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The residency begins July 1st, or the Monday following July 1st. The first 2 weeks of the residency are designed as an orientation period to both Cincinnati Children’s Hospital Medical Center and the Sports Medicine Biodynamics Center. This orientation includes administration responsibilities, equipment, operations and resident responsibilities.
Clinical responsibilities will begin in the month of July. Throughout the year, the resident will participate in 32 hours per week of patient care in the clinic. Approximately 16 hours of this time is shared with the Residency Director. Two hours of this weekly shared time is scheduled as “unopposed mentoring,” in which the resident provides care and the Residency Director observes his / her patient care and provides mentoring to the resident. While the resident’s caseload will consist of the broad spectrum of body regions, scheduling interventions will be made to assure that the resident is provided with evaluation and treatment opportunities that match the body region focus of the particular curriculum module that the resident is currently studying.
Didactic education will occur throughout the year in several forms. Four modules of didactic and lab education are set up through the course of the year, each 3 months in duration. The 4 module curriculum includes topics in Spine, Hip / Knee, Shoulder / Upper Extremity and Foot / Ankle / TMJ. During that 3 month time, lectures will be delivered by physical therapists and physicians on topics of anatomy and pathoanatomy, differential diagnosis, evaluation, treatment, radiology findings, and case reports. In addition, clinical lab sessions will be incorporated on evaluation and treatment of various conditions. The resident’s learning is further supplemented with independent study materials, which are assigned with each module. Module Content Outlines serve as a “check off” list of the required didactic components of each module.
The resident will also have access to multiple other educational opportunities, including our annual Pediatric Sports Medicine Physical Therapy Conference, Cincinnati’s Sports Medicine Grand Rounds, Cincinnati Children’s Hospital’s Sports Medicine Fellowship Grand Rounds, Sports Medicine Journal clubs, OrthoSurg / Radiology Sports Medicine Conference (Quarterly) and Ortho / Sports physical therapy problem conference. These opportunities will be utilized periodically to enhance the resident’s learning experience and also to meet any specific learning needs identified by the resident and mentor.
The sequence of these modules is specifically designed to match the goals of the residency as well as the needs of the patient population of the clinic. The body region focus of the first module is the spine. The rationale for this placement is that the spine is the most common body region of this clinic’s patient population, so the resident will be best prepared to meet the needs of their clinic patient population for the entire year by beginning with the study of the spine. Also, the spine is dominant body region reported in surveys of Orthopaedic specialty practice and fills approximately 45% of questions of the OCS exam. Beginning with the spine allows the resident to have the most remaining time to further develop their skills in this critical area.
The knee is the second most-treated body region in our clinic and is the focus of Module 2. Module 2 includes the study of hip / thigh, which is ideally placed to integrate it with the preceding focus of the spine.
Shoulder / UE in Module 3 which occurs from January – March serves to prepare the resident for the influx of throwing athletes coming into our clinic associated with spring baseball.
Module 4 consