TO: LSU/Ochsner Ophthalmology Residents, Faculty, and Fellows

TO: LSU/Ochsner Ophthalmology Residents, Faculty, and Fellows

FROM:Marie D. Acierno, M.D.

Residency Program Director

H. Sprague Eustis, M.D.

Assistant Residency Program Director

Subject: 2009-2010 Grand Rounds and Journal Club Guidelines

Date: June 22, 2009

We will be changing the format of case presentations for Grand Rounds Clinical Case Sessions for the 2009/2010 academic year. There will be fewer cases presented per session, but the expectation regarding content and quality of each presentation will be greater. Faculty members at each site are encouraged to serve in an advisory capacity to assist residents in generating interesting cases and preparing quality presentations for Grand Rounds. Residents should try to use cases from their own clinics when possible, but faculty members are also encouraged to share interesting cases with residents.

Because each resident will be presenting fewer times during the year, residents should plan ahead, save interesting cases throughout year, and be sure to get good documentation/imaging. Start planning a least a month in advance with your faculty advisor. A few guidelines for Grand Rounds case presentations are listed below as a starting point, and specific feedback will be given during the first few Grand Rounds of the new academic year in order to familiarize everyone with what is expected.

Guidelines for LSU/Ochsner Grand Rounds Clinical Case Presentations

-2-3 cases will be presented during each session, between 5pm-6pm. PGY4 residents will be asked to present surgical morbidity conference cases beginning after October 15th(see guidelines below).

-Each case presentation should last approximately 15-20 minutes except, for PGY4 surgical morbidity cases which will be given 30 minutes.

-Each grand rounds session will consist of either:

-2 senior residents presenting morbidity cases and each will have 30 minutes for their presentation or 1 senior resident presenting for 30 minutes and 2 case presentations at 15 minutes each or 3 case presentations at 20 minutes each

-Each case MUST have a faculty advisor who has reviewed the case with the resident (well in advance) and should be present during the Grand Rounds to facilitate discussion. The faculty advisor’s name should be listed on the title slide along with the resident.

-With room for artistic license, each presentation should have the following features:

• The case should be initially presented as an unknown with a complete history and clinical exam and with key features well documented with quality images
• After the clinical case has been described, allow for a short pause to generate a thorough differential diagnosis
• After the diagnosis is given, a brief discussion should follow with relevant clinical and historical information about the diagnosis/disease process/treatment/procedure and include a current literature review
• When possible, refer back to the clinical case and give follow up on how the patient was treated/final disposition/outcome, etc
• At least one case presentation per Grand Rounds sessions must include a Cost Analysis slide or Helpful Coding Tip pertinent to the case. Please include such information as the billing codes for the clinical ophthalmic examination and expected dollar amounts for clinical, surgical, laboratory and radiology testing.

-Morbidity Cases will be assigned to the PGY4 senior resident. This should be a 30 minute presentation during Grand Rounds where clinical and/or surgical cases are presented because of their complexity of management, complications, poor visual outcomes etc. Examples: ruptured globe cases, cataract surgery complications, removal of IOL for reasons of malposition, increased IOP etc. Each case MUST have a faculty advisor who has reviewed the case with the resident (well in advance) and should be present during the Grand Rounds to facilitate discussion. The faculty advisor’s name should be listed on the title slide along with the resident. The cases should be presented as thoroughly as possible and there should be ample time for discussion. The discussion should include if pertinent to the case: timing of management, alternative management means, advice for future similar cases etc. The morbidity case is intended to be instructional and educational so that each of us can learn what others would have opted to do in a difficult clinical/surgical case. Please make reference to pertinent literature on the cases presented. Surgical tapes (cases performed by the assigned resident or “professional” prepared videos) are highly encouraged for this conference.

- 4 Grand Rounds of Science lectures have been scheduled.

- 2-3 Guest Lectures are being planned.

There will be a designated site for grand rounds each week but, we will still teleconference from all the other sites to accommodate everyone's needs on a given clinical day. Designated site means that the resident presenter should be physically presentwhen possible especially, if you are not at an away rotation. This also means that we will want other residents and/or faculty to be at the designated site if possible for improved audience participation.

1st and 3rd Wednesday LSU Rosenthal conference room

2nd and 4th Wednesday Ochsner 3rd Floor Atrium Tower Conference Room or Monroe Hall

Residents from the following rotation sites will be assigned GR cases on the 2nd and 4th Wednesday:

OCF Glaucoma

OCF Triage

OCF Retina

OCF Peds; Children's

OCF Plastics

Houma-CMC

Residents from the following rotation sites will be assigned GR cases on the1st and 3rd Wednesday:

UMC

EKL

LSUIH

BOG/LK

VA

Houma-CMC

Thank you all for your efforts in improving our Grand Rounds experience through your continued participation and interest.

Journal Club:

Journal Club assignments have been issued to LSU/Ochsner faculty/staff for coordination and article selection. The articles will be assigned two weeks in advance of the event by the staff host to residents rotating on their service and at their site location. The final copies of journal articles are to be given to Kathy Cunningham by 5:00 P.M. on Tuesday one-week prior to Journal Club. There should be a maximum/minimum of five articles plus discussion of one ethics chapter. A checklist is enclosed for resident use. This is to aid in preparation for journal clubs. Please keep a copy of this for your portfolio.

Attendance:

All residents are to be excused at 1:00 from clinic and surgical assignments to attend the required educational programs.

The ACGME and RRC dictate mandatory required hours of lecture that a resident must attend during their 36 month training period. If you are not meeting these required hours then, you will not be able to successfully complete your residency training program.

Please review the schedule for your BCSC assignments and mark your calendars accordingly. If you have any conflict, please contact Kathy Cunningham, 504-842-3917, to make alternative arrangements.

If you have any questions, please contact Dr. Marie Acierno at or 504-390-6089.

Enclosure

cc: April VanekGale Abbass