New Application: Undersea and Hyperbaric Medicine

New Application: Undersea and Hyperbaric Medicine

Review Committees for Emergency Medicine or Preventive Medicine

ACGME

Sponsoring Institution

If applicable, describe how the program structure includes the participation of a medical school.
[PR I.A.1.]

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Program Personnel and Resources

Program Director

Attach, or copy and paste below, the written statement that outlines the educational goals of the program with respect to knowledge, skills, and other attributes of fellows for each major rotation or other program assignment. [PR II.A.3.e)]

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How often will the program director evaluate the knowledge, skills, and professional growth of the fellow, suing appropriate criteria and procedures? [PR II.A.4.a)]

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Will the program director maintain a permanent record of evaluation for each fellow and have it accessible to the fellow and other authorized personnel? [PR II.A.4.d)] ☐ YES ☐ NO

Will the program director provide a written final evaluation for each fellow who completes the program? [PR II.A.4.e)] ☐ YES ☐ NO

Faculty

List only those individuals who are available to the Undersea and Hyperbaric Medicine program for consultation and academic lectures.[PR II.B.10.]

Special Expertise / Name / Qualifications / # of Consults Annually
Anesthesiology / Name / Qualifications / # of consults /
Critical Care / Name / Qualifications / # of consults /
Emergency Medicine / Name / Qualifications / # of consults /
Infectious Disease / Name / Qualifications / # of consults /
Ophthalmology / Name / Qualifications / # of consults /
Orthopaedic Surgery / Name / Qualifications / # of consults /
Plastic Surgery / Name / Qualifications / # of consults /
Preventive Medicine / Name / Qualifications / # of consults /
Rehabilitative Medicine / Name / Qualifications / # of consults /
Vascular Surgery / Name / Qualifications / # of consults /
Others (specify):Specify / Name / Qualifications / # of consults /
Specify / Name / Qualifications / # of consults /

Facilities and Resources

Provide the following information for each site to which fellows will rotate [PR II.D.1. – II.D.2.d); II.D.5.b)]

Site #1 / Site #2 / Site #3 / Site #4
Is there a hyperbaric chamber available? / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO
Is there a full-service clinical laboratory available at all times? / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO
Are radiologic services available at all times? / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO
Are pediatric inpatient facilities available? / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO
Are adult inpatient facilities available? / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO
Are pediatric surgical and intensive units available? / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO
Are adult surgical and intensive care units available? / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO
Are outpatient facilities available? / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO
Will fellows have access to computer-based literature review service at all times? / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO
Is faculty and fellow research space available? / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO
Is faculty and fellow administrative/study space available? / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO
Is conference and teaching space available? / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO

Provide the following information for each site where fellows are assigned for required rotations. If more than 4 sites are involved, copy this section and continue with site #5 [PR II.D.3.a); II.D.5.a)]

12-month period covered by statistics / FROM:Click or tap to enter a date. / TO:Click or tap to enter a date.
Hospital Data / Site #1 / Site #2 / Site #3 / Site #4 / Row Total
Number of Hospital Beds / # / # / # / # / # /
Total Hospital Admissions / # / # / # / # / # /
Average Bed Occupancy (%) / # % / # % / # % / # % / # %
Current Accreditation/Licensure Dates
JCAHO / Enter a date / Enter a date / Enter a date / Enter a date /
Other (State, etc.) / Enter a date / Enter a date / Enter a date / Enter a date /
Other / Enter a date / Enter a date / Enter a date / Enter a date /
Does site participate in ACGME-accredited residencies below?
Internal Medicine / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO
Anesthesiology / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO
General Surgery / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO
# of Hyperbaric Patients / # / # / # / # / # /

Provide the following information for each site to which fellows will rotate.[PR II.D.4.]

Site #1 / Site #2 / Site #3 / Site #4
Are physical therapy services available? / ☐ YES ☐NO / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO
Are social services available? / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO
Are occupational medicine services available? / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO
Are psychologic and psychological testing services available? / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO
Are hyperbaric medicine services available 24 hours? / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO / ☐ YES ☐ NO

Are the inpatient and outpatient facilities including intensive care units capable of addressing the following patient care needs? [PR II.D.2.d)]

a)Respiratory poisons...... ☐ YES ☐ NO

b)Gas forming infections...... ☐ YES ☐ NO

c)Wound healing problems...... ☐ YES ☐ NO

d)Gas embolisms...... ☐ YES ☐ NO

e)Other conditions requiring hyperbaric treatment...... ☐ YES ☐ NO

Explain any “no” responses

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Educational Program

Resident Role

Describe the manner in which fellows will take call.How will faculty member backup for this experience be structured?How will call activities be reviewed by faculty members and how will feedback be given to fellows regarding their decisions while on call?How will fellows exercise graduated responsibility with regard to call?[PR I.B.1.g) – h)]

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Other than on-call responsibilities, will fellows have a period of training in which they are responsible for activities in more than one section of the laboratory at a time?If so, describe this experience.[PR I.B.1.g) – h)]

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How will fellows be involved in hospital and local, regional, and/or national activities related to the practice of Undersea and Hyperbaric Medicine/medicine?Give specific examples, e.g., list hospital committees on which fellows will serve.[PR I.B.1.g) – h)]

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How will fellows be instructed in review of the medical literature?[PR IV.A.2.c).(1) – (2)]

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How will fellow stress, including mental or emotional conditions inhibiting performance or learning and drug- or alcohol-related dysfunction, be monitored?[PR II.A.3.k) – II.A.3.k).(2)]

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Describe the manner in which fellows will have the opportunity to assume increasing patient responsibility as they progress through the program.[PR II.A.4.c)]

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Describe the manner in which fellows will be given the opportunity to function as consultants to other physicians.[PR I.B.5.]

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Will fellows always sign out their cases with a member of the staff?[PR VI.A.2.a).(1)]...... ☐ YES ☐ NO

Curriculum Organization and Fellow Experiences

1.Does the curriculum include the following academic and clinical content?[PR IV.A.3.a).(1) – IV.A.3.a).(16)]

a)History of undersea and hyperbaric medicine...... ☐ YES ☐ NO

b)Decompression theory and physiology...... ☐ YES ☐ NO

c)Oxygen physiology...... ☐ YES ☐ NO

d)Pathophysiology of decompression illness and arterial gas embolism...... ☐ YES ☐ NO

e)Diving operations and human performance in hypo/hyperbaric environments...... ☐ YES ☐ NO

f)Medical examination/standards for divers...... ☐ YES ☐ NO

g)Effects of hyperbaric oxygenation on infectious diseases...... ☐ YES ☐ NO

h)Principles of treating gas exposures...... ☐ YES ☐ NO

i)Effects of hyperbaric oxygenation on irradiated tissues and ischemic wounds...... ☐ YES ☐ NO

j)Tissue oxygen measurement...... ☐ YES ☐ NO

k)Multiplace and monoplace hyperbaric chamber operations...... ☐ YES ☐ NO

l)Evaluation for clinical hyperbaric treatment...... ☐ YES ☐ NO

m)Hazards of standard electrical standards...... ☐ YES ☐ NO

n)Emergency procedures for monoplace and multiplace installations...... ☐ YES ☐ NO

o)Saturation diving ...... ☐ YES ☐ NO

p)Systems management...... ☐ YES ☐ NO

Provide a single page description of the clinical experience available to the fellows. Describe the length of the experience and the role of each fellow as primary or consulting physician.
[PR IV.A.3.b)]

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Describe how fellows will maintain their primary board skills during training. [PR IV.A.3.d)]

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4.Will fellows have the opportunity to teach undersea and hyperbaric medicine to health care trainees and professionals, including medical students, interns, fellows, and nurses? [PR IV.A.3.e)]
...... ☐ YES ☐ NO

