Curriculum
Clinics
There are several multidisciplinary clinics held at Temple University Hospital, Good Shepherd Rehabilitation Hospital and Children’s Hospital of Philadelphia (CHOP). The clinics Good Shepherd includes are the Spina Bifida, Stroke, Spinal Cord Injury, and Prosthetics and Orthotics Clinics. All residents on rotations are encouraged to participate in available clinics.
Prosthetic and Stroke Follow-up Clinics are held at Temple University Hospital in addition to Sports, Musculoskeletal, Ultrasound teaching and OR time for Spine procedure for Pain Management.
Consult Service
The resident will fully evaluate the medical and rehabilitative needs of the patients referred from the acute care medical and surgical services. The resident will be assigned approximately six to ten consultations per day according to the patient medical acuity, rehabilitation needs and resident capabilities. Each resident is assigned to an attending physician who is a member of the full-time or volunteer faculty of Temple University Hospital, Department of Physical Medicine and Rehabilitation.
The consultation will include history and physical examination, functional status, rehabilitation goals, and rehabilitation program. The resident will consider the patient's post acute care needs such as inpatient rehabilitation, outpatient care or home care. The resident should review all medical tests and radiological studies prior to prescribing a rehabilitation program. As part of the duties, the resident will write all prescriptions for equipment such as wheelchairs and referrals for continued rehabilitative care.
The resident will write or dictate the consultation according to the individual hospital's guidelines and provide the necessary follow-up assessments.
The attending physician will supervise the resident by reviewing all rehabilitation evaluations and programs written. Teaching occurs at the bedside, in small group discussions, case presentations and lectures.
Electives
All residents complete the same mandatory core rotations. Electives are designed for motivated residents wishing to focus on an area of particular interest. Elective time is available based on educational objectives and program needs. Residents can also to do short away (audition) rotations as needed on a case by case basis.
Clinical:
- Dedicated Sports Medicine in Pediatric and Adult
- Interventional Spine procedures at Pennsylvania Pain & Spine Institute
- Outpatient - TUH and affiliated practices Premier Orthopedics (Delaware county)
- Junior Outpatient Clinic- Good Shepherd Hospital
- Senior Ambulatory Rotation - Temple University Hospital
Musculoskeletal Ultrasound at the William Maul Measey Institute for Clinical Simulation and Patient Safety
Beginning March 2022, the Department of Physical Medicine and Rehabilitation will host an annual course on Musculoskeletal Ultrasound at the William Maul Measey Institute for Clinical Simulation and Patient Safety at the Lewis Katz School of Medicine. This course will provide: 6 sessions, with each session including live demonstrations, standardized patients, a Vimedix ultrasound simulator, 10 Butterfly iQ, 2 Sonosite and 2 GE ultrasound machines. Courses will be held throughout the year, with each 2-hour session focusing on a single anatomical region.
Dr. Franklin Womble (PGY-3) and Chief Resident Joseph LaPenna (PGY-4) attend the PM&R department’s first meeting at the William Maul Measey Institute for Clinical Simulation and Patient Safety.
Electrodiagnostic Medicine
The resident will initially observe electrodiagnostic procedures with the attending physician. The resident will gradually assume more responsibility with the goal of performing EMGs only with supervision by the end of the rotation.
As part of the Electrodiagnostic rotation, the resident will fully evaluate the patients referred for studies. Each resident is assigned to an attending physician, who is a member of the full-time or volunteer faculty.
The resident will write or dictate the EMG data, conclusions and recommendations, according to the individual service's guidelines on the day of the procedure.
The attending physician will supervise the resident by reviewing all electrodiagnostic studies performed. Teaching occurs with each individual patient, small group discussions, case presentations, and lectures.
The resident is to maintain a record of all electrodiagnostic studies including patient name and number, diagnosis and regions studied which he or she performed for purposes of the American Board of Physical Medicine and Rehabilitation and the American Board of Electrodiagnostic Medicine.
Inpatient Services
The majority required core inpatient rotation will be conducted at Good Shepherd.
The residents will fully evaluate the medical and rehabilitative needs of their assigned patients. In general, the resident is assigned a reasonable patient load to balance learning through teaching, reading and experience. Each resident is assigned to an attending physician, who is a member of the full-time or volunteer faculty.
The initial evaluation will include history and physical examination, functional assessment, rehabilitation goals, medical orders and rehabilitation program. The resident will have primary responsibility for patient care, which includes daily rounds, review of medical test results and overview of the rehabilitation program. The resident will write all prescriptions for equipment such as wheelchairs, prosthetics, orthotics, etc. The resident will participate actively in rehabilitation team meetings such as gym rounds and team conferences.
The resident will dictate the discharge summary according to the individual hospital's guidelines and write an off-service note for each patient during the last week of a rotation on each service.
The attending physician will supervise the resident by reviewing all patient orders, rehabilitation evaluations and orders written. Teaching occurs at the bedside, small group discussions, case presentations, and lectures. The attending is expected to provide the resident with educational goals/objectives for each rotation.
Outpatient Services
The resident will fully evaluate the medical and rehabilitative needs of the patients referred for outpatient physiatric evaluations. Each resident is assigned to an attending physician, who is a member of the full-time or volunteer faculty.
The outpatient consultation will include history and physical examination, functional status, rehabilitation goals and needs, and the alternatives for management such as inpatient rehabilitation, outpatient care or home care. The resident should review all available medical tests and radiological studies prior to prescribing a rehabilitation program. The resident will write all prescriptions for equipment such as wheelchairs, orthotics, prosthetics, etc. and therapeutic prescriptions or referrals for continued rehabilitative care.
The resident will write or dictate the consultation according to the individual hospital's guidelines.
