Upon completion of the plastic surgery rotation, the neurosurgery resident shall be able to:
- Outline the mechanism of normal wound healing.
- Outline the factors that impair normal wound healing.
- Outline the different types of soft tissue wounds and their management, including lacerations, abrasions, contusions, avulsions, clean and contaminated wounds.
- Discuss the various types of skin infections and their management, including: cellulitis, erysipelas and necrotizing fasciitis.
- Outline the initial assessment, diagnosis, and classification of facial fractures.
- Perform the following skills:
- Repair all types of skin/scalp lacerations.
- Recognize the most appropriate closure for a given skin defect, including: primary closure, skin graft, flap, etc.
During the rotation, all residents should fulfill the Royal College’s CanMEDS Competencies.
COMMUNICATOR:
- Develop rapport, trust, and ethical therapeutic relationships with patients and families, be able to review/update day to day care with patients.
- Conduct, document and present pertinent history and physical exam in context of plastics surgery with particular attention to problems also seen also in neurosurgical patients – i.e. wound healing/flaps.
- With appropriate supervision discuss relevant information with patients and family in a compassionate way and be able to obtain consent for common procedures.
- Share and present information with other health care providers, with attention to communicating information to when organizing diagnostic tests and procedures.
COLLABORATOR:
- Work/collaborate effectively in an interdisciplinary team, including wound care nurses/service to coordinate patient care.
- Consult other services when appropriate in context of a complicated patient with multiple medical comorbidities – internal medicine/geriatrics/ICU.
- Take part in all educational activities and teaching afforded by the service during the rotation.
- Be able to share workload and duties appropriately with other residents and medical students
- Be able to teach medical students, other residents and patients.
- Describe the surgeon’s roles and responsibilities to other professionals; Describe the elements of a good consultation
- Work with other health professionals effectively to prevent, negotiate, and resolve conflict
MANAGER:
- Effectively utilize and allocate finite resources, prioritize tests and OR emergency cases.
- While on a busy surgical service manage own time, education and personal life for a balanced lifestyle.
- Work effectively and efficiently
- Triage patients being able to identify plastic surgery emergencies that require prompt and immediate management such as ischemic flap, wound debridement, burn patients.
- Demonstrate an understanding of the influences that affect the workings of the health care system at various levels
- Participate in discharge planning of a complex surgical patient.
- Participate in setting up appropriate expectations for patients requiring elective plastic procedures.
HEALTH ADVOCATE:
- Recognize and council patients on determinants of health in patients, especially with respect to surgical risks and wound healing such as smoking, DM and bmi.
- Contribute to overall patient well-being and outcome, though appropriate pre and post-operative care.
- Promote lifestyle which improves surgical risks, especially preoperatively in clinic setting.
- Facilitate return of patient to community/alternate care and help put care/support in place to reduce return to hospital for surgical care.
- Ensure consults and tests are done in an appropriate timely manner.
SCHOLAR:
- Participate in rounds and educational activities provided by the plastic surgery service.
- Identify and seek out personal learning needs, especially with conditions relevant to neurosurgical patients such as wound healing, scalp flaps, tissue handling, blood supply of tissues/skin, appropriate incisions to minimize cosmetic impact of incisions.
- Apply principles of critical appraisal to medical information.
- Participate in patient, student and peer learning
- Contribute to development of new knowledge and be involved in appropriate research projects as available.
PROFESSIONAL:
- Demonstrate a commitment to their patients, profession, and society through ethical practice
- Exhibit appropriate professional behaviors in practice, including honesty, integrity, commitment, compassion, respect and altruism
- Maintain appropriate relations with patients and other health care providers.
- Show appropriate respect for opinions of other health care providers
- Be able to appraise and identify own limits with respect to knowledge and patient care, and when to ask for assistance and consult effectively