Orthopaedic Surgery Residency Program: COMPETENCY BASED STREAM
MODULE 3: EMERGENCY SURGERY Dr. Khalid Syed
Learning
CanMEDS Role
Learning Outcomes:
Source Doc(s)
Context
(s)
Goals/Objectives
Medical Expert
Trainee
KNOW:
Refer to CBC Portal
acquires
Able to conduct an
the
assessment and create a Reference textbooks:
knowledge
treatment plan for
and skills
patients requiring below
1) Campbell’s
to manage
knee amputation, through Operative
Orthopaedics
many of
knee amputation, above
the
knee amputation, and hip Amputation Surgery
and Rehabilitation:
Orthopaed
disarticulation.
ic
conditions
2) Gillespie and
that
Kostuik
constitute
3) Rockwood and
a surgical
Green, 5th edition
emergenc
y.
4)Hoppenfeld:
Surgical Exposures
Medical Expert
KNOW: Able to Classify
Refer to CBC Portal
and manage open
fractures, including the
initial Rx, antibiotic and
AO Manual, 2nd edition
tetanus regimen, and
chapter 4.2 and 4.5
management of clostridial
infection
Medical Expert
KNOW: Demonstrates
knowledge of
bacteriology of common
joint infections and
anatomy of joints.
Refer to CBC Portal
Specific Competencies
DO: Perform an appropriate
history and physical
examination and order the
appropriate investigations
to manage a patient who
requires an emergent
amputation.
DO: Perform the surgical
procedures of below,
through, and above knee
amputation on cadaver
models and in the OR, as
available
DO: Conduct extensive
debridement and irrigation
of an open fracture
20Jan15 Version
Learning/Teaching
Evaluation
Strategies
Method or Tools
Review of Source
1. Throughout
documents
module,
resident will
Surgical Skills session
receive
summative
Application of
and formative
knowledge in clinical
feedback
situation
from
supervising
Attendance in vascular
surgeons
surgery outpatient
2. Mid-module
clinics for one week
meeting to
during module to learn
evaluate
how to work up patients
resident on
with vascular
knowledge
insufficiency
around
surgical triage
Review of Source
documents
3. final
examination
assessing:
Surgical Skills session
Application of
knowledge in clinical
situation
DO: Perform an appropriate
history and physical
examination and order the
appropriate investigations
to manage a patient who
presents with a septic joint
DO: Able to Aspirate all
major joints (ankle, knee,
hip, shoulder, elbow, wrist),
and conduct surgical
arthrotomy of all major
joints. To be performed in
cadaver models and in
Review of Source
documents
Surgical Skills session
Application of
knowledge in clinical
situation
a) OSATS on
amputation,
decompressive
fasciotomy, or
joint aspiration
b) oral
examination on
standardized
scenarios of
ischemic limbs,
compartment
syndrome, open
fractures, joint
sepsis
4. end of module
meeting with
module leader
with summative
1
Learning
Context
CanMEDS Role
(s)
Learning Outcomes:
Goals/Objectives
Source Doc(s)
Specific Competencies
Learning/Teaching
Strategies
hospital ER, ward, and OR,
when available
Medical Expert
Health Advocate
Communicator
Able to diagnose and
manage a patient
presenting with
compartment syndrome
Refer to CBC Portal
AO Manual, 2nd edition
chapter 1.6
Able to triage emergent
cases appropriately and
have knowledge of
access to healthcare
resources for patients
presenting with
compartment syndrome,
joint sepsis, open
fractures, and ischemic
limbs
1) Powerpoint
presentation at
beginning of module
2) review of OR
Booking list policy at
TWH at beginning of
module
Able to communicate
effectively with patients
and caregivers in
emergency surgical
situations
CMPA/CPSO
Obtaining Consent
http://www.cmpaacpm.ca/cmpapd04/d
ocs/resource_files/ml_
guides/consent_guide/
com_cg_typesconsent
-e.cfm
DO: Conduct a
decompressive fasciotomy
of arm, buttock, thigh, leg,
and foot on cadaver models
and in operating room, as
available
Triage the surgical booking
list appropriately to
accommodate patients with
compartment syndrome,
joint sepsis, open fractures,
and ischemic limbs
Review of Source
documents
Surgical Skills session
Application of
knowledge in clinical
situation
Paper assignment:
Residents to review 5
written scenarios and
priority rank providing
rationale for ranking
(week 1)
Residents to review 5
written scenarios and
priority rank providing
rationale for ranking
(week 4)
Obtain consent from a
patient or family member
requiring emergency
surgery
Evaluation
Method or Tools
and formative
feedback while
reviewing ITER
Review of Source
documents
Observation and
opportunity to ask
questions in clinical
setting
 Oral
examination
with supervisor
to assess
residents’
knowledge of
prioritizing
booking
 Review of
residents’ paper
assignments
with formative
and summative
feedback
 Summative and
formative
feedback from
supervising
surgeon
 End of module
ITER
2