Policy&ProceduresManualforthe

DivisionofInfectiousDiseasesUniversityofKansasSchoolofMedicine

KansasCity,Kansas

CoveringPoliciesandProceduresforFellowsInTraining

AsasupplementtotheHouseStaffPolicyandProcedureManualoftheUniversityofKansasSchoolofMedicine,

OfficeofGraduateMedicalEducationAnd

ProgramManualforResidentsintheDepartmentofMedicineUniversityofKansasSchoolofMedicine,KansasCity,Kansas

Designed&ApprovedbytheKUMCInfectiousDiseasesEducationCommittee

(CommitteeoftheWhole)

RevisedAugust2011

DanielHinthorn,MD,ProgramDirectorLisaClough,MD,AssociateProgramDirectorMichaelLuchi,MD,AssociateProgramDirector

DivisionofInfectiousDiseasesDepartmentofInternalMedicine

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TABLEOFCONTENTS:

I. INTRODUCTION 4II. CONTACTINFORMATION 5III. INSTITUTIONALSUPERVISINGFACULTY 7IV. ACADEMIC

A. ProgramOverview 9B. MissionStatement 9C. DivisionGoals 9D. PerformanceExpectations 10E. Curriculum 14F. Conferences,LecturesandOtherEducationopportunities 22G. EvaluationofFellows 27H. Advancementtosucceedingtrainingyear 28I. EvaluationofFacultyandProgram 28J. DocumentationofTraining 29

V. POLICYANDPROCEDURES 30A. Prerequisites 30B. FellowshipSelectionProcess 30C. DurationofProgram 31D. Duties 31E. DutyhoursPolicyandFatigue 32F. CallSchedule 33G. LinesofCommunicationandResponsibilities 34H. MeetingAttendance 36I. VacationandLeaveTimePolicy 37J. Benefits 39K. Moonlighting 40L. Ethics 41M. UtilizationManagement 41N. QualityImprovement 41O. RiskManagement 42P. Professionalism 43Q. Impairment 44R. DisciplinaryActions,Probation,SuspensionandTermination 44S. GrievanceResolution 47

VI. APPENDIX…A. CoreCurriculumSchedule 49B. IDConferences 51C. ObjectivesbyCompetencies

1. YearOne 522. YearTwo 52

D. GoalsandObjectiveforRotations1. Inpatient 542. OutpatientClinics 58

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3. Microbiology 654. Research 68

E. CoreCompetencyMatrix 71F. RequiredEvaluations 72G. Evaluations

1. FacultyofProgram 732. FacultyofFellow 763. FellowofFaculty 794. FellowofProgram 835. FellowofPeer 866. FellowSelfAssessment 897. PatientEvaluation 928. ResearchFacultyofFellow 939. SupportStaffofFellow 96

H. RecommendedReadingforFellows 98I. FellowHand‐OffPolicy 99J. GMECFatigue(Transportation/SwingRoom)Guidelines 100K. OnlineTrainingL. VanderbiltMatrix M. SupervisionTemplate

ThepurposeofthemanualistoconsolidateourrotationGoalsandObjectives,PoliciesandProceduresandCurriculumandtoprovideaguidetoformattingindividuallearningplansforourfellows.Additionalinformationwillbeaddedovertime.Versionnumbersanddatesreflectupdatestothemanual.

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I.IntroductionWelcometotheInfectiousDiseasesDivisionattheUniversityofKansasSchoolofMedicine.WearepleasedthatyouhavechosenthisProgramtocontinueyourtraining.WebelievethatyouwillfindtheKUIDDivisiontobeanexcellentprogramwithatalentedanddedicatedfacultyeagertoprovideinstructionandguidancetoyouasyoucompleteyourtraining.Withinthisprogram,youwillencounterabroadarrayofinfectiousdiseasesthatwillallowyoutobecomeanexcellentconsultantinthediscipline.Additionally,webelievethatprofessionalism,ethicalstandardsandhumanisticqualitiesareparamounttothesuccessfulpracticeofmedicineandarefosteredwithinourprogram.Ourfacultysubscribestothe“leadbyexample”philosophy.Whenyoucompleteyourtraining,ourgoalandexpectationsarethatyouwillbeacompetent,compassionate,ethicalinfectiousdiseasesphysicianwhowillbealife‐longlearnerandadedicatedteacherforthenextgeneration,readytosolvenewproblemsanddisseminateinformationforotherstostudyandemulate.TheKUInfectiousDiseasesfacultyandIconsideritaprivilegetoworkwithyou,thephysiciansofthefuture,andwetakeourcontributionstoyoureducationseriously.Myexpectationsarethesameforyouaswellasforourfaculty:acommitmenttoexcellenceinclinicalcare,education,andresearch,coupledwithazestforlife‐longlearning.Welookforwardtoworkingwithyouandhaveeveryconfidencethatyouwillgraduateasacompetent,confident,compassionatephysician.Youhavemanyexcitingopportunitiesahead,andwewelcometheopportunitytosharethemwithyou.

DanielR.Hinthorn,M.D.,FACP,FIDSAProfessorofMedicine,Pediatrics,andFamilyMedicineDirector,DivisionofInfectiousDiseases

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II.ContactInformationInfectiousDiseasesFacultyDivisionofInfectiousDiseases‐KUMCDanielHinthorn,M.D.–Director,ProfessorofMedicine,Pediatrics(hon.),andFamilyMedicine(hon.)MichaelLuchi,M.D.,AssociateProfessorChienLiu,M.D.(EmeritusProfessorofMedicineandPediatrics)AlbertEid,M.D.,AssociateProfessorStephenWaller,MD,AssistantProfessorLisaClough,M.D.,AssistantProfessorFernandoMerino,MD,AssistantProfessorKassemHammoud,MD,AssistantProfessorWissamElAtrouni,MD,AssistantProfessorNitaGanguly,MD,AssistantProfessorDanaHawkinson,MD,AssistantProfessorDivisionofInfectiousDiseases‐KCVAMCVinuthaKumar,M.D.,AssistantProfessorArundhatiDesai,MD,AssistantProfessorDivisionofInfectiousDiseases‐ResearchMedicalCenterDavidMcKinsey,M.D.,ClinicalProfessorJoelMcKinsey,MD,ClinicalProfessorPaulBrune,MD,ClinicalAssistantProfessorAssociatedFaculty:DivisionofPediatricInfectiousDiseases‐KUMCWilliamKeough,MD,AssistantProfessorDepartmentofPharmacyPractice‐InfectiousDiseaseSpecialistsAmberSawyer,Pharm.D.DepartmentsofClinicalMicrobiologyLaboratoryRebeccaHorvat,Ph.D.‐Director,ClinicalMicrobiologyLaboratoryDepartmentofPreventiveMedicineTomD.Y.Chin,M.D.,M.P.H.(EmeritusProfessor)StanleyEdlavitch,PhD,ProfessorofEpidemiologyandPreventiveMedicineHospitalInfectionControlandPreventionShawnMueller,RN,InfectionPreventionandControlmanagerSupportStaffoftheIDDivisionJudithSpeer,BBA,DivisionAdministratorKendraColburn,OfficeSecretary

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JennyWest,RN,OPATCoordinatorAmyStewart,RN,OPATCoordinatorStacyMcCrea‐Robertson,MS,MT,ResearchCoordinatorMeaganMcDade,LPN,ClinicCoordinatorDianaZarco,RN,ClinicNurseKarenLane,PatientServicesRepresentative

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III.InstitutionalSupervisingFacultyKUHospital(KUH)andKUMC:SponsoringInstitutionDirector&SiteDirector:DanielHinthorn,MD(20hrseachweek)Supervisoroffellowonconsultationservice:AttendingassignedtoprimaryserviceSupervisoroffellowonclinicrotation:AttendingassignedtocliniconsamedaySupervisoroffellowonresearchrotation:Director,LisaClough,MDKansasCityVeteransAdministrationMedicalCenter(KCVAMC)SiteDirector:VinuthaKumar,MDSupervisoroffellowonconsultationservice:AttendingassignedtoprimaryserviceSupervisoroffellowonclinicrotation:AttendingassignedtocliniconsamedayResearchMedicalCenter(RMC)SiteDirector:DavidMcKinsey,MDSupervisoroffellowonconsultationservice:AttendingassignedtoprimaryserviceSupervisoroffellowonclinicrotation:AttendingassignedtocliniconsamedayKeyClinicalFaculty,teachingfaculty(10hrseachweek)Requirements:broadknowledgeofandexperiencewithID,ABIMcertified,scholarlyactivity(definedasSectionV.E.)DanielHinthorn,MD,DivisionDirector,FellowshipDirector,ViceChairofMedicineMichaelLuchi,MD,AssociateFellowshipDirectorLisaClough,MD,AssociateFellowshipDirectorWissamElAtrouni,MDKassemHammoud,MDNitaGanguly,MDFernandoMerino,MDStephenWaller,MDAlbertEid,MDDanaHawkinson,MDArundhatiDesai,MDVinuthaKumar,MDDavidMcKinsey,MDJoelMcKinsey,MDPaulBrune,MDKeyClinicalFacultyClinicalInvestigators(10hrseachweek)Requirements:publicationsinpeerreviewedclinicaljournals,&responsibleforplanning,implementing,monitoringandevaluationoffellow’sclinicalandresearchtraining.KUHospital(KUH)andKUMCLisaClough,MDAlbertEid,MDWissamElAtrouni,MD

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NitaGanguly,MDKassemHammoud,MDDanaHawkinson,MDDanielHinthorn,MDMichaelLuchi,MDFernandoMerino,MDStephenWaller,MDKansasCityVeteransAdministrationMedicalCenter(KCVAMC)ArundhatiDesai,MDVinuthaKumar,MDResearchMedicalCenter(RMC)DavidMcKinsey,MDJoelMcKinsey,MDPaulBrune,MD

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IV.AcademicA.ProgramOverview:TheInfectiousDiseasesFellowshipTrainingProgramattheUniversityofKansasisatwo‐yearprogramdesignedtotrainoutstandingcliniciansininfectiousdiseaseswhowillhavetheskillsandknowledgetosucceedineithertheacademicorprivatehealthcaresectors.Athirdyearoftrainingismadeavailableinexceptionalcasesinwhichthefellowistraininginresearchtechniquesinpreparationtoacceptafacultyposition.Thetrainingprogramutilizesthreetrainingsites:TheUniversityofKansasMedicalCenter,KansasCityVeteran’sAdministrationMedicalCenterandResearchMedicalCenter.Theeducationalrationaleforpresenceateachtrainingsiteiscarefullyconsidered.ClinicalexperienceattheUniversityofKansasHospitalprovidesopportunitiesforfellowstolearnunderthementorshipofbothclinicalinvestigatorsandmedicaleducators,whilecaringforapatientpopulationwhichincludestertiarycarereferralsfromphysiciansthroughouttheregion,aswellaslocal,culturallydiversepopulations.OureducationalaffiliationwiththeKansasCityVAMedicalCenterisdesignedspecificallytoexposefellowstoapracticesettingwithincreasedautonomy,yetadequatefacultysupervision,andapatientpopulationwithadifferentspectrumofdiseasethanouruniversityhospital.ExperienceatResearchMedicalCenteremphasizescarewithininalargemetropolitanhospitalbasedprivateInfectiousDiseasespractice.Thissettingisdesignedtoexposefellowstoapracticeenvironmentthatisrepresentativeofhealthcaresystemsinmanycities.B.MissionStatementThemission of the Division of Infectious Diseases at the University of Kansas School ofMedicine aligns closely with the overall mission of the Department of Medicine. Ourprimarymissionistoprovideaneducationalenvironmentconducivetopreparationforalifetimeofstudy,problemsolving,andcriticaldecisionmakinginthepracticeofInfectiousDiseases. The fulfillmentofoureducationalmissionrequires theprovisionofexemplaryclinicalservices.ThemissionoftheInfectiousDiseasesFellowshipProgramistodevelopandfosterexcellenceinpostgraduatetraininginInfectiousDiseasesbyeducatingfellowstobeoutstandingpractitioners,lifelonglearners,criticalthinkers,andpatientadvocates.TothisaimtheProgramseeksto:1.FostermaximumdevelopmentofeachfellowinthecorecompetenciesofinternalmedicinewhichincludePatientCare,MedicalKnowledge,Practice‐BasedLearningandImprovement,InterpersonalSkillsandCommunication,Professionalism,andSystems‐BasedPracticeastheyapplytoInfectiousDiseases;2.Developmeasuresdesignedtoimprovedeficienciesandassessprogressiontowardmasteryineachofthesixdefinedcorecompetences;3.Fosteracommitmenttoacademicachievementbyemphasizingtheimportanceofresearchandinvestigationbothasacareerchoiceandasameansofincorporating

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principalsofcriticalthinkingintoeachfellow’sclinicalpractice,continuingeducationandprofessionaldevelopment.C.DivisionalGoalsGoalsforFellowscompletingtheKUInfectiousDiseasesFellowshipprograminclude:

1. To obtain clinical competence by experiencing comprehensive training in both inpatient and outpatient setting of the clinical features, diagnosis, natural history, prevention and treatment of a broad range of infectious diseases.

2. To acquire a knowledge base and cognitive skills to be an effective independent consultant and practitioner of the discipline of Infectious Diseases.

3. To acquire,andmaintaintheprofessionalism,ethicalstandardsandhumanisticqualitiesrequiredtobeaneffective,respectedphysician.

4. Toprovideeducationtoothers,includingpatients,otherhealth‐careworkers,andphysicians,andtodosowithhumilityandcompassion.

5. To develop personal life-long learning skills,includingsystemizedassessmentofpatientcarepracticesandimprovementinpracticebasedonscientificevidenceasappliedtotheassessment.

6. Tohaveabasicknowledgeofqualityassurance,qualityimprovementandeconomicsinreferencetoone’sindividualpracticeofinfectiousdiseasesaswellasthehealthcaresystem.

7. Toobtainabasicunderstandingofcriticalreviewofmedicalliterature,researchdesign,informedconsent,ethicsinresearchandcommunicationofresearchresults.

8. Tobecome a graduate who is competent, compassionate, and is successful in becoming a board eligible and board certified physician in Infectious Diseases.

D.PerformanceExpectations

TheAccreditationCouncilforGraduateMedicalEducation(ACGME)hasidentifiedsixareasofcompetencytobetaughtandevaluatedbyfellowsoverthecourseoftheirtraining.TheprogramprovidesaunifiedexperiencethatallowsfellowstodevelopexcellenceinthecompetenciesspecifiedbytheACGMEastheyapplytothespecialtyofInfectiousDiseases.Thiscurriculumpresentstheobjectives,educationalactivities,evaluationtoolsandclinicalrotationswithintheframeworkofthesesixcompetencies.

1. PatientCareFellowsareexpectedtoprovidecarethatiscompassionate,appropriate,andeffectiveforthepromotionofhealth,preventionofillness,treatmentofdisease,andcareattheendoflifetopatientsofeachgenderfromadolescencetooldage.Specifically,thisrequiresthatafellowbecompetentinthefollowingareas:

a. Gatheraccurate,essentialinformationfromallsources,includingmedicalinterviews,physicalexamination,records,anddiagnostic/therapeuticprocedures.

b. Makeinformedrecommendationsaboutpreventive,diagnostic,andtherapeuticoptionsandinterventionsthatarebasedonclinicaljudgment,scientificevidence,andpatientpreferences.

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c. Develop,negotiate,andimplementpatient‐focusedmanagementplansemphasizingtheappropriateuseofantimicrobialagents.

d. Performcompetentlythediagnosticproceduresconsideredessentialtothepracticeofinfectiousdiseases.

EducationalActivitiesExposuretotheentirerangeofcasesininfectiousdiseasesincludingregularlyencounteredinpatientandoutpatientinfectionsandspecialsituationincludingHIV/AIDS,impairedhosts,nosocomialinfections,sexuallytransmittedinfections,illnessesoftravelersandtheepidemiologyofinfectiousdiseaseswillbeprovided.Avarietyofpatientcenteredexperiencesinclude:InpatientConsultation,OutpatientClinic,CaseConference,CurriculumConference,ClinicalMicrobiologyConference,AntibioticCommittee,InfectionControlCommitteeandJournalClub.

EvaluationtoolsDailydirectobservationbyattendingphysician,360‐degreeevaluation,chart‐stimulatedrecall,periodicobservationtoolssuchasmini‐clinicalevaluation(mini‐CEX),andsimulationoftherapeuticdecisionmaking.

2. MedicalKnowledge

Fellowsareexpectedtodemonstrateknowledgeofestablishedandevolvingbiomedical,clinical,andsocialsciences,anddemonstratetheapplicationoftheirknowledgetopatientcareandeducationofothers.Specifically,thisrequiresthatafellowbecompetentto:

a. Applyanopen‐mindedandanalyticalapproachtoacquiringnewknowledge.b. Developclinicallyapplicableknowledgeofthebasicandclinicalsciencesthat

underliethepracticeofInfectiousDiseases.c. Applythisknowledgeindevelopingcriticalthinking,clinicalproblem‐

solving,andevidence‐basedclinicaldecision‐makingtothedifferentialdiagnosisandcomplexmanagementofpatientswithinfectiousdiseases,includingthosewithregularlyencounteredinpatientandoutpatientinfections,andspecialsituationssuchasHIV/AIDS,impairedhosts,nosocomialinfections,antibiotic‐resistanceinfectionsandthoseinfectedwithneworemergingpathogens.

d. Accessandcriticallyevaluatecurrentmedicalinformationandscientificevidenceandmodifyknowledgebaseaccordingly.

e. UnderstandpatientconfidentialityandHIPPAregulations. EducationalActivities Directpatientcareinavarietyofsettingswillincludethefollowing:Inpatient

consultation,OutpatientClinic,CaseConferences,JournalClub,ResearchConference,ClinicalMicrobiologyRounds,InfectionControlCommittee,AntibioticCommittee.AppropriateuseofthemedicalliteraturethroughEMRandlibrarylinkedresources.

Evaluationtools:In‐servicetrainingexamination,chartstimulatedrecall,directobservationbyattendingphysician,conferenceattendanceandpresentation.

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3. Practice‐BasedLearningandImprovement:Fellowsareexpectedtobeabletousescientificmethodsandevidencetoinvestigate,evaluate,andimprovetheirpatientcarepractices.Specifically,thisrequiresthatafellowbecompetentasfollows:

a. Identifyareasforimprovementandimplementstrategiestoimprovetheirknowledge,skills,attitudes,andprocessesofcare.

b. Analyzeandevaluatetheirpracticeexperiences,setlearningandimprovementgoalsandimplementstrategiestocontinuallyimprovetheirqualityofpatientpractice.

c. Developandmaintainawillingnesstolearnfromerrorsanduseerrorstoimprovethesystemorprocessesofcare.

d. Useinformationtechnologyorotheravailablemethodologiestoaccessandmanageinformationandsupportpatientcaredecisionsandtheirowneducation.

e. Facilitatethelearningofpatients,families,studentsandotherhealthcareprofessionals.

EducationalActivitiesCriticalevaluationofpracticeexperienceandperformancewilloccurthroughInpatientConsultationrounds,Outpatientclinics,CaseConference,CurriculumConference,JournalClub,ResearchConference,In‐servicetrainingexamination,OPATprogram,libraryandlinkedresourcesof“bestpractices”anduseoftheEMR.

Evaluationtools360degreeevaluation,continuityclinicQIprojects,IDCaseConferenceandDepartmentofMedicinePatientSafetyConferenceparticipationutilizingtheVanderbiltPatientHealthcareMatrix,directobservationandEMR.

4. InterpersonalSkillsandCommunication:

Fellowsareexpectedtodemonstrateinterpersonalandcommunicationskillsthatenablethemtoestablishandmaintainprofessionalrelationshipswithpatients,familiesandothermembersofhealthcareteams.Specifically,thisrequiresthataresidentbecompetentto:

a. Provideeffectiveandprofessionalconsultationtootherphysiciansandhealthcareprofessionals.

b. Interactwithconsultantsinarespectfulandappropriatefashion.c. Sustainethicallysoundprofessionalrelationshipswithpatients,their

families,andcolleagues.d. Useeffectivelistening,nonverbal,questioning,andnarrativeskillsto

communicatewithpatientsandfamiliesacrossabroadrangeofsocioeconomicandculturalbackgrounds.

e. Maintaincomprehensive,timely,andlegiblemedicalrecords.

EducationalActivities

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Throughexperienceininpatientandoutpatientsettingsincludingrounds,clinics,OPATprogram,fellowswilllearnandpracticecommunicationsskillswithpatients,familiesandprofessionals.ThroughpresentationsinavarietyofconferencesincludingResearchConference,CaseConference,CurriculumConference,JournalClubfellowswilldevelopwrittenandoralcommunicationskills.

EvaluationTools360‐degreeevaluations,observedclinicalevaluationskills(OCES)withfacultyfeedback,mini‐CEX,mentoredself‐reflectionduringsemi‐annualevaluations,chartreview.

5. Professionalism:

Fellowsareexpectedtodemonstratebehaviorsthatreflectacommitmenttocontinuousprofessionaldevelopment,ethicalpractice,anunderstandingandsensitivitytodiversityandaresponsibleattitudetowardtheirpatients,theirprofessionandsociety.Specifically,thisrequiresthataresidentbecompetentinthefollowingways:

a. Demonstraterespect,compassion,integrity,andaltruismintheirrelationshipswithpatients,families,andcolleagues.

b. Demonstratesensitivityandresponsivenesstopatientsandcolleagues,includingbutnotlimitedtodiversityingender,age,culture,religion,sexualorientation,socioeconomicstatus,beliefs,behaviors,anddisabilities.

c. Adheretoprinciplesofconfidentiality,scientific/academicintegrity,andinformedconsent.

d. Recognizeandidentifydeficienciesinpeerperformance.e. Bepersonallyawareoflimitations,excessivestress,fatigue,burn‐out,or

depressionandknowwhenandfromwhomtoseekguidance.EducationalActivitiesAllacademicandclinicvenueswillprovideexperiencetopracticeprofessionalism.Clinicalvenueswillprovideanopportunitytodealwithpatientsofmanyages,ethnicitiesandvaryingdegreesofimpairment.Intellectualintegrityisemphasizedinallsettings,includingtheclinic,theconferenceroomandresearchopportunities.

EvaluationTools360‐degreeevaluations,presentationskillsevaluationandfeedback,mentoredself‐reflection,conferenceattendancetracking,medicalrecordcompliance.

6. Systems‐BasedPractice:

Fellowsareexpectedtodemonstrateanunderstandingofthecontextsandsystemsinwhichhealthcareisprovided,anddemonstratetheabilitytocalleffectivelyonotherresourcesinthesystemtoimproveandoptimizehealthcare.Specifically,thisrequiresthataresidentbecompetenttodothefollowing:

a. Understand,access,andutilizetheresourcesandprovidersnecessarytoprovideoptimalcare.

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b. Understandthelimitationsandopportunitiesinherentinvariouspracticetypesanddeliverysystems,anddevelopstrategiestooptimizecarefortheindividualpatient.

c. Incorporatecost‐awarenessandriskbenefitanalysistopresentation,diagnosis,anddiseasemanagement.

d. Advocateforqualitypatientcareandoptimalpatientcaresystemse. Workininter‐professionalteamstoenhancepatientsafetyandimprove

patientcarequalityincludingtransitionofcarebetweensettings

EducationalActivitiesOpportunitiestodevelopanawarenessandresponsivenesstothehealthcaresystemwillbeavailableinallsettingsincluding:InpatientConsultation,OPATprogram,InfectionControlandPreventionandOutpatientclinic,inparticularthefellow’sHIV/AIDSclinic.Thesesettingswillserveasvenueswheretheywillcoordinateinterdisciplinarycarebyarangeofmedicalandnon‐medicalspecialists.Theywillutilizecomponentsofthelocalandnationalhealthcaresystemsandoptimizecoordinationofpatientcarebothwithinone’sownpracticeandwithinthehealthcaresystem.

EvaluationTools360evaluations,QIprojects,chartstimulatedrecall,IDCaseConferenceandInternalMedicinePatientSafetyConferenceparticipationutilizingtheVanderbiltpatientHealthcareMatrix,semi‐annualcontinuityclinic,QIproject.

E.CurriculumTheDivisionhasestablishedrotationalgoalsandobjectivesforallaspectsofitsfellowshipeducationandtrainingwhichisavailabletothefellowsandfacultyforreviewonourwebsite.Thecurriculumcontainsalistofobjectivesforeachleveloftraining.Theselearningobjectivesaremeanttobetheminimumachievedwhileoneachservice.Asummarytableofrotationalgoalsandobjectivesisprovidedintheappendix.YearOneFellowshipInfectiousDiseaseConsultationServicesTrainingSites:KansasUniversityHospital(KUH),KansasCityVeteransAdministrationMedicalCenter(KCVAMC),ResearchMedicalCenter(RMC).

FirstyearfellowsparticipateintheInfectiousDiseaseConsultationServicefor12rotationsofonemontheach.Atthediscretionofthefellowshipdirector,2weeksfromaclinicalrotationmaybegrantedduringofthefirstyeartoorganizeandsubmitaclinicalresearchprojecttotheInstitutionalReviewBoard.FellowsrotatebetweenKUH,KCVAMCandResearchMedicalCenterproviding6monthsconsultserviceKUHand3monthseachconsultserviceatKCVAMCandRMC.WhileatKUH,fellowsrotateonamonthlybasisamongfourgeneralIDconsultativeservices.WhileatKCVAMCandRMCfellowsareassignedtothegeneralIDconsultativeservice.

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Ateachparticipatingtrainingsite,thefellowisresponsibleforallactivitiesoftheinpatientconsultservice.Theyevaluateanddiscusseachpatientwiththeprimaryservice,viewradiographicstudieselectronically,reviewthelaboratorystudiesandmicrobiologyandimmunologyresults.Oftenthiswillinvolveconsultationwiththemicrobiologylaboratory.ThefellowprepareseithertheconsultationreportordailyprogressnoteandpresentsthepatientandfindingstotheIDconsultantattending.Togethertheyinterviewandexaminethepatient,reviewanddiscussthelaboratoryandmicrobiologyresults.Thefellowpresentshisorherassessmentofproblemsanddiagnosesandmanagement,whichtheattendingreviews,critiques,andmodifies.Eachpatientisseendailyonattendingrounds.Bedsideteachingbytheattendingisintegraltodailyrounds.Theattendingandfellowseeallconsultationsonthesamedayaswhentheconsultationisordered.TheDivisiondiscouragescurbsideconsultsandrequestsformalreviewbythefacultyandfellow.

Fellowsarerequiredtocontacttheattendingoftheirserviceforanyareaofdiagnosticortherapeuticuncertainty,andbeforetheymakeevenpreliminaryrecommendationsinsuchcases.Ifquestionsariseafterhours,onefacultypersonisoncallforsuchtelephonecalls24hourseveryday.FellowsareencouragedtocalltheDirectoratanytimeifadditionalquestionsarise.

