Dermatopathology PGY-2

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Dermatopathology Rotation Goals/Objectives for PGY-2
Patient Care
Goal: To provide skin biopsy evaluation that is effective in assisting clinicians with diagnosis
and optimizing patient outcomes.
Objectives:

1. Consistently obtains accurate history from the pathology requisition. PC4
2. Identifies biopsy type (e.g. shave, punch, excisional biopsy). PC4
3. Distinguishes normal from abnormal histology and recognizes confounding factors (eg.
   artifact). PC4
4. Distinguish between inflammatory and neoplastic diseases. PC4
5. Generates a list of next steps (ancillary testing; has awareness of options available)
   needed to refine differential in the clinical context. PC4
6. Performs interpretation of margins and interpretation of special stains (histochemical and
   immunohistochemical), including whether control tissue stained appropriately. PC4
7. Applies clinical correlation to the interpretation of histopathological findings. PC4
8. Begins to make connections between clinical differential diagnosis and microscopic
   pathologic findings. PC4
9. Understands and applies Electronic Medical Record (EMR) to obtain added clinical
   information. PC4
10. Understands that advanced precision diagnostics and personalized medicine (e.g..
    molecular diagnostic testing) may be applied to patient care for genetic, neoplastic and
    infectious disorders, and population health. PC4
11. Usually interprets and applies histopathologic findings to clinical care accurately. PC4
12. Usually suggests appropriate specialist consultations. PC4
13. Brings clinical/ancillary information to sign-out (e.g.. prior cases). PC4
14. Becomes familiar with synoptic reporting. PC4
    ynoptic repo tong Pout (es. prior cases) PC.
15. Formulates a differential diagnosis of pathologic findings for common diseases. PC7
    Medical Knowledge
    Goal: To acquire knowledge in dermatopathology, demonstrate competence in knowledge of
    topics specified by the American Board of Dermatology and develop expertise in
    clinicopathologic correlation.
    Objectives:
16. Demonstrates knowledge of the pathophysiology, clinical manifestations, expected
    course, and management options of common neoplastic and inflammatory conditions
    and is able to distinguishes those that are urgent from non-urgent. MK1
17. Recognizes histologic patterns of inflammatory disease and common neoplastic
    conditions. MK1
18. Occasionally identifies histopathologic findings of common skin disorders correctly
    MK1
19. Uses histopathological terminology to describe microscope findings. MK2

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5. Demonstrates knowledge of direct and indirect immunofluorescence tests and correct
locations for biopsies MK1
6. Demonstrates knowledge of relevant special stains. MK1
Practice-Based Learning and Improvement
Goal: Develop skills in acquiring, analyzing, applying and teaching dermatopathology
knowledge. Develop the ability to self-analyze and the ability to design quality improvement
projects to optimize patient outcomes.
Objectives:

1. Without being directed, access appropriate print or electronic resources to find dermatology
   and dermatopathology information requested or assigned. PBLI1
2. Consistently ask for feedback. PBLI2
3. Remain open to constructive criticism of performance, avoid defensiveness or denial of
   constructive criticisms received PBLI2
4. Participate in the collection and analysis of program-specific resident competency data (for
   example, patient logs, procedure logs, and treatment logs) PBLI2
5. Identify deviations from standards of dermatologic care (for example, identifies when
   guidelines of care were not followed, and when over- or under-utilization of diagnostic testing
   and therapy has occurred). PBLI2
6. Articulates clinical questions and elicits patient preferences and values in order to guide
   evidence-based care. PBLI1
7. Demonstrates openness to performance data (feedback and other input) in order to inform
   goals. PBLI2
8. Analyzes and reflects on the factors which contribute to gap(s) between expectations and
   actual performance. PBLI2
9. Designs and implements a learning plan, with prompting. PBLI2
   Interpersonal Communication
   Goal: To communicate with health professionals and ancillary staff in a clear, concise, caring.
   and respectful manner.
   Objectives:
10. Works effectively with all the members of the pathology team. ICS2
11. Demonstrates respect for team members. ICS2
12. Usually communicates effectively and builds rapport with consultants and referring
    physicians. ICS
13. Speaks in easily understandable language, using dermatopathology terminology and lay
    terminology when appropriate. ICS1
14. Communicates effectively with health care team members in ways that demonstrate
    appreciation for their skills and contributions. ICS2
15. Demonstrates receptiveness to requests for consultations from other specialties and
    communicates promptly with referring providers. ICS2

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7. Consistently documents telephone conversations, consultations, letters to referring
providers, procedures, and counseling with clearly written and relevant information for
routine situations, but occasionally needs assistance with complex situations. ICS2
8. Identifies elements of shared decision making. ICS1
9. Solicits feedback on performance as a member of the health care team. ICS2
Professionalism
Goal: Develop a commitment to excellence and integrity in dermatopathology and in the
interactions with other health professionals and staff.
Objectives:

1. Treat all patients with respect and dignity, regardless of socio- economic, racial, or ethnic
   background or sexual orientation PROF1
2. Understand the actions and relationships that constitute potential boundary crossings and
   violations, and actively avoid these. PROF1
3. Respond promptly and appropriately to clinical responsibilities (for example, timely reporting
   for duty, completion of medical records, returning patient phone calls, answering pages). PROF2
4. Carry out timely interactions with colleagues, patients, and their designated caregivers.
   PROF2
5. Promptly complete clinical tasks. PROF2
6. Explain the concept of leading by example. PROF1
7. May need assistance with time management and setting priorities, but all patient care
   activities are completed in a timely fashion. PROF2
8. Consistently demonstrate empathy and compassion to patients of all ages. PROF1
9. Demonstrates insight into professional behavior in routine situations. PROF1
10. Takes responsibility for own professionalism lapses. PROF1
11. Analyzes straightforward situations using ethical principles. PROF1
12. Performs tasks and responsibilities in a timely manner with appropriate attention to detail in
    routine situations. PROF2
13. Recognizes situations that may impact own ability to complete tasks and responsibilities in a
    timely manner. PROF2
14. Independently recognizes status of personal and professional well-being. PROF3
15. Independently recognizes limits in one’s own knowledge/skills and seeks help when
    appropriate. PROF3
    Systems Based Practice
    Goal: Competently navigate the health care system using the resources available to provide
    effective yet cost-conscious dermatopathology services.
    Objectives:
16. Maintains access to all needed systems.SBP1
17. Accesses support services appropriately. SBP2
18. Describes the use of checklists and briefings to prevent adverse events in health care;
    recognizes the roles of team members and participates in briefings. SBP1

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4. Articulates understanding of institutional risk-management resources available. SBP1
5. Demonstrates knowledge of how a patient’s health care is paid for, and how this affects
the patient’s care. SBP3
6. Articulates awareness of cost associated with the technical and professional aspects of
skin biopsies, including the costs of stains. SBP3
7. Considers cost of ancillary studies used in pathology, and incorporates this into decision-
making. SBP3
8. Demonstrates awareness of minimizing unnecessary care. SBP3
9. Is aware of accrediting agencies of the laboratory. SBP3
10. Is aware of cost-benefit analysis for new technology. SBP3
11. Identifies system factors that lead to safety events. SBP1
12. Reports patient safety events through institutional reporting systems. SBP1
13. Describes local quality improvement initiatives (e.g., handwashing, needle stick
prevention, wrong site surgery prevention, mislabeled slides). SBP1
14. Identifies specific population and community health needs and inequities for their local
population. SBP2
15. Describes how components of a complex health care system are interrelated, and how this
impacts patient care. SBP3
16. Describes core administrative knowledge needed for transition to practice. SBP3