Adult Cardiology Fellowship

All procedures, evaluations and assessment tools are logged electronically through the Trainees Management System (New Innovations). Fellows are assessed by faculty members during and at the end of each assigned rotation as in the log-book specifically clinical cases/procedural skills/academic activities and overall ACGME competences.

These evaluations will be based on the objectives for that assignment and appropriate to the level of the fellow. Appropriate feedback is given throughout the rotation as needed and the assessment is discussed with the fellow at the end of the rotation. Completed assessments are forwarded to the program director to be used in the semi-annual evaluation meeting.

The fellow’s admission notes, progress notes, outpatient notes and discharge summaries will be reviewed randomly by faculty. Feedback can be given to the fellow with regard to the quality of their written notes and faculty has a direct opportunity to continuously evaluate fellow performance.

The communication skills of a fellow in cardiology must be both verbal and written. Verbal communication skills and clinical skills of the fellows are evaluated on a daily basis when residents discuss cases with faculty in outpatient department or in ward and suggestions made when appropriate.

ASSESSMENT BY ROTATION SUPERVISOR (DIRECT OBSERVATION)

The assessment will be carried out by a rotation supervisor. One Rotation Supervisor will be identified at each site and they will endeavor to solicit feedback from all the consultants and specialists a trainee worked with. A verbal mid-rotation evaluation will be provided. This will aim to identify certain issues that the trainee may have and allow him/her, the rest of rotation to rectify any short-comings or deficiencies. A final, formal, evaluation will be completed by the respective rotation supervisors. After completion of the rotation, the final evaluation of the rotation supervisor will be based on the fulfillment of the rotation objectives as determined by:

Personal observation during interaction with the fellow.

Evidence of extensive literature reviews appropriate for the individual patient

Ability to construct a logical management plan.

Inclusion of appropriate physical examination.

Appropriateness of use of diagnostic tests.

Correct interpretation of diagnostic tests.

Appropriate selection of pharmacologic and non-pharmacologic therapies.

Competent performance of cardiac procedures relative to the fellow’s level of

training.

Appropriate follow-up.

Feedback from other team members, other healthcare providers, and patients.

A successful completion of all rotations is mandatory for the successful completion of the cardiology fellowship program. A trainee who fails the rotation will be expected to complete a remedial rotation(s). The site of the remedial rotation will be at the discretion of the program director.

LOG BOOK/PORTFOLIO

The logbook is an essential method for assessing the fellow’s progress and graded responsibilities during their training years. The decision to allow the trainee to perform procedures independently will depend on the supervisor’s assessment of the individual’s skills and not necessarily on the number of procedures observed / assisted.

It is not necessary to document every case seen or encountered. The fellows are required to document interesting/complicated cases encountered, academic activities and all procedures participated in and the level of contribution based on following four point scale: O: Observed A: Assisted S: Supervised I: Independently. The faculty will document ACGME-I competencies for each fellow.

All procedures, evaluations and assessment tools must be used or logged electronically through the Trainees Management System (New Innovations). Fellows will be evaluated by appropriate faculty members during and at the end of each assigned rotation as in the log- book specifically clinical cases/procedural skills/academic activities and overall ACGME competences.

ASSESSMENT AND FEEDBACK METHODS BASED ON THE ACGME –I COMPETENCES

Fellow’s performance will be assessed throughout her/his tenure in the training program to ensure appropriate development of skills and competencies. Methods used will provide assessment of competencies in patient care, medical knowledge, and Practice-Based Learning and Improvement, interpersonal and communication skills, professionalism, and systems- based practice. The fellows are specifically evaluated on the ACGME-I competencies every rotation by the rotation supervisor.

All fellows are expected to get signatures of their supervisors same time/day of case seen or procedure done and at the end of their rotation from the rotation supervisor. In addition, semi-annual logbook has to be signed by the program director and then countersigned by the chairperson of the education committee.

