Clinical Rotations
Abdominal Imaging (GI/GU Fluoroscopy)
Competency-Based Goals and Objectives
by level of training
(Pediatric fluoroscopic imaging G&O are included in the pediatric rotations.)
Rotation One
1.
Medical Knowledge
Instrumentation and Protocols
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Basic fluoroscopic instrumentation
Common fluoroscopic artifacts
Become familiar with protocols
Types of oral and intravenous contrast
Bowel
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Normal appearance of the esophagus, stomach, small bowel and colon on fluoroscopic examination
Common inflammatory conditions of the gastrointestinal tract
Neoplasms of the gastrointestinal tract
Perforation/leak: esophagus, post-operative stomach and small bowel
Normal variants
Infectious colitis, ischemic bowel and bowel perforation
Bowel obstructions and underlying etiology
Intussusception, volvulus, closed loop obstruction, incarcerated hernias, strangulation
Gynecology
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Normal appearance of the uterus and uterine tubes on hysterosalpingography
Abnormal appearance of the uterus and uterine tubes on hysterosalpingography including complications from pelvic
inflammatory disease
Urethra and Bladder
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Normal and abnormal appearance of the urethra on retrograde urethrogram (RUG)
Normal and abnormal appearance of the urinary bladder and urethra on voiding cystourethrogram (VCUG)
Assessment methods
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2.
Faculty evaluations
Mock orals
ACR in-service examination results
Patient Care
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Gather essential and accurate clinical information about patients relevant to the interpretation of the examination
including correlation with prior radiological studies.
Communicate effectively and demonstrate caring, respectful behavior when interacting with patients and their
families, answering their questions and helping them to understand the image-guided procedure as well as its clinical
significance.
Use information technology to support patient care decisions.
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Perform fluoroscopic examinations such as esophagrams, upper GI series, small bowel follow through series, contrast
enemas, video swallow examination, dobhoff tube placement, urethrogram, VCUG
Assessment Methods
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3.
Faculty evaluations
360 evaluations
Mock orals
Semi-annual review of procedure log
Practice-Based Learning and Improvement
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Participate in self-directed learning including outside reading on anatomy and common pathology
supplemented with information on emergency/trauma processes.
Participate in QA/QI activities.
Use information technology to access on-line medical information, and to facilitate self-directed learning.
Assessment Methods
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4.
Faculty evaluations
Learning portfolios (learning plan)
Mock orals
ACR in-service examination
Interpersonal and Communication Skills
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Dictate prompt, accurate and concise radiological reports for basic studies.
Develop effective communication skills with patients, patients’ families, physicians and other members of the health
care team.
Obtain informed consent for procedures with faculty guidance.
Promptly communicate urgent, critical or unexpected findings to residents, referring physicians or clinicians and
document the communication in the radiological report.
Assessment Methods
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5.
Faculty evaluations
360 evaluations
Formal evaluation of resident dictations documented in resident learning portfolios
Professionalism
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Demonstrate integrity, respect and compassion to patients, physicians, staff and other health care professionals.
Demonstrate positive work habits, including punctuality and professional appearance.
Demonstrate a commitment to the ethical principles pertaining to confidentiality of patient information.
Demonstrate a commitment to continuous professional development and lifelong learning through consistent
conference attendance and participation.
Assessment Methods
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6.
Faculty evaluations
360 evaluations
Semi-annual review of conference attendance
Systems-Based Practice
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Understand how medical decisions affect patient care within the larger system.
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Demonstrate knowledge of and apply appropriateness criteria and other cost-effective healthcare principles to
professional practice.
Assessment Method
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Faculty evaluations
Suggested References
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Manual on Fluoroscopic Techniques at workstation
The Requisites in GI, GU
Rotation Two
1.
Medical Knowledge
Bowel
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More complex bowel surgery post-operative appearance
Uncommon neoplasms of the GI tract
Barrett’s esophagus
Rings, webs and strictures
Polyposis syndromes
Henoch-Schonlein purpura
Polyarteritis nodosa
Systemic lupus erythematosis
NSAIDS enteritis
Varices
Malabsorption
Sprue
Lymphangiectasia
Carcinoid
Inflammatory conditions of the GI tract
Assessment Methods
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2.
Faculty evaluations
Mock orals
ACR in-service
Patient Care
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Screen, supervise and perform more complex studies
Correlate fluoroscopic examinations with cross-sectional imaging such as CT and MRI
Assessment Methods
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3.
Faculty evaluations
360 evaluations
Semi-annual review of procedure log
Practice-Based Learning and Improvement
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Participate in self-directed learning with outside reading from the Mayo Clinic Review and the Case Review Series.
Demonstrate knowledge and the application of the principles of evidence-based medicine in practice.
Participate in QA/QI activities.
Assessment Methods
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4.
Faculty evaluations
Learning portfolios (learning plan)
Mock orals
ACR in-service examination
Interpersonal and Communication Skills
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Interact with residents and attending physicians in consultation to enhance clinical radiological correlation.
Dictate accurate and concise radiological reports for more complex studies with concise impression including diagnosis
and/or differential diagnoses
Assessment Methods
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5.
Faculty evaluations
Direct observation by the faculty
Formal evaluation of resident dictations documented in resident learning portfolios
Professionalism
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Demonstrate responsiveness to the needs of patients that supercedes self-interest (altruism).
Demonstrate a commitment to continuous professional development and lifelong learning through consistent
conference attendance and participation.
Assessment Methods
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6.
Faculty evaluations
360 evaluations
semi-annual review of conference attendance
Systems-Based Practice
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Effectively prioritize patients requiring cross-sectional imaging studies.
Participate in discussions with faculty regarding system challenges and potential solutions regarding radiological service
and patient care.
Assessment Method
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Faculty evaluations
Suggested References:
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Mayo Clinic Gastrointestinal Imaging Review by C. Daniel Johnson and Grant D. Schmit
Case Review Series for GI, GU
On-line teaching files
A complete list of GI/GU learning objectives is included in the Abdominal Imaging G&O.