Image-Guided Thoracentesis

Entrustable Professional Activity (EPA) Checklist: Residents must document 3 successful Thoracenteses prior to performing with indirect supervision (with direct supervision immediately available).

Guidance (circle): CT US

RESIDENT: ______Level: R1 R2 R3 R4

EXPECTATION: KNOWS KNOWS HOW SHOWS HOW ASSISTS DOES

Miller’s Pyramid

Medical Knowledge

1.  The resident knows (states) what a Thoracentesis is, why it is being performed and the indications/contraindications; knows how (describes) how to perform the procedure, including risks and benefits; shows how to perform the procedure?

Yes No N/A

Interpersonal Communication Skills

2.  The resident introduces her-/himself to the patient, explains the procedure adequately, answers all patient and family’s questions and obtains informed consent?

Yes No N/A

Patient Care & Procedural Skill

3.  The resident checks pertinent history, exams, and indications? The resident examines the patient prior to prep for appropriate entry site?

Yes No N/A

4.  The resident performs (does) the procedure in a technically competent manner?

Scrubbed?

Time out?

Sterile technique?

Identify appropriate location, avoiding lung?

Local anesthesia?

Ensure sample is labeled & labs ordered properly?

Confirm dressing placement?

Enter post-op orders?

Yes No N/A

Medical Knowledge (& Communication Skills)

5.  The resident creates an appropriate dictation which includes significant findings and pertinent negatives?

Yes No N/A

Practiced based learning and improvement

6.  The resident selects appropriate additional views or maneuvers to accomplish proper puncture location?

Yes No N/A

Systems Based Practice

7.  The resident uses principles of ALARA to minimize radiation dose?

Yes No N/A

Professionalism

8.  The resident effectively communicates with patient, technologists and all others present before, during and after the procedure?

Yes No N/A

The Resident performed the procedure/examination at the following level (circle one):

KNOWS KNOWS HOW SHOWS HOW ASSISTS DOES

The resident performed this procedure in a competent manner?

Yes No (If No is selected, faculty must provide written formative feedback in the box below.)

PROVIDE FEEDBACK IN THE BOX BELOW:

The Resident has successfully completed 3 Image-Guided Thoracenteses using US or CT and is competent to perform this procedure with indirect supervision (with direct supervision immediately available).

Yes No N/A

Faculty Signature: ______Date______

Faculty Name/Title: ______