Assessment is marked as 3 grades –Unsatisfactory (below expectations)/ Satisfactory (meets expectations) /Good (exceeds expectation). 1. Unsatisfactory-Poor competency judgment, Requires continuous supervision. 2. Satisfactory- Meets Expectations, Effective competency judgment. Supervision needed for complex/difficulty situations.3. Good- Exceeds Expectations, Exemplary competency judgment including in complex/difficult situations. Can practice independently.

A trainee who fails the rotation will be expected to complete a remedial rotation(s). The site of the remedial rotation will be at the discretion of the program Director.

The following are the utilized Assessment forms:

In – Training Assessment Report (ITAR):

This form is used by the supervisor of the rotation to evaluate the fellow competence on multiple criteria including Medical Knowledge, Patient Care, Professionalism, Practice-Based Learning and Improvement, Interpersonal and Communication Skills and SYSTEMS-BASED PRACTICE.

Mini - clinical Assessment (MINI-CEX):

This form is used to evaluate a quick clinical competence of a fellow by the in charge consultant of the team.

Rotation Evaluation Form:

This form is used by the supervisor, to evaluate the fellow for the complete rotation, including the number of patients seen by the fellow, presentations done, patient management and ward rounds.

Final In-Training Assessment Report (FITAR):

This form is used to assess in depth the fellow on the six different ACGME competencies as an overall performance. It is done at the end of the program by the Program Director.

These forms and others are used in the fellowship evaluation according to the following description:

Journal club: the rotating fellow is expected to present an article pre-chosen with a local faculty member. Journal clubs will be held once per month.

Academic half-day [Every Monday afternoon 2:00 – 4:00 pm]: These will be coordinated with the faculty at each of the two training sites alternatively, the Sultan Qaboos University

Communication skills:

effective and clear communication with patients is a vital component of the daily patient care. The practice of cardiology tests this skill in various settings; such  as the ambulatory  clinic, inpatient wards, intensive care unit and  before procedures. This particular simulation activity aims to provide the candidate to practice these skills in a simulated environment under direct supervision. Some proposed themes include:

1.Obtaining consent for elective and emergency procedures

2.Counselling patients about a serious diagnosis or serious abnormal finding on a cardiac investigation

3.Counselling a pregnant patient and spouse about a serious cardiac diagnosis addressing maternal and fetal risks on the discussion (severe LV dysfunction, severe mitral stenosis, severe pulmonary hypertension)

4.Counsel family members about the deteriorating condition of a relative in the critical care unit

5.Counsel a patient about the side effects of a new medication

Observed Simulated Clinical Exam (OSCE) Stations:

The simulation sessions will be used in preparing the candidates for local and international exit examinations, specifically for the OSCE and clinical short-case component. These MOCK exam sessions will include bedside focused cardiac examination, interpretation of echocardiographic, angiographic and hemodynamic data.

The themes suggested above are only suggestions and are going to be a moving target for modification based on training requirements. The activity will allow for a rich medium for discussion and interaction between faculty, invited faculty and fellows. The faculty conducting the sessions is expected, where appropriate, to generate 10-15 multiple choice or case-based questions on their respective stations. These will be used to construct a local cardiology question bank with the prospect of assisting local faculty in independently assembling validated exist-examination templates in the near future.

Educational Activities arranged by the Oman Heart Association (OHA):

the OHA with its active scientific committee, conducts a series of high-quality educational activities delivered by local, regional and international experts in cardiology. Fellows will be encouraged to attend and participate in these activities to further enrich their training experience.

Regional and International Cardiology Conferences/Workshops:

The program will strive to allow its senior (2nd and 3rd year) fellows to attend, and more importantly actively participate in regional and international conferences with case presentations, presentation of their research work … etc. This activity is  subject to  availability of funding source and agreement of members of the education committee evaluating performance of the potential candidate.

Academic Schedule for Adult Cardiology Fellowship Program- 2020/2021

Adult Cardiology Fellowship Academic Program December 2020