Learning Objectives

Below are the overall learning objectives for the Critical Care Selective. These are based on the overall UNC School of Medicine Competencies/Milestones.

Medical Knowledge:

Students must demonstrate knowledge of established and evolving biomedical, clinical, and cognate (e.g., epidemiological and social-behavioral) sciences and the application of this knowledge in patient care, specifically:

1) Integrate knowledge of the expected changes in organ function as well as normal physiologic changes across the life span into the care of critically ill and emergent patients at the end-of-life.

2) Discuss the pathogenesis of major conditions seen in critically ill patients and how they represent an alteration in structure and function of organ systems.

3) Describe principles underlying laboratory and radiologic studies into the care of critically ill and emergent patients and indications for their use.

Patient Care/Clinical Skills:

Students must be able to provide care that is compassionate, appropriate, and effective for treating health problems and promoting health, specifically:

1) Obtain an accurate age-appropriate medical history from patients in the ICU or from their family members and/or medical record.

2) Demonstrate focused physical examination of a critically ill patient that is symptom focused.

3) Perform selected advanced procedures under supervision and discuss the indications for and the risks and benefits of the procedure.

4) Apply clinical reasoning and critical thinking skills in developing a differential diagnosis and treatment plan for critically ill patients by integrating information obtained from history and physical, medical record review, diagnostic testing and review of the clinical literature.

5) Apply the principles of pharmacology, therapeutics and therapeutic decision making to the care of a critically ill patient and differentiate between alternative medications for common ICU conditions based on therapeutic effectiveness and cost.

6) Participate in the diagnosis and management of common life-threatening conditions.

7) Sensitively address end-of-life issues with patients and their families including do-not-resuscitate orders and pain management by participating in a patient/family meeting.

Interpersonal and Communication Skills:

Students must demonstrate interpersonal and communication skills that facilitate effective interactions with patients and their families and other health professionals, specifically:

1) Communicate effectively with patients, patients’ families, colleagues and other health care professionals by use of written, verbal and electronic communication skills effectively within the ICU setting through use of the medical record, oral presentations on rounds.

2) Demonstrate teamwork skills and initiative, working collaboratively with all members of the health care team in the ICU or ER.

Professionalism:

Students must demonstrate a commitment to professional service, adherence to ethical principles, sensitivity to patients, and maintain personal health and well-being, specifically:

1) Demonstrate honesty and integrity in all interactions with patients and families.

2) Identify ethical challenges in the care of the critically ill patient and identify resources within the healthcare setting to assist with them.

3) Be punctual and dress appropriately.

4) Complete all scheduled assignments.

Practice Based Learning:

Students must be able to investigate and evaluate their patient care practices, appraise and assimilate scientific evidence, and improve their practice of medicine, specifically: Exhibits characteristics of a self-directed learner:

1) Actively seek, reflect on and respond to feedback about professional performance by seeking out mid-course feedback and then build on this to enhance professional development and performance.

2) Demonstrate skills in retrieving, critically assessing and integrating biomedical information into clinical decision making in the ICU in order to address diagnostic, prognostic or treatment questions.

3) Discuss principles of patient safety and quality improvement as they relate to the ICU environment such as healthcare acquired infections, never events, bundles of care, error disclosure and morbidity and mortality.

4) Participate in all scheduled learning experiences such as journal clubs, grand rounds and morbidity and mortality conferences.

5) Demonstrate on clinical log and feedback form that you have sought out required learning experiences.

System-Based Practice:

Students must demonstrate an awareness of and responsiveness to the larger context and systems of health care and the ability to call on system resources to provide care that is of optimal value, specifically:

1) Use electronic and other information tools such as electronic health records and computer order entry where available.

2) Identify when it is appropriate to move an ICU patient to a different level of care and describe the elements of the hand-off of that patient to the next heath care team.

Managing Health of Populations:

Students must demonstrate an understanding of the management of populations, for both specific clinical populations and to diseases and conditions important to North Carolina and the US.

1) Describe and apply principles of population health improvement for an ICU patient population with attention to access, cost and clinical outcomes including quality of care, morbidity and mortality, functional status and quality of life.  Examples of specific populations might include: trauma, geriatric, pediatric, neonatal, cardiac, etc.