Briefly describe how fellows will participate in the formal didactic teaching program (attendance, planning, presenting, etc.)? [PR IV.A.3.f)]

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Patient Care

Indicate the settings and activities in which residents will develop proficiency in t the following areas of patient care. Also indicate the method(s) that will be used to evaluate proficiency.[PR IV.A.2.a).(1).(a) – (g)]

Competency Area / Estimated # of Opportunities/patients during an academic year per fellow / List in Bulleted Format the Learning Activities and Settings Used to Address the Core Knowledge Area / List in Bulleted Format the Method(s) Used to Evaluate Fellow Competency*
Assessment of prospective divers for fitness to dive / # /

Learning Activity and Setting

Evaluation method(s)

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Assessment of hyperbaric chamber personnel / # /

Learning Activity and Setting

Evaluation method(s)

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Assessment of patients with suspected decompression sickness / # /

Learning Activity and Setting

Evaluation method(s)

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Assessment of patients with specific problem wounds / # /

Learning Activity and Setting

Evaluation method(s)

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Assessment and management of patients with complications of hyperbaric therapy / # /

Learning Activity and Setting

Evaluation method(s)

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Management of critically ill patients in the hyperbaric environment / # /

Learning Activity and Setting

Evaluation method(s)

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Assessment of indications for hyperbaric oxygen therapy / # /

Learning Activity and Setting

Evaluation method(s)

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Assessment of patient with toxic gas exposure / # /

Learning Activity and Setting

Evaluation method(s)

*Examples of evaluation methods for competence may include: direct observation, global assessment, multisource assessment, practice/billing audit, patient survey, record/chart review, review of patient outcomes, simulations/models, structured case discussion, in-house written examination, In-training examination, oral examination and computer-based learning.

Medical Knowledge

Describe the activities and settings in which fellows will be given opportunities to develop knowledge in the following topics and evaluation methods used.

Competency Area / List in Bulleted Format the Learning Activities and Settings Used to Address the Core Knowledge Area / List in Bulleted Format the Method(s) Used to Evaluate Fellow Competency*
Indications for hyperbaric oxygen therapy [PR IV.A.2.b).(1)] /

Learning Activity and Setting

Evaluation method(s)

Program Conferences

1.List the conferences, seminars, journal clubs, etc. in which fellows will participate.[PR IV.A.1.b); IV.A.1.c).(1)]

Undersea and Hyperbaric MedicineUpdated 04/2017

Name of Conference / Frequency Held / Individual(s) or Department Responsible for Organization of Sessions
Medical Morbidity/Mortality / Frequency / Individual(s) or Dept. /
Journal Club/Research / Frequency / Individual(s) or Dept. /
On-Call Review / Frequency / Individual(s) or Dept. /
Other (specify): / Frequency / Individual(s) or Dept. /
Other (specify): / Frequency / Individual(s) or Dept. /
Other (specify): / Frequency / Individual(s) or Dept. /
Other (specify): / Frequency / Individual(s) or Dept. /
Other (specify): / Frequency / Individual(s) or Dept. /
Other (specify): / Frequency / Individual(s) or Dept. /

Undersea and Hyperbaric MedicineUpdated 04/2017

2.Specifically describe how fellows will be provided an average of at least 5 hours per week of planned educational experiences.[PR IV.A.1.c)]

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Evaluation

How will the program ensure that the program director, with participation of members of the teaching staff advancesfellows to positions of higher responsibility only on the basis of evidence of their satisfactory progressive scholarship and professional growth?

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How will the teaching staff evaluate the following?[PR V.C.1. – V.C.2.a)]

a)The utilization of the resources available to the program

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b)The contribution of each site participating in the program

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c)The financial and administrative support of the program

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d)The volume and variety of patients available to the program for educational purposes

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e)The performance of members of the teaching staff

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f)The quality of supervision of fellows

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Undersea and Hyperbaric MedicineUpdated 04/2017