Orthopaedic Surgery Residency Program: COMPETENCY BASED STREAM
Phase 2: Module 14: Hand and Upper Extremity Dr. Christian Veillette
Learning
CanMEDS
Learning
Source
Specific Competencies
Context
Role (s)
Outcomes:
Doc(s)
Goals/Objectives
Medical Expert KNOW:
CBC Portal Be able to diagnose
In this
module, the
specifically:
Surgical
trainee will
Demonstrate
a) Common upper limb
be exposed
knowledge of
fractures and
Skills
to plastic
common and
dislocations.
Sessions
surgery and
uncommon upper
b) Degenerative, overuse
orthopaedic
limb injuries and
and traumatic tendon
1.Hand &
surgery
conditions that
injuries
Wrist
faculty in
require treatment.
c) Peripheral nerve
order to
injuries, entrapments,
2.Elbow
achieve
and chronic regional
competence
pain syndromes
3.Shoulder
in managing
d) Infections, including
issues
those specific to the
pertaining to
hand
hand and
e) Compartment
upper
syndromes
extremity
f) Common vascular,
conditions.
inflammatory and
There will be
congenital conditions
overlap
g) Ganglions and
between this
neoplasms
module and
h) Complex upper limb
the advanced
fractures and
arthroscopy
dislocations.
module.
i) Complex periarticular
fractures and fracturedislocations
j) DRUJ and carpal
instabilities
k) Joint contractures
including Dupuytren’s
Able to describe the principles
and indications for:
a) arthroscopy in the
20Jan15Version
Learning/Teaching
Strategies
Evaluation
Method or Tools
Clinical Experience
Bedside Teaching
Teaching Rounds
Surgical Skills Lab
OR observation and
practice – opportunity
for questions and
feedback.
Assessment of
performance on
these
competencies will
be a continuous
process over the
course of the
rotation with both
summative and
formative
feedback coming
from supervising
surgeons and
allied health
professionals
A mid-module
assessment will
occur for
shoulder/elbow
and hand/wrist
aspects of the
module where
resident will be
evaluated with
multiple choice
and short-answer
questions. A
summative and
formative
evaluation is
conducted with
the use of a
STACER Clinical. Hx PE
exam (oral) form
1
Orthopaedic Surgery Residency Program: COMPETENCY BASED STREAM
Phase 2: Module 14: Hand and Upper Extremity Dr. Christian Veillette
Learning
CanMEDS
Learning
Source
Specific Competencies
Context
Role (s)
Outcomes:
Doc(s)
Goals/Objectives
shoulder
b) arthroscopy in the
elbow and wrist
c) amputations and
arthrodesis
d) Brachial plexus and
tendon transfers
Able to describe the unique
principles of treatment of
skeletal metastases
Able to describe the principles
and indications for joint
reconstruction of the upper
limb
Able to describe appropriate
splinting and rehabilitation
plans
20Jan15Version
Learning/Teaching
Strategies
Evaluation
Method or Tools
An end-of-module
assessment will
occur where
resident will be
evaluated with an
oral examination
and multiple
choice and shortanswer questions.
A summative and
formative
evaluation will
then follow
An ITER will be
filled out at the
end of module at
the time of the
exit interview
During the latter
half of the
module, the
resident will be
evaluated via a
STACER –
Surgical form on
the following
procedures
:
1) carpal tunnel
decompression
2) shoulder
hemiarthroplasty
or arthroscopic
2
Orthopaedic Surgery Residency Program: COMPETENCY BASED STREAM
Phase 2: Module 14: Hand and Upper Extremity Dr. Christian Veillette
Learning
CanMEDS
Learning
Source
Specific Competencies
Context
Role (s)
Outcomes:
Doc(s)
Goals/Objectives
20Jan15Version
Learning/Teaching
Strategies
Evaluation
Method or Tools
subacromial
decompression
Medical Expert
Able to demonstrate
proficient and
appropriate use of
procedural skills in
orthopaedic hand
and upper extremity
procedures.
CBC Portal
DO:
Specific competencies
include performing:

Diagnostic and
therapeutic injections
to the upper limb
 Closed and open
reduction techniques
for common upper
limb fractures and
dislocations
 Common surgical
exposures to the
upper limb
 Tendon rupture repair
and reconstruction
• Rotator cuff and
Distal biceps
• Extensor Pollicis
Clinical Experience
Bedside Teaching
Rounds – Medical
Topics
Surgical Skills Lab
OR observation and
practice – opportunity
for questions and
feedback.
3
Orthopaedic Surgery Residency Program: COMPETENCY BASED STREAM
Phase 2: Module 14: Hand and Upper Extremity Dr. Christian Veillette
Learning
CanMEDS
Learning
Source
Specific Competencies
Context
Role (s)
Outcomes:
Doc(s)
Goals/Objectives
Longus
DO
DO