Fellowsarealsoresponsiblefortheorganizationanddirectorshipofotherlearners,includingInternalMedicineresidentsandmedicalstudentsthatmayberotatingontheconsultativeservice.Fellowsshouldmeetwiththelearnerspriortoformalrounds,reviewwork‐upandpresentationsandofferinstructionasappropriate.Fellowsarealsoexpectedtoprovidebriefformallecturescoveringbasicinfectiousdiseaseprinciplesonaroutinebasis.Facultyshouldbeavailabletocontributetotheseteachingsessions.

IDconsultationsatKUHarefromallmedicalandsurgicalservicesincluding:generalmedicineandeachofthemedicalandsurgicalsub‐specialists,familyandcommunitymedicine,ICUs,Level1traumaforgeneral,neurologicalandorthopedicservices,hematology&oncology,burn,stemcellandsolidorgantransplant,obstetricsandgynecology,emergencymedicine,pediatrics,geriatrics,palliativeandrehabilitationmedicine.

ConsultationsatRMCandKCVAMCarefromallmedicalandsurgicalservicesincludingICU.KCVAMCofferstheadditionalopportunitytoseepatientswithmilitaryexperiencewhomaybereturningfrominternationalconflicts,andtheuniqueinfectionsassociatedwiththeseexperiences.

EachfellowisassessedastohowwelltheydemonstrateknowledgeofIDliterature,obtainacompletehistory,performappropriateexaminationandmakecogentassessments.Thefellowisevaluatedaswhetherheorshehascollectedclinicalinformationinarespectful,thorough,andcompletemannerandwhetherheorshehasbeenabletogivealogicalpresentationwithappropriateassessmentandrecommendations.Theactivitiesofthefellowareevaluatedforethicalandprofessionalconduct.Fellowevaluationsareinformallymadeverballyonanongoingbasisthroughouttheclinicalrotationandformallyinwrittenandverbalformatatthecompletionoftherotationasdescribedbelow.

Theprogramdirectorandchieffellowmakeupthecallschedulewithattentiontogivingeachfellowatleastonedayoffeverysevendays.Onserviceswherethereisonlyonefellow,atRMCandKCVAMC,fellowsarealwaysgivenonedayoff(includingbeepercall)eachsevendaysaveragedoveronemonth.

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ObjectivesfortheFirst‐yearFellowonInpatientConsultativeServices

a. Demonstrateabilitytogatherdata,orderdiagnostictests,interpretdata,makediagnosticandtherapeuticdecisions.

b. DemonstrateabilitytoperformandinterpretGramstains.c. Demonstrateabilitytomanagepatienttherapiesemphasizingappropriateuseof

antimicrobials.d. Workwithotherstoprovidepatient‐focusedcare.e. Demonstratecompetenceinthediagnosisandmanagementofinfectiousdisease

areasincluding:Bacterialinfections,Fungalinfections,Viralinfections,HIV/AIDS,Parasiticinfections,Sepsissyndromes,Infectionsinpatientswithimpairedhostdefenses,Infectionsinpatientsinintensivecareunits,Infectionsinsurgicalpatients,Healthcare‐associatedinfections,Infectedtravelers,Sexuallytransmittedinfections,Prostheticdeviceinfections.

f. Demonstrateknowledgeofinfectioncontrolandhospitalepidemiology.g. Understandtheprinciplesofprophylaxistoenhanceresistancetoinfections.h. RecognizeandmanageopportunisticinfectionsinpatientswithHIV/AIDS.i. ManagecommonandcomplexIDproblemsinthefaceofantibioticresistance.j. Understandthefundamentalsofhostdefenseandmechanismsofmicroorganism

pathogenesis.k. Understandthecharacteristics,useandcomplicationsofantiretroviralagents,

mechanismsandclinicalsignificanceofviralresistancetoantiretroviralagents.l. Demonstratecomprehensiveknowledgeofindications,contraindications,

limitations,complications,techniques,andinterpretationsofresultsofthosediagnosticandtherapeuticproceduresintegraltothedisciplineincludingappropriateindicationforanduseofscreeningtests/procedures.

m. Demonstrateknowledgeofthemechanismsofactionandadversereactionsofantimicrobialagents.

n. Demonstrateknowledgeofantimicrobialresistance,drug‐druginteractionsbetweenantimicrobialagentsandothercompounds.

o. Demonstrateknowledgeandapplicationoftheappropriateuseandmanagementofantimicrobialagentsinthehospitalandnonacutecareunits.

p. Developskillstoappraisethecurrentmedicalliteraturetosupportdecision‐making.q. Developcommunicationskillstofacilitatethelearningofothers.r. Useeffectivelistening,narrative,andnon‐verbalskillsandwritelegibleand

comprehensivenotes.s. Beresponsivetopatientsandsocietyneedssupersedingself‐interest.t. Demonstrateintegrity,honesty,reliability,cooperative,andacceptresponsibility.u. Workwithhealthcareprofessionalstoprovidepatientfocusedcare;advocatefor

qualitypatientcare.v. Workininter‐professionalteamstoenhancepatientsafetyandimprovepatient

qualityofcare.w. Demonstrateahighstandardofethicalbehavior,includingabilitytomaintain

professionalrelationshipswithotherphysiciansandabilitytoavoidconflictsofinterest.

x. Participateinscholarlyactivitiesincludingpresentationatjournalclub,case

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conferences,IDcorelectures.

EducationalActivitiesInadditiontodirectpatientcare,educationalobjectivesaremetthroughaseriesofcase‐based,smallgroupinteractivediscussion,problem‐orientedreading,role‐modelingbyexperiencedfacultyandhealthsystempersonnel,interactionwithotherhousestaffandfacultyandself‐directedstudy.InfectiousDiseasesClinicsTrainingsites:KUH,KCVAMC

FirstyearfellowsparticipateintheInfectiousDiseases/HIVClinicatKansasUniversityHospital.Fellowsarerequiredtohaveone½daycontinuitycliniceachweekatKUH.Thisclinicprovidesanopportunitytoseeavarietyofoutpatientambulatoryinfectiousdiseasesconsults,hospitalfollow‐up,OPATandpatientswithHIV.Fellowsareexpectedtocontinuouslyfollowaminimumof20HIVpatientsinthisclinic.Duringtheclinic,thefellowinitiallyevaluateseachpatient,andpresentsthecasetotheattendingphysicianwhoconfirmsthehistoryandthephysicalfindingsandwiththefellowdevelopsaplanofmanagement.Underthedirectionofafacultymember,eachfellowdealswithissuesofcomplexantibioticmanagement,antimicrobialresistance,antiretroviraltherapy,analysisofgenotypesofHIV,prophylaxisandmanagementofopportunisticinfectionsandthesocialandfinancialaspectsofcasemanagement.Inaddition,fellowslearntoworkwiththehealthcareteamincludingnurses,pharmacists,andsocialservicecasemanagers

WhenrotatingattheKCVAMC,thefellowsattendtwoHIVclinicseachweek.ThisprovidesfellowswithanopportunitytoexperienceabroaderrangeofHIVinfectedpatientsandexposuretothevariousmanifestationsandcomplicationsofthisdisease.

Fellowsareassessedonhowtheyperforminclinicusingthecorecompetencycomputerbasede*valueevaluationonamonthlybasis.

ObjectivesfortheFirst‐yearFellowinOutpatientClinicsa. Demonstrateabilitytogatherdata;orderdiagnostictests;interpretdata;make

diagnosticandtherapeuticdecisions.b. Managemedicalandpsychosocialaspectsofcommonandcomplexoutpatient

infectiousdiseases.c. Demonstratecompetenceinthediagnosisandmanagementofinfectiousdiseaseareas

including:Bacterialinfections,Fungalinfections,Viralinfections,HIV/AIDS,Parasiticinfections,Infectionsinpatientswithimpairedhostdefenses,Infectionsinsurgicalpatients,Healthcare‐associatedinfections,Infectedtravelers,Sexuallytransmittedinfections,Prostheticdeviceinfections.

d. Developskillintheuseofantimicrobialandprophylacticagents.e. DemonstrateunderstandingofHIVinfectionincludingantiretroviraltherapy,genotype

resistanceprofiles,prophylaxisandmanagementofopportunisticinfections,andnon‐medicalofcasemanagementandfinancialandpsychosocialissues.

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f. Demonstratecomprehensiveknowledgeofindications,contraindications,limitations,complications,techniques,andinterpretationsofresultsofthosediagnosticandtherapeuticproceduresintegraltothedisciplineincludingappropriateindicationforanduseofscreeningtests/procedures.

g. Demonstrateknowledgeofthemechanismsofactionandadversereactionsofantimicrobialagents,antimicrobialresistance,drug‐druginteractionsbetweenantimicrobialagentsandothercompounds.

h. Demonstrateknowledgeandapplicationoftheappropriateuseandmanagementofantimicrobialagentsintheoutpatientclinicsetting.

i. Appraisethemedicalliteratureregardingoutpatientcaretosupportdecisionmakingj. Useeffectivelistening,narrative,andnon‐verbalskills;writelegibleand

comprehensivenotes.k. Beresponsivetoneedsofpatientsandsocietysupersedingself‐interest.l. Demonstraterespect,compassion,andintegrity;behonest,reliable,cooperative,and

acceptresponsibility.m. Workwithhealthcareprofessionalseffectivelytoprovidepatientfocusedcareand

advocateforqualitypatientcare.n. Workininter‐professionalteamstoenhancepatientsafetyandimprovepatientquality

ofcare.ClinicalMicrobiologyLaboratoryTrainingSites:KUH,KCVAMC,RMC

ThemicrobiologylabsatKUH,KCVAMCandRMCarefully‐equipped,stateoftheartclinicalmicrobiologylabswhichuseup‐to‐datediagnosticequipmentfortheidentificationofbacteriaanddeterminationoftheirantimicrobialsusceptibility.Thelaboratoriesalsomaintainequipmentnecessaryforthepurposeofculturing,detecting,identifyingandcharacterizingbacteria,fungi,virusesandmycobacterium.TheKUHlaboratoryisequippedwithaSmartCyclerforPCRandBiosafetylevel2and3workareas.

FellowsattendClinicalMicrobiologyRoundstwodaysperweekatKUH.Roundsareattendedbyfellows,residents,andstudentsrotatingonIDservice,IDfaculty,clinicalmicrobiologydirectorandlaboratorytechnologists.Topicsofinstructionincludebasictechniquesinculturing,identificationandsusceptibilitytesting,presentationofroutinecases,aswellasdiscussionofunusual,butimportantpathogensthathavebeenidentifiedinthelaboratory.

ClinicalMicrobiologyRoundspromotetraininginbasicandadvancedclinicalbacteriology,mycology,virology,parasitology,antimicrobialsusceptibilitytesting,immunology,mycobacteriology,advancemoleculardiagnosticsandmedicalgenetics.Communicationandprofessionalismskillsareemphasizedbyprovidinginteractionswithotherhealthsystemproviders.

Patientsimulationinvolvesapplicationofspecimenspresentedtohypotheticalpatientswiththispathogeninfectinganyanatomicsite.Fellowsareexpectedtodiscusshowdiagnosisandmanagementwouldbemodifiedbyalternatefactors

ObjectivesfortheFirst‐yearFellowinClinicalMicrobiologyLaboratory

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a. Becomefamiliarwiththetechnicalaspectsofpathogenisolation,sensitivitytestingandmolecularmethods.

b. Developcommunicationskillstofacilitatethelearningofothers.c. Communicateclearlywiththemicrobiologystaff.d. Workwithmicrobiologystaffandclinicalservicestoprovideamultidisciplinary

approachtothediagnosisandtreatmentofinfections.e. Demonstratehonesty,integrityandreliability.f. Appraisethemedicalliteraturetosupportdecisionmaking.g. Workwiththemicrobiologystaffandclinicalserviceteamstoenhancepatient

safetyandimprovepatientqualityofcare.ResearchTrainingsite:KUH

Firstyearfellowsareexpectedtoidentifyafacultymentorandresearchprojectearlyintheirfirstyear.Thisallowsthemtheopportunitytoadequatelyplanstudyobjectives,methods,datacollectionandbiostatisticalanalysis.FellowswillpresenttheirproposedresearchprojectatthemonthlyIDResearchmeetingduringtheirfirstyear.Thismeetingisattendedbyfellows,faculty,andinterdepartmentalcontributorsandprovidesavenueforcriticalappraisaloftheproject.Fellowswillsubmittheirprojectforinstitutionalreviewboard(IRB)reviewwhenappropriateandapprovalduringtheirfirstyear.

Duringthisyear,fellowsareencouragedtocompletetheweb‐basedversionoftheSchoolofMedicineIntroductiontoClinicalResearchCourse.Coursematerialcanbeaccessedathttps://www.kumc.edu/som/facdev/researchers.html.Thisisa16‐sessioncoursedesignedtoprovideabasicandbroadoverviewtoclinicalresearch.FellowsarerequiredtocompletetrainingandcertificationinHumanSubjectProtectionandHIPPA(HealthInsurancePortabilityandAccountabilityAct)andhavetheopportunitytoparticipateassub‐investigatorsonthedivisionssponsoredclinicalresearch.FellowsattendthemonthlyIDResearchConference.Thisconferenceprovidesavenueforfacultyandfellowstopresenttheirongoingresearchprojectsandgenerateideasforfutureresearch.Attendancefromcollaborativepartnersoutsidethedivisionisstronglyencouraged.ObjectivesfortheFirst‐yearFellowonResearch

a. Learnthebasicprinciplesofresearchincluding:studydesign,outcomemeasures,appropriatestatisticalmodeling.

b. Demonstratecompetenceinformulatingatestablehypothesis.c. Provideawrittendescriptionoftheirproposedprojects.d. LearnabouttheIRBapprovalprocessandwhatapprovalsarenecessaryforspecific

projecttypes.e. SuccessfullygainIRBapprovalforallprojectsinvolvinghumansubjects.f. SuccessfullygainIACUCapprovalforallprojectsinvolvinganimals.g. Understandtheissuessurroundingappropriatetreatmentofresearchsubjects.h. Demonstratecompetenceinsummarizingdatainabstractsforpresentationat

regionalandnationalmeetings.

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i. Demonstratecompetenceinposterororalpresentationpreparationforanationalmeeting.

j. Learntheconstructionofstudieswhichadequatelystresstheethicsofclinicalresearch,protectionofhumansubjectsandobtainingeffectiveinformedconsent

k. Communicateinterimresultstofaculty.l. Demonstratecompetenceinevaluatingrelevantliteraturerelatedtoaspecific

researchquestion,includingtypeofresearchmodelandevaluationoftheappropriateuseofstatistics.

m. Learntorecognizeandmakecontingencyplansforpotentialproblemsinaresearchplan.

n. Demonstratetheabilitytounderstandhowclinicalandbasicscienceresearchresultsinfluenceclinicalpractice.

o. Developcommunicationskillstofacilitatethelearningofothers.

YearTwoFellowshipInfectiousDiseaseConsultationServicesTrainingSites:KUH,KCVAMCSecondyearfellowsparticipateintheInfectiousDiseaseConsultationServiceforninerotationsofonemontheach.WithapprovaloftheFellowshipDirector,DivisionDirector,&DivisionalResearchDirector,sixtoninemonthsofclinicalconsultationservicemaybecompletedinordertoprovideadditionalmonthsofresearchtraining. Inadditiontotheobjectivesandresponsibilitiesdescribedforthefirstyearfellowsontheconsultationservice,thesecondyearfellowthathasmadesatisfactoryprogressisgivenmorefreedomtomakeinitialrecommendations.Thisisencouragedifheorsheiscomfortableandconfidentintherecommendation.Inthesecondyear,thefellow’srecommendationmaybereviewedinitiallywiththeattendingbyphoneandmadedirectlytotheprimaryservice,buttheattendingphysicianwillseethepatientthesamedayastheconsultisrequested.Fellowsshouldcontacttheattendinganytimedayornightifheorshehasdoubtaboutanyassessmentorrecommendation.Asduringthefirstyearoffellowship,theweekendcoverageisarrangedtoensurethatfellowshaveonedayoffeverysevendays,averagedoverfourweeks,andonthatday,theywillbefreeofdirectpatientcaredutiesandfreeofbeepercall..Inadditiontoyear1objectives,theyear2fellowwilldothefollowing:

a. Participateinanddirectconsultationrounds.b. Accuratelyapplyclinicalinformationtoensurepositivepatientoutcomes.c. Assumemoreresponsibilitymakingclinicaldecisions.d. Havespecialized,detailedknowledgeofimportantareasinID.e. Regularlyusemedicalliteraturetosupportdecisionmaking.f. Demonstrateknowledgeandleadershipinguidingotherhealthcarememberson appropriateantibioticutilizationandrestrictionpolicies.g. Effectivelydiscussendoflifecarewithpatientsandfamilies.h. Displayinitiativeandleadership.i. Appropriatelydelegateresponsibilitytoothers.

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j. Showcommitmenttoprofessionaldevelopment.k. Usesystematicapproachestoreduceerrors.l. Partnerwithproviderstoimprovepatientcare.m. Providecosteffectivecare.n. Understandqualityofcareprinciplesandapplytheseatthebedside.o. Advocateforqualitypatientcareincorporatingconsiderationofcostandrisk‐

benefitanalysisasappropriateforequitablecareforallinfectiousdiseasepatients.

InfectiousDiseasesClinicTrainingSite:KUH,KCVAMCSecondyearfellowscontinuetospend½dayeachweekinthecontinuityambulatoryclinicforinfectiousdiseasesatKUH.DuringclinicalrotationsatKCVAMC,fellowswillspendanadditionaltwo½daysperweekinambulatoryclinic.Theresponsibilitiesandobjectivesdescribedforfirstyearfellowscontinue,butinadditioneachfellowisgivenmoreindependentauthoritytomakemanagementdecisionsontheirownpanelofHIV‐infectedpatients.Thiscontinuestobedoneunderthedirectionoftheirattendingphysicianwhoalsoseeseachpatientwiththefellow.Thisincludesbutisnotlimitedtoselectionandmodificationantiretroviraltherapy,immunizations,managementofpreventionandtherapyofopportunisticinfections,andsocialandfinancialaspectsofcomplexHIVcases.

Inadditiontoyear1objectives,theyear2fellowwilladdthefollowing:

a. EstablishtheirownpanelofHIV‐positivepatientstounderstandmanagementissues,includingfinancialandpsychosocial,relatedtoantiretroviraltherapy,prophylaxisandmanagementofopportunisticinfections,andnon‐medicalofcasemanagement.

b. Understandmanagementissuesassociatedwithoutpatientadministrationofantibiotics.

c. Demonstrateknowledgeandleadershipinguidingotherhealthcaremembersonappropriateantibioticutilizationandrestrictionpolicies.

d. Continuetodevelopandimproveconsultativeskillsintheoutpatientsetting.e. Effectivelydiscussendoflifecarewithpatientsandtheirfamilies.f. Displayinitiativeandleadershipininitiatingandmaintainingeffective

communication.g. Showacommitmenttoprofessionaldevelopment.h. Partnerwithotherproviderstoimprovepatientcare.i. Regularlyusemedicalliteraturetosupportdecisionmaking.j. Regularlyapplynewcontributionstothemanagementandcareofinfectiousdisease

patientsinoutpatientsettings.k. Continuetodevelopandimproveconsultativeskillsintheoutpatientsettings.l. Advocateforqualitypatientcareincorporatingconsiderationofcostandrisk‐

benefitanalysisasappropriateforequitablecareforallinfectiousdiseasepatients.m. Usesystematicapproachestoreduceerrorsinoutpatientsettings.

ResearchTrainingsite:KUH

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Secondyearfellowsareencouragedtospendthreemonthsdirectlyineitherclinicalorbasicresearch.Thistimemaybeshortenedorlengthenedatthediscretionoftheprogramdirectorbaseduponproposedresearchproject.Inadditiontotheobjectivesandresponsibilitiesforfirstyearfellows,secondyearfellowsareencouragedtoprepareandpresentoralandwrittenpapersforpeerreviewandpublicationinappropriatejournalsandatregionalandnationalmeetings.Academicprofessionalismisstressedduringthisresearchprocess.Inadditiontoyear1objectives,theyear2fellowwilladdthefollowing:

a. Becomeadeptatobtainingandanalyzingtherelevantresearchliterature.b. Demonstratecompetenceinmanuscriptpublicationinapeer‐reviewedjournal,

includingpreparationoffigures.c. Learntoacceptandutilizecriticalevaluationofone’swork.d. Displayinitiativeandleadershipininitiatingandmaintainingeffective

communicationregardingresearchideasandformaldisseminationandpresentationofresearchfindings.

e. Showacommitmenttoprofessionaldevelopment.f. Prepareresearchforpublicationand/orpresentationatanationalmeetingor

conference.g. Demonstratecompetenceindatacollectionandorganizationforsubsequent

evaluation.h. Demonstrateunderstandingofstatisticalanalysisofdatacollected.i. Learntoevaluateresultsforagivenprojectinthecontextofotherworkinthe

researcharea.j. Competenceinproposingfutureexperimentstoaugmentresultsfromagiven

project.PediatricInfectiousDiseasesTrainingsite:KUH

IDfellowsseepediatricpatientsinconjunctionwiththeirattendingwhenconsulted

onthispatientpopulation.ThepediatricIDfacultymemberattendstheadultIDmeetingsandpresentscasesandleadsdiscussiononuniquetopicsinpediatrics.Pediatricinfectionsareintegratedintotheusualrotationsforfellows.PediatricinfectionsarealsoaddressedinJournalClubs,caseconferences,andinlecturesinthecorecurriculumgivenbythepediatricIDconsultant.YearThreeofInfectiousDiseasesFellowshipGoalsforthethirdyearoftrainingAthirdyearoftrainingismadeavailableinexceptionalcases.Thepurposeofthe3rdyearofFellowshipinInfectiousDiseasesistopreparethetraineeforacareerinacademicmedicine.FellowswhodesirethistrackwillplantheirspecificrotationswiththeFellowshipProgramDirectorandwillhaveaspecificresearchprogramplannedaswellasadesignatedfacultymentor.Suchafellowwillhaveworkedonthespecificorarelatedproblemearlierduringtheirtrainingprogram.

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The3rdyearoffellowshipmayincludecourseworkinstatistics,molecularbiology,andbiochemistry,ifpertinent.OthersmayelecttoparticipateintheMasterofPublicHealthdegreeprogram.Suchfellowswillbecompletingongoingprojects,andpreparetoenteranacademiccareerbysubmittingagrantapplication.F.Conferences,LecturesandOtherEducationOpportunitiesAttendanceatIDcaseconferences,CoreConference,ResearchConferenceandJournalClubismandatory.Fellowsareexpectedtowillinglytakepartintheseconferenceopportunities.Attendanceistakenateachconference.Itistheexpectationthatfellowswillattendallconferencesexceptintheinstancesofillnessorvacation.InfectiousDiseasesClinicalCaseConferenceClinicalcaseconferenceisheldweekly.Casesareselectedbytheattendingphysicianindiscussionwiththefellowandgenerallyinvolveunusualandcomplexcases.Fellowsareaskedtoframethepresentationaroundoneortwoimportantclinicalquestions.Casepresentationsinvolvereviewofclinicalinformation,radiographicstudies,gramstainandothermicrobiologicdiagnosticsandpathologystudies.Followingcasepresentation,afellownotpreviouslyinvolvedinthecaseisaskedtodevelopanapproachtothecaseandtodiscussinterpretationsofclinicaldata,differentialdiagnosisandmanagement.Followingthisdiscussion,thepresentingfellowprovidesanevidence‐baseddiscussionoftheclinicalquestionsandmanagementissuesrelevanttothecase.Attheconclusionoftheconference,anevaluationofthefellowpresentationisconductedbyoneofthefaculty.Inaddition,relevantsupplementalarticlesandupdatesareprovidedtothefacultyandfellows.

CompetenciesEmphasized1. PatientCare:Specificelementsofthecareofeachcasearedescribedindetailand

arecriticallyaddressedbythefaculty.Discussionemphasizesthediagnosticandtherapeuticapproachtotheproblem(s)manifestedbythepatient.Fellowsactivelyparticipateindiscussingallaspectsofcare.Themanagementofaclinicalproblemservesasthebasisforanactivediscussionofproblemsolvingandliteraturereview.

2. MedicalKnowledge:Thediscussionreviewscurrentandrelevantmedicalliterature.3. Practice‐BasedLearning:fellowsidentifystrengths,deficienciesandlimitsintheir

knowledgeandexpertise.4. InterpersonalandcommunicationSkills:Clarityandorganizationarekeyelements

oftheconference.Fellowsinteractwithotherfacultyandfellows,5. Professionalism:Academicprofessionalismandintegrityareemphasized.6. System‐BasedPractice:Discussioninvolvesconsiderationofmultipledisciplines.

CoreCurriculumConferenceCoreConferenceisheldweeklyandattendedbyfellowsandfaculty.Conferencesaremadeavailabletofellowsoffsitethroughweb‐basedprogram.Theconferenceseriesisa2‐yearcurriculumoflectures.LecturescoverallmajortopicsofInfectiousDiseasesmodeledaftercontentsofPrincipleandPracticesofInfectiousDiseases(seeAppendixforconferenceschedule).Duringthefirst4weeksofeachacademicyear,conferencesareheldtwice

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weekly.ThegoalsofthisacceleratedconferenceseriesistoexposenewfellowstocoreIDtopicsearlyintheirtraining(HIVinfection,boneandjointinfections,endocarditis).InadditiontomajorIDtopics,supplementallecturesincludingmoleculardiagnostics,specialpopulationssuchasCysticfibrosisandtransplantation,billingcompliance,Qualityimprovementarealsoincludedwithinthe2‐yearcurriculum.Conferencesarepresentedasdidacticteachingsessionsledbyfellowsandfacultyandassignedonayearlybasis.Fellowsareassignedafacultymentorwhocontributestothefellow’spreparationandpresentation.

CompetenciesEmphasized1. PatientCare:Thefellowsapplyinformationtotheirownpatients,2. MedicalKnowledge:Discussionsreviewcurrentconceptsininfectiousdiseases.3. Practice‐BasedLearning:Fellowsidentifystrengths,deficiencies,andlimitsintheir

knowledgeandexpertisecanandcansetlearninggoals.4. InterpersonalandCommunicationSkills:Theclarityandorganizationofthe

discussionarekeyelementstotheconference.5. Professionalism:Fellowsareresponsibleforassignedreadingandpresentation6. System‐BasedLearning:Discussionoftopicsofteninvolveconsiderationofmultiple

disciplinessuchasothermedicalandnon‐medicalspecialties,infectionprevention,quality,billingandpublichealth.

