We intend to teach the Orthopaedic surgery resident to take advanced responsibility by exercising supervised independence and providing supervised teaching; to participate in a didactic program based on the science of Orthopaedic surgery; to learn and utilize computerized patient records and radiology, understanding concerns about privacy and security; to provide feedback that allows improvement of this educational experience for future residents; and to practice in an environment equipped to allow for science based independent study.
Resident surgeons assigned to the Orthopaedic surgery service at the West Los Angeles VA Healthcare Center are expected to make initial independent patient evaluations and to draw conclusions based on these evaluations, using those conclusions to propose plans for treatment. Once they have formulated a plan for treatment they discuss this with and confer with more senior residents and a staff attending surgeon. We intend that this supervised independence allows them to gradually advance the amount of responsibility they take for patient care and allows them to become more independent in their evaluations and plan making for future patients.
In a similar manner we expect the Orthopaedic surgery residents to advance their surgical skills. Once the attending surgeon and the Orthopaedic surgery residents have planned the patient's surgical treatment the resident is expected to participate in the surgical care of this patient to the extent that his training and ability permits. In addition the more senior residents are expected to participate in the teaching of the more junior residents. The supervised teaching is also intended to allow them to gradually advance the amount of responsibility they take for patient care and to allow them to become more independent in carrying out their plans for care.
In addition to supervised independent practice, the residents are expected to participate in a didactic program. At case conferences attended by academic attending staff physicians and Orthopaedic surgeons in community practice the residents discuss and examine patients and make proposals for their further care. In this setting their evaluations of these patients and examinations of them are observed and critiqued by fellow residents, by academic attending surgeons, and by community based surgeons. This gives them an additional opportunity for teaching, for an academic case presentation and for a review of relevant Orthopaedic science.
The Orthopaedic surgery residents have around-the-clock access to an Orthopaedic library which includes texts, journals, and educational videos. They participate in a didactic MRI conference; a case based presentation by the bone radiology faculty.
The Orthopaedic surgery residents are instructed in and expected to make use of a computerized patient recordkeeping system and an all digital radiology system. We exclusively use these computerized systems in the care of our patients. In conjunction with these systems the Veterans Administration requires annual instruction and testing in privacy and security regulations.
At the end of their experience at the Veterans Administration the residents are asked to provide feedback. This candid feedback has resulted in a gradual improvement and alteration of the educational experience for them here at the VA. Providing this feedback is an important part of their responsibility during this rotation.