Description:
When rotating at the Bronx VA, the resident will staff a weekly neurology clinic precepted by the VA Practice Chief or a designated attending. The patients at this clinic consist of a mixture of veterans recently discharged from the Bronx VA, that were seen by the neurology team while admitted as well as new consults received from other outpatient clinics. The goal is to provide experience in follow up care and exposure to the range of neurological problems encountered in an outpatient setting. If extended neurological care is necessary patients are triaged into the appropriate general or sub-specialty attending clinic.
Goals
1- To improve the resident's understanding of outpatient neurological care.
2- To improve the resident’s understanding of how the VA healthcare delivery system functions and how to work most effectively within that system.
3- To provide quality outpatient care to the veteran population.
Objectives
The resident will:
Recognize the common and uncommon presentations of outpatient neurological diagnoses most prevalent in the VA population, including chronic pain, seizures, traumatic brain injury, headache and cancer metastatic to the CNS (Patient Care)
Begin to develop diagnostic and long-term management plans independently for outpatient neurological patients (Patient Care)
Become proficient in gathering accurate and pertinent histories and performing focused neurological examinations efficiently (Patient Care)
Recognize the significant interaction between neurological disease and substance abuse (Patient Care)
Recognize the significant interaction between neurological and psychiatric disease (Patient Care)
Improve skills in counseling and education of outpatient neurological patients (Patient Care, Interpersonal and Communication Skills)
Efficiently and effectively utilize the VA's medical record system to access comprehensive patient information and to provide seamless communication between all of the patient's care providers (Patient Care, Practice-Based Learning and Improvement, Systems-Based Practice)
Learn to anticipate disease course so as to provide neurological care aimed at maintaining functional status and preventing problems (Patient Care)
Know and apply their knowledge of the biomedical, clinical and biosocial aspects of neurological illness effectively to individual outpatients (Medical Knowledge)
Identify deficiencies in their knowledge base and correct through self-directed reading and guided patient exposure (Practice-Based Learning and Improvement)
Incorporate formative evaluation feedback into daily practice (Practice-Based Learning and Improvement)
Utilize appropriate scientific evidence to guide decision-making in individual cases (Practice-Based Learning and Improvement)
Work effectively as a member of the VA clinic team, alongside nurses, practice managers and scheduling personnel (Interpersonal and Communication Skills)
Deliver case presentations that are clear, organized and effectively communicate a patient's history, exam and other relevant information along with the resident's management plan (Interpersonal and Communication Skills)
Maintain clear, organized and comprehensive electronic progress notes documenting patient interaction (Interpersonal and Communication Skills)
Demonstrate respect and compassion towards every veteran (Professionalism)
Demonstrate sensitivity towards age and disability (Professionalism)
Recognize how outpatient neurology specialty care fits into the patient's overall health care plan (Systems-Based Practice)
Learn to allocate limited resources effectively without compromising patient care (Systems-Based Practice)
Understand how the VA healthcare delivery system functions (Systems-Based Practice)