ResearchConferenceResearchConferencetakesplacemonthly.Firstyearfellowsareaskedtopresenttheirproposedresearchproject,whichisopentocriticaldiscussionbytheattendees.Inthesecondyear,fellowsareaskedtopresentthefindingsoftheirresearchproject.Inadditionthisconferenceisusedtoupdatefellowsonfacultyresearchandtoserveasavenueforgeneratingnewprojectsandcollaborativeendeavors.

CompetenciesEmphasized1. PatientCare:Theapplicabilityoftheresearchtopatientcareisdiscussed.2. Medicalknowledge:Discussionincludesareviewoftheresearchtopicandits

importance.3. Practice‐BasedLearning:Fellowscanidentifystrengths,deficienciesandlimitsin

theirknowledgeandexpertise.4. InterpersonalandCommunicationSkills:Theclarityandorganizationofthe

presentationarekeyelementsintheconference.5. Professionalism:Ethicalissuesofresearcharediscussed.6. System‐BasedPractice:Asystemsbasedapproachtoresearchisemphasized.

JournalClub

TheJournalClubConferencehasbeenheldweeklysince1961,andisthesettingforreviewofawidearrayofclinicalandbasicsciencearticles.Thefellows,clinicalmicrobiologists,clinicalpharmacists,biostaticiansandepidemiologists,presentarticlesonarotatingbasis.Thediscussionfocusesoncriticalevaluationandinterpretationoftheinfectiousdiseaseliterature.CompetenciesEmphasized

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1. PatientCare:Presentationsemphasizetheapplicabilityoffindingstopatientcare.2. MedicalKnowledge:Thediscussionincludesacriticalpresentationofthe proposedarticle,anddisseminationandreviewofemerginginfectiousdiseases literature.3. Practice‐BasedLearningandImprovement:Theliteratureiscriticallyappraisedby facultyandfellows.Thereisemphasisonsamplesize,potentialbiases, appropriatenessofstatisticaltestsandlegitimacyofconclusions.Conclusions derivedfromthereviewareappliedtoindividualpatientcarepracticeofthe fellows.4. Interpersonalskills:Theclarityandorganizationofthepresentationarekey elementsintheconference.5. Professionalism:Academicprofessionalismisemphasized.6. Systems‐BasedPractice:Emphasisisplacedonsystemsapproachtoresearch.

TheKansasCityInfectiousDiseasesSociety(KCIDS)KCIDSmeetingconsistsofcliniciansfromtheKansasCityareawhopresentinterestingandchallengingcasesfordiscussion.Presentationoccursonarotatingbasisfromcontributinginstitutions.FellowsarerequiredtopresentrepresentativecasesfromKUH,RMCandtheKCVAMC.ConferenceformatfollowstheKUHClinicalCaseconferenceprovidingcasepresentation,asegmentinwhichtheaudienceisaskedtodevelopanapproachtothecaseanddiscussinterpretationofdata,differentialdiagnosisandmanagement,pathophysiology,appropriateuseoftechnologyandprevention.Thepresenterthenprovidesanevidencebaseddiscussionofmanagementissues.

CompetenciesEmphasized1. PatientCare:Specificelementsofthecareofeachcasearedescribedindetailand

arecriticallyaddressedbytheaudience.Discussionemphasizesthediagnosticandtherapeuticapproachtotheproblem(s)manifestedbythepatient.Fellowsactivelyparticipateindiscussingallaspectsofcare.Themanagementofaclinicalproblemservesasthebasisforanactivediscussionofproblemsolvingandliteraturereview.

2. MedicalKnowledge:Thediscussionreviewscurrentandrelevantmedicalliterature.3. Practice‐BasedLearning:fellowsidentifystrengths,deficienciesandlimitsintheir

knowledgeandexpertise.4. InterpersonalandcommunicationSkills:Clarityandorganizationarekeyelements

oftheconference.FellowsinteractwithotherfacultyandcommunitybasedIDclinicians.

5. Professionalism:Academicprofessionalismandintegrityareemphasized.6. System‐BasedPractice:Discussioninvolvesconsiderationofmultipledisciplines.

AntibioticCommitteeThefocusofthecommitteeistomonitortheepidemiologyofinfectionandantimicrobialdruguseininpatients,providedirectionforcost‐effectiveandrationaldruguse,reviewdrugutilizationandpracticeguidelinesanddeterminehowtheseshouldbeusedtochangeindividualandsystempractice.ThecommitteeisdirectedjointlybyIDDirectorandIDPharmD.Committeemembersrepresentabroadrangeofhealthsystemexperts:

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Pharmacy,InfectionPreventionandControl,Microbiology,CriticalCareMedicine,Trauma,andFamilyMedicine.

CompetenciesEmphasized1. PatientCare:Presentationsemphasizetheapplicabilityoffindingstopatientcare.2. MedicalKnowledge:Thediscussionincludesacriticalpresentationofthe guidelinesandarticlesimportanttosupportingsystem‐basedchanges.3. Practice‐BasedLearningandImprovement:Theliteratureiscriticallyappraisedby thecommittee.Conclusionsderivedfromthereviewareappliedtoindividual patientcarepracticeofthefellows.4. Interpersonalskills:Discussionamongamultidisciplinarygroupofhealthcare providersisrequired.Theclarityandorganizationofthepresentationarekey elementsintheconference.5. Professionalism:Academicprofessionalismisemphasizedstressingintegrity, honestyandrespect.6. Systems‐BasedPractice:Emphasisisplacedonsystemsapproachtoimproving antibioticadministrationanddevelopmentofinstitutionalguidelines.

InfectionPreventionandControlCommitteeInfectiousDiseasesfellowsattendthemonthlyinfectioncontrolmeetingatKUHandparticipateininfectioncontrolrelateddecisions.ThiscommitteeisdirectedbytheIDAssociateProgramDirectorandtheChiefInfectionPreventionPrecautionNurse.Participationinthiscommitteeprovidesfellowswithexperienceandexpertiseintheappropriateusesofinfectioncontrolinterventionsinahospitalsystem.Fellowswillhaveopportunitiestoassistwithdevelopmentandimplementationofinfectioncontrolpolicies,determiningappropriateinfectioncontrolmeasuresininpatientandoutpatientsettings,learnhospitalandpatientbenefitsofeffectivequalityassuranceandcostcontainment,OSHAregulations,riskmanagementandadministrativeresponsibilitiesoftheinfectionpreventionandcontrolcommittee.

CompetenciesEmphasized1. PatientCare:Discussionemphasizestheapplicabilityoffindingstopatientcare.2. MedicalKnowledge:ThediscussionincludesapresentationofNationalguidelinesandinstitutionalpoliciesapplicabletopatientcare.

3. Practice‐BasedLearningandImprovement:Fellowscanidentifystrengths,deficienciesandlimitsintheirknowledgeandexpertiseandapplyevidence‐basedchangestotheirpractice.

4. Interpersonalskills:Discussionamongamultidisciplinarygroupofhealthcareprovidersisrequired.Theclarityandorganizationofthepresentationarekeyelementsintheconference.

5. Professionalism:Academicprofessionalismandintegrityisemphasized6. Systems‐BasedPractice:Emphasisisplacedonsystemsapproachtoimprovinginfectionpreventionandcontrolanddevelopmentofinstitutionalguidelines

OutpatientAntibioticTherapy(OPAT)

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Duetoearlydischargefromtheinpatientservices,outpatientparenteralantibiotictherapyhasbecomecommon.ThereforeappropriateinstructionregardingmanagementofoutpatientparenteraltherapyisvitaltoanIDtrainingprogram.Fellowslearnstrategiesfordeterminingappropriatenessofoutpatienttherapy,safety,monitoringanddeliveryofoutpatientantibiotics.TheyworkcloselywiththeIDantibioticnurseclinician,hospitaldischargeplanningcoordinatorandprimaryservices.Fellowsareinvolvedincommunicationwithhomehealthagencyandassistedlivingfacilitiesinvolvedinpatientcare.Fellowshavedirectfacultysupervision.AllOPATpatientsareassignedtoanattendingphysicianthatworkswiththefellowtodeliversafeandreliablecare.

CompetenciesEmphasized1. PatientCare:ThefellowlearnstodeliverOPATinsafeandappropriatemanner.2. MedicalKnowledge:Becomefamiliarwithselectionofappropriatepatients,antibioticchoicesandmonitoringofOPAT.

3. Practice‐BasedLearningandImprovement:Fellowscanidentifystrengths,deficienciesandlimitsintheirknowledgeandexpertiseandapplyevidence‐basedchangestotheirpractice.

4. Interpersonalskills:Workcloselywithamultidisciplinaryteamofnurses,casemanagers,pharmacist,homehealthagenciesandassistedlivingfacilityadministrators.

5. Professionalism:Emphasizeacademicprofessionalismandintegrity.6. Systems‐BasedPractice:EmphasisisplacedonsystemsapproachtoimprovingthedeliveryofOPAT.

DepartmentofMedicinePatientSafetyandClinicopathologicalConferenceFellowsattendthesetwoDepartmentalConferenceswhicheachmeetmonthly.ThePatientSafetyConferenceisdesignedtocriticallyreviewpatientmanagementacrossthespectrumofthehealthcaresystem.Fellowswillspecificallylearnhowtocreatea“cultureofsafety”,aligningtheinterestsofclinicianswiththegoalsoftheorganization,learnfromdefectsinpatientcare,incorporatehumanandenvironmentalfactorstoreduceerror,andempowercliniciansbyprovidingthemwithtoolstoeffectivelyimplementchange.TheVanderbiltMatrixisusedasakeytooltoevaluatingeachcase(Seeappendix)inthePatientSafetyConference.ThistoolfollowsthesixACGMEClinicalCompetenciesaswellasthesixIOMAims(safe,timely,effective,efficient,equitable,patientcentered).Thisisdevelopedingridlikeformattocovereachpatientallowingidentificationofanyareaofdeficiency.Attendeespresentrepresentallspecialtiesfromthemedicalcenterandalsoincludetheriskmanagement,attorneys,administration,nursing,qualitycontrol,andothers.TheClinicopathologicalConferenceisamultidisciplinaryconferencepresentedascase‐basedteachingfollowedbycorrelationofclinicalandpathologicalfindings.Thisconferenceprovidesavenueforfellowstoreviewbiopsyorautopsyresultsofcasesanddiscusstheimpactthesefindingshaveonpatientandsystemchangestoimprovehealthcaredelivery.Inaddition,theconferenceservestoconveyanunderstandingofproblem‐solvingskillsandtoprovideanin‐depthreviewofcomplexorunusualcases.

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EthicsandSocietalImpactThetrainingprogramprovideseducationtailoredtoethicsofmedicalcareandbiomedicalresearch.Areasaddressedinclude:thesocialandeconomicimpactofmedicaldecisionsonpatientsandsociety,physicianaspatientadvocate,qualityassessmentandimprovement,riskmanagement,preventivemedicine,occupationalandenvironmentalhealth,medicalinformatics,painmanagement,endoflifecareandsubstanceusedisorders.Muchofthistrainingoccursatthebedsideandinconferencesandlectures.ProfessionalEthicalBehaviorThetrainingprogrammentorsstrivetomaintainandrolemodelaculturethatvaluesprofessionalismandethicalbehavior.Qualitiesemphasizedbyfacultyinclude:commitmenttoscholarship,excellenceinclinicalcare,humanisticqualitiesincludingrespect,compassiontowardpatientsandprofessionalandcollegialattitudetowardcolleagues.Fellowsareinstructedtorecognizeandinterveneifcolleaguessufferphysicalorpsychologicalimpairment,includingsubstanceabuse,alcoholism,sleepdeprivation,orexcessivestress.Opportunityistakeninconferences,bedsideroundsandinone‐on‐oneevaluationsessionwiththeprogramdirectorandfacultytodiscussandeducatethefellowsonbiomedicalethicsandtoallowthefellowstoparticipateinethicaldecisionsarisingfromthemanagementoftheirpatients.G.EvaluationofFellowsFellowsareevaluatedusingavarietyofassessments(seeappendix:RequiredEvaluationsforIDfellowsandprogram).Facultymembersevaluatefellowsoninpatient,outpatientandresearchrotations.Ontheconsultservices,fellowsareassessedmonthlybyafacultymemberwhohaddirectsupervisionduringtherotation.Theevaluationisconductedwithanelectronicform(e*value)subdividedintothesixcorecompetenciesofpatientcare,medicalknowledge,practice‐basedlearning,interpersonalskillandcommunication,professionalismandsystembasedpractice.Evaluatorsareaskedtochoosearatingscalethatmeasuresthestrengthofagreementwithaclearstatementaboutthehowwellthefellowsucceededineachcategory.Inaddition,inpatientchartsareauditeddailybytheattendingphysician,anddailycase‐basedfeedbackisprovidedtothefellow.ConcernsofthefacultyorfellowsareaddressedimmediatelybytheProgramDirector.Fellowsalsoreceivequarterly3600evaluationsfromclinicstaffandpatientwithassessmentsoftheircommunication,interpersonalandprofessionalismskills.Evaluationofresearchrotationsiscompetencybasedandassessesthefellow’scompetencyinresearchdesign,skillsinscientificwriting,knowledgeofIRBregulations,andaccomplishmentofstatedgoals.Evaluatorsareaskedtochoosearatingscalethatmeasuresthestrengthofagreementwithaclearstatementaboutthehowwellthefellowsucceededineachcategory.TheProgramDirectormeetswitheachfellowatleasttwiceperyearforareviewofhisorherperformancewithawrittenreportfiledinthetrainee’sevaluationfolder.Attheendofthetwo‐yeartraining,awrittensummaryofthetrainee’sperformancereviewedwiththe

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fellowandplacedinhisorherfolderforapermanentrecordforfuturereference.H.AdvancementtoSucceedingTrainingYearTheKUIDPromotionCommitteemeetsyearlytorevieweachfellow’sperformanceandmakerecommendationsforadvancingtothenextyear.AdditionalmeetingmaybecalledatthediscretionoftheIDFellowshipProgramDirector.AllKUIDfacultyareappointedtothePromotionCommittee.Criteriausedtobaserecommendationsforpromotioninclude:qualityofmonthlyrotationalevaluationswithspecificemphasisonthefellows’performanceinthecoreACGMEcompetencies;participationinacademicconferences;scoringsatisfactorilyontheannualIDin‐trainingexamination(althoughanabsolutescoreontheexaminationisnotrequiredforpromotion);compliancewithallhospital,departmentalandfellowshiprecordkeeping,policyanddocumentationrequirements.AdditionalexpectationsareoutlinedinSectionV.Rbelow.Disciplinaryandremedialactionmaybeinitiatedwhentheprogramdirector,afterconsultingwithkeyclinicalfaculty,determinethatsuchactioniswarranted.IDDivisionalactionsfollowtheproceduresandappealsasoutlinedintheProgramManualfortheDepartmentofInternalMedicineandaredescribedbelowinSectionII.M.I.EvaluationofFacultyandProgramFellowsevaluatefacultyattheendofeachrotation.Theseevaluationsaresubmittedanonymously.TheyaresummarizedforindividualfacultyandfortheProgramDirectorandareusedtocounselfacultyandtoassignfacultytospecificteachingrotations.FellowsevaluatetheprogramonanannualbasisandtheseevaluationsareusedtodevelopprogrammaticchangesJ.DocumentationofTrainingTheprogrammaintainsafileoneachfellow,whichincludescopiesoftheirevaluations,copiesoftheirsummaries,lettersofrecommendation,andanyotherdocumentpertinenttotheirtrainingandperformance.Thefellowmayviewthisfolderatanytime.Thesefilesaremaintainedpermanentlytodocumentthelengthandcontentoftheirtrainingaswellastheirperformance.Theprogramisresponsibleforcompletionofformsdocumentingtrainingasresidentsapplyforhospitalcredentials,statemedicallicenses,etc.Fellowsshouldensurethattheprogramhasupdatedcontactinformation,includingbusinessaddress,e‐mail,andphonenumberssothatfuturecommunicationcanbemaintained.

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V.POLICIESANDPROCEDURESTheInfectiousDiseasesProgramusesitsbestefforts,withinthelimitsofavailableresources,toprovideaneducationaltrainingprogramthatmeetstheACGME'saccreditationstandards.Inaddition,theprogramwillprovidethefellowwithadequateandappropriatesupportstaffandfacilitiesinaccordancewithfederal,state,local,andACGMErequirements.Thepolicyandproceduresinthismanualareinadditiontothepoliciesandproceduresmanualsinplaceatthedepartmentalandinstitutionallevel.FellowsshouldrefertotheGMEofficeHousestaffPolicyandProcedureManualandtheProgramManualDepartmentofInternalMedicineforacomprehensivereviewofHousestaffPolicyforfulldetails.Thesemanualsarereviewedatgeneralhousestafforientation.Copiesofthesematerialsareavailablefromtheprogramdirector,departmentadministration,orthedean'soffice.TheyarealsoavailableontheKUMCwebsites:http://gme.kumc.edu/policiesandprocedures.htmlandhttp://www2.kumc.edu/internalmedicine/residency/residency.html A.PrerequisitesFellowsmustholdaMDorDOdegreefromanaccreditedmedicalschoolmeetingoneofthefollowingcriteria:1.GraduationfromamedicalschoolintheUnitedStatesorCanadaaccreditedbytheLiaisonCommitteeonMedicalEducation(LCME)2.GraduationfromacollegeofosteopathicmedicineintheUnitedStatesaccreditedbytheAmericanOsteopathicAssociation(AOA)3.GraduationfromanacceptablemedicalschooloutsidetheUnitedStatesorCanadawithoneofthefollowing:

i.SuccessfulcompletionofaFifthPathwayprogramprovidedbyanLCMEaccreditedmedicalschool,

ii.Acurrent,validcertificatefromtheEducationalCommissionforForeignMedicalGraduates(ECFMG)priortoappointmentiii.AllCanadiancitizensandeligibleCanadianLandedImmigrantswhoareNOTgraduatesofaforeignmedicalschoolmustholdastatus,whichallowsemploymentasamedicalresident,andmaintainanappropriatestatusthroughoutthelengthofthegraduatemedicaltrainingprogram.Possessionofvalidimmigrationdocumentswhichverifythestatusmustbepresentediv.Afull,unrestrictedlicensetopracticemedicineintheStateofKansasandtheStateofMissouri,dependingonthetrainingprogram.DefinitionofacceptableMedicalschooloutsidetheUnitedStatesisfurtherdefinedintheGME office Housestaff Policy and Procedure Manual (Section 4.1)

FellowsmusthavesatisfactorilycompletedanACGMEaccreditedUSresidencyprograminInternalMedicine.Onrareoccasions,fellowsmaybeacceptedintransferfromanotheraccreditedInfectiousDiseasesTrainingprogram.TransferringfellowsmustmeetrequirementsandregulationsasoutlinedintheGMEofficeHousestaffPolicyandProcedureManual(Section4.2)B.FellowshipSelectionProcessTheIDdivisionparticipatesintheElectronicResidencyApplicationService(ERAS).We

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alsoparticipateintheNationalResidencyMatchProgramforInternalMedicineSubspecialtyPrograms.PotentialfellowapplicantsmustsubmitanapplicationconsistingoftheERASform,anupdatedcurriculumvitae,threelettersofrecommendation,andapersonalstatementpriortoconsiderationforapersonalinterview.Afterreviewofthesubmittedmaterials,selectedapplicantsmaybeinvitedtopersonallyvisittheprogramandinterviewwithmembersofthefaculty.Everyattemptismadeforapplicantstomeetthemajorityofthefull‐timeKUMC‐basedkeyclinicalfaculty.Afterthepersonalinterviewwiththeprogramdirectorandfaculty,candidateevaluationformsaresubmittedtothedirector.Oncethecandidateisinterviewed,afellowshipselectioncommittee,consistingoftheprogramdirectorandKUMCfaculty,meettorankthecandidatesaccordingtointerviewevaluationratings.TheapplicantsselectedbythecommitteeareinformedoftheselectionbytheProgramDirector.Afterreceivingacontingentofferofappointment,thefellowmustcompleteappropriatedocumentationandrequirementsasdetailedintheGMEofficeHousestaffPolicyandProcedureManual(Section4.5).OfficialnotificationfromtheUniversityofKansasSchoolofMedicineisbycontractthatismailedinthespringpriortobeginningthefellowship.C.DurationofProgramTheprogramistwoyears(24months)withanemphasisontraininginclinicalinfectiousdiseases.Athirdyearoftrainingismadeavailableinexceptionalcasesinwhichthefellowisacceptedintoresearchstudiesinpreparationtoacceptanacademicposition.D.DutiesThefellowshipincludesbothclinicalandresearchresponsibilities.Itwillbethedutyofthefellowtocarryouttheclinicalresponsibilitiesoftheservicestowhichthefellowhasbeenassigned.Thisincludesnotonlyclinicallyevaluatingpatients,followingtheirprogressandimplementingtherapybutalsoteachingofmedicalstudentsandresidents.Fellowsshouldbeawareofthefellowandattendingon‐callscheduleaspostedontheDivisionalcalendar.Weeklyelectronicemailremindersofcallschedulewillbesent.Fellowsareexpectedtoutilizethedivisionalstructuredcheckoutprocedurewhenrotatingtoanewservice.Thisprovidesanopportunityforthefellowtolearntoworkinteamsandeffectivelytransmitnecessaryclinicalinformationtoensuresafeandpropercareofpatients.Specificdutiesforeachrotationareoutlinedandreviewedpriortothebeginningofeachrotation.Educationalexpectationsandguidelinesshouldbereviewedbythefellowanddiscussedbytheattendingstaffatthebeginningoftherotation.Theguidelinesareprovidedtoeachfellowatthebeginningofthefellowshipandremainavailablethroughdepartmentalwebsiteforreview.Intheareaofresearch,thefellowisexpectedtocarryoutaprojectundertheguidanceofafacultymentor.Thisprojectshouldculminateinbothpublicationinajournalandscientificpresentationataregionalornationalmeeting(ExamplesofthesemeetingsincludetheKansasACP,theIDSA,theASMortheICAACmeetings).LaboratoryresearchtrainingandexperiencemaybeacquiredinconjunctionwithInfectiousDiseases,InternalMedicinefacultyorthroughanotherdepartmentapprovedbytheProgramDirector.ExperiencewithInfectiousDiseasesClinicalTrialsisavailablewiththeInfectiousDiseasesresearchstaff.

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Inadditiontotraininginthedisciplineofinfectiousdiseases,fellowsareexpectedtoparticipateintheeducationofInternalMedicineresidents,medicalstudents,pharmacystudents,nursepractitioners,inPracticeBasedLearning(PBL),FacultyStudentInteractionsessionsandinphysicaldiagnosiseducation.Itisthephilosophyoftheprogramthatfellowsshouldbehighlymotivatedanddeveloplifelonghabitsofself‐instruction.Thus,fellowsareexpectedtousethemedicalliteraturetosolveclinicalproblemsbeforethecasesarepresentedtothefaculty.AlthoughmostdisordersencounteredbyanIDconsultantwilleventuallybeseenandmanagedbythefellowduringthetwo‐yearfellowship,somedisorderswillnot.Thus,itisexpectedthatmostofthesewillbediscussedincorecurriculumconferences,caseconferencesorthatthefellowwillidentifysuchareasandobtainarticlesfromthemedicalliteraturesothattheyhaveaconceptualunderstandingofthesedisorders.Thefacultyareexpectedtobereadilyavailableforguidanceandsuggestions.E.DutyHoursPolicyandFatigueThefellowshipprogramstrictlyadherestotheACGMErequirementconcerningworkhoursasreflectedintheKUGMEPolicyandProcedureManual(Section15).Tothisend,fellowswillnotworkmorethan80hoursperweekaveragedoverafourweekperiod,inclusiveofallin‐housecallactivitiesduringanyrotation.Moonlightinghourswillbeincludedinthiscalculation.Fellowswillbeprovided1dayin7freefromalleducationalandclinicalresponsibilities,averagedovera4‐weekperiod,inclusiveofcall.Onedayisdefinedas1continuous24‐hourperiodfreefromallclinical,educational,andadministrativeduties.Adequatetimeforrestandpersonalactivitiesmustbeprovided.Theprogramdirectorcontinuouslymonitorsworkhoursbymonthlyrotationsurveysperformedbythefellowsandatthesemi‐annualevaluationconductedwitheachfellow.Inaddition,questionsaboutworkhourswillbeaddedtotheendofmonthrotationsurvey.TheGMEofficewillconductsemi‐annualsurveysofalltraineesatKUMC.Theusualtimeforfellowstobegintheworkdayvariesbyhospital,rotation,anddayoftheweek.Ingeneral,fellowsareexpectedtobeginclinicalserviceworkby7am.Oneto2daysperweek,fellowsareexpectedtoattenda7amconference.Theconclusionofthedayiswhenallclinicalresponsibilitiesaremetincludingevaluatingpatients,completingappropriatedocumentationandcoordinatingacareplanforthefollowingdaywiththeattending.Itismandatorythatsenior‐levelresidentshavetenhoursfreeofdutybetweenscheduleddutyperiods.Specificdutyhourandworkexpectationswillbeuniquetotheindividualsitethefellowisassigned.Expectationsareatthediscretionoftheattendingandwillbereviewedatthebeginningofeachclinicalrotation.EachIDfellowworkscloselywithoneIDfacultypersonatonetime.Thuswhenthefelloworthefacultysensethattheclinicalcareneedsoftheservicearelikelytobecomegreaterthanafellowshouldbeinvolvedintogivetheoptimaleducationalexperience,thefacultyassumestheprimarycareforpatients.FellowsareshieldedfromasignificantportionoftheclinicalresponsibilitiesoneachofthefiveKUinpatientservicesinordertoprovidethemwithanoptimalworkenvironment.

