Orthopedic Surgery Curriculum – Students will have to learn and be tested on the following information laid out in the curriculum*. All information can be accessed in the resources and lecture videos listed below the curriculum. 

Expectations:

The Orthopedic Clerkship curriculum is designed to ensure that osteopathic medical students develop clinical skills in orthopedic surgery. The overall goal of this rotation is to provide a basic understanding of the pre- and post-operative evaluation of the emergent and elective surgery cases, basic knowledge of surgical decision making, proper wound and musculoskeletal management.

Emphasis will be placed on the following:

  • Demonstrating an understanding of the basic science, physiology, pathophysiology, pathology, and natural history of common orthopedic conditions and injuries.
  • Obtaining and report a basic history and physical examination, both operative and non-operative, as it relates to common acute and chronic orthopedic injuries and conditions.
  • Recognizing and articulating of the pathology and biomechanics of injury.
  • Knowledge of possible preventative measures to avoid common orthopedic conditions and injuries.
  • Recommending appropriate laboratory and radiologic testing to determine an appropriate diagnosis.
  • Devising a working differential diagnosis for common orthopedic conditions.
  • Discriminating between appropriate treatment modalities for orthopedic surgicalconditions.
  • Functional understanding of integrated osteopathic manipulative treatment for orthopedic surgical patients
  • Differentiating between injury requiring immediate treatment and those that can be treated non-operatively.
  • Recognizing injuries for which a minor delay in treatment would not be deleterious to the patient
  • Demonstrating understanding of the indications, risks, and limitations of the commonly performed procedures in orthopedics
  • Assisting in the management of preoperative, peri- and post-operative patient care under supervision.
  • Developing fundamental psychosocial skills by observing physician-patient interactions during this rotation.
  • Recognizing the psychological effect of injury on the patient and when to select those that need further consultation to assist in their management.

Competencies & Objectives

The KCUMB educational program has identified specific broad areas that students should develop during their training. These help ensure that the students are able to demonstrate and/or develop specific skills. This overarching competencies and objectives specifically addressed in the Orthopedic Surgery clerkship are denoted in bold:

  1. Demonstrate basic knowledge of osteopathic philosophy and practice and osteopathic manipulative treatment;
  2. Demonstrate medical knowledge through one or more of the following: Passing of course tests, standardized tests of the NBOME, end-of-clerkship tests, research activities, presentations, and participation in directed reading programs and/or journal clubs; and/or other evidence based medical activities;
  3. Demonstrate interpersonal and communication skills with patients and other health care professionals;
  4. Demonstrate knowledge of professional, ethical, legal, practice management, and public health issues applicable to medical practice;
  5. Demonstrate the ability to effectively treat patients, provide medical care that incorporates the osteopathic philosophy, patient empathy, awareness of behavioral issues, the incorporation of preventive medicine, and health promotion;
  6. Demonstrate the ability to critically evaluate their methods of clinical practice, integrate evidence-based medicine into patient care, show an understanding of research methods, and improve patient care practices;
  7. Demonstrate an understanding of health care delivery systems, provide effective and qualitative patient care with the system, and practice cost- effective medicine.

Course Objectives:

Four weeks is an insufficient amount of time to cover a comprehensive list of objectives in any area of practice. Clearly, subjects addressed in any clerkship are dependent on the numbers of patients and kinds of disease entities presenting to a particular service. Nevertheless, certain minimum content must be addressed, either by clinical exposure or by didactic materials so that students are prepared for board examinations and other testing. Broad goals listed above are a minimum; objectives for rotations not specifically listed in these guidelines should include the Affective Objectives listed below. The University depends on the supervising physician to establish more specific objectives dealing with the scope of the particular specialty. Therefore, the following sections contain relatively broad, basic objectives for which students are responsible.

Patient Care

  • Demonstrate the ability to obtain and report a basic orthopedic patient history for common orthopedic conditions and injuries with particular emphasis on the chief complaint, inciting events, mechanism of injury, exacerbating and alleviating factors, timing of symptoms and associated symptoms.
  • Demonstrate an ability to perform and report a basic orthopedic physical examination of the spine, shoulder, elbow, wrist and hand, pelvis and hip, knee, foot and ankle
  • Demonstrate an ability to develop and execute patient care plans appropriate for level of training and follows the SOAP/problem oriented format.
  • Describe different suture materials and how selection for use is based.
  • Describe alternative methods of wound closures dependent on anatomical location.
  • Demonstrate aseptic technique in the OR and in ER when asked to manage awound.
  • Demonstrate patient safety concerns regarding body alignment, padding bonyprominence, proper tourniquet application, and environmental safety preoperatively when preparing the patient for surgery.
  • Demonstrate the ability to perform and record an osteopathic structural examination on a surgical patient and document such using acceptable osteopathic terminology.
  • Demonstrate the application of the osteopathic philosophy into the pre- and post- operative care of the surgical patient.
  • Demonstrate proper extremity immobilization methods, drain care, surgical site assessment postoperatively and rehabilitation.
  • Demonstrate an understanding of palpatory findings, which are found in common conditions, encountered in a surgical practice.
  • Demonstrate ability to assess sensory and perfusion of extremities after injury and after reconstruction.
  • Demonstrate ability to assess unique congenital deformities in the head, neck, and spine that can affect pre- and postoperative care.

Medical Knowledge

• Define, describe and discuss the following:
o Open and closed fractures, dislocations, and subluxations.
o Clinical and radiological features of fractures.
o Management priorities in treating fractures, dislocations and subluxations.

  • Discuss common fractures and joint injuries
  • Identify specific problems with their diagnosis and management
  • Discuss the indications and contraindications for replantation of an amputatedappendage
  • Discuss the proper method of transporting the amputated part

Professionalism

  • Demonstrate a commitment to continuity of patient care.
  • Display a sense of responsibility and respect to patients, families, staff and peers.
  • Demonstrate cultural sensitivity.
  • Maintain a professional appearance, well groomed, appropriately dressed.
  • Punctual in attendance, prompt and available when called upon.
  • Demonstrate motivation to learn, shows appropriate assertiveness, flexibility, adaptability toward education.
  • Demonstrate appropriate attitude, cooperative, receptive to feedback.
  • Communicate effectively with attending, resident, team members and other health care professionals.
  • Document legible medical records entries
  • Communicate appropriately and professionally with patient and family members
  • Seek and respond to feedback

Systems-based Practice

  • Follow policy and procedures set forth by the health care facility and departments within that facility
  • Report to appropriate institutional authority when absent following Clinical Affairs guidelines

*Orthopedic Surgery Curriculum – This curriculum is a curriculum formed by the Kansas City University of Medicine.