The attending physician will supervise the resident by reviewing all rehabilitation evaluations and programs written. Teaching occurs with each individual patient, small group discussions and case presentations, and lectures.
Research
Residents are expected to complete a scientific project such as case reports, review articles, or original research project appropriate for publication or presentation at a major conference. Residents are strongly encouraged to participate in quality improvement in any area of Physical Medicine and Rehabilitation in their first year and to continue its development to conclusion by the end of their training program. Yearly didactics papers should be of quality that is presented to fellow residents every Wednesday critiqued and commented by attendings present in presentation. Support is provided through a variety of faculty advisors and selected members of and Lewis Katz School of Medicine at Temple University faculty. All research projects involving patients must be approved by the Program Director, Chairperson and respective hospital Institutional Review Board.
Rotations
Inpatient Care:
Good Shepherd Rehabilitation Hospital
Children's Hospital of Philadelphia
Jefferson Moss-Magee Rehabilitation
Consult Services:
Temple University Hospital
Children's Hospital of Philadelphia
Electrodiagnostic Medicine:
Temple University Hospital
Good Shepherd Rehabilitation Hospital
Outpatient Services:
Temple University Hospital
Children's Hospital of Philadelphia
Off-site interventional pain, sports and musculoskeletal rotations
Conferences
Local, regional and national conferences sponsored by the American Academy of Physical Medicine and Rehabilitation (AAPM&R), the Association of Academic Physiatrists (AAP), the American Osteopathic College of Physical Medicine and Rehabilitation (AOCPMR) and other major organizations invite presentations and attendance by residents.
Temple University Hospital's PM&R Residency Program encourages resident participation in:
- Poster and paper (oral) presentations
- Panel discussions
- Administrative areas (Resident Physician Council)
- Program organization
Funds are available to support residents to attend selected conferences including travel and lodging. The amount of reimbursement is determined by the Temple University Hospital Graduate Medical Education department. Departmental awards are given to the best submissions each year.
Courses
In a collaborative spirit of education, each Philadelphia area PM&R residency program (UPenn and Moss Rehababilitation Hospital) sponsors and presents a two to three-day course annually. These include:
- Gait & Orthotics: Moss Rehabilitation Hospital
- Prosthetics: University of Pennsylvania
- Electrodiagnostic Medicine: Thomas Jefferson University Hospital
MSK Ultrasound Anatomy Course: Residents participate in an interactive course focused on ultrasound-based musculoskeletal anatomy. The course includes multiple skills lab held throughout the year.
Physical Examination Workshops: Residents participate in multiple interactive workshops through the year focused on different aspects of the physiatric physical examination including the neuromusculoskeletal examination.
Temple University Hospital Physical Medicine & Rehabilitation Quality Improvement Synopsis
With the Accreditation Council for Graduate Medical Education (ACGME) mandating resident involvement in quality improvement initiatives, Temple Physical Medicine and Rehabilitation Residency (PM&R) has elected to start a new approach to quality. The residency Program Directors established the PM&R Quality Improvement Committee which began creating and collaborating with representatives from Temple with the mission to improve the care of patients and the quality of the residency program. The PM&R Quality Improvement Committee is made up of residency Program Directors, GME Program Administrator, a Chief Resident, a PGY3 level resident, and representatives from each class supporting various quality initiatives.
The PM&R Quality Improvement Committee designed an improvement and research curriculum that will be compromised into two components: Patient Safety and Quality Improvement Projects, and Research Mentorship.
The PM&R residents are dedicated to providing the best possible care for their patients. They are working on analyzing service challenges that simultaneously help patients and the Temple residency program, and ensure that their initiatives align with both institution’s patient safety and QI priorities. The goal behind the curriculum is to facilitate the learning process of, and resident participation in, quality improvement project design and implementation, academic research, and to promote a lifelong approach of actively pursuing and implementing evidence-based best clinical practices.
Quality Improvement – IHI Open School
PM&R IHI Open School is an educational tool offered online to help the residents and faculty deliver excellent, safe care. The modules that have been identified for you are in Quality Improvement, Patient Safety and Person and Family Centered Care.
Requirements: 2- QI Courses, 3- PS Courses, 2/3 PFCC Courses per academic year for each PGY level. All courses to be completed before residency graduation.
PATIENT SAFETY COURSES
PS 101: Introduction to Patient Safety
PS 102: From Error to Harm
PS 103: Human Factors and Safety
PS 104: Teamwork and Communication in a Culture of Safety
PS 105: Responding to Adverse Events
PS 201: Root Cause and Systems Analysis
PS 202: Building a Culture of Safety
PS 203: Partnering to Heal: Teaming Up Against Healthcare-Associated Infections
PS 204: Preventing Pressure Ulcers Next Meeting
QUALITY IMPROVEMENT COURSES
QI 101: Introduction to Health Care Improvement
QI 102: How to Improve with the Model for Improvement
QI 103: Testing and Measuring Changes with PDSA Cycles
QI 104: Interpreting Data: Run Charts, Control Charts, and other Measurement Tools
QI 105: Leading Quality Improvement
QI 201: Planning for Spread: From Local Improvements to System-Wide Change
PERSON- AND FAMILY-CENTERED CARE
PFC 101: Introduction to Patient-Centered Care
PFC 102: Key Dimensions of Patient- and Family-Centered Care
PFC 103: Incorporating Mindfulness into Clinical Practice
PFC 201: A Guide to Shadowing: Seeing Care through the Eyes of Patients and Families
PFC 202: Having the Conversation: Basic Skills for Conversations about End-of-Life Care
The modules will be a compliance component and included in each resident’s semi-annual/end of year evaluations with the residency Program Directors.