Cardiovascular Intensive Care Unit (CVICU) Rotation Goals and Objectives

Purpose

Goal: To provide an opportunity for upper-level residents to enhance clinical and procedural skills and to develop a deeper understanding of decisions related to invasive, diagnostic, and therapeutic interventions in the cardiology critical care and advanced heart failure arenas.

Patient Care Goals and Objectives

Goal: To provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.

Residents are expected to:

  1. Efficiently and effectively take a relevant medical history and use that history to guide further diagnostic testing.
  2. Perform evidence-based physical exam maneuvers to guide diagnosis and management. Relate abnormal physical findings to the results obtained from invasive and non-invasive diagnostic studies.
  3. Develop prioritized differential diagnoses and practice continued reflection on one’s own clinical reasoning.
  4. Learn the indications for various treatments for acute and chronic cardiac illnesses as well as complications of those treatments.
  5. Obtain a basic understanding of the indications, pre-procedure optimization, procedural descriptions, post-procedural management, and acute/chronic complications of cardiac assistive devices and heart transplantation.

Medical Knowledge

Goal: To demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as the application of this knowledge to patient care.

Residents are expected to:

  1. Learn clinical and physiological basis for management of acute cardiac illnesses, including myocardial infarction, arrhythmias, congestive heart failure and their complications.
  2. Demonstrate competence in EKG interpretation.
  3. Learn the pharmacological properties and toxic effects of cardiovascular drugs.
  4. Learn the indications for thrombolytic therapy and percutaneous interventions in acute coronary syndromes.
  5. Learn the myriad pharmacologic and mechanical options for cardiac support in cardiogenic shock and advanced heart failure.
  6. Recognize complications of commonly employed medications and mechanical devices used in cardiogenic shock and advanced heart failure.

Interpersonal and Communication Skills

Goal: To demonstrate interpersonal and communication skills that result in the effective exchange of information and teaming with patients, their families, and professional associates.

Residents are expected to:

  1. Collaborate and communicate effectively with other members of CVICU care team including, but not limited to, providers in cardiothoracic surgery and anesthesia.
  2. Coordinate care between the primary team and consultants.
  3. Relay important clinical and prognostic information to patients and their families.
  4. Participate in goals of care discussion with patients, families, and in multidisciplinary meetings.

Professionalism

Goal: To demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles.

Residents are expected to:

  1. Behave and communicate in a professional manner with other care team members, consultants, patients, and patients’ families.
  2. Analyze complex situations and engage with appropriate resources for managing and addressing ethical dilemmas as needed.

Practice-Based Learning and Improvement

Goal: To demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and life-long learning.

Residents are expected to:

  1. Recognize areas for personal growth in all other clinical competency domains and actively seek out feedback from supervisors.
  2. Consult medical literature when clinical questions arise and share the information learned with the team.

Systems-Based Practice

Goal: To demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care.

Residents are expected to:

  1. Deliver safe and effective transitions of care, including but not limited to daily hand offs and transfers to/from ICU.
  2. Identify and call attention to patient safety events. Conduct analysis of patient safety events and offer error prevention strategies.
  3. Provide patient-centered care by navigating the healthcare system and advocating for patients with careful consideration of each patient’s psychosocial situation, payment model, and goals.

Method of Evaluation of Resident Competence

Residents are evaluated by the attending with the assistance of the fellow on the rotation using the standard Departmental Evaluation form for each competency. Patient Care is assessed based on direct observation and chart review. Medical Knowledge is assessed through direct questioning on rounds and based on documentation in EHR. The resident must demonstrate competent EKG interpretation. Interpersonal and Communication Skills is assessed by observing the resident’s interactions with patients, families, and staff. Professionalism is assessed based on observation of the resident’s demeanor and behavior on this rotation Systems-Based Practice is evaluated based on the resident’s ability to learn and improve his or her skills based on feedback, study, and literature review. Practice-Based Learning is evaluated based on the ability to consult the literature and to improve their performance throughout the rotation.