Welcome to the Internal Medicine Residency's "Procedures and Consult Rotation" Homepage

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Our goal is to be on the leading edge of emerging technology when it contributes positively to resident education and patient care. The Procedure and Consult Rotation is a perfect example of this philosophy at work. The rotation started in 2007 in response to the desire from internal medicine residents to have increased exposure to those procedures mandated by the ACGME, and more importantly, those thought to be important in the armamentarium of a practicing internist. Additionally, the skill of being an effective internal medicine consultant is an increasingly important part of the hospitalist's role and constitutes an important learning aspect of this required rotation during the first year of internal medicine residency.

The resident on the rotation spends a significant amount of time in the Abbott Northwestern Hospital Center for Clinical Simulation that was initially started by the residency program in response to the national trend for an increasing role of using high-fidelity "ultrasound-real" patient simulation to foster experiential procedure and examining in a safe environment. The center allows Abbott Northwestern Hospital's faculty and trainees to apply state-of-the-art simulators to learning the practice of invasive procedures in a risk-free environment with the ultimate goal being benefit to our patients. The center has since greatly expanded its scope and facilities beyond procedural simulation to include high-fidelity "full body" simulation encompassing code scenarios and multiple other events in ER and ICU settings.

Bedside ultrasound is becoming an integral part of many procedures, including central lines, paracentesis and thoracentesis. Residents are trained in the use of bedside ultrasound using a portable ultrasound machine owned by the residency program. Our procedure simulators in the simulation center are "ultrasound-real" to give our trainees the most realistic simulation environment. In addition, we anticipate ultrasound technology becoming an essential tool for the internal medicine physician to improve physical exam and diagnostic skills in the future. We are incorporating significant general ultrasound training into the procedure rotation with the expectation that are residents are proficient in basic ultrasound skills.

 

A typical month on the Procedure Rotation:

The resident on the rotation goes through a methodical training regimen consisting of procedural knowledge acquisition, technical skills acquisition, full simulation training on state-of-the-art ultrasound real simulators in the clinical simulation center, and finally performance of procedures on patients.  Throughout all of these steps, the resident receives feedback and assessment by the clinical procedure team staff assuring competency before moving on to the next level of procedures. Formal assessment with multimedia interactive testing tools occurs at various points during the 4 week rotation. There is significant 1-on-1 time between the resident and the procedure rotation staff necessary to adequately teach the intricacies and troubleshooting of the individual procedures.  This rotation is expanding steadily as it becomes a routine part of the hospital services. During the last year, the Internal Medicine Resident Procedure Team performed over 400 procedures. The goal is for continued growth, balanced with ample educational and simulation training time while the resident is on the rotation.