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Ophthalmology

By Phillip Jordan,2014-04-26 19:57
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Ophthalmology

    Ophthalmology

    Competency Based Goals and Objectives

    The goal of this rotation is to understand how to distinguish whether a child is normal or has a pathological eye condition. Understand the pediatrician’s role in preventing ophthalmic injury or disorders in children. Understand how to recognize, manage and refer ophthalmic problems that generally require referral, and those generally do not require referral.

COMPETENCY 1. Patient Care. Provide family centered patient care that is

    developmentally and age appropriate, compassionate, and effective for the treatment of health problems and the promotion of health.

OPHTHALMOLOGY:

    ; Explain to parents the normal development of visual acuity and visual tracking in

    children.

    ; Distinguish normal or clinically insignificant eye findings from potentially serious

    ones.

    ; Demonstrate ability to do a good funduscopic examination on children, using

    mydriatics if needed.

    ; Request or perform and interpret the following clinical studies useful in

    evaluating eye conditions: conjunctival swab for culture and chlamydia FA,

    fluorescein eye exam, radiologic studies of head and orbit, including plain film,

    CT and MRI.

    ; Evaluate and appropriately treat or refer commonly presenting ophthalmologic

    signs and symptoms.

    ; Diagnose and manage patients with common ophthalmologic conditions that

    generally do not require referral.

     Conjunctivitis, Corneal abrasion, Periorbital cellulitis, Hordeolum,

     Blocked lacrimal duct, Simple foreign bodies

    ; Recognize, provide initial management, and refer appropriately conditions that

    usually require ophthalmologic referral.

     Amblyopia, Cataract, Chemical burns, Complicated and intraocular

     foreign bodies, Decreased visual acuity, Esotropia, exotropia, ptosis,

     Glaucoma, Herpetic keratitis,Orbital cellulitis, Retinopathy of prematurity,

     Significant eye trauma manifested by hyphema, extraocular muscle palsy,

     globe penetration, or orbital fracture, White pupillary reflex

    ; Recognize various signs of ophthalmologic pathology that may be manifestations

    of systemic disorders.

    ; Perform diagnostic and screening procedures associated with pediatric

    ophthalmology.

COMPETENCY 2. Medical Knowledge. Understand the scope of established and

    evolving biomedical, clinical, epidemiological and social-behavioral knowledge needed by a pediatrician; demonstrate the ability to acquire, critically interpret and apply this knowledge in patient care.

OPHTHALMOLOGY:

    ; Understand the pediatrician’s role in preventing ophthalmic disease, injury and

    dysfunction through counseling, screening and early intervention.

    ; Differentiate normal from pathologic eye conditions.

COMPETENCY 3. Communication Skills. Demonstrate interpersonal and

    communication skills that result in information exchange and partnering with patients, their families and professional associates.

    ; Talk to family members about sensitive issues that relate to a patient’s illness, e.g.,

    coping with the child’s altered needs in his/her home setting.

    ; Communicate effectively with physicians, other health professionals, and health

    related agencies to create and sustain information exchange and team work for

    patient care.

    ; Work effectively as a member or a leader of a health care team, and collaborate

    productively with professional organizations.

    ; Maintain comprehensive, timely and legible medical records.

COMPETENCY 4. Practice-based Learning and Improvement. Demonstrate

    knowledge, skills and attitudes needed for continuous self-assessment, using scientific methods and evidence to investigate, evaluate, and improve one’s patient care practice.

    ; Describe the epidemiology of common pediatric eye injuries and evidence-based

    strategies to prevent injury and improve outcome.

    ; Identify standardized guidelines for diagnosis and treatment of complex eye

    diseases and learn the rationale for adaptations that optimize treatment.

    ; Identify personal learning needs, systematically organize relevant information

    resources for future reference, and plan for continuing data acquisition if

    appropriate.

    ; Throughout a specialty rotation, take the initiative to evaluate your performance

    from the perspective of patients, staff, and colleagues; ask for input as needed to

    complete your self-audit.

COMPETENCY 5. Professionalism. Demonstrate a commitment to carrying out

    professional responsibilities, adherence to ethical principles, and sensitivity to diversity.

    ; Function as a pediatric consultant to ophthalmologic colleagues in the diagnosis

    and management of pediatric patients.

    ; Be honest and use integrity in your professional duties.

    ; Reflect on your own biases toward particular illnesses or patient groups, and take

    steps to assure that these biases don’t interfere with the care you deliver.

    ; Be sensitive to the ethical and legal dilemmas faced by providers working with

    ophthalmology patients. Strive to understand how these specialists and the care

    team deals with these dilemmas and use such experiences to enhance your own

    understanding.

    COMPETENCY 6. Systems-Based Practice. Understand how to practice quality

    health care and advocate for patients within the context of the health care system.

    ; Describe the role of emergency response teams, emergency rooms, and medical

    professionals in reducing the extent of injury and counseling families about future

    injury prevention.

    ; Describe the role of case management in the care of children with complex

    surgical conditions and evidence that this can improve outcome.

    ; Describe the role of pediatricians as advocates for legislation of proven benefit for

    reducing injury (Importance of protective eye wear for sports, , ultraviolet light

    exposure and other activities which warrant eye protection.)

    ; Clarify how documentation and billing/charges differ for consultations vs.

    referrals vs. on-going management of children treated by surgical subspecialists. ; Demonstrate sensitivity to the costs of clinical care in this setting, and take steps

    to minimize costs without compromising quality.

    ; Routine screening for visual acuity and eye disorders in the newborn nursery,

    office and school setting.

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