Joint Instabilities
 Open/Arthroscopic
Shoulder
Stabilization
 AC Instability –
acute and chronic

Stabilization
techniques for elbow
or carpal dissociations
20Jan15Version
Learning/Teaching
Strategies
Evaluation
Method or Tools
DO
Arthroplasty
 Primary shoulder
hemiarthroplasty
 Radial head
arthroplasty
DO:

DO:

DO:

Arthroscopy of the
upper limb
Loose body removal
Arthrodeses of the:
 Shoulder
 Wrist
 Digits
DO:
4
Orthopaedic Surgery Residency Program: COMPETENCY BASED STREAM
Phase 2: Module 14: Hand and Upper Extremity Dr. Christian Veillette
Learning
CanMEDS
Learning
Source
Specific Competencies
Context
Role (s)
Outcomes:
Doc(s)
Goals/Objectives
 Treatment of joint
contractures:
 Adhesive
capsulitis
 Elbow
 Dupuytren’s
disease
DO:

Medical Expert
Able to manage a pre
and post-operative
scenario and take the
lead where
necessary in various
procedural
circumstances.
CBC Portal
20Jan15Version
Learning/Teaching
Strategies
Evaluation
Method or Tools
Amputations –
traumatic and elective
Demonstrate skill in the
surgical management of:
• Compartment syndromes
• Nerve entrapment
syndromes
• Ganglions
• Infections
• Diagnostic arthroscopy of
the shoulder
Demonstrate skill in the
management of intra-articular
and periprosthetic fractures of
the upper limb
Clinical Experience
Bedside Teaching
Rounds – Medical
Topics
Surgical Skills Lab
OR observation and
practice – opportunity
for questions and
feedback.
Demonstrate skill in the
management of scaphoid
5
Orthopaedic Surgery Residency Program: COMPETENCY BASED STREAM
Phase 2: Module 14: Hand and Upper Extremity Dr. Christian Veillette
Learning
CanMEDS
Learning
Source
Specific Competencies
Context
Role (s)
Outcomes:
Doc(s)
Goals/Objectives
non-union
Communicator
Communicator
Communicator
Communicator
Manager
KNOW:
Able to obtain an
informed consent for
common upper limb
procedures.
Obtain an
appropriate informed
consent for patients
undergoing
interventions.
Demonstrate an
understanding of the
consent requirements
for communication
with third party
agents
Be capable of
effective oral and
written
communication with
third party agents
such as Workers’
Compensation
Insurance and
disability insurers
Utilize time and
resources effectively
in order to balance
patient care, outside
activities and
personal lifestyle
WSIB –
Ask Herb
von
Schroeder,
Director
Hand &
Surgical
DO
Able to carry out a corrective
osteotomy of the distal radius
Effectively complete all
necessary forms for WSIB
patients
Resident to spend
time in clinic
shadowing
supervisor
Evaluation
Method or Tools
Direct
Observation
Review and
assessment of
resident forms
from clinic
360 of resident
in clinic –ITER
Resident will review
of source documents
Powerpoint
presentatio
n – How to
fill out
WSIB
forms
properly
EMR – Use
of an
Learning/Teaching
Strategies
Supervisor will review
form completion by
resident and provide
time for feedback and
questions
Sample
form –
clinical
rotator cuff
Health
Informatics
Book/ Ch’s
20Jan15Version
Orientation with
workers
compensation
through educational
lecture.
Prioritize emergent and
elective care based on
evidence for the benefit of
individual patients,
populations served and
resource availability
Resident will meet
with supervisor to
have one-on-one
session to describe
an observed
inefficiency and be
Presentation of
how efficiencies
in healthcare
system can be
improved
6
Orthopaedic Surgery Residency Program: COMPETENCY BASED STREAM
Phase 2: Module 14: Hand and Upper Extremity Dr. Christian Veillette
Learning
CanMEDS
Learning
Source
Specific Competencies
Context
Role (s)
Outcomes:
Doc(s)
Goals/Objectives
considerations.
electronic
medical
Demonstrate leadership when
record
allocating finite health care
resources
Manager
Establish an
Determine inefficiencies in the
understanding of
healthcare environment and
health care resource
describe to supervisor and
allocation and
peers.
educational
resources
Manager
Effectively utilize
Determine a solution for
information
inefficiency through the use of
technology to
a technology.
optimize patient care
and for continued
Recognize the financial
self-directed learning.
impact of implementing new
technologies into clinical
practice
Manager
KNOW:
Apply evidence and
Demonstrate an
management processes for
understanding of the
cost-appropriate care
importance of the
allocation of health
care resources and
how that effects wait
list management
20Jan15Version
Learning/Teaching
Strategies
able to provide
explanation of
possible solutions to
inefficiency.
Evaluation
Method or Tools
Lead teaching
rounds at the
end of rotation
7