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Allclinicalfacultyandfellowshavebeeninstructedontheworkhourpolicyandthedetectionoffatigueintraineesandupdatedoninstitutionalpoliciesannually.BothfacultyandfellowsarerequiredtosuccessfullycompletetheANGELFatiguemodule.Signsandsymptomsoffellowfatigueand/orstressmayincludebutarenotlimitedtothefollowing:inattentivenesstodetails,forgetfulness,emotionalstability,moodswings,increasedconflictswithothers,lackoforattentiontoproperattireorhygiene,difficultywithnoveltasksandmultitasking,awarenessisimpaired(fallbackonrotememory),lackofinsightintoimpairment.Supervisingfacultyconstantlymonitorfellowsforsignsoffatigueandreportthesefindingstotheprogramdirectorassoonaspossible.Theprogramencouragesresidentstousealertnessmanagementstrategiessuchasstrategicnapping,inthecontextofpatientcareresponsibilities.Fellowshaveaccesstosleepingquarters(KUHIMoncallrooms4461‐4464)tobeusedattheirdiscretion.Appropriateactionincludingreliefofdutiesforrest,modificationofdutiestoinsureadequaterest,cancellationofmoonlightingprivilegeswillbeinstitutedbytheprogramdirectorafterdiscussionwiththefellowandfacultyifsuchneedarises.AnoverviewoftheGMECFatigue(Transportation/SwingRoomGuidelinesareprovidedintheAppendix,pg100).F.CallScheduleFellowswillbeonat‐homecallwhenonaninpatientconsultationservices.AtKUH,arotatingcallscheduleamongeligiblefellowsismadebytheInfectiousDiseaseschieffellow.Thecallscheduleandscheduleofdutyassignmentsispublishedandmadeavailableforreviewbythefellowsonamonthlybasis.FellowcallatKCVAMCandRMCwillbemadeinagreementbetweentheattendingphysicianandfellowandmeetprogramrequirementsofworkhoursandtimeawayfromwork.At‐homecallwillnotbesofrequentastoprecluderestandreasonablepersonaltimeforeachresident.Residentstakingat‐homecallmustbeprovidedwithonedayinsevencompletelyfreefromalleducationalandclinicalresponsibilities,averagedoverafour‐weekperiod.Duringoncallduty,fellowswilltakefirstcallonclinicalcasesreferredtotheIDdivision.Theywilltakecallfromhomeintheeveningsandonweekends.Theywillbeexpectedtoseeanynewemergencyconsultinatimelymanner.Thismayinvolvecomingtothehospitalatanytimeofthedayorweekthattheyareassignedtobeonat‐homecall.Weexpecttheat‐homecallfellowtoreceive3to7telephonecallsatnightoronweekends.Ingeneral,fellowsarerequiredtoreturntothehospitaltoparticipateinpatientcarenomorefrequentlythanonceweekly.Thisgenerallyoccursduringweekendcall.Saturdaycallrequirementsincludetakingfirstcallonclinicalcases,completinginitialevaluationandrecommendationfornewconsultationsandprovidingfollow‐uprecommendationforselectongoingpatientsinconjunctionwiththeattendingphysician.Attendingphysiciansareexpectedtoseeanddiscussthesecaseswiththefellowoncallinatimelymanner.InhouserequirementsforSaturdayaregenerallycompletedbetween7amand5pm.AtKUH,afellowwilltakecallonSunday.InhouseSundayworkhoursaverage4‐6hours.Whenfellowsarecalledintothehospitalfromhome,thehoursthefellowspendsin‐housearecountedtowardthe80‐hourlimit.Fellowcallbackstothehospitalwhileonhome‐calldonotinitiateanewoff‐dutyperiod.FellowswillbefreefromcallonSundaysattheKCVAMCandRMC.Theprogramdirectorandthefacultywillmonitorthedemandsofat‐homecallintheirprograms,andmakeschedulingadjustmentsasnecessarytomitigateexcessiveservicedemandsandorfatigue.

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G:LinesofCommunication,ResponsibilityandHand‐OffCommunicationCommunicationbetweenfacultyandfellowsisessentialregardingpatientcareaswellasothersareas.Fellowsareencouragedtousetextpaging,voicemail,EMRandGroupWiseelectroniccommunicationtoupdatefacultyofanyinteractionswithpatients.Telephonecallsbetweenpatientsandfacultyshouldbechartedastelephoneencounterintheelectronicmedicalrecordedandcopiedtothefacultyattendingphysicianinatimelymanner.Whencomplexdecisionsareaddressed,fellowsarerequiredtocontactfacultyatoncepersonallyorbyphone.Facultysupervisionoccurscontinuously.Duringthefirstyearoftraining,fellowsreviewallchangesintherapyorrecommendationsforinvasiveprocedureswiththefacultyattendingpriortomakingtherecommendationtoanotherphysician.Duringthesecondyear,ifthetraineehasmadesatisfactoryprogress,theyaregivenmoreresponsibilitytomakerecommendationsifhe/sheiscomfortableandconfidentintherecommendationandthenreviewwiththeIDattendingfollowingthecommunication.Traineerecommendationsmustbereviewedwithin24‐hours.TraineesareencouragedtocontacttheconsultingIDphysician,atanytimedayornightregardingtheirrecommendations.Suchsupervisionappliestoinpatientandoutpatientcare,homehealthcaremanagement,phonecallsfromoutsidephysiciansorfamilymembers.Supervisionbyattendingfacultymemberisexpectedforallprocedures.Duringaclinicalservicerotation,fellowsmayworkdirectlywithmedicalstudentsandInternalMedicineresidentsassignedtotheservice.StudentsshouldreportinitiallytoIMresidentsortoIDfellowsaccordingtotheservicetheyareassigned.TheIMresidentsreporttotheIDfellowwhomanagestheconsultationservices.AnyofthetraineesmaydirectlycontacttheIDconsultationattendingatanytimeforproblems,advice,ordirection.Whencommunicatingwithotherservices,studentsandresidentsmustbeclearthattheirrecommendationsaresuggestionsandmustbereviewedwiththeIDattendingpriortomakingaformalrecommendation.IDServiceHand‐OffFellowsareinstructedtofollowastandardhand‐offprocesswhenrotatingfromonemonthlyconsultativemonthtothenext(SeeAppendixpg).TheprocessisbasedontheANTICIpatemodel.Onthefinaldayofconsultrotation,thefellowisaskedtoEmailacheckoutlistofthepatientstheyareactivelyfollowingtothefellowtakingovertheirservice.Emailsshouldonlybesentusingthepasswordprotected/securedkumc.eduaddresswithtitle[SecuredPatientInformation].Theemailshouldinclude:1)AtKUH:allpatientsontheteam’sEMRlist(i.e.TeamAlist)2)AtResearchMedicalCenter:theICUpatientslikelytoremaininICUatthetimethenewfellowwilltakeovertheservice3)AtKCVAMC:allpatientsontheIDinpatientconsultservicelist.Fellowsshouldcopytheattendingphysicianonthischeckoutforreviewofcontent.Ifthefellowisroundingwitharesident/studenttheyaretocopythemaswell.Thecheckoutisahelpfulteachingtool.Fellowsshouldalsoencouragetheresidentworkingwiththemtosignouthis/herpatients

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totheincomingresidentaswellforimprovedcontinuityofcare.SignoutnotesshouldincludetheelementsofANTICipate:Administrative,NewInformation,Task,Illness,andContingencyplans.Theemailshouldprovidethenewfellowtimetoreviewandcall/email/pagewithquestionsandshouldbecompletedassoonaspossiblethedayservicerotationsoccur.Thecheckoutshouldconcludewithacontactpiecee.g.pleasecallmycellat999‐999‐9999after8tofurtherdiscussthepatientsorifyouhaveadditionalquestions.Itmayhappenthatrelevantquestionsdonotariseuntilthefirstdaythenewfellowtakesovercareandfellowsshouldbepreparedtofieldquestionslatershouldtheycomeup.Inadditiontofellowhand‐off,attendingphysicianswillbeengaginginasignoffprocessastheyrotateonandoffserviceaswellasonweekendcoverage.Thiswilloccurthroughwrittenandverbalreport.Fellowsareexpectedtobecopiedonwrittenhand‐offreportsandavailablefordiscussionsthatmightoccur.Atallinstitutionstheactivepatientlistsintheelectronicrecordshouldbekeptupdatedwithservicedesignationandprovidername.ThisprovidesboththeIDserviceandotherpatientcareprovidersawarenessoftheassignedIDpatientandcontactinformationfortheconsultingteam.Non‐teachingPatientsAnoccasionalpatientisseenbythefacultyattendingphysicianandnotbytheIDfellow.Suchapatientisconsideredanon‐teachingpatient.Fellowsarenotexpectedtoprovideanytypeofroutineservicesforsuchpatients.Fellowsdonotroundonthem,donotwriteordersnormonitortheirlaboratorystudies.Ifthefellowshouldreceiveacalltoassistinthemanagementofsuchapatient,theyareexpectedtocontacttherespectiveIDconsultantattendingphysicianortheon‐callattendingstafftoconferandtoprovidemanagement..AtKUHthereare5IDconsultationservices.NotallIDservicesarecoveredbyanIDfellow.Duringregularworkhours,fellowsarenotexpectedtocoverorevaluatepatientswhoarenotontheirassignedservice,unlessthereareexceptionalcircumstances.Afterhourstheon‐callfellowmaybeaskedaboutclinicpatientsorinpatientswithwhomheorsheisnotfamiliar.Fellowsareexpectedtoreviewtherelevantrecordsasindicatedandtodeveloparesponsewhichmaybedelivereddirectlytothephysicianorpatientcalling.Insituationsinwhichthefellowisuncertainastowhichcourseofactionshouldbepursued,heorsheshouldcalleithertheattendingoncall,orthefacultymemberfollowingthepatient.Attendingsareopentoquestionsregardingtheirpatientsatalltimes,andfellowsshouldnothesitatetocall.ATRMCandtheKCVAMCIDconsultationpatientsareonasingleservice.Fellowsareexpectedtoevaluatenewconsultsontheseservicesandfollowthemdaily.Thereisnoafterhourscallforfellowsateitherlocation.Fellowsarenotaskedtocovernon‐teachingpatients.OrderWritingInfectiousDiseasesFellowsdonotwriteroutineordersonpatientsseeninconsultation.Exceptionstothisruleincludethefollowing:1)Whenrequestedbytheconsultingservice.2)Iftheclinicalconditionoftheindividualpatientrequiresatimelyorderandtheprimary

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serviceisnotimmediatelyavailable.ItistheresponsibilityoftheIDfelloworattendingwhoiswritingtheordertonotifytheprimaryservicethattheorderwaswritten.Thismaybedonebyphone,textpageorEMRnotificationoftheprimaryservice.FellowsmustundergotheappropriateEMRtrainingpriortowritingorders.TheProgramrequiresthatallfellowsabidebythehospital’sorderguidelinesforlearner’s‐in‐trainingregardingallpoliciesincludingorderwritingpoliciesforphysiciansasoutlinedbythePharmacyDepartment.Ingeneral,itisthefellow’sresponsibilitytoensurethathis/herDEAlicenseisup‐to‐dateandthatthenumberisprovidedtothepharmacyDepartment.Whenconcernsaboutafellow’sorderwritingcompetencyareraised,afellowhashis/herorderwritingprivilegessuspendedandmusthaveallorderscosignedbeforetheybecomepartofthechartandarecarriedout.ThisdecisionisattheProgramDirector’sdiscretionandexplicitlyoutlinedtothefellowinquestionbeforeimplementation.LinesofresponsibilityTheIDDivisionDirectorreportsdirectlytotheChairoftheDepartmentofInternalMedicinewhoisresponsibletotheDeanoftheMedicalSchool.TheIDDivisionFellowshipdirectorreports,inthiscapacity,totheDepartmentofMedicineResidencyandFellowshipCommitteeandDirector.TheInternalMedicineResidencyandFellowshipDirectorreportstotheDIO. TheIDattendingreporttotheDirector,DivisionofInfectiousDiseases.TheIDfellowsareresponsibletotheIDattendingassignedtooverseeclinicalresponsibilitiesforpatientrelatededucationalmatters.FellowsaretoreporttotheIDDivisionDirectorortotheIDFellowshipDirectorforfellowshipconcerns.H.MeetingAttendanceFellowsareexpectedtoattend3weeklyconferencesandonemonthlyconference.

Monday7amCaseConference Tuesday12pmJournalClub Thursday12pmCoreCurriculumConference Wednesday12:30pm,monthlyResearchConference

TheMondayamCaseConferenceisconductedatKUMC.WhenafellowisassignedtoarotationoutsideKUMCtheyareexpectedtotraveltoKUMCforthisconferencesbutreturnpromptlytotheirtrainingsitetocompleterotationassignmentsinatimelymanner.JournalClub,CoreCurriculumandResearchConferencesareavailablethroughinteractivewebbasedpresentationanddonotrequirethatfellowstraveltoKUMC.FellowsareprovidedcomputerandofficespacetoparticipateinthesewebbasedconferenceswhenassignedtorotationsoutsideKUMC.Fellowsareexpectedtoaccuratelyrecordattendanceandtimingwiththeircentraladministration.Fellowsareexpectedtoattendallconferencesunlessillnessorvacationprecludes.Intheeventofamissedconference,PowerPointpresentationsareavailableonasecuredivisionalwebsite.Itistheexpectationthatfellows

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willreviewthecontentofamissedconferencewithinareasonableperiodoftime.ItistheexpectationoftheprogramthatIDfacultywillroutinelyattendthesemeeting.TheDivisionregardsseveralinstitutionalmeetingsasanintegralpartoffellowshipeducation.Fellowsareexpectedtoparticipateinthefollowingmeetingsateacheducationalsite(KUH,KCVAMC,andRMC):infectionpreventionandcontrol,pharmacyandtherapeuticsantibioticsubcommittee,PatientSafetyConferences,ClinicalPathologicConference,InternalMedicineGrandRounds,InternalMedicineCoreConferencegivenbyIDfaculty.Inaddition,fellowsareexpectedtoparticipateinregionalmeetingsincludingKansasCityInfectiousDiseasesSociety(KCIDS)andKansasACP.I.VacationandLeaveTimeScheduledleave(sickleave,maternityandpaternityleave,personalandinterviewtime)mustberequestedinadvancebycompletingthe“DivisionofInfectiousDiseasesFellowLeaveRequest”form.ThisformmustbesignedbyboththeDivisionDirectorandtheIDattendingontheserviceatanysite(RMC,KCVAMC,KUH)influencedbytheleave.TheIDOfficeCoordinator,willmaintaintheformsandprovideofficialnotificationthatleavetimehasbeenapproved.TheIDDivisionrequiresthatIDfellowscompletetheLeaveRequestformatleast6weekspriortoplannedvacation,meeting,orothertimeawayfromanyrotation.VacationFellowsareentitledto3weeksvacationeachyear.Inaddition,fellowsmaytakeoneweekofCME/meetingactivityiftheyarepresentingapaperorposterataregionalornationalmeeting.Attendanceatmeetingswherethefellowdoesnothaveascheduledpresentationwillcounttowardvacationtime.Fellowsareexpectedtotakevacationin1‐weekblocksunlessaspecialexceptionhasbeengranted.VacationsgenerallystartonMondaysandfinishonSundays;howeversomeexceptionscanbemadebasedonthefellowsschedule.The3weeksmaynotbesplittomakemorethantheintended3weeks.Thethreeweek’svacationrefersto3x5workdaysexcludingweekends,not21dayssplittomean4+weeks.Vacationsshouldbeplannedsothatone‐weekistakenateachinstitution(RMC,KCVAMC,andKUMC).TheKUInfectiousDiseasesandInternalMedicineprogramsrequiresleavewithoutpayforfellowthatdoesnotreturnontimefromvacation–includingpersonsunabletoreturnontimeduetoimmigrationprocessreasons.ThisprogramalsoadvisesIDfellowsthattheprogramisnotresponsibleforproblemsthatimpedeascheduledinternationalreturn.Shouldanyfellowwishadviceonthismatter,theymayseekcounselfromtheKUMCofficethatspecializesinimmigrationmattersandimmigrationlaw.PersonalandInterviewLeaveFellowsreceiveuptothree(3)daysduringtheirtrainingtouseforinterviewingforpost‐fellowshippositions.Fellowsarealsoentitledto2personalleavedaysduringthefellowship.ApprovalforinterviewleavemustbeobtainedfromtheProgramDirector,andtheIDofficeadministrativestaff.Writtennotificationmustbeonfileinthefellowship

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officeatleast6weekspriortotheleave.Notificationofapersonaldayleaveuseshouldbeprovidedtotheattendingandfellowshipofficeassoonasitisevidentthatthefellowwillrequiretimeoff. SickLeaveTheUniversitywillprovideupto10workdaysofsickleaveperyeartocoverpersonalillnessorillnessintheresident’simmediatefamily(spouseorchildren).Sickleavecannotbeaccumulatedfromyeartoyear.TheuseofsickleavemustbeapprovedbytheProgramDirectororDivisionChair.AtthediscretionoftheProgramDirectororChair,aphysician’sstatementmayberequiredasaconditionofapprovalofsickleaveorforreturntowork.Forshort‐termillnesses(colds,fluduringyourresidency)fellowsareaskedtosimplyinformtheappropriateIDattendingandDivisionAdministrativeCoordinator.Foranyillness,whichwillrequiretheresidenttotakealeaveofabsence,promptnotificationtotheProgramDirectormustbeobtainedinwriting.Shouldaleaveofabsenceexceedaccruedtime,stipendpaymentswillbeinterrupted.However,familyhealthinsurancebenefitswillcontinueaslongastheresidentpaystheindividualpremium.TheAmericanBoardofInternalMedicineallowsuptoonemonth,peryear,astimeawayfromtheprogram.TimeusedbeyondthisonemonthwillberequiredtobemadeuptomeettherequirementsforwritingtheBoards.TheABIMdoesnotdistinguishbetweenvacationtimeandleaveforillness,includingpregnancy‐relateddisabilities,andincludesthemastimeawayfromtheprogram.(SeeIMHouseStaffProgramManual,SectionL)FamilyLeavePolicyTheDivisionofInfectiousDiseasesfollowsthefamilyleavepolicydelineatedintheKUSchoolofMedicineGraduateMedicalEducationPolicyManual(Section5).Thisdocumentincludesdescriptionofleavepolicyforeachparent,andsupersedesanypolicyoftheIDDivision.Shouldtherebeextenuatingcircumstances,theDivisionDirectorwelcomesthefellowtobringanyunforeseenproblemstoattentionforconsideration.ItisimportanttoinformtheProgramDirectorpromptlyuponknowledgeofpregnancy.Thispermitsnecessaryadjustmentsintheschedule.Ingeneral,maternityleaveiscoveredbyunusedsickleave/vacationtime.Therefore5weeksincluding3weeksofvacationand2weeksofsicktimecanbeusedtocovermaternityleave.Oneweekofvacationorsickleavemaybetakenforpaternityleave.Shouldaleaveofabsenceexceedaccruedtime,stipendpaymentswillbeinterrupted.However,familyhealthinsurancebenefitswillcontinueaslongastheresidentpaystheindividualpremium.Inaddition,residentsarerequiredtomakeuptimeattheendofresidencyshouldtheyexceedtheiraccumulatedtimeforleave.ThisissubjecttoapprovalfromtheProgramDirectorastheDepartmentofMedicinebecomesfinanciallyresponsibleforaresident’ssalaryiftrainingiscompleted“offcycle,”orafterJune30ofthesecondyearoftraining.(SeeIMHousestaffProgramManual,SectionM)LateStart

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TheIDprogramcannotallowalatestart(afterJuly1)totheusualtrainingperiodduetofinancialrestraintsattheUniversity.Thismeansthatanunscheduledandunforeseenabilitytoinitiateortocontinuetrainingontimemayresultintheinabilityoftheprogramtoacceptsuchafellow.J.BenefitsCompensationissetbytheDepartmentofMedicine.ThefirstyearfellowisconsideredatthePGY4levelandthesecondyearatthePGY5level.AdditionalbenefitsarethosedesignatedbytheDepartmentofMedicineforresidentsofthesamelevel.TheseareprovidedbytheDepartmentofMedicineandareoutlinedindetailintheDepartmentofMedicineProgramManual(Section5).BenefitquestionscanbefurtherdirectedtotheIDDivisionadministrator(588‐3891)ortheInternalMedicineBusinessoffice.(588‐6001).

A. PayFellowsgetpaideverytwoweeks,startingtwoweeksafterthefellowcompletesthefirstpayperiod.Aresidentcanchoosetohavethepaycheckmailedtohis/herhomeorhaveitdepositedelectronicallyintohis/heraccount.

B. MedicalinsuranceMedicalinsuranceispaidbytheUniversitybutfellowsdohaveachoiceregardingparticularplans.ThisisthesamechoiceofferedtoUniversityemployees.Detailedinformationonthevariouscoverageplanswillbemadeavailableduringthenewfellow’sorientation.

C. Lifeinsurance.TheDepartmentpurchasesagrouptermlifeinsurancepolicyforallofitsresidentsandfellowswithoutthenecessityofpriorexamination.Thisincludesaccidentaldeathanddismembermentprotectionintheamountof$50,000.Thispolicyisconvertibletopermanentlifeinsurancewithin31daysofleavingthegroup.Thisbenefitshouldbekeptfirmlyinmindasthetrainingprogramfinishes.

D. MalpracticeinsuranceWhilepracticingmedicineattheKUMedicalCenteranditsaffiliatedhospitaltrainingsites,fellowsarecoveredbyaself‐insuranceplanadministeredbytheStateofKansas.Thispolicyprovidesstandardcoverageforallactivitiestypicaltointernalmedicine.ThereistailcoverageforanysuitsfiledafterafellowshaslefttheDepartmentforaperiodof3years.ThispolicycoversfellowsonlywhilepracticingunderapprovedcircumstancesintheKUMCanditsaffiliatedhospitals.Ingeneral,thisisnotconfining.However,whenconsideringissuesrelatedtomoonlighting,theremaynotbecoverageprovidedfornon‐affiliatedhospitals.Itistheresident’sresponsibilitytoknowiftheyhavecoverageduringmoonlightingtime.

E. DisabilityinsuranceTheDepartmentinsuresresidentsshouldtheybecomedisabledandcannotwork.Thepolicypays$1000/monthinbenefitsbeginning181daysafterthedisability.Thispolicytakeseffectwithoutthenecessityofaqualifyingphysicalexamination.Thispolicymaybeconvertedtoprivateuse,againwithoutrequiringanexamination,ifonedecidestodosowithin31daysoftheterminationofwiththeDepartment.Thisispotentiallyaveryvaluablebenefitwhichshouldbeconsideredasoneapproachestheendoftraining.Therearemultiplesupplementalpolicieswhicharefurtherdefinedinoneoftheorientationlectures.

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F. ParkingAKUparkingpassisprovidedbytheIDDivisionatthebeginningoftheacademicyear.ParkingattheKCVAMCandRMCisalsoprovidedfreeofcharge.

G. WhitecoatsTheIDDivisionprovideseachresidentwithtwowhitecoats.ResidentsshouldbeawarethatitisofficialmedicalschoolpolicythatwhitecoatswithnameandhospitalIDbewornatalltimes.Thissamepolicystatesthatnootherbuttons,stickers,pictures,appliqués,statements,politicalcommentsetc.adornthewhitecoats.

H. AccesstoMedicalLiteratureandBoardPreparationMaterialsTheArchieDykesLibraryfortheHealthSciencesislocatedacross39thStreetnorthofthehospital.Thelibrarystocksthevastmajorityofcommonlydesiredperiodicalsbytheclinicalandbasicsciencestaff.Booksandmanualsarealsoreadilyavailable.Accesstothelibrary’selectronicjournalsanddatabasesareavailableonlinethroughtheKUMCwebsite,bothonandoffcampus.TherearebooksandcomputersavailableintheIDFellowoffice(6065)andtheDivisionLibrary(Delp6070).AlltheUniversityandKCVAMCcomputershaveUpToDateonthemandinternetaccesstotheDykeslibraryisavailable.Inaddition,anumberofboardreviewresourcesareavailableforfellows’useintheIDFellowsoffice

I. WorkenvironmentTheIDProgramwillprovideasafeandadequateworkenvironmentasoutlinedintheGMEofficeHousestaffPolicyandProcedureManual(Section5.8.3).FoodandRestTheProgramwillprovideaccesstofoodserviceandsleepingquarterstothefellowwhileon‐callorotherwiseengagedinclinicalactivitiesrequiringthefellowstoremainintheMedicalCenterovernight.Sleepingquartersandquietroomsarealsoavailableforfellowsshouldtheyexperiencefatiguethatwouldmitigatealertnessmanagementstrategiessuchasstrategicnapping.ProtectiveEquipmentInaddition,personalprotectiveequipmentincludinggloves,face/mouth/eyeprotectionintheformofmasksandeyeshields,andgownswillbeavailable.TheOccupationalSafetyandHealthAdministration(OSHA)andtheCentersforDiseaseControl(CDC)assumethatalldirectcontactswithapatient’sbloodorotherbodysubstancesareinfectious.Therefore,theuseofprotectiveequipmenttopreventparenteral,mucousmembraneandnon‐intactskinexposurestoahealthcareproviderisstronglyrecommended.

