significant educational value. This may include cases where you have learned what doesn’t work—let’s all learn from each others mistakes. When presenting surgical cases, DO NOT mention or allude to the name of the attending physician unless he or she specifically asks you to. The surgical case presentation format should include: Powerpoint Presentation 10-15 minutes Digital clinical images Digital X-rays Digital MRI and CT Digital Camera at VAMC (or use your own) You may want to include a brief reference to current literature related to your topic—this is very useful to all residents and is encouraged. Please do not create a lengthy topic review as part of your case presentation. Plan in advance to prepare your case presentations so that you are able to collect information, photos, x-rays, etc as you work up a specific case rather than months later. You may want to bring a digital camera with you to any scheduled cases that sound like they have potential for educational value. Surgical Case Presentations

11. Surgical Case Presentation Format -HIPPA- Delete all patient identifiers. • CC: “One liner” • HPI: Brief summary • Physical Exam: Include all pertinent • Pertinent Labs: Include all pertinent • Imaging: The more the merrier • Options to consider: Ask listeners to give some ideas • Treatment: What actually happened • Outcome: Plan in advance so that you can contact the attending if necessary for detailed follow up—it is best if you can review details rather than “he’s/she’s doing well”. • Review of current literature applicable to your subject—do not make this a lecture on it’s own, just review brief pertinent information. • References: Use same format as lecture

12. Journal Club • Selections from the Latest Literature, including but not limited to: • Journal of Foot & Ankle Surgery • Foot & Ankle International • Journal of the American Podiatric Medical Association • Journal of Bone & Joint Surgery (Am, Br) • Diabetes • Diabetes Care • Will take place in the form of a single journal article each week presented by rotating residents. • Bring a copy for each resident the week prior to your presentation or by email.

13. Journal Article Presentation Outline • Title • Author • Type of Study (prospective, Retrospective, Double Blind, etc) • Size of the study • Question of the Study (Purpose) • MAJOR points or answers • Materials and methods (BRIEF) • Critiques (good Vs. Bad, What Could be changed?) • How will this change/affect the way I practice? **Please be prepared with a typed outline for everyone**

14. IMC Grand Rounds • VA residents will bring one case per month to Grand Rounds to present. • Follow Case Presentation guidelines as above. • These cases will be backup.

15. M&M Conference is an opportunity to routinely discuss complications related to patient care. These discussions will be conducted by PGY-3’s. The discussions during these meetings should not include the name of attendings unless they specifically request that you share their information. This is an opportunity for us to learn from adverse results and to try to identify ways to avoid repeating them in the future. If guest attendings are present, they may be asked to participate—but again, please respect the privacy of all attendings. M&M (Morbidity and Mortality Conference)

16. Skills Workshops • The goal of these workshops is to assist the residents with a fundamental understanding and competency with basic surgical skills and advanced diagnostic/treatment modalities. • An opportunity to introduce residents to new or difficult surgical techniques in a practice setting. • Workshops are mandatory for all residents and will be conducted by guest attending. • Assist with mastery of basic surgical skills • Dates to be announced • Suggestions for workshops are encouraged, if you have an idea please contact the Chief Resident as soon as possible.

17. Guest Lectures • Required for ALL Residents • Additional talks may be added • Time & Dates TBA- Typically 3rd Wednesday • Topics may include, but are not limited to: • Infectious Disease • Trauma • Pediatrics • Neurology • Dermatology • Practice Management • Plastic Surgery

18. McGlamry Review • REQUIRED for PGY-1&2 Residents • Last Wednesday of each month • VAMC in BLDG #9 • 6-6:30 p.m. • Assigned Chapters • Discuss content of chapters or view Presents Lecture during this time • Turn in every chapter outline

19. Research • CPME 320 • All residents are required to submit a research proposal—this does not include case presentations. • This is traditionally an area where podiatry is lacking and most residents too. • In order to help each other stay on track, we would like to have more formal discussion with residents throughout the year about research ideas and how to structure a proposal—this will likely be the topic of a TBA guest lecture part way through the year.

20. References • 1. American Medical Association Manual of Style: A Guide for Authors and Editors. 9th ed. Baltimore, MD: American Medical Association;1998. • 2. Gupta AK, et al. Prevalence and epidemiology of toenail onychomycosis in diabetic subjects: a multicentre survey. Br J Dermatol. 1998;139:665-71. • Banks AS, Downey MS, Martin DE, Miller SJ, eds. McGlamry's Comprehensive Textbook of Foot and Ankle Surgery. 3rd edition. Philadelphia, PA: Lippincott, Williams &Wilkins; 2001. • CPME 320. • 5. Veterans Affairs Medical Center Podiatric Residency Training Program Policy Manual.