K.MoonlightingPolicyProfessionalactivityoutsideofthescopeofthefellowshipprogram,whichincludesvolunteerworkorserviceinaclinicalsetting,oremploymentthatisnotrequiredbytheprogram(moonlighting)shallnotjeopardizeanytrainingprogramoftheUniversity,compromisethevalueofthetrainee'seducationexperienceorinterfereinanywaywiththeresponsibilities,dutiesandassignmentsofthefellowshipprogram.Itiswithinthesole

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discretionoftheProgramDirectortodeterminewhetheroutsideactivitiesinterferewiththeresponsibilities,dutiesandassignmentsofthefellowshipprogram.BeforeengaginginactivityoutsidethescopeoftheFellowshipProgram,fellowsmustreceivethewrittenapprovaloftheDivisionDirectorand/orFellowshipProgramDirectorofthenature,durationandlocationoftheoutsideactivity.Furthermore,thefrequencyordurationofoutsideprofessionalactivitiesmustnotbesuchastoresultinphysicalandmentalfatigueleadingtoimpairmentoftraining.TheIDfellowmaynotscheduletimetoexceedthe80hoursmaximumdutytimeeachweekmandatedbytheGMEPolicyandProcedureManual.Fellowswhileengagedinprofessionalactivitiesoutsidethescopeofthefellowshiparenotprovidedprofessionalliability.AfellowprovidingservicesoutsidethescopeofthefellowshipprogramshallwarranttoUniversitythatthefellowisandwillremaininsuredduringthetermofanyoutsideprofessionalactivities.TheregulationsgoverningmoonlightingactivitiesandprofessionalliabilityinsurancerequirementsfortheseactivitiesarediscussedintheDepartmentofMedicineProgramManualPolicyandProceduresSectionV.OandtheKUGMEPolicyandProcedureManualSection16.ThedocumentsaremadeavailabletothefellowduringtheDepartmentofMedicineorientationandareavailableonline.L.EthicsWithincreasingmedicalsophistication,theethicalquestions,whichsurroundapatient’scareoftenoverwhelmthemedicaldecisions.Medicaland,evenmoreso,ethicalcomplexitiesarecommonplaceinthefieldofmedicine.Eveninthemostcomplicatedethicalsituation,thefirstandmostimportantstepistotalkwiththepatientand,ifpermittedbythepatient,thefamily.Onlythroughfullcommunicationwiththeappropriatedecisionmakercanthefellowaddresshonestly,thoroughlyandexpedientlytheissuesofconcern.Thehospitalethicscommittee,available24hoursadaybypager,consistsofbothmedicalandotherpersonnelwhoareavailabletoexploreandadviseonmajorethicalconcerns.Physiciansonthecommitteeareavailablefordiscussionandforconsultationatanytime.Inaddition,thereisamonthlyEthicsconferenceheldbytheEthicscommitteeinconjunctionwiththeGeneralMedicinedivision.Ethicaldilemmasarisingontheinpatientmedicalservicesarediscussedinaninformalsetting.M.UtilizationManagementItistheresponsibilityoftheIDFellowtoassurethatdocumentationintherecordcompletelydescribesthepatient'sseverityofillness,aswellastheintensityoftreatmentservicesprovidedtothepatient.Documentationoflevelofcare,complexityofthecase,recordsreviewed,diagnostictestsandradiographspersonallyreviewed,diagnoses,andrecommendedmanagementaretobeincludedoneverynoteinthepatient’schart.N.QualityImprovement

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ContinuousQualityImprovement(CQI)isanongoing,flexible,integratedandcoordinatedhealthcareprogramthatstressesacommitmenttocontinuouslyimprovepatientcareandserviceandresolveidentifiedproblemsbyassessingandimprovingallaspectsthatmostaffectpatientoutcomes.Itistheresponsibilityofallemployees,includingfellows,toactivelyparticipateintheCQIactivities.ThegoaloftheCQIprogramistodevelopcollectiontools,analyzedata,formulatedatadrivenrecommendationsforimprovement,andcoordinateresolutionoftheidentifiedopportunitiesforimprovement.Inidentifyingopportunitiesforimprovement,theCQIprogramplacesemphasisoncost,quality,access,customerservice,desiredpatientoutcome.Itpursuesopportunitytoimprovecare/service,allowsforresolutionofidentifiedproblems,assuresasafeandhealthyenvironmentforpatients,patientfamiliesandemployees,andensuresappropriateandeffectiveutilizationofresources.ContinuousQualityImprovementActivitiesFacultyandfellowswillbeexpectedtoparticipateinthePatientSafetyConferenceoftheDepartmentofMedicine,whichispresentedmonthly.InthisconferencetheVanderbiltHealthcareMatrixisutilizedtoreviewthecase.ThistoolfollowsthesixACGMEClinicalCompetenciesaswellasthesixIOMAims(safe,timely,effective,efficient,equitable,patientcentered.Thetoolprovidesastructuredopportunityfortheparticipantstolookatanepisodeofcareanddeterminehowthequalityofcarewasaffectedbythecorecompetenciesandidentifypotentialareasofdeficienciesandopportunitiesforimprovement.Similarly,theVanderbiltHealthcareMatrixhasbeenincorporatedintotheweeklyIDCaseConference.HerefellowsandattendingsareprovidedtheopportunitytoexaminetheepisodeofcareinthesettingofthecorecompetenciesandIOMaimsandinstitutechangesdirectlytotheirpatientsandpractice.ThemonthlyDepartmentofMedicineCPCConferencealsoprovidesastructuredenvironmenttoexamineindividualandsystempracticesandopportunitiesforimprovement.LecturescoveringthetopicofqualityimprovementaresponsoredthroughouttheyearbytheDepartmentofMedicine.InfectiousDiseasesFellowsarerequiredtoattend.O.RiskManagementThissectionsupplementstheKUGMEandInternalMedicinePolicyandProcedureManuals.RiskManagementinvolvesboththeHospitalandTheUniversityofKansas.Italsoinvolvesthepreventionorhandlingofadverseeventsandthehandlingoflegalissues.AdverseEventsTheStateofKansasrequiresreportingofalladverseeventstoaconfidentialreportingsystem.Whenapatientsuffersanadverseevent,thefirstpriorityistoassurethepatient’ssafetythroughinterventionandfollow‐up,includingorderinganyadditionalmonitoringortests.Anexamplemightbeananaphylacticreactiontoaknownmedicationallergen.Prioritiesincludestabilizingthepatientandmakingsurestaffreporttheadversethroughthehospitalsadverseeventreportingsystem.

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Ifanadverseeventoccursthathasthepotentialtoleaveapatientwithsevere,permanentdisabilityordeath,TheJointCommissionrequiresaRootCauseAnalysis(RCA)beconductedtodeterminecontributingfactorsandanactionplantopreventrecurrenceofsuchanevent.TheHospital’s1RiskManagerwillfacilitatetheRCAanditsfollow‐up.FellowsshouldalsocontacttheUniversityRiskManagerat913‐588‐7283,andinformtheUniversityRiskManagerofthesituation.Donotwriteanynotesaboutthesituation,otherthanobjectivechartinginthepatient’srecord,oradditionalnotesintheadversereportingsystemfortheHospitalorfacility.Ifanyoneasksyoutowriteasummaryofevents,contacttheUniversityRiskManager.OtherReasonstoContacttheUniversityRiskManagerInadditiontoseriousorfataladverseeventsinvolvingpatients,theUniversityRiskManagershouldbecontactedwheneverthefollowinghappens:

1. Aphonecallreceivedfromanyattorneyrequestingtomeetwithyou.Thesecanbeplaintiff’sattorneysinourorothersmalpracticecases,defenseattorneysinourorothersmalpracticecases,criminaldefenseattorneys,orcriminalprosecutingattorneys,usuallyaDistrictAttorney’soffice.

2. Asubpoenareceivedfromanysource.Asubpoenaisacourtdocumentdirectingyoutocourttotestifyoradepositiontoprovidesworntestimonypriortoacase,eithercivilorcriminal.AsubpoenamustbeproperlyservedbeforeitisenforceableandtheUniversityRiskManagerwillassistyouinproperlyrespondingtothesubpoenaandassuringyoudonotmissanytimedeadlinesthatmightputyouatriskofbeingheldincontempt.

3. Asummonsreceivedfromanysource.Thisisacourtdocumentthat“summons”youtocourttodefendyourselfinalawsuit.Youhavealimitedtime,20days,torespondtoasummonssocontacttheUniversityRiskManagerimmediately.Adefenseattorneywillbeassignedtoyoutorespondtothesummons.Incivilcases,thesummonsisaccompaniedbyapetitionorcomplaint.Inacriminalcase,thesummonsisaccompaniedbyanarrestwarrant.

4. Ifthereareanyquestionsaboutmedical‐legalsituations.Itisfareasierforeveryoneinvolvedtoanswerquestionsandtakepreventativemeasuresthantoundosomesituations.Examplesinclude:

a. Questionsaroundrequiredreportingofabuse,victimsofcrimes,etc.b. Questionsaroundhowtochartadverseeventsinthepatientchart.c. Questionsaroundlitigationprocess,contactingdefenseattorneys,etc.d. Wantingtoreviewacaseandevaluatepotentialrisksissues.

P.ProfessionalismItisimperativethatthefellowlearnappropriatebehaviorofaprofessionalduringtheirexperience.Itisrecognizedthathealthcareisbestdeliveredwhenphysiciansarecollegial,yetfrankwitheachotherandrespectfulandcaringoftheirpatients.Itisthusthe1ThiscouldbetheVeterans’AdministrationMedicalCenter,theUniversityofKansasHospital,orotherfacilitywherefellowactivitiesareperformed.

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responsibilityofthefellowtobefit,readyforworkanddressedappropriately.Facultyshouldbenotifiediftheconductofthefellowsiseverconsideredlessthanprofessional.TheProgramDirectorwilldiscusssuchincidentswiththefellowinquestion.Theuseofillicitdrugswillnotbepermittedatanytimeandalcoholshallnotbeconsumedbyanyonewhoisoncalloronactiveduty.Anyonefoundinviolationoftheseruleswillbetreatedinaccordancewithdepartmentalandschoolpolicy.Sexualorgenderharassmentbyfellowsofanyonewillnotbetoleratedandwillbegroundsforreferraltothedepartment'sadministration.Atthesametime,nofellowshouldeverbethesubjectofsexual,gender,religious,ethnicorotherharassment.AnycomplaintofsuchbehaviorshouldbereportedtotheDivisionDirector,theprogramdirector,orthedepartmentchairman.Finally,theDivisionrecognizestheadvantagesofdiversityamongstitsmembersandsupportstheirrightstodifferentreligious,political,economic,andartisticbeliefs.Thus,anydiscriminationorharassmentofanyfellow,oranyothermemberoftheDivision,becauseofthesedifferencesshouldbereported.ThesepoliciesandproceduresareasupplementtothepoliciesandproceduresoutlinedfortheDepartmentofMedicineandtheKUSOMGraduateMedicalEducationOffice.ThesemanualsareprovidedatthebeginningofthefellowshipandavailableonthewebsitesofInternalMedicineortheGraduateMedicalEducationOffice.Q.ImpairmentSatisfactoryperformanceincludestheabsenceofsignificantimpairmentduetophysical,mental,oremotionalillness,personalitydisorder,orsubstanceabuse.Afellowthatshowsimpairedfunctiontoadegreeitiscausinglessthansatisfactoryperformance,and/ortheimpairedfunctionisnotcorrectedorisuncorrectable,islikelytoleadtofutureunsatisfactoryperformance.Everyeffortwillbemadetoreasonablyaccommodatethoseindividualswithconditionsorimpairmentsthatqualifyasadisabilityunderapplicablelaw,providedthattheaccommodationdoesnotpresentanunduehardshipfortheDepartment,theMedicalSchool,orvenuesoftraining.FellowswillneverthelessberequiredtosatisfactorilymeettheDepartment’sperformancecriteria,requirements,andexpectationsoftheInfectiousDiseasesFellowshipProgram.IftheDirectorhascausetosuspectthatafellow’sbehaviormaybealteredduetoaphysicalormentalimpairment,theuseofdrugs,narcotics,oralcohol,theDirectorwillconsultwiththeIMRRCofficetofollowthestandardproceduresoftheUniversityinthisregard.PleaserefertoKUGMEPolicyandProcedureManual(Section7)forthedetailsofinstitutionalpolicyregardingidentificationofimpairment,reintegrationintotraining,andongoingmonitoringofaffectedresidentsorfellows.R.DisciplinaryActions,Probation,SuspensionandTerminationTheFellowshipDirectorortheAssociateFellowshipDirectorisresponsiblefortheevaluationanddisciplineofeachIDfellowinthisprogram.Fellowsaremonitoredand

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evaluatedbasedonthesixcorecompetenciesandstandardssetforthbytheDivisionandInstitutionandincludethefollowing:

1) Patientcarethatiscompassionate,appropriateandeffectiveforthetreatmentof healthproblemsandthepromotionofhealth.2) Medicalknowledgeincludingestablishedandevolvingbiomedical,basicscienceand

clinical,sciencesandtheapplicationofthesetopatientcare.3) Practice‐basedlearningandimprovementthatinvolvesinvestigationandevaluation

ofthefellow’sownprovisionsofpatientcare,appraisalandassimilationofscientificevidence,followedbyimprovementsindeliveryofpatientcare.

4) Interpersonalandcommunicationskillsthatresultineffectiveinformationexchangemakingprovisiontoteamwithpatients,families,andotherhealthprofessionals.

5) Professionalismasshownbyacommitmenttocarryingoutprofessionalactivitiesandresponsibilities,adherencetoethicalprinciples,andsensitivitytodiversepatienttypesandbackgrounds.

6) Systems‐basedpracticeshownbyactionsthatdemonstrateawarenessofandresponsivenesstothelargerhealthcaresystem,theabilitytoeffectivelyusesystemresourcestoprovideoptimalcare.

Inaddition,thefellowwillcomplywiththerulesandrequirementsofKUH,theKUMCGMEoffice,theDepartmentofMedicineInternalMedicineProgramManual.WhilerotatingattheKCVAMCorRMC,eachfellowwillcomplywiththeirspecificrules,guidelines,andrequirementsaswellasthosepromulgatedbytheBoardsofHealingArtsoftheStatesofKansasorMissouriasrequired.Otherspecificguidelinesrequirethateachfellowwill:

1) Developapersonalprogramoflearningforcontinuedprofessionalgrowthwithguidancefromtheteachingstaff.

2) Participateintheeducationalandscholarlyactivitiesoftheirprogramandteachorsuperviseotherresidents,students,orfellows.

3) Participateinappropriateinstitutionalcommitteesasappointedbythedivisiondirectororthedesignee.

4) Submitregularlyanelectronicanonymousconfidentialevaluationofthefacultyandoftheeducationalexperience.

5) Continueinactivescholarship.Thismayincludepublications,orpresentationsatlocal,regional,ornationalscientificsocietymeetingsandcouldinvolvecases,reportsorclinicalseries,ortranslationalresearch.

6) Beanactiveparticipantinclinicaldiscussions,rounds,journalclubs,andresearchconferencesinamannerthatpromotescollegiality,inquiryandscholarship.

PerformanceDeficienciesAftertheDirectorreceivesnotificationofsatisfactoryevaluationsandcompliancewiththestandardsoutlinedaboveandafterallothertermsoftheIDFellowshiptrainingPoliciesandProceduresaremet,eachfellowshouldexpecttocontinuetothenextleveloftrainingtocompletetheprogram.

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Shouldafellowbefoundtobedeficientinanyofthecriteriaorparametersofperformanceandnotmeetadvancementorpromotionspecifics,he/shewillmeetwiththeProgramDirector,theAssociateDirectorortheirdesigneewherein:1.Theexpectationsanddeficiencieswillbestated.2.Whattheindividualcandotoimprovewillbeexploredandplanned.3.Anattemptwillbemadetodetermineifthereareoutsidefactorswhichmayexplainwhyaproblemhasdeveloped.AtthispointadeterminationwillbemadebytheprogramleadershipofwhetherthefellowisingoodstandingorisinaPerformanceWarningStatus(PWS).ThePWSwillinvolveaperiodof3months,wheretheperformanceofthefellowcanbemonitoredmoreclosely.PWSisdesignedtoidentifyweaknessesthat,ifnotremedied,mayleadtoprobationordismissal.TheProgramDirector,AssociateProgramDirector,ortheirdesigneewillberesponsiblefordeterminingtheprocessforremediation.Thismeetingwillbedocumented,giventothefellowforhis/heragreementofthemeetingcontent,andafinalcopywillgointothefellow’spersonalfile.Unlessotherwisestated,afellowinPWSisstillconsideredtobeingoodstandinganddoesnothavetoreportthisactiononfutureprofessionalapplications.Should,however,thefellowsbeplacedinPWSagainaftertheinitial3monthperiod,he/sheiseligibletobeplacedonprobation.Shouldtheresidentcontinuetobedeficientdespiteappropriatecounseling,professionalassessmentandinput(ifindicated),andfacultyefforts,aperiodofprobation(usually3months)isindicated.Beforebeingplacedonprobation,thefellowwillappearbeforetheResidencyEducationCommitteewhereinhis/hercasewillbediscussed.Thefellowinquestionwillhavetherighttorebuketheclaimsmadeagainsthim/her.Ifhis/herperformanceisdeemedtowarrantprobation,thentheinstitution’sGraduateMedicalEducationofficewillbenotifiedandallpoliciesdelineatedwithintheGMEPolicyManualwillbefollowed.Aformalwrittenletterofprobationwillbedrafted.Awrittenletterofprobationshould:1.Statedeficienciesthattheindividualhasbeencounseledforanddocumentthatinsufficientimprovementhasbeenmade.2.Stateexplicitlythatbecauseofthistheindividualisbeingputonprobation.3.Stateperiodofprobation,4.Statewhatisexpectedduringthisperiod.5.Statewhatwillbedonetoassisttheindividualinmeetingtheseexpectations.6.Statewhatthemechanism(s)willbetodetermineimprovement.7.Statewhattheconsequencesoroptionsaretobeifexpectationsarenotmet.Thedeficientfellowwillreceivethisletterandacopywillgointohis/herpersonalfile.Fellowsplacedonprobationmayhavedifficultywithlicensureinsomejurisdictions.TheprobationaryperiodisintendedtoemphasizetotheresidenttheimportanceofsatisfactorilymeetingthefellowshiptrainingrequirementsandexpectationsoftheDepartment.Thefellowshouldclearlyappreciatethemeaningofexpectedremediation,appreciatethedefinedtimeinwhichthismustbeaccomplished,andalerthis/herattendingfacultyduringthisperiodofprobationtotheimportanceofhelpingthefellow

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withdefinedproblems.Thefacultyshouldprovideanhonestevaluation,andcomplywithrequestsbytheDepartmentforassessment,counseling,orassistance,shouldtherebeanypossibilityofpersonalproblems,learningdisability,oroutsidefactorsthatmaybecontributorytothefellow’sperformance.Fellowsonprobationmustachieveasatisfactoryevaluationfromtheirattendingfacultyonassignedclinicalservicerotationsduringtheirprobationaryperiod.Probationaryactionswillonlybesharedwiththoseneedingtoknow.Shouldthefellowfailtheaboveprobationaryperiod,thenatthediscretionoftheDepartment,aletterextendingtheprobationmaybeissued,oraletterdismissingthefellowfromtheprogramonadesignateddatewillbeissued,assumingthatdismissalwasaconsequenceofprobationaryfailureasstatedabove.Accompanyingthislettermustbeastatementofthefellow’srightofappeal.Afellowwhomayormaynothavebeenonprobation(andsuccessfullyaccomplishedremediationintheprobationaryperiod),butwhohasreceivedintermittentlowsatisfactoryorisolatedunsatisfactorymarksduringthe8to12monthsoftheacademicyear(andparticularlyfollowingaprobationaryperiod),maybeaskedtorepeattheyear.ThisisparticularlytrueiftheDepartmentwillinalllikelihoodbeunabletocertifytheresidenttositfortheABIMexaminationshouldtheresident’sperformancetrendcontinue.(PleaserefertotheGMEmanualforacomprehensivesectionondeficiencyandremediationpolicies.)S.GrievanceResolutionGrievablemattersarethoserelatingtotheinterpretationof,applicationof,orcompliancewiththeprovisionsoftheResidentAgreement,thepoliciesandproceduresgoverninggraduatemedicaleducation,andthegeneralpoliciesandproceduresoftheUniversityofKansasMedicalCenter.Questionsofcapricious,arbitrary,punitiveorretaliatoryactionsorinterpretationsofthepoliciesgoverninggraduatemedicaleducationonthepartofanyfacultymemberorofficeroftheInfectiousDiseasesFellowshipProgramaresubjecttothegrievanceprocess.Agrievanceprocedureisavailabletofellowsforresolutionofproblemsrelatingtotheirappointmentsorresponsibilities,includingdifferenceswiththeSchool,Program,oranyrepresentativethereof.TheSchoolensurestheavailabilityofproceduresforredressofgrievances,includingcomplaintsofdiscriminationandsexualharassment,inamannerconsistentwiththelawandwiththegeneralpoliciesandproceduresoftheUniversityofKansasandtheSchool.AcompletedescriptionofthegrievanceprocessisavailableintheIMandGMEProgrammanuals

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VII. APPENDIX

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IDCORECURRICULUMSCHEDULE

Itisexpectedthatbytheendofthetrainingperiod,thetraineewillhavehadextensivepersonalexperienceandwillhaveacquiredaknowledgebasefromdidacticteachingandreadingtodealcompetentlywithallofthefollowing:(Pleaseseedivisionalcalendarforeachspecificyearforthedatesoftheselecturesandpresenters)Year1and2BootCampCurriculum(Twiceweeklyfor5weeks)InfectioncontrolLine‐relatedinfectionsOsteomyelitis:(includingvertosteo/septicarthritis)ProstheticJointInfections/ForeignbodyInfections(CNSshunts;pacemakers,etc.)HIV:GeneraloverviewHIV:anti‐retroviralsHIV:opportunisticinfectionsAntibioticsI:B‐lactams/aminoglycosidesAntibioticsII:otherabxclassesMicrobiologyLab:basicoverview

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Year1Curriculum(Weeklyconference)

Nocardia/actinomycesSTD’s:gonorrhea,Chlamydia,chancroid,etcDesigningaresearchprotocolSyphilisandotherspirochetalillnessesFungalInfectionsI:endemicfungi(histo/blasto/cocci,sporothrix)FungalInfectionsII:cryptococcus/candidaspp.FungalInfectionsIII:filamentousfungiHuman/animalbiteInfectionsinIVDU’sAntiviralagentsPK/PDFoodpoisoningBMToverviewStemcell/BMTInfectionsTropicalmedicinereview(otherthanmalaria)TravelmedicineZoonoses

Burns/WoundsHIV:relatedmalignanciesMono‐likesyndromes(DMV,EBV,Toxo,etc)Bacterialgenetics/mechanismsofresistanceStreptococcalinfectionsStaphylococcalinfections/virulencefactorsBasicsofbillingImmunosuppressionImmunizationsofadultsAntimicrobialProphylaxis:(surgical;bacterialendocarditis,HIVPEP,Hepatitis,Rabies,Varicella,etcAntifungalagents

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Year2Curriculum(WeeklyConference)MoleculardiagnosticsSepsisFebrileneutropeniaCommunity‐acquiredpneumoniaHospital‐acquiredpneumoniaSOTInfections:ISOTInfections:IIHepB/HepCHepatitisA,D‐GCNSII:acutemeningitis/brainabscessesCNSIII:chronicmeningitis/prionsAntibiogramIntraabdominalinfectionsC.diff/InflammatoryEnteritidiesTuberculosisNon‐tuberculousmycobacteriumMicrobialpathogenesisHeadandneckinfectionsInfectionsoftheeyeFUOHSV/VZVRickettsialinfectionsTick‐borneIllnessesHIV:Coinfection(TB;HepB/HepC;pregnancy)UrinarytractinfectionsPost‐partuminfectionsBioterrorism

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IDCONFERENCES

Conference Day Time Frequency IDCaseConference Monday 7am WeeklyIDJournalClub Tuesday 12pm WeeklyIDCoreConference Thursday 12pm WeeklyIDResearchMeeting 3rdWednesday 12:30pm MonthlyIMPatientSafety 2ndMonday 12pm MonthlyIMClinicalPathologicConference 4thTuesday 12pm MonthlyIMGrandRounds Friday 8am WeeklyInfectionControlandPrevention Friday 1pm MonthlyAntibioticP&TSubcommittee 2ndTuesday 7am MonthlyGMEcurriculumseries Tobeannounced 6:30am Quarterly

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GMERESIDENTSUPERVISIONTEMPLATE

Per

Pro

gram

Spe

cific

RR

C R

equi

rem

ents

RRC APPROVED LICENSED INDEPENDENT PRACTITIONER SUPERVISOR (PR VI.D.1) VI.D.1. In the clinical learning environment, each patient must have an identifiable, appropriately-credentialed and privileged attending physician (or licensed independent practitioner as approved by each Review Committee) who is ultimately responsible for that patient’s care. Infectious Diseases does not utilize licensed independent practitioners. VI.D.1.a) This information should be available to residents, faculty members, and patients. VI.D.1.b) Residents and faculty members should inform patients of their respective roles in each patient’s care. OPTIMAL CLINICAL WORKLOAD (PR VI.E.) Clinical Responsibilities The clinical responsibilities for each resident must be based on PGY-level, patient safety, resident education, severity and complexity of patient illness/condition and available support services. The optimal clinical workload is not currently defined by RRC for Infectious Diseases. MEMBERS OF THE INTERPROFESSIONAL TEAM (PR VI.F.) VI.F. Teamwork Residents must care for patients in an environment that maximizes effective communication. This must include the opportunity to work as a member of effective interprofessional teams that are appropriate to the delivery of care in the specialty. Specific review committee elements have not been defined by RRC for Infectious Diseases. COMPETENCIES TO ALLOW PGY1 RESIDENTS TO PROGRESS TO INDIRECT SUPERVISION (PR VI.D.5.a).(1) ) Not applicable for Infectious Diseases DEFINING RESIDENT LEVELS “INTERMEDIATE LEVEL” & “FINAL YEARS OF TRAINING ” For establishing the minimum rest period between duty periods (PR VI.G.5.b&c) Not applicable for Infectious Diseases VI.G.5.c) Residents in the final years of education [as defined by the Review Committee] must be prepared to enter the unsupervised

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practice of medicine and care for patients over irregular or extended periods. CIRCUMSTANANCES WHEN RESIDENTS IN THEIR FINAL YEARS OF EDUCATION MAY REMAIN OR RETURN IN < 8 HOURS (PR VI.G.5.c).(1)) The majority of RRCs defined these circumstances as “required continuity of care for a severely ill or unstable patient, or a complex patient with whom the resident has been involved; events of exceptional educational value; or, humanistic attention to the needs of a patient or family. As a consulting service, requirements for fellows to remain or return with less than 8 hours off does not occur. DEFINED MAXIMUM NUMBER OF CONSECUTIVE WEEKS AND MAXIMUM NUMBER OF MONTHS PER YEAR OF IN-HOUSE NIGHT FLOAT (PR VI.G.6.) VI.G.6. Maximum Frequency of In-House Night Float Fellows must not be scheduled for more than six consecutive nights of night float. Infectious Diseases fellows do not participate in night float.

Program-specific guidelines for circumstances and events in which residents must communicate with appropriate supervising faculty (PR VI.D.5)

1. Admission to Hospital 2. Consultation 3. Transfer of patient to a higher level of care 4. End-of-Life decisions

Source of specific criteria and/or specific national standards-based criteria

used to evaluate each resident’s abilities (PR VI.D.4.a) RRC has yet to define specify criteria or identify national standard based criteria to

be used for Infectious Diseases

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Inpatientservice Outpatientclinic Research MicrobiologyFellowswill:‐gatherdata;orderdiagnostictests;interpretdata;makediagnosticandtherapeuticdecisions;performandinterpretGramstains;managepatienttherapies,emphasizingappropriateuseofantimicrobials;andworkwithotherstoprovidepatient‐focusedcare(PC,MK,P,CS,PB,SBL)‐managecommonandcomplexID;problemsnthefaceofantibioticresistance(PC,MK,PBL)‐developskillstoappraisethecurrentmedicalliteraturetosupportdecision‐making(PBL,MK‐developcommunicationskillstofacilitatethelearningofothers(PBL,SBL,CS,P)‐useeffectivelistening,narrative,andnon‐verbalskills;writelegibleandcomprehensivenotes(CS,P)‐beresponsivetopatientsandsociety,supersedingself‐interest(P)‐demonstrateintegrity,honesty,reliability,cooperative,andacceptresponsibility(P)‐workwithhealthcareprofessionalstoprovidepatientfocusedcare;advocateforqualitypatientcare(SBL,CS,P)

Fellowswill:‐managemedicalandpsychosocialaspectsofcommonandcomplexoutpatientinfectiousdiseases(PC,MK,CS,PBL,SBL,P)‐developskillintheuseofantibiotics,andprophylacticagents(PC,MK)‐appraisethemedicalliteratureregardingoutpatientcaretosupportdecisionmaking(PBL,MK,SBL,PC)‐Useeffectivelistening,narrative,andnon‐verbalskills;writelegibleandcomprehensivenotes(CS,P)‐Beresponsivetoneedsofpatientsandsocietysupersedingself‐interest(P)‐demonstraterespect,compassion,andintegrity;behonest,reliable,cooperative,andacceptresponsibility(P)‐Workwithhealthcareprofessionalseffectivelytoprovidepatientfocusedcareadvocateforqualitypatientcare(SBL,CS,P)

Fellowswill:‐provideawrittendescriptionoftheirproposedprojectandseekIRBapproval(CS,P,SBL)‐gainskillsinthedesignofapproachesthatprotectsubjectsinresearchstudies(PC,MK,P,PBL,CS)‐learntheconstructionofstudieswhichadequatelystresstheethicsofclinicalresearch,appropriatestatisticalmodeling,obtainingeffectiveinformedconsent(PC,MK,P,PBL,SBL,CS)‐communicatinginterimresultstopatientsfaculty,andtheIRB(CS,P)

Fellowswill:‐becomefamiliarwiththetechnicalaspectsofpathogenisolation,sensitivitytesting,andmolecularmethods(MK,PC)‐communicateclearlywiththemicrobiologystaffandclinicalservice(SBL,CS,P)‐demonstratehonesty,integrity,reliability(P,CS)

OverviewoftheEducationalObjectiveswithReferenceToSixCoreCompetenciesYearOneFellowship

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Inpatientservice Outpatientclinic ResearchInadditiontoyear1objectives,fellowswill:‐accuratelyapplyclinicalinformationtoensurepositivepatientoutcomes(PC,PBL,MK)‐assumemoreresponsibilitymakingclinicaldecisions(PC,MK,P)‐regularlyusemedicalliteraturetosupportdecisionmaking(PBL,MK,PC)‐effectivelydiscussendoflifecarewithpatientsandtheirfamilies(CS,P)‐displayinitiativeandleadership(P,CS,SBL)‐appropriatelydelegateresponsibilitytoothers(P,SBL,CS)‐showacommitmenttoprofessionaldevelopment(P)‐usesystematicapproachestoreduceerrors(SBL)‐partnerwithotherproviderstoimprovepatientcare(SBL,CS,P)‐providecost‐effectivecare(SBL,PBL,MK)

Inadditiontoyear1objectives,thefellowwill:‐establishtheirownpanelofHIV‐positivepatientstounderstandmanagementissues,includingfinancialandpsychosocial,relatedtoantiretroviraltherapy,prophylaxisandmanagementofopportunisticinfections,andnon‐medicalofcasemanagement(PC,MK,PBL,CS,P,SBL)‐understandmanagementissuesassociatedwithoutpatientadministrationofantibiotics(PC,MK,SBL)continuetodevelopandimproveconsultativeskillsintheoutpatientsetting(PC,CS,P,SBL.PBL,MK)

Inadditiontoyear1objectives,fellowswill:‐becomeadeptatobtainingandanalyzingtherelevantresearchliterature(MK,PBL)‐prepareresearchforpublicationand/orpresentation(CS,P,SBL)

Competency: CS= InterpersonalandcommunicationskillsPC= Patientcare P=ProfessionalismMK= Medicalknowledge SBL= SystemsbasedLearningPBL= Practice‐basedlearning

OverviewoftheEducationalObjectiveswithReferenceToSixCoreCompetenciesYearTwoFellowship

57

OVERVIEWOFGOALSANDOBJECTIVESFORROTATIONS

InfectiousDiseasesFellowship:KansasUniversityHospital(KUH)InpatientConsultation

Duration: 1styearFellowsareassignedtotheKUHinpatientconsultservicefor6months

2ndyearFellowsareassignedtotheKUHinpatientconsultservicefor9months.

Supervision(Interactionwithfaculty)

SupervisionofthefellowbyInfectiousDiseaseattendingatKUHforinpatientservice

RotationFacility UniversityofKansasHospital

RequiredDidactics/conferences:

IDCaseConference,IDJournalClub,IDCoreConference

InfectiousDiseasesFellowship:KUHInpatient

ConsultationRotation

FellowYear1&2

PATIENTCAREGoal:Demonstratecompetenceinthecontinuumofinpatientcareforinfectiousdiseasespatients

FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

1 2

Demonstrateabilitytogatherdata;orderdiagnostictests;interpretdata;makediagnosticandtherapeuticdecisions;

DemonstrateabilitytoperformandinterpretGramstains;

Demonstrateabilitytomanagepatienttherapies,emphasizingappropriateuseofantimicrobials;

Workeffectivelywithotherstoprovidepatient‐focusedcare;

DemonstrateabilitytomanagecommonandcomplexIDproblemsinthefaceofantibioticresistance

2 Accuratelyapplyclinicalinformationtoensurepositivepatientoutcomes

Goal:Demonstratecompetenceinthediagnosisandmanagementofinfectiousdiseaseareas

FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

1 2

Thiswillincludethefollowinginfectiousdiseasesareas:BacterialinfectionsFungalinfectionsViralinfections

58

HIV/AIDSParasiticinfectionsSepsissyndromesInfectionsinpatientswithimpairedhostdefensesInfectionsinpatientsinintensivecareunitsInfectionsinsurgicalpatientsHealthcare‐associatedinfectionsInfectedtravelersSexuallytransmittedinfectionsProstheticdeviseinfections

EvaluationMethods:AttendingEvaluation,SelfEvaluation,DirectObservation,360Evaluation,RecordReview,Chartsimulatedrecall,In‐trainingExam

MEDICALKNOWLEDGEGoal: DevelopincreasedmasteryofknowledgesurroundingallaspectsofinfectiousdiseaseFellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives. 

1 2

Demonstrateknowledgeofinfectioncontrolandhospitalepidemiology

Understandtheprinciplesofprophylaxisandimmunoprophylaxistoenhanceresistancetoinfections

1 2

Understandthefundamentalsofhostdefenseandmechanismsofmicroorganismpathogenesis.

Understandthecharacteristics,useandcomplicationsofantiretroviralagents,mechanismsandclinicalsignificanceofviralresistancetoantiretroviralagents

RecognizeandmanageopportunisticinfectionsinpatientswithHIV/AIDS

1 2

Demonstratecomprehensiveknowledgeofindications,contraindications,limitations,complications,techniques,andinterpretationsofresultsofthosediagnosticandtherapeuticproceduresintegraltothedisciplineincludingappropriateindicationforanduseofscreeningtests/procedures.

Demonstrateknowledgeofthemechanismsofactionandadversereactionsofantimicrobialagents

Antimicrobialresistance,drug‐druginteractionsbetweenantimicrobialagentsandothercompounds

Demonstrateknowledgeandapplicationoftheappropriateuseandmanagementofantimicrobialagentsinthehospitalandnonacutecareunits.

� 2Assumemoreresponsibilitymakingclinicaldecisions

Demonstrateknowledgeandleadershipinguidingotherhealthcaremembersonappropriateantibioticutilizationandrestrictionpolicies.

EvaluationMethods:AttendingEvaluation,SelfEvaluation,DirectObservation,In‐trainingexam,Role‐playorsimulations

INTERPERSONALCOMMUNICATIONSKILLSGoal:Developinterpersonalcommunicationskillsthatresultinimprovedcommunicationwithpatients,familyandhealthcareteammembers.Fellow Objectives

59

LEVEL Level2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

Developcommunicationskillstofacilitatethelearningofothers

Useeffectivelistening,narrative,andnon‐verbalskills;writelegibleandcomprehensivenotes

� Effectivelydiscussendoflifecarewithpatientsandtheirfamilies

Displayinitiativeandleadershipininitiatingandmaintainingeffectivecommunication.EvaluationMethods:AttendingEvaluation,SelfEvaluation,DirectObservation,360Evaluation,Patientsurvey

PROFESSIONALISMGoal:Demonstrateabilityandcommitmenttocarryingoutprofessionalresponsibilitiesandadherencetoethicprinciplesinthecareofinfectiousdiseasepatients.FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

Demonstratetheabilitytoberesponsivetopatientsandsociety,supersedingself‐interest

Demonstrateintegrity,honesty,reliability,cooperative,andacceptresponsibility

Demonstrateahighstandardofethicalbehavior,includingabilitytomaintainprofessionalrelationshipswithotherphysiciansandabilitytoavoidconflictsofinterest

Demonstrateacommitmenttolifelonglearning

� Showacommitmenttoprofessionaldevelopment

PartnerwithotherproviderstoimprovepatientcareEvaluationMethods:AttendingEvaluation,SelfEvaluation,DirectObservation,360Evaluation

PRACTICEBASEDLEARNINGGoal:Demonstrateunderstandingandabilityforselfreflectionandlife‐longlearningthroughtheabilitytoinvestigateandevaluatepersonalcareofpatientsandappraiseandassimilatescientificevidencetocontinuallyimprovepatientcareforinfectiousdiseasepatients.

FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1 objectivesaswellasdemonstratecompetenceonlevel2objectives

Developskillstoappraisethecurrentmedicalliteraturetosupportevidencebaseddecision‐making

� Regularlyusemedicalliteraturetosupportdecisionmaking

Regularlyapplynewcontributionstothemanagementandcareofinfectiousdiseasepatients.EvaluationMethods:AttendingEvaluation,SelfEvaluation

SYSTEMSBASEDPRACTICEGoal:Demonstrateunderstandingandresponsivenesstothelargercontextandsystemofhealthcareandabilitytoutilizeresourcesinthesystemtoestablishandmaintainoptimalhealthcareforinfectiousdiseasepatients.

FellowLEVEL Objectives

60

Level2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

Demonstrateabilitytoworkwithhealthcareprofessionalstoprovidepatientfocusedcare;advocateforqualitypatientcare

Workininter‐professionalteamstoenhancepatientsafetyandimprovepatientqualityofcare.

�

Advocateforqualitypatientcareincorporatingconsiderationofcostandrisk‐benefitanalysisasappropriateforequitablecareforallinfectiousdiseasepatients

Usesystematicapproachestoreduceerrors EvaluationMethods:AttendingEvaluation,SelfEvaluation,DirectObservation

61

InfectiousDiseasesFellowship:KansasCityVeteransAdministrationMedicalCenter(KCVAMC)Inpatient

Consultation

Duration: 1styearFellowsareassignedtotheKCVAMC inpatientconsultservicefor3monthseach2ndyearFellowsareassignedtotheKCVAMC inpatientconsultservicefor1‐2monthseach

Supervision(Interactionwithfaculty)

SupervisionofthefellowbyInfectiousDiseaseattendingatKCVAMCforinpatientservice

RotationFacility KansasCityVeteransAdministrationCenter

RequiredDidactics/conferences:

IDCaseConference,IDJournalClub,IDCoreConference

InfectiousDiseasesFellowship:KCVAMCInpatient

ConsultationRotation

FellowYear1&2

PATIENTCAREGoal:Demonstratecompetenceinthecontinuumofinpatientcareforinfectiousdiseasespatients

FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

1 2

Demonstrateabilitytogatherdata;orderdiagnostictests;interpretdata;makediagnosticandtherapeuticdecisions;

DemonstrateabilitytoperformandinterpretGramstains;

Demonstrateabilitytomanagepatienttherapies,emphasizingappropriateuseofantimicrobials;

Workeffectivelywithotherstoprovidepatient‐focusedcare;

DemonstrateabilitytomanagecommonandcomplexIDproblemsinthefaceofantibioticresistance

2 Accuratelyapplyclinicalinformationtoensurepositivepatientoutcomes

Goal:Demonstratecompetenceinthediagnosisandmanagementofinfectiousdiseaseareas

FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

1 2

Thiswillincludethefollowinginfectiousdiseasesareas:BacterialinfectionsFungalinfectionsViralinfectionsHIV/AIDS

62

ParasiticinfectionsSepsissyndromesInfectionsinpatientswithimpairedhostdefensesInfectionsinpatientsinintensivecareunitsInfectionsinsurgicalpatientsHealthcare‐associatedinfectionsInfectedtravelersSexuallytransmittedinfectionsProstheticdeviseinfections

EvaluationMethods:AttendingEvaluation,SelfEvaluation,DirectObservation,360Evaluation,RecordReview,Chartsimulatedrecall,In‐trainingExam

MEDICALKNOWLEDGEGoal: DevelopincreasedmasteryofknowledgesurroundingallaspectsofinfectiousdiseaseFellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives. 

1 2

Demonstrateknowledgeofinfectioncontrolandhospitalepidemiology

Understandtheprinciplesofprophylaxisandimmunoprophylaxistoenhanceresistancetoinfections

1 2

Understandthefundamentalsofhostdefenseandmechanismsofmicroorganismpathogenesis.

Understandthecharacteristics,useandcomplicationsofantiretroviralagents,mechanismsandclinicalsignificanceofviralresistancetoantiretroviralagents

RecognizeandmanageopportunisticinfectionsinpatientswithHIV/AIDS

1 2

Demonstratecomprehensiveknowledgeofindications,contraindications,limitations,complications,techniques,andinterpretationsofresultsofthosediagnosticandtherapeuticproceduresintegraltothedisciplineincludingappropriateindicationforanduseofscreeningtests/procedures.

Demonstrateknowledgeofthemechanismsofactionandadversereactionsofantimicrobialagents

Antimicrobialresistance,drug‐druginteractionsbetweenantimicrobialagentsandothercompounds

Demonstrateknowledgeandapplicationoftheappropriateuseandmanagementofantimicrobialagentsinthehospitalandnonacutecareunits.

2Assumemoreresponsibilitymakingclinicaldecisions

Demonstrateknowledgeandleadershipinguidingotherhealthcaremembersonappropriateantibioticutilizationandrestrictionpolicies.

EvaluationMethods:AttendingEvaluation,SelfEvaluation,DirectObservation,In‐trainingexam,Role‐playorsimulations

INTERPERSONALCOMMUNICATIONSKILLSGoal:Developinterpersonalcommunicationskillsthatresultinimprovedcommunicationwithpatients,familyandhealthcareteammembers.FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

63

Developcommunicationskillstofacilitatethelearningofothers

Useeffectivelistening,narrative,andnon‐verbalskills;writelegibleandcomprehensivenotes

Effectivelydiscussendoflifecarewithpatientsandtheirfamilies

Displayinitiativeandleadershipininitiatingandmaintainingeffectivecommunication.EvaluationMethods:AttendingEvaluation,SelfEvaluation,DirectObservation,360Evaluation,Patientsurvey

PROFESSIONALISMGoal:Demonstrateabilityandcommitmenttocarryingoutprofessionalresponsibilitiesandadherencetoethicprinciplesinthecareofinfectiousdiseasepatients.FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

Demonstratetheabilitytoberesponsivetopatientsandsociety,supersedingself‐interest

Demonstrateintegrity,honesty,reliability,cooperative,andacceptresponsibility

Demonstrateahighstandardofethicalbehavior,includingabilitytomaintainprofessionalrelationshipswithotherphysiciansandabilitytoavoidconflictsofinterest

Demonstrateacommitmenttolifelonglearning

Showacommitmenttoprofessionaldevelopment

PartnerwithotherproviderstoimprovepatientcareEvaluationMethods:AttendingEvaluation,SelfEvaluation,DirectObservation,360Evaluation

PRACTICEBASEDLEARNINGGoal:Demonstrateunderstandingandabilityforselfreflectionandlife‐longlearningthroughtheabilitytoinvestigateandevaluatepersonalcareofpatientsandappraiseandassimilatescientificevidencetocontinuallyimprovepatientcareforinfectiousdiseasepatients.

FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

Developskillstoappraisethecurrentmedicalliteraturetosupportevidencebaseddecision‐making

� Regularlyusemedicalliteraturetosupportdecisionmaking

Regularlyapplynewcontributionstothemanagementandcareofinfectiousdiseasepatients.EvaluationMethods:AttendingEvaluation,SelfEvaluation

SYSTEMSBASEDPRACTICEGoal:Demonstrateunderstandingandresponsivenesstothelargercontextandsystemofhealthcareandabilitytoutilizeresourcesinthesystemtoestablishandmaintainoptimalhealthcareforinfectiousdiseasepatients.

FellowLEVEL ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

64

Demonstrateabilitytoworkwithhealthcareprofessionalstoprovidepatientfocusedcare;advocateforqualitypatientcare

Workininter‐professionalteamstoenhancepatientsafetyandimprovepatientqualityofcare.

Advocateforqualitypatientcareincorporatingconsiderationofcostandrisk‐benefitanalysisasappropriateforequitablecareforallinfectiousdiseasepatients

Usesystematicapproachestoreduceerrors EvaluationMethods:AttendingEvaluation,SelfEvaluation,DirectObservation

65

InfectiousDiseasesFellowship:ResearchMedicalCenter(RMC)InpatientConsultation

Duration: 1styearFellowsareassignedtotheRMCinpatientconsultservicefor3months

each.2ndyearFellowsareassignedtotheRMC inpatientconsultservicefor1‐2monthseach

Supervision(Interactionwithfaculty)

SupervisionofthefellowbyInfectiousDiseaseattendingatRMCforinpatientservice

RotationFacility ResearchMedicalCenter

RequiredDidactics/conferences:

IDCaseConference,IDJournalClub,IDCoreConference

InfectiousDiseasesFellowship:RMCInpatient

ConsultationRotation

FellowYear1&2

PATIENTCAREGoal:Demonstratecompetenceinthecontinuumofinpatientcareforinfectiousdiseasespatients

FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

1 2

Demonstrateabilitytogatherdata;orderdiagnostictests;interpretdata;makediagnosticandtherapeuticdecisions;

DemonstrateabilitytoperformandinterpretGramstains;

Demonstrateabilitytomanagepatienttherapies,emphasizingappropriateuseofantimicrobials;

Workeffectivelywithotherstoprovidepatient‐focusedcare;

DemonstrateabilitytomanagecommonandcomplexIDproblemsinthefaceofantibioticresistance

2 Accuratelyapplyclinicalinformationtoensurepositivepatientoutcomes

Goal:Demonstratecompetenceinthediagnosisandmanagementofinfectiousdiseaseareas

FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

1 2

Thiswillincludethefollowinginfectiousdiseasesareas:BacterialinfectionsFungalinfectionsViralinfectionsHIV/AIDSParasiticinfectionsSepsissyndromes

66

InfectionsinpatientswithimpairedhostdefensesInfectionsinpatientsinintensivecareunitsInfectionsinsurgicalpatientsHealthcare‐associatedinfectionsInfectedtravelersSexuallytransmittedinfectionsProstheticdeviseinfections

EvaluationMethods:AttendingEvaluation,SelfEvaluation,DirectObservation,360Evaluation,RecordReview,Chartsimulatedrecall,In‐trainingExam

MEDICALKNOWLEDGEGoal: DevelopincreasedmasteryofknowledgesurroundingallaspectsofinfectiousdiseaseFellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives. 

1 2

Demonstrateknowledgeofinfection controlandhospitalepidemiology

Understandtheprinciplesofprophylaxisandimmunoprophylaxistoenhanceresistancetoinfections

1 2

Understandthefundamentalsofhostdefenseandmechanismsofmicroorganismpathogenesis.

Understandthecharacteristics,useandcomplicationsofantiretroviralagents,mechanismsandclinicalsignificanceofviralresistancetoantiretroviralagents

RecognizeandmanageopportunisticinfectionsinpatientswithHIV/AIDS

1 2

Demonstratecomprehensiveknowledgeofindications,contraindications,limitations,complications,techniques,andinterpretationsofresultsofthosediagnosticandtherapeuticproceduresintegraltothedisciplineincludingappropriateindicationforanduseofscreeningtests/procedures.

Demonstrateknowledgeofthemechanismsofactionandadversereactionsofantimicrobialagents

Antimicrobialresistance,drug‐druginteractionsbetweenantimicrobialagentsandothercompounds

Demonstrateknowledgeandapplicationoftheappropriateuseandmanagementofantimicrobialagentsinthehospitalandnonacutecareunits.

2Assumemoreresponsibilitymakingclinicaldecisions

Demonstrateknowledgeandleadershipinguidingotherhealthcaremembersonappropriateantibioticutilizationandrestrictionpolicies.

EvaluationMethods:AttendingEvaluation,SelfEvaluation,DirectObservation,In‐trainingexam,Role‐playorsimulations

INTERPERSONALCOMMUNICATIONSKILLSGoal:Developinterpersonalcommunicationskillsthatresultinimprovedcommunicationwithpatients,familyandhealthcareteammembers.FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

Developcommunicationskillstofacilitatethelearningofothers

67

Useeffectivelistening,narrative,andnon‐verbalskills;writelegibleandcomprehensivenotes

Effectivelydiscussendoflifecarewithpatientsandtheirfamilies

Displayinitiativeandleadershipininitiatingandmaintainingeffectivecommunication.EvaluationMethods:AttendingEvaluation,SelfEvaluation,DirectObservation,360Evaluation,Patientsurvey

PROFESSIONALISMGoal:Demonstrateabilityandcommitmenttocarryingoutprofessionalresponsibilitiesandadherencetoethicprinciplesinthecareofinfectiousdiseasepatients.FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

Demonstratetheabilitytoberesponsivetopatientsandsociety,supersedingself‐interest

Demonstrateintegrity,honesty,reliability,cooperative,andacceptresponsibility

Demonstrateahighstandardofethicalbehavior,includingabilitytomaintainprofessionalrelationshipswithotherphysiciansandabilitytoavoidconflictsofinterest

Demonstrateacommitmenttolifelonglearning

Showacommitmenttoprofessionaldevelopment

PartnerwithotherproviderstoimprovepatientcareEvaluationMethods:AttendingEvaluation,SelfEvaluation,DirectObservation,360Evaluation

PRACTICEBASEDLEARNINGGoal:Demonstrateunderstandingandabilityforselfreflectionandlife‐longlearningthroughtheabilitytoinvestigateandevaluatepersonalcareofpatientsandappraiseandassimilatescientificevidencetocontinuallyimprovepatientcareforinfectiousdiseasepatients.

FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

Developskillstoappraisethecurrentmedicalliteraturetosupportevidencebaseddecision‐making

Regularlyusemedicalliteraturetosupportdecisionmaking

Regularlyapplynewcontributionstothemanagementandcareofinfectiousdiseasepatients.EvaluationMethods:AttendingEvaluation,SelfEvaluation

SYSTEMSBASEDPRACTICEGoal:Demonstrateunderstandingandresponsivenesstothelargercontextandsystemofhealthcareandabilitytoutilizeresourcesinthesystemtoestablishandmaintainoptimalhealthcareforinfectiousdiseasepatients.

FellowLEVEL ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

68

Demonstrateabilitytoworkwithhealthcareprofessionalstoprovidepatientfocusedcare;advocateforqualitypatientcare

Workininter‐professionalteamstoenhancepatientsafetyandimprovepatientqualityofcare.

Advocateforqualitypatientcareincorporatingconsiderationofcostandrisk‐benefitanalysisasappropriateforequitablecareforallinfectiousdiseasepatients

Usesystematicapproachestoreduceerrors EvaluationMethods:AttendingEvaluation,SelfEvaluation,DirectObservation

69

InfectiousDiseasesFellowship:ClinicRotation

Duration: 1styearFellowsareassignedtotheoutpatientconsultservicefor12months

2ndyearFellowsareassignedtotheKUHinpatientconsultservicefor12months

Supervision(Interactionwithfaculty)

SupervisionofthefellowbyInfectiousDiseaseattendingatKUHforinpatientservice

RotationFacility UniversityofKansasHospital

RequiredDidactics/conferences:

IDCaseConference,IDJournalClub,IDCoreConference

InfectiousDiseasesFellowship:ClinicRotation

UniversityofKansasMedicalCenter

FellowYear1&2

PATIENTCAREGoal:Demonstratecompetenceinthecontinuumofoutpatientcareforinfectiousdiseasespatients

FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

1 2

Demonstrateabilitytogatherdata;orderdiagnostictests;interpretdata;makediagnosticandtherapeuticdecisions;

Managemedicalandpsychosocialaspectsofcommonandcomplexoutpatientinfectiousdiseases

Workeffectivelywithotherstoprovidepatient‐focusedcare

DemonstrateabilitytomanagecommonandcomplexIDproblemsinthefaceofantibioticresistance

2

DemonstrateabilitytoestablishapanelofHIV‐positivepatientstounderstandpatientmanagementissues,includingfinancialandpsychosocial,relatedtoantiretroviraltherapy,prophylaxisandmanagementofopportunisticinfections,andnon‐medicalofcasemanagement

Goal:Demonstratecompetenceinthediagnosisandmanagementofinfectiousdiseaseareas

FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

1 2

Thiswillincludethefollowinginfectiousdiseasesareas:BacterialinfectionsFungalinfectionsViralinfectionsHIV/AIDSParasiticinfections

70

SepsissyndromesInfectionsinpatientswithimpairedhostdefensesInfectionsinpatientsinintensivecareunitsInfectionsinsurgicalpatientsHealthcare‐associatedinfectionsInfectedtravelersSexuallytransmittedinfectionsProstheticdeviseinfections

TeachingMethods:DirectPatientCare,IDCoreCurriculum,IDCaseConference

EvaluationMethods:AttendingEvaluation,SelfEvaluation,360Evaluation

MEDICALKNOWLEDGEGoal: DevelopincreasedmasteryofknowledgesurroundingallaspectsofinfectiousdiseaseFellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives. 

1 2

Developskillintheuseofantibioticsandprophylacticagents

Understandtheprinciplesof prophylaxisandimmunoprophylaxistoenhanceresistancetoinfections

1 2

Understandthefundamentalsofhostdefenseandmechanismsofmicroorganismpathogenesis.

Understandthecharacteristics,useandcomplicationsofantiretroviralagents,mechanismsandclinicalsignificanceofviralresistancetoantiretroviralagents

RecognizeandmanageopportunisticinfectionsinpatientswithHIV/AIDS

1 2

Demonstratecomprehensiveknowledgeofindications,contraindications,limitations,complications,techniques,andinterpretationsofresultsofthosediagnosticandtherapeuticproceduresintegraltothedisciplineincludingappropriateindicationforanduseofscreeningtests/procedures.

Demonstrateknowledgeofthemechanismsofactionandadversereactionsofantimicrobialagents

Antimicrobialresistance,drug‐druginteractionsbetweenantimicrobialagentsandothercompounds

Demonstrateknowledgeandapplicationoftheappropriateuseandmanagementofantimicrobialagentsintheoutpatientsetting.

2Understandmanagementissuesassociatedwithoutpatientadministrationfantibiotics

Demonstrateknowledgeandleadershipinguidingotherhealthcaremembersonappropriateantibioticutilizationandrestrictionpolicies.

TeachingMethods:DirectPatientCare,IDCoreCurriculum,IDCaseConference

EvaluationMethods:AttendingEvaluation,SelfEvaluation,360Evaluation

INTERPERSONALCOMMUNICATIONSKILLSGoal:Developinterpersonalcommunicationskillsthatresultin improvedcommunicationwithpatients,familyandhealthcareteammembers.

71

FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

Developcommunicationskillstofacilitatethelearningofothers

Useeffectivelistening,narrative,andnon‐verbalskills;writelegibleandcomprehensivenotes

Effectivelydiscussendoflifecarewithpatientsandtheirfamilies

Displayinitiativeandleadershipininitiatingandmaintainingeffectivecommunication.TeachingMethods:DirectPatientCare,IDCoreCurriculum,IDCaseConference

EvaluationMethods:AttendingEvaluation,SelfEvaluation,360Evaluation

PROFESSIONALISMGoal:Demonstrateabilityandcommitmenttocarryingoutprofessionalresponsibilitiesandadherencetoethicprinciplesinthecareofinfectiousdiseasepatients.FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

Demonstratetheabilitytoberesponsivetopatientsandsociety,supersedingself‐interest

Beresponsivetoneedsofpatientsandsocietysupersedingself‐interest

Demonstraterespect,compassionandintegrity;behonest,reliable,cooperativeandacceptresponsibility

Demonstrateacommitmenttolifelonglearning

Showacommitmenttoprofessionaldevelopment

Partnerwithotherproviderstoimprovepatient careEvaluationMethods:AttendingEvaluation,SelfEvaluation,360Evaluation

PRACTICEBASEDLEARNINGGoal:Demonstrateunderstandingandabilityforself‐reflectionandlife‐longlearningthroughtheabilitytoinvestigateandevaluatepersonalcareofpatientsandappraiseandassimilatescientificevidencetocontinuallyimprovepatientcareforinfectiousdiseasepatients.

FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

Developskillstoappraisethecurrentmedicalliteraturetosupportevidencebaseddecision‐making

Regularlyusemedicalliteraturetosupportdecisionmaking

Regularlyapplynewcontributionstothemanagementandcareofinfectiousdiseasepatientsinoutpatientsettings

Continuetodevelopandimproveconsultativeskillsintheoutpatientsetting.

TeachingMethods:DirectPatientCare,IDCoreCurriculum,IDCaseConference

EvaluationMethods:AttendingEvaluation,SelfEvaluation

72

SYSTEMSBASEDPRACTICEGoal:Demonstrateunderstandingandresponsivenesstothelargercontextandsystemofhealthcareandabilitytoutilizeresourcesinthesystemtoestablishandmaintainoptimalhealthcareforinfectiousdiseasepatients.

FellowLEVEL ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

Demonstrateabilitytoworkwithhealthcareprofessionalstoprovidepatientfocusedcare;advocateforqualitypatientcare

Workininter‐professionalteamstoenhancepatientsafetyandimprovepatientqualityofcare

Advocateforqualitypatientcareincorporatingconsiderationofcostandrisk‐benefitanalysisasappropriateforequitablecareforallinfectiousdiseasepatients

Usesystematicapproachestoreduceerrors TeachingMethods:DirectPatientCare,IDCoreCurriculum,IDCaseConference

EvaluationMethods:AttendingEvaluation,SelfEvaluation,360Evaluation

73

InfectiousDiseasesFellowship:KansasCityVeteransAdministrationMedicalCenter(KCVAMC)ClinicRotation

Duration: 1styearFellowsareassignedtotheKCVAMCoutpatientclinicsfortwo1/2daysper

weekduringrotation

2ndyearFellowsareassignedtotheKCVAMCoutpatientclinicsfortwo1/2daysperweekduringrotation

Supervision(Interactionwithfaculty)

SupervisionofthefellowbyInfectiousDiseaseattendingatKCVAMCforinpatientservice

RotationFacility KansasCityVeteransAdministrationMedicalCenter

RequiredDidactics/conferences:

TeachingMethods:DirectPatientCareandIDCoreCurriculum,IDCaseConferencebyAdobeconnect

InfectiousDiseasesFellowship:ClinicRotation

KansasCityVeteransAdministrationMedicalCenter(KCVAMC)

FellowYear1&2

PATIENTCAREGoal:Demonstratecompetenceinthecontinuumofoutpatientcareforinfectiousdiseasespatients

FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

1 2

Demonstrateabilitytogatherdata;orderdiagnostictests;interpretdata;makediagnosticandtherapeuticdecisions;

Managemedicalandpsychosocialaspectsofcommonandcomplexoutpatientinfectiousdiseases

Workeffectivelywithotherstoprovidepatient‐focusedcare

DemonstrateabilitytomanagecommonandcomplexIDproblemsinthefaceofantibioticresistance

2

DemonstrateabilitymanageHIV‐positivepatientstounderstandpatientmanagementissues,includingfinancialandpsychosocial,relatedtoantiretroviraltherapy,prophylaxisandmanagementofopportunisticinfections,andnon‐medicalcasemanagement

Goal:Demonstratecompetenceinthediagnosisandmanagementofinfectiousdiseaseareas

FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

1 2Thiswillincludethefollowinginfectiousdiseasesareas:Bacterialinfections

74

FungalinfectionsViralinfectionsHIV/AIDSParasiticinfectionsSepsissyndromesInfectionsinpatientswithimpairedhostdefensesInfectionsinpatientsinintensivecareunitsInfectionsinsurgicalpatientsHealthcare‐associatedinfectionsInfectedtravelersSexuallytransmittedinfectionsProstheticdeviseinfections

TeachingMethods:DirectPatientCareandIDCoreCurriculum,IDCaseConferencebyAdobeconnect

EvaluationMethods:AttendingEvaluation,SelfEvaluation

MEDICALKNOWLEDGEGoal: DevelopincreasedmasteryofknowledgesurroundingallaspectsofinfectiousdiseaseFellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives. 

1 2

Developskillintheuseofantibioticsandprophylacticagents

Understandtheprinciplesofprophylaxisandimmunoprophylaxistoenhanceresistancetoinfections

1 2

Understandthefundamentalsofhostdefenseandmechanismsofmicroorganismpathogenesis.Understandthecharacteristics,useandcomplicationsofantiretroviralagents,mechanismsandclinicalsignificanceofviralresistancetoantiretroviralagents

RecognizeandmanageopportunisticinfectionsinpatientswithHIV/AIDS

1 2

Demonstratecomprehensiveknowledgeofindications,contraindications,limitations,complications,techniques,andinterpretationsofresultsofthosediagnosticandtherapeuticproceduresintegraltothedisciplineincludingappropriateindicationforanduseofscreeningtests/procedures.

Demonstrateknowledgeofthemechanismsofactionandadversereactionsofantimicrobialagents

Antimicrobialresistance,drug‐druginteractionsbetweenantimicrobialagentsandothercompounds

Demonstrateknowledgeandapplicationoftheappropriateuseandmanagementofantimicrobialagentsintheoutpatientsetting.

2

Understandmanagementissuesassociatedwithoutpatientadministrationfantibiotics

Demonstrateknowledgeandleadershipinguidingotherhealthcaremembersonappropriateantibioticutilizationandrestrictionpolicies.

TeachingMethods:DirectPatientCareandIDCoreCurriculum,IDCaseConferencebyAdobeconnect

75

EvaluationMethods:AttendingEvaluation,Self Evaluation

INTERPERSONALCOMMUNICATIONSKILLSGoal:Developinterpersonalcommunicationskillsthatresultinimprovedcommunicationwithpatients,familyandhealthcareteammembers.

FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

Developcommunicationskillstofacilitatethelearningofothers

Useeffectivelistening,narrative,andnon‐verbalskills;writelegibleandcomprehensivenotes

Effectivelydiscussendoflifecarewithpatientsandtheirfamilies

Displayinitiativeandleadershipininitiatingandmaintainingeffectivecommunication.

TeachingMethods:DirectPatientCareandIDCoreCurriculum,IDCaseConferencebyAdobeconnect

EvaluationMethods:AttendingEvaluation,SelfEvaluation

PROFESSIONALISMGoal:Demonstrateabilityandcommitmenttocarryingoutprofessionalresponsibilitiesandadherencetoethicprinciplesinthecareofinfectiousdiseasepatients.

FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

Demonstratetheabilitytoberesponsivetopatientsandsociety,supersedingself‐interest

Demonstraterespect,compassionandintegrity;behonest,reliable,cooperativeandacceptresponsibility

Demonstrateacommitmenttolifelonglearning

Showacommitmenttoprofessionaldevelopment

Partnerwithotherproviderstoimprovepatientcare

TeachingMethods:DirectPatientCareandIDCoreCurriculum,IDCaseConferencebyAdobeconnect

EvaluationMethods:AttendingEvaluation,SelfEvaluation

PRACTICEBASEDLEARNINGGoal:Demonstrateunderstandingandabilityforself‐reflectionandlife‐longlearningthroughtheabilitytoinvestigateandevaluatepersonalcareofpatientsandappraiseandassimilatescientificevidencetocontinuallyimprovepatientcareforinfectiousdiseasepatients.

FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

Developskillstoappraisethecurrentmedicalliteraturetosupportevidencebaseddecision‐

76

making

Regularlyusemedicalliteraturetosupportdecisionmaking

Regularlyapplynewcontributionstothemanagementandcareofinfectiousdiseasepatientsinoutpatientsettings

Continuetodevelopandimproveconsultativeskillsintheoutpatientsetting.

TeachingMethods:DirectPatientCareandIDCoreCurriculum,IDCaseConferencebyAdobeconnect

EvaluationMethods:AttendingEvaluation,SelfEvaluation

SYSTEMSBASEDPRACTICEGoal:Demonstrateunderstandingandresponsivenesstothelargercontextandsystemofhealthcareandabilitytoutilizeresourcesinthesystemtoestablishandmaintainoptimalhealthcareforinfectiousdiseasepatients.

FellowLEVEL ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

Demonstrateabilitytoworkwithhealthcareprofessionalstoprovidepatientfocusedcare;advocateforqualitypatientcare

Workininter‐professionalteamstoenhancepatientsafetyandimprovepatientqualityofcare

Advocateforqualitypatientcareincorporatingconsiderationofcostandrisk‐benefitanalysisasappropriateforequitablecareforallinfectiousdiseasepatients

Usesystematicapproachestoreduceerrors

TeachingMethods:DirectPatientCareandIDCoreCurriculum,IDCaseConferencebyAdobeconnect

EvaluationMethods:AttendingEvaluation,SelfEvaluation

77

InfectiousDiseasesFellowship:MicrobiologyRotation Duration: PGY4Fellowsareassignedtothemicrobiologylab30minutesfor2daysaweekfor6

months

PGY5fellowsareassignedtothemicrobiologylab30minutesfor2daysaweekfor9months

Supervision(Interactionwithfaculty):

SupervisionofthefellowbyfacultyMicrobiologists

RotationFacility: UniversityofKansasMedicalCenter

InfectiousDiseaseFellowship:MicrobiologyRotation

UniversityofKansas

Fellowyear1&2

PATIENTCAREGoal:Demonstratecompetenceaspectsofmicrobiologyasitappliestoinfectiousdiseases.FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

1 2Becomefamiliarwiththetechnicalaspectsofpathogenisolation,sensitivitytesting,andmolecularmethodsanddevelopknowledgeofhowtheyareappliedtothecontinuumofpatientcare

2

Begintoinstructtheyearonefellowsandaskclinicalquestionsofthemwhileviewingthepathogenwiththemicrobiologists

TeachingMethods:DirectPatientCare

EvaluationMethods:SelfEvaluation,360Evaluation

MEDICALKNOWLEDGEGoal:Developincreasedmasteryofknowledgesurroundingallaspectsofinfectiousdisease.FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

1 2Becomefamiliarwiththetechnicalaspectsofpathogenisolation,sensitivitytesting,andmolecularmethods.

2Begintoinstructtheyearonefellowsandaskclinicalquestionsofthemwhileviewingthepathogenwiththemicrobiologists

TeachingMethods:DirectPatientCare,IDCaseConference,IDCoreConference

EvaluationMethods:AttendingEvaluation,SelfEvaluation

INTERPERSONALCOMMUNICATIONSKILLSGoal:Developinterpersonalcommunicationskillsthatresultinimprovedcommunicationwithpatients,familyandhealthcareteammembers.Fellow Objectives

78

LEVEL Level2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

1 2

Developcommunicationskillstofacilitatethelearningofothers

Communicateclearlywiththemicrobiologystaffandclinicalservice

Workwithmicrobiologystaffandclinicalservicestoprovideamultidisciplinaryapproachtothediagnosisandtreatmentofinfections

2

Effectivelydiscussendoflifecarewithpatientsandtheirfamilies

DisplayinitiativeandleadershipininitiatingandmaintainingeffectivecommunicationTeachingMethods:DirectPatientCare

EvaluationMethods:AttendingEvaluation,360Evaluation

PROFESSIONALISMGoal:Demonstrateabilityandcommitmenttocarryingoutprofessionalresponsibilitiesandadherencetoethicalprinciplesinthecareofinfectiousdiseasepatients.

FellowLEVEL

ObjectivesLevel2fellowswillbeexpected todevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

1 2 Demonstraterespect,compassion,andintegrity;behonest,reliable,cooperativeandacceptresponsibility

2Showacommitmenttoprofessionaldevelopment

Partnerwithotherproviderstoimprovepatientcare

TeachingMethods:DirectPatientCare

EvaluationMethods:AttendingEvaluation,360Evaluation

PRACTICEBASEDLEARNINGGoal:

Demonstrateunderstandingandabilityforself‐reflectionandlife‐longlearningthroughtheabilitytoinvestigateandevaluatepersonalcareofpatientsandappraiseandassimilatescientificevidencetocontinuallyimprovepatientcareforinfectiousdiseasepatients.

FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

1 2 Appraisethemedicalliteraturetosupportdecisionmaking. 2 Regularlyusemedicalliteraturetosupportdecisionmaking

TeachingMethods:IDCaseConference,IDCoreConference

EvaluationMethods:AttendingEvaluation,SelfEvaluation

SYSTEMSBASEDPRACTICEGoal:Demonstrateunderstandingandresponsivenesstothelargercontextandsystemofhealthcareandabilitytoutilizeresourcesinthesystemtoestablishandmaintainoptimalhealthcareforinfectiousdiseasepatients.

FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

79

1 2Workwiththemicrobiologystaffandclinicalserviceteamstoenhancepatientsafetyandimprovepatientqualityofcare.

2Advocateforqualitypatientcareincorporatingconsiderationofcostandrisk‐benefitanalysisasappropriateforequitablecareforallinfectiousdiseasepatients

UsesystematicapproachestoreduceerrorsTeachingMethods:DirectPatientCare

EvaluationMethods:AttendingEvaluation,360Evaluation

80

InfectiousDiseaseFellowshipResearchRotation Duration: PGY4Fellowsmaybeassignedtotheresearchrotationfor2weeks

PGY5fellowsareassignedtotheresearchrotationforupto3months

Supervision(Interactionwithfaculty):

SupervisionofthefellowbyInfectiousDiseasefacultymentor

RotationFacility: UniversityofKansasMedicalCenterRequiredDidactics/conferences: KUResearchConference;Regularlyscheduledmeetingwithresearchmentor

InfectiousDiseaseFellowshipResearchRotation

UniversityofKansas

Fellowyear1&2INTERPERSONALCOMMUNICATIONSKILLS

Goal:Developcompetenceinpresentationofresearchstudyfindings,includingpresentationsatnationalmeetingsaswellaspreparingamanuscriptforpublication..FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

1 2

Developcommunicationskillstofacilitatethelearningofothers

Demonstratecompetenceinsummarizingdatainabstractsforpresentationatregionalandnationalmeetings

Demonstratecompetenceinposterororalpresentationpreparationforanationalmeeting

2

Demonstratecompetenceinmanuscriptpublicationinapeer‐reviewedjournal,includingpreparationoffiguresLearntoacceptandutilizecriticalevaluationofone’swork

Displayinitiativeandleadershipininitiatingandmaintainingeffectivecommunicationregardingresearchideasandformaldisseminationandpresentationofresearchfindings

TeachingMethods:FacultyMentoring

EvaluationMethods:AttendingEvaluation,SelfEvaluation

PROFESSIONALISMGoal:Become familiar with research regulations and ethics. FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

1 2

LearnabouttheIRBapprovalprocessandwhatapprovalsarenecessaryforspecificprojecttypes

Demonstratecompetencyinprivacyregulationsregardinguseofpatientdata

SuccessfullygainIRBapprovalforallprojectsinvolvinghumansubjects

81

SuccessfullygainIACUCapprovalforallprojectsinvolvinganimals

Understandtheissuessurroundingappropriatetreatmentofresearchsubjects

2Showacommitmenttoprofessionaldevelopment

Prepareresearchforpublicationand/orpresentationatanationalmeetingorconference

TeachingMethods:IDCaseConference,IDResearchConference

EvaluationMethods:AttendingEvaluation,SelfEvaluation,DirectedProject

PRACTICEBASEDLEARNINGGoal:Understand how to design a research project, including formulating a hypothesis and designing an experimental strategy to evaluate it.

FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

1 2

Demonstratecompetenceinevaluatingrelevantliteraturerelatedtoaspecificresearchquestion,includingtypeofresearchmodelandevaluationoftheappropriateuseofstatistics

Demonstratecompetenceinformulatingatestablehypothesis

Demonstratefamiliarizationwithappropriatestatisticalmethodstobeusedfordataanalysis

Learntorecognizeandmakecontingencyplansforpotentialproblemsinaresearchplan

Demonstratetheabilitytounderstandhowclinicalandbasicscienceresearchresultsinfluenceclinicalpractice

Goal:

Learn to execute a clinical and/or a basic science research project, including mastering the appropriate technical skills required for completion of the project.

FellowLEVEL

ObjectivesLevel2fellowswillbeexpectedtodevelopfurthercompetenceonlevel1objectivesaswellasdemonstratecompetenceonlevel2objectives

2

Demonstratecompetenceintheappropriatemethodsforexecutionofabasicscienceproject,includingtissueprocessing,physiologicalrecording,etc.

Demonstratecompetenceintroubleshootingtechnicalproblemsandevaluatingtheirimpactonprojects

Demonstratecompetenceindatacollectionandorganizationforsubsequentevaluation

Demonstrateunderstandingofstatisticalanalysisofdatacollected

Learntoevaluateresultsforagivenprojectinthecontextofotherworkintheresearcharea

Competenceinproposingfutureexperimentstoaugmentresultsfromagivenproject

TeachingMethods:FacultyMentoring,IDCoreCurriculum

EvaluationMethods:AttendingEvaluation

82

CORECOMPETENCYTEACHINGANDASSESSMENTMATRIXTEMPLATECoreCompetency TEACHINGMETHODS EVALUATIONMETHODS

   Didactic Lecture 

Group Discussion  

Online Tool 

Project 

Role M

odeling 

Simulations 

Clinical Patient 

Experience 

Vanderbilt m

atrix 

OTH

ER 

   Record Review 

Chart Stim

ulated Recall 

Global Rating 

Assessm

ents (E*value) 

Obj Structured Clinical 

Exam

  

Simulations & M

odels 

360° Assessm

ents 

Written Examination 

On‐Line Training 

Vanderbilt M

atrix 

Patient Survey 

PRACTICE‐BASEDLEARNING&IMPROVEMENT PRACTICE‐BASEDLEARNING&IMPROVEMENTAnalyzeownpracticeforneededimprovements

X X X X X X X X X

Useofevidencefromscientificstudies X X X X X X X X X

Applicationofresearch&statisticalmethods

X X X X X

Useofinformationtechnology X X X X X

Facilitatelearningofothers X X X X X X X X X

INTERPERSONAL&COMMUNICATIONSKILLS INTERPERSONAL&COMMUNICATIONSKILLSCreationoftherapeuticrelationshipwithpatients

X X X X X X X X

Listeningskills X X X X X X X X

PROFESSIONALISM PROFESSIONALISM

Respectful,altruistic X X X X X X X X X X X

Ethicallysoundpractice X X X X X X X X X X

Sensitivetocultural,age,gender,disabilityissues

X X X X X X X X X X

SYSTEMS‐BASEDPRACTICE SYSTEMS‐BASEDPRACTICE

Understandinteractionoftheirpracticeswiththelargersystem

X X X X X X X X X X

Knowledgeofpracticeanddeliverysystems X X X X X X X X X X X X

Practicecost‐effectivecare X X X X X X X X X X

Advocateforpatientswithinthehealthsystem

X X X X X X X X X

83

RequiredEvaluationsforIDFellows&IDProgramEvaluations,required,andine‐value Format

1.Facultyoffellow/endrotation Electronic

2.Fellowoffaculty Electronic

3.Fellowofprogram Electronic

4.Facultyofprogram Electronic

5.FellowSemi‐annualevaluation Paper(Scannedin)

6.360ofresident(patient,RN,LPN) Electronic

7.Peerevaluation(chieffellow) Electronic

8.Selfevaluation Electronic

9.FellowFinalsummative Paper(Scannedin)

10.Programdirectoroffaculty Electronic

11.Annualprogramreview Electronic

12.Alumnisurvey Paper

84

FACULTY EVALUATION OF PROGRAM

Fellows model professional behavior in their interactions with patients and co-workers. (Question 1 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

There is an appropriate volume and variety of patients available to the program for educational purposes. (Question 2 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Fellows have adequate opportunities for clinical research. (Question 3 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Fellows are adequately supervised during patient care activities. (Question 4 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

The fellowship program staff is responsive and helpful. (Question 5 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

The program leadership is responsive to faculty questions and concerns. (Question 6 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

The program communicates well with the faculty regarding educational goals and requirements. (Question 7 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Fellows are compliant with work hour limitations (avg. 80 hrs/wk, max 24 hr. continuous duty, avg. at least one day off per week). (Question 8 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Fellows completing the program are well-prepared for Infectious Diseases practice. (Question 9 of 21 - Mandatory)

85

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

The Department of Internal Medicine provides adequate support for fellowship training. (Question 10 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

The School of Medicine provides adequate support for fellowship training. (Question 11 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

The University of Kansas Hospital provides adequate support for fellowship training. (Question 12 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

The Kansas City Veteran's Affairs Medical Center provides adequate support for fellowship training. (Question 13 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

The Research Medical Center provides adequate support for fellowship training. (Question 14 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Most fellowship faculty have adequate time for fellow teaching. (Question 15 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Workload and schedule in the inpatient setting is conducive to teaching. (Question 16 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Workload and schedule in the ambulatory setting is conducive to teaching. (Question 17 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

86

Fellows are well-prepared for rounds on their patients. (Question 18 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Faculty does a good job of providing feedback about fellow performance. (Question 19 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Fellows read appropriately and are prepared to discuss differential diagnosis and pathophysiology on their patients. (Question 20 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Comments: (Question 21 of 21 - Mandatory) (Please write about Strengths, Weaknesses and Areas of Improvement)

Review your answers in this evaluation. If you are satisfied with the evaluation, click the SUBMIT button below. Once submitted, evaluations are no longer available for you to make further changes.

87

FACULTY OF FELLOW EVALUATION

Demonstrates understanding of clinical problems: (PC) (Question 1 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Demonstrates appropriate physical exam skills: (PC) (Question 2 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Demonstrates appropriate test selection: (PC) (Question 3 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Advocates for patients: (PC) (Question 4 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Reads specific knowledge: (MK) (Question 5 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Develops appropriate differential diagnoses: (MK) (Question 6 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Has appropriate knowledge base for level of training: (MK) (Question 7 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Note content is appropriate: (ICS) (Question 8 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Interpersonal skills with staff and patients are appropriate: (ICS) (Question 9 of 21 - Mandatory)

No Unsatisfactory Average Superior

88

interaction

0 1 2 3 4 5 6 7 8 9

Presents cases in clear, concise manner: (ICS) (Question 10 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Displays professional attitude: (P) (Question 11 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Completes work in a timely fashion and attends round on time: (P) (Question 12 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Responsible for their workload: (P) (Question 13 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Effectively utilizes hospital resources: (SBP) (Question 14 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Communicates effectively with consultants: (SBP) (Question 15 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Understands health care delivery appropriate for level of training: (SBP) (Question 16 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Advocates for quality patient care and assists patients in dealing with systems complexities: (SBP) (Question 17 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Identifies areas for improvement and applies it to practice: (PBLI) (Question 18 of 21 - Mandatory)

89

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Shows interest in learning from complex care issues: (PBLI) (Question 19 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Participates in educational activities including rounds and conferences: (PBLI) (Question 20 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Comments: (Question 21 of 21) (Please write about Strengths, Weaknesses and Areas of Improvement)

Review your answers in this evaluation. If you are satisfied with the evaluation, click the SUBMIT button below. Once submitted, evaluations are no longer available for you to make further changes.

c

90

FELLOW OF FACULTY EVALUATION

Placed the patient’s interest first: (P) (Question 1 of 24 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Displayed sensitive, caring, respectful attitude towards patients: (P) (Question 2 of 24 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Established rapport with team members: (P) (Question 3 of 24 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Established respect for physicians in other specialties/subspecialties and health care professionals: (P) (Question 4 of 24 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Served as a role model: (P) (Question 5 of 24 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Was enthusiastic and stimulating: (P) (Question 6 of 24 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Demonstrated gender sensitivity: (P) (Question 7 of 24 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Is usually prompt: (Question 8 of 24 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Respected the value of my time: (Question 9 of 24 - Mandatory)

No Unsatisfactory Average Superior

91

interaction

0 1 2 3 4 5 6 7 8 9

Kept interruptions to a minimum: (Question 10 of 24 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Spent enough time on rounds; was unhurried: (Question 11 of 24 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Kept discussions focused on case or topic: (Question 12 of 24 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Used bedside teaching to demonstrate history and physical skills: (Question 13 of 24 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Emphasized problem solving (thought processes leading to decisions): (Question 14 of 24 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Provided feedback regarding performance on rotations or evaluation period: (Question 15 of 24 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Showed an interest in teaching: (Question 16 of 24 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Discussed pathophysiological mechanism of the disease encountered: (Question 17 of 24 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Demonstrated cost effective use of laboratory and therapeutic modalities: (Question 18 of 24 - Mandatory)

92

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Provided instruction and adequate assistance in helping manage patients in the outpatient clinics: (Question 19 of 24 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Suggested references for further reading/studying: (Question 20 of 24 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Stimulated team members to read and review pertinent data: (Question 21 of 24 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Provided special help as needed: (Question 22 of 24 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Attending provides appropriate supervision during procedures: (Question 23 of 24 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Comments: (Question 24 of 24) (Please write about Strengths, Weaknesses and Areas of Improvement)

Review your answers in this evaluation. If you are satisfied with the evaluation, click the SUBMIT button below. Once submitted, evaluations are no longer available for you to make further changes.

93

FELLOW OF PROGRAM EVALUATION

The diversity of diseases in this program gave me a broad experience in infectious diseases: (PC) (Question 1 of 15 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

The ambulatory experience has allowed me to develop appropriate outpatient skills: (PC) (Question 2 of 15 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

I understood what I should learn from each rotation: (MK) (Question 3 of 15 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

I became more comfortable in selecting cases that provide good teaching concepts (Clinical Case Conference): (ICS) (Question 4 of 15 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Program leadership serves as my advocate: (ICS) (Question 5 of 15 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

I had opportunity to work on or present an oral or written presentation: (ICS) (Question 6 of 15 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

I was able to work with one or more HIV care coordinators: (ICS) (Question 7 of 15 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Faculty teach and supervise in ways that facilitate learning: (P) (Question 8 of 15 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

The case conference was an appropriate learning experience: (P) (Question 9 of 15 - Mandatory)

No Unsatisfactory Average Superior

94

interaction

0 1 2 3 4 5 6 7 8 9

The information technologies (computers) available to me allowed me to obtain current medical information and scientific evidence: (SBP) (Question 10 of 15 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

These sessions helped me to read gram stains and understand them (Clinical Micro Conference): (SBP) (Question 11 of 15 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

I was given sufficient responsibility for decision-making and patient care:(PBLI) (Question 12 of 15 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

I was able to work on one or more research projects: (Question 13 of 15 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

My overall level of satisfaction with this fellowship program is such that I would recommend it to junior residents. (Question 14 of 15 -Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

95

Comments: (Question 15 of 15) (Please write about Strengths, Weaknesses and Areas of Improvement)

Review your answers in this evaluation. If you are satisfied with the evaluation, click the SUBMIT button below. Once submitted, evaluations are no longer available for you to make further changes.

96

FELLOW PEER EVALUATION

PATIENT CARE: Fellows must be able to provide patient care that is compassionate, appropriate and effective for the treatment of health problems and the promotion of health. (Question 1 of 15 - Mandatory) I am comfortable picking up cases this fellow has managed.

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

I am comfortable having this fellow cover my patients. (Question 2 of 15 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

MEDICAL KNOWLEDGE: Fellows are expected to demonstrate knowledge of established and evolving biomedical, clinical and basic science principles and to apply them to the tasks at hand. (Question 3 of 15 - Mandatory) Fellow demonstrates an active pursuit of knowledge.

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Fellow is able to synthesize data effectively in formulating management plans. (Question 4 of 15 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

INTERPERSONAL AND COMMUNICATION SKILLS: Fellows are expected to be able to demonstrate interpersonal and communication skills that result in effective information exchange and teaming with co-workers, peers and professional associates. (Question 5 of 15 - Mandatory) Fellow objectively listens to information provided by other members of the health care team.

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Fellow records complete and accurate information in a manner that makes it easier for members of the health care team to care for the patients. (Question 6 of 15 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

PROFESSIONALISM: Fellows are expected to demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles and professional behavior. (Question 7 of 15 - Mandatory) Fellow demonstrates honesty and integrity.

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

97

Fellow respects other members of the health care system. (Question 8 of 15 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Fellow is accountable for own actions. (Question 9 of 15 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

SYSTEMS BASED PRACTICE: Fellows must demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care. (Question 10 of 15 - Mandatory) I would want this fellow to join me in my practice after I graduate.

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Fellow effectively accesses and evaluates patients when receiving or referring a consult. (Question 11 of 15 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

PRACTICE BASED LEARNING AND IMPROVEMENT: Fellows are expected to be able to use scientific evidence and methods to investigate, evaluate and improve research practices. (Question 12 of 15 - Mandatory) This fellow identifies and analyzes own strengths and weaknesses.

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Fellow satisfactorily conveys their knowledge to residents, students and other health care professionals. (Question 13 of 15 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

OVERALL RATING: Based on the above ratings of each component skill, please provide an overall rating of and comments about the fellow's clinical performance. (Question 14 of 15 - Mandatory) Overall rating:

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Overall comments: (Question 15 of 15 - Mandatory)

98

Review your answers in this evaluation. If you are satisfied with the evaluation, click the SUBMIT button below. Once submitted, evaluations are no longer available for you to make further changes.

99

FELLOW SELF ASSESSMENT EVALUATION

OVERVIEW: The Fellow Self Evaluation is part of the Division of Infectious Diseases Multi Source Assessment, which will be useful in assessing the Fellowship Training Program. This evaluation will be done semi-annually. The goal of this form is to provide information from which the fellow and faculty, working together, can create goals and action plans.

Assess your delivery of patient care and whether or not it is compassionate, appropriate and effective for the treatment of health programs and the promotion of health. (PC) (Question 1 of 15 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

In what ways do you believe you can improve? (Question 2 of 15 - Mandatory)

Assess your medical knowledge about established and evolving biomedical, clinical and cognitive sciences and how it has been applied to patient care? (MK) (Question 3 of 15 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

In what ways do you believe you can improve? (Question 4 of 15 - Mandatory)

Assess your communication and interpersonal skills as manifested in your effective exchange of information and collaboration with patients, their families and other health professionals. (ICS) (Question 5 of 15 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

In what ways do you believe you can improve? (Question 6 of 15 - Mandatory)

100

Assess your professionalism as manifested through your commitment to carrying out professional responsibilities, adherence to ethical principles and sensitivity to patients of diverse backgrounds. (P) (Question 7 of 15 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

In what ways do you believe you can improve? (Question 8 of 15 - Mandatory)

How do you assess your system based practice as manifested by actions that demonstrate an awareness of and responsiveness to the large context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care? (SBP) (Question 9 of 15 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

In what ways do you believe you can improve? (Question 10 of 15 - Mandatory)

Assess your practice based learning and improvement which involves the investigation and evaluation of care for patients, the appraisal and assimilation of scientific evidence and improvements in patient care. (PBLI) (Question 11 of 15 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

In what ways do you believe you can improve? (Question 12 of 15 - Mandatory)

101

After having completed this self-assessment, what would you identify as your strengths? Please list three. (Question 13 of 15 - Mandatory)

What would you identify as your areas for improvement? Please list three. (Question 14 of 15 - Mandatory)

Please list three specific learning objectives and goals to work on over the next six months. (Question 15 of 15 - Mandatory)

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102

NURSE EVALUATION OF FELLOW

The fellow provided excellent patient care consistent with his or her level of training: (PC) (Question 1 of 10 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

The fellow shared appropriate understanding and gave good responses when asked questions about the patient's disease states: (MK) (Question 2 of 10 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

The fellow was available to nursing staff within a reasonable time when assistance was needed: (ICS) (Question 3 of 10 -Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

The fellow communicated effectively and respectfully with the patient and their family: (ICS) (Question 4 of 10 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

The fellow communicated effectively and respectfully with nursing staff: (ICS) (Question 5 of 10 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

The fellow demonstrated respect and compassion for the patient and their family: (P) (Question 6 of 10 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

The fellow demonstrated respect for the role and opinions of nursing staff: (P) (Question 7 of 10 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

The fellow demonstrated respect for the roles and opinions of all team members: (P) (Question 8 of 10 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

The fellow participated effectively as a member of the multi-disciplinary team: (SBP) (Question 9 of 10 - Mandatory)

103

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Comments: (Question 10 of 10) (Please write about Strengths, Weaknesses and Areas of Improvement)

Review your answers in this evaluation. If you are satisfied with the evaluation, click the SUBMIT button below. Once submitted, evaluations are no longer available for you to make further changes.

104

PATIENT EVALUATION OF FELLOWS

Greeting you warmly: being friendly, never rude: (P) (Question 1 of 6 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Letting you tell your story and asking thoughtful questions: (ICS) (Question 2 of 6 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Letting you know, during the physical exam about what he/she is going to do; tell you what is found: (ICS) (Question 3 of 6 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Addressing your questions: (ICS) (Question 4 of 6 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Using words you can understand: (ICS) (Question 5 of 6 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Comments: (Question 6 of 6) (Please write about Strengths, Weaknesses and Areas of Improvement)

Review your answers in this evaluation. If you are satisfied with the evaluation, click the SUBMIT button below. Once submitted, evaluations are no longer available for you to make further changes.

105

RESEARCH FACULTY OF FELLOW

Develops relevant research questions and objectives: (RP) (Question 1 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Demonstrates appropriate understanding of research design implementation: (RP) (Question 2 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Demonstrates appropriate understanding of data management and analysis: (RP) (Question 3 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Demonstrates good understanding of Good Clinical Practice Guidelines including research subject rights and protection: (RP) (Question 4 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Reads specific ID literature relevant to research project: (MK) (Question 5 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Demonstrates understanding of research design: (MK) (Question 6 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Has appropriate understanding of research infrastructure for level of training: (MK) (Question 7 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Written research proposals are appropriate: (ICS) (Question 8 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Interpersonal skills with staff and patients are appropriate: (ICS) (Question 9 of 21 - Mandatory)

No Unsatisfactory Average Superior

106

interaction

0 1 2 3 4 5 6 7 8 9

Presents research ideas in a clear, concise manner: (ICS) (Question 10 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Displays a professional attitude: (P) (Question 11 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Completes work in a timely fashion and attends conferences on time: (P) (Question 12 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Responsible for their workload: (P) (Question 13 of 21 - Mandatory)

Not Applicable Strongly Disagree

Disagree Neutral Agree Strongly Agree

0 1 2 3 4 5

Effectively utilizes research resources: (SBP) (Question 14 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Communicates effectively with research team and consultants: (SBP) (Question 15 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Understands research system appropriate for level of training: (SBP) (Question 16 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Advocates for rights and protection of research subjects: (SBP) (Question 17 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Identifies areas for improvement and applies it to practice: (PBLI) (Question 18 of 21 - Mandatory)

107

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Shows interest in learning from complex care issues: (PBLI) (Question 19 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Participates in educational activities including rounds and conferences: (PBLI) (Question 20 of 21 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Comments: (Question 21 of 21) (Please write about Strengths, Weaknesses and Areas of Improvement)

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108

Support Staff of Fellow Evaluation

The fellow is available within a reasonable time when assistance is needed (P) (Question 1 of 7 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

The fellow communicates effectively with Staff (P) (Question 2 of 7 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

The fellow completes GME paperwork in a timely manner (P) (Question 3 of 7 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Fellow is approachable (P) (Question 4 of 7 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

The fellow demonstrates accountability (P) (Question 5 of 7 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

The fellow takes responsibility for their education (P) (Question 6 of 7 - Mandatory)

No interaction

Unsatisfactory

Average

Superior

0 1 2 3 4 5 6 7 8 9

Comments: (Question 7 of 7) (Please write about Strengths, Weaknesses and Areas of Improvement)

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109

RECOMMENDEDREFERENCES

1. Mandel,Douglas,andBennett‐PrinciplesandPracticeofInfectiousDiseases,6thed.,Churchill‐Livingston,NewYork(CurrentEdition)

2. SanfordGuidetoAntimicrobialTherapy‐CurrentEdition3. Murray,Baron,Pfaller,et.al.,ManualofClinicalMicrobiology,CurrentEdition,,ASM

Press,Washington,DC4. JournalofInfectiousDiseases5. ClinicalInfectiousDiseases6. InfectiousDiseaseinClinicalPractice7. AntimicrobialAgentsandChemotherapy8. JournalofClinicalMicrobiology9. ClinicalMicrobiologyReviews10. Science11. Nature12. LancetInfectiousDiseases13. NewEnglandJournalofMedicine14. AmericanJournalofMedicine15. JournaloftheAmericanMedicalAssociation16. AnnalsofInternalMedicine,andACPJournalClub17. ArchivesofInternalMedicine18. MMWR19. MedicalLetter20. CherryandFeigen,PediatricInfectiousDiseases,currentedition21. Up‐to‐date‐online

Fulltextsareavailableon‐linethroughtheKUHwebsiteandtheDykesLibrary.Inaddition,mostoftheseresourcesareavailableintheDivisionLibrary(Delp6070).Traineesareexpectedtoreadextensivelyfromtheaboveresourcesthroughoutthetrainingperiod.

110

FELLOWHAND‐OFFPOLICY

ANTICipateAdministrative‐name,location,primaryteamNewInformation(clinicalupdate)Task‐pending,follow‐upresultsIllness‐ActivemedicalissuesContingencyplans‐if___then____

1) Email(usingthepasswordprotected/securedkumc.eduaddresswiththetitle:[SECUREPATIENTINFORMATION]acheckoutlistofthepatientsyouareactivelyfollowingtothefellowtakingoveryourservice.Include:

a. AtKU:allpatientsonyourteam’sEMRlist(i.e.onTeamAlist)b. AtResearchMedicalCenter:theICUpatientslikelytoremaininICUatthetime

thenewfellowwilltakeovertheservicec. AtKCVA:allpatientsontheIDinpatientconsultservicelistd. Atalllocationsencouragetheresidentyouareworkingwithtohand‐offhis/her

patientstotheincomingresidentaswellaspartofyouteachingservicesandforimprovedcontinuityofcare)

2) Copyyourattendingphysicianonthischeckoutforreviewofcontent.Ifyouareroundingwitharesident/studentpleasecopythemaswell.Thecheckoutisahelpfulteachingtool.

3) Hand‐offnoteshouldincludetheelementsofANTICipatenoteoutlinedabove.Hand‐offatKUwilldifferslightlyastheEMRprovidesmuchoftheAdministrativeinformationinthecheckout.Theemailshouldutilizepatientnamesbutcanskipto“N”whenrelayinginformationasitshouldbeusedinconjunctionwiththeEMRlisting.

4) Theemailshouldprovidethenewfellowtimetoreviewandcall/email/pagewithquestionsthusshouldbecompletedassoonaspossiblethedayyoufinishservice.Knowingthatinmanyinstancesthispass‐offmayoccuronaweekday,itshouldbenearlycompletedpriortothelastdayonserviceprovidingyoutimetoupdateitthedayyoufinish.

5) Thecheckoutshouldconcludewithacontactpiecei.e.pleasecallmycellat999‐999‐9999after8tofurtherdiscussthepatientsorifyouhaveadditionalquestions.Itmayhappenthatrelevantquestionsdonotariseuntilthefirstdaythenewfellowtakesovercareandyoushouldbepreparedtofieldquestionslatershouldtheycomeup.

111

GMECFatigue(Transportation/SwingRoom)Guidelines

•Ifyouarefatiguedandunabletoperformyourpatientcareduties,pleasecontactyoursupervisor(i.e.,chieffellow,facultysupervisor,programdirector,Chairand/orGMEOffice/DIO).Pleaseinformyoursupervisorofyoursituationsothattheycanarrangeforalternatecoveragetoensurecontinuityofpatientcare.•Programcallrooms(KUH4461‐4464)shouldbeutilizedforfatiguedresidents/fellowsforrestand/orpowernapping.•Ifyourprogramdoesnothaveacallroomorifyourassignedcallroomsareunavailableorinuse,youmayusetheswingcallroom–(HHroom2901(code1023*)•Ifadequaterestfacilitiesarenotavailable,thenyoumayusethevoucherfatiguetransportationservice•Theprogramleadershipandadministrationwillreceive2vouchersforevery10residents.(Attached)ThePCshouldkeepthisinaplacewellknowntotheresidentsforeasyaccessafterhours.•Foreachevent2voucherswillbeneeded(oneforhomeandthenoneforbacktoworkthefollowingmorning)•TheVoucherswillneedtobefilledinbytheresident/fellowandthetransportationservicedriver(designatedasKUMCResidentProgramTransportationvoucher).Pleaseprintyourname,Departmentandhomeaddressonthevoucher.•Whenyouarereadytoleave,pleasecall10/10TaxiService(913‐647‐0010)andtellthemyouareusingtheKUMCResidentProgramTransportationvoucherandyourdestination.TheywillpickyouupattheMainEntranceofthehospital.•ThetransportationservicewillcollecteachvoucherwhitecopyandsubmittotheGMEOffice.ItisimportantthatyoureturntheYELLOWcopyofthevouchertoyourprogramdirector.•ThetransportationserviceisallowedtopickyouupfromtheKUHHospitalMainEntranceanddropyouoffatyourhomeaddress,withoutanyintervalstops.Thisalsoappliesforthereturntripfromyourhometobacktothehospitalmainentrancethenextmorning.Youneedtousethesecondvoucherforthereturntrip.•TheresidentisresponsiblefordiscussingtheeventandfatigueissuewiththeirProgramLeadershipthefollowingday.Thismustbedocumentedbytheprogramleadershipinthe“Fatigue/TransportationIncidentReport”ThisisavailableinE*Value–Fatigue/TransportationIncidentReport(examplebelow).Again,pleasereturntheyellowvouchercopiestoyourprogramdirectoratthistimeaswell.Thepurposeofthisfileistotrackbothindividualandprogram‐wideepisodesoffatigueandadditionaldutyinordertomitigatefuturerecurrences.•TheGMEOfficewillmanagethecabvouchersandbillbackthedepartmentsastheyarebeingusedaswellasreplenishthevouchersupply.

112

FELLOWREQUIREDONLINETRAININGCOURSES

AngelTrainingCourses

Course Title Assessment Title RequirementGME: Required Curriculum

Professionalism Module: Post Test

One-Time

GME: Required Curriculum

Life Curriculum - Fatigue: Post Test

One-Time

GME: Required Curriculum

Life Curriculum - Substance Abuse: Post Test

One-Time

GME: Required Curriculum

Residents as Teachers: Post Test

One-Time

ChalkTrainingCourses

Training RequirementComputer Security Awareness Training

Ongoing

Counseling and Support Services One-Time

Duty Hour Reporting One-Time

Employee Health Overview One-Time

Equal Rights and Responsibilities One-Time

GME Policy and Procedure Manual One-Time

HIPAA Training for KUMC Providers Ongoing

Harassment Training Ongoing

KU Precautions and OSHA One-Time

KUMC Policies for New Employees One-Time

Safety Training Annual Update Ongoing

Violence in the Workplace Ongoing

113

2011COMMONPROGRAMREQUIREMENTUPDATES

RESIDENTS’ PARTICIPATION IN PATIENT SAFETY PROGRAMS (ANNUAL) (PR VI.A.3) Institutional:

Institutional quarterly Patient Safety Conference GME Core Competency Conferences Resident PGY‐1 orientation: Take Action course synopsis & Resident Handovers group sessions Resident education in patient safety & quality GMEC subcommittee PSN reporting mechanism Risk Management CHALK online modules Resident Council PSN education & reviews of quarterly reports  

Program: Internal Medicine Departmental Patient Safety Conference Internal Medicine Departmental CPC conferences ID Program Handover education & process education ID Program Case Conferences with Vanderbilt Matrix tool Antibiotic Subcommittee review of patient safety concerns 

RESIDENTS’ PARTICIPATION IN INTERDISCIPLINARY CLINICAL QUALITY IMPROVEMENT PROGRAMS (ANNUAL) (PR VI.A.3) Institutional:

Institutional quarterly Patient Safety Conference GME Core Competency Conferences Resident PGY‐1 orientation: Take Action course synopsis & Resident Handovers group sessions Resident education in patient safety & quality GMEC subcommittee PSN reporting mechanism Risk Management CHALK online modules Resident Council PSN education & reviews of quarterly reports TeamSTEPPS dissemination 

Program:

InterdisciplinaryProgramPBLIprojects(usePBLItemplate)Internal Medicine Departmental Patient Safety Conference Internal Medicine Departmental CPC conferences 

IDDepartmentQImonitoringIDCaseConferencewithVanderbiltMatrixtool  

BACK UP SYSTEM WHEN CLINICAL CARE NEEDS EXCEED RESIDENTS’ ABILITY (PR VI.C.2) Institutional:

Institutional GME Manual Policy statement KUH Hospital Links online on‐call system‐ 

TeamupdatesofO2TeaminEpic Resident Orientation (Duty Hour & Supervision talk) 

114

Program: IDDivisionCallSchedule‐postedonlineIDDivisionPolicyManualdescriptionofcontinuitycoverageforfatiguedresident   

SCHEDULES THAT INFORM ALL TEAM MEMBERS OF ATTENDING/RESIDENTS CURRENTLY RESPONSIBLE FOR EACH PATIENT’S CARE (VI.B.4) & RESIDENTS & FACULTY INFORM PATIENTS OF THEIR ROLES IN CARE (VI.D.1.B) Institutional:

KUH admission Handout to patient with description of level of caregivers UKP clinic handout of caregiver definitions KUH Oncall system in Hospital links O2 “patient care team” accuracy Bedside whiteboard 

Program:

RRC‐defineddesignationoflicensedindependentpractitionerinGMECResidentSupervisionTemplateattachedtoG&Oand/orhandbookProgramsupervisionpoliciesupdatedtoincludenewsupervisionrequirementsID Division on‐call schedule mechanisms education Picture roster (faculty with all residents listed) Business cards given to patients with names/titles 

DESCRIBE HOW CLINICAL ASSIGNMENTS DESIGNED TO MINIMIZE PATIENT CARE TRANSITIONS (PR VI.B.1) Institutional:

Program:

AnnualIDProgramOutcomesAssessmentandActionPlanReportcheckboxMonthly Fellow rotation schedule Continuity clinic assigned to faculty clinic for 2 year duration

EDUCATION & IMPLEMENTATAION OF STRUCTURED HAND-OVER PROCESS(PR VI.B.2) Institutional:

Residents’ orientation video & small group sessions Residents’ SIGNOUT Template pocket card EPIC O2 Signout instrument Angel online module about handoffs/transitions of care          

Program: ID Program specific education at orientation  Written handoff process described in ID Division manual  

FATIGUE, SLEEP DEPRIVATION AND MITIGATION EDUCATION (PR VI.A.5.e & VI.C.1.a), INCLUDING EDUCATION OF PREFESSIONAL RESPONSIBILITY TO APPEAR FOR DUTY RESTED/FIT (VI.A.1) Institutional:

GME ANGEL online Fatigue Education Module modification 

115

Resident Orientation (Duty Hour & Supervision talk) Institutional Policy statement Add to IR and SV preparation process checklists 

Program:

IDDivisionspecificfatigueeducation InternalMedicineDepartmentandIDDivisionPolicyManualStatements(inprofessionalismorDutyHourPolicy)

FATIGUE MITIGATION PROCESSES, CONTINUITY OF CARE IF UNABLE TO PERFORM DUTIES AND SLEEP/TRANSPORTATION FOR FATIGUED RESIDENTS (VI.C.1-3) Institutional:

Resident Orientation (Duty Hour & Supervision talk) Resident Council education GMEC education Department call rooms & Swing Call room Fatigue Transportation service (GME Manual guidelines section) 

Program:

E*Value fatigue file (fatigue transportation incidents & explanation box for 24hr and 8hr rule violations‐ monitored by PD) 

ID Division call schedule ID Division Policy Manual‐describe continuity process Team updates of O2 Team in Epic 

MONITORING PATIENT CARE PERFORMANCE INDICATORS (VI.A.5.g) Institutional: Program:

Dept QI requirements/measures KUH QI report requirements/measures UKP QI report requirements/measures Internal Medicine Patient Safety and CPC conferences  Infectious Diseases Case Conference  Patient 360‐degree surveys/evaluations 

FACILITIES (all available) □ Sleeping Rooms – segregated by Gender □ Shower/Bath □ Secure room or lockers 

116

INDEX A

Advancement to Succeeding Training Year 28 Adverse Events 42

B Benefits 39 Access to Medical Literature 40 Board Preparation Materials 40 Disability Insurance 39 Life Insurance 39 Malpractice Insurance 39 Medical Insurance 39 Parking 40 Pay 39 White Coats 40 Work Environment 40

C Call Schedule 33 Common Program Requirement Updates 111 Communication 34 Conferences, Lectures and Other Education Opportunities 22 Antibiotic Committee 25 Clinicopathological Conference 27 Core Curriculum Conference 23 Infection Prevention and Control Committee 26 Infectious Diseases Clinical Case Conference 23 Journal Club 24 Kansas City Infectious Diseases Society (KCIDS) 25 Patient Safety Conference 27 Research Conference 24 Contact Information 5 Core Competency Teaching and Assessment Matrix 82 Core Curriculum Schedule 49 Curriculum 14 Year One Fellowship 14 Year Two Fellowship 20 Year Three Fellowship 22

D Disciplinary Actions 44 Divisional Goals 10 Documentation of Training 29 Duration of Program 31 Duties 31 Duty Hours Policy 32

E Educational Objectives 53 Ethics 28, 41

117

Evaluation of Faculty and Program 29 Evaluation of Fellows 28 Evaluations, Forms Faculty Evaluation of Program 84 Faculty of Fellow Evaluation 87 Fellow of Faculty Evaluation 90 Fellow of Program Evaluation 93 Fellow Peer Evaluation 96 Fellow Self Assessment Evaluation 99 Nurse Evaluation of Fellow 102 Patient Evaluation of Fellows 104 Research Faculty of Fellow 105 Support Staff of Fellow Evaluation 108 Evaluations, Required 83

F Family Leave 38 Fatigue 32 Fatigue Guidelines 111 Fellowship Selection Process 30

G GME Supervision Template 53 GMEC Fatigue (Transportation/Swing Room Guidelines 107 Goals, Divisional Grievance Resolution 47

H Hand Off Policy 110 Hand Off, Service 34

I ID Conferences 52 ID Service Hand Off 34 Impairment 44 Institutional Supervising Faculty 7 Interview Leave 37 Introduction 4

L Late Start 38 Leave Family 38 Interview 37 Personal 37 Vacation 37 Lines of Responsibility 36

M Meeting Attendance 36 Mission Statement 9 Moonlighting 40

118

N Non-teaching Patients 35

O Objectives First Year Inpatient Consultative Service 16 First Year Outpatient Clinics 17 First Year Clinical Microbiology Laboratory 18 First Year Research 19 Second Year Inpatient Consultation Service 20 Second Year Outpatient Clinics 21 Second Year Research 22 Online Training 112 Order Writing 35 Outpatient Antibiotic Therapy (OPAT) 26 Overview of the Educational Objective with Reference to Six Core Competencies Year One 55 Year Two 56 Overview of Goals and Objectives for Rotations University of Kansas Inpatient Consultation 57 Kansas City Veterans Administration Medical Center Inpatient Consultation 61 Research Medical Center Inpatient Consultation 65 University of Kansas Clinic Rotation 69 Kansas City Veterans Administration Medical Center Clinic Rotation 73 Microbiology Rotation 77 Research Rotation 80 Overview, Program 9

P Pediatric Infectious Diseases 22 Performance Deficiencies 45 Performance Expectations 10 Patient Care 10 Medical Knowledge 11 Practice-Based Learning 12 Interpersonal Skills and Communication 12 Professionalism 13 Systems-Based Practice 13 Personal Leave 37 Policies and Procedures 30 Prerequisites 30 Probation 44 Professional Ethical Behavior 28 Professionalism 43 Program Overview 9

Q Quality Improvement 41

R Recommended References 109

119

Required Evaluations, List 81 Required Online Training 112 Risk Management 42

S Sick Leave 38 Suspension 44

T Termination 44

U Utilization Management 41

V Vacation Leave 37

Y Year One Fellowship 14 Year Two Fellowship 20 Year Three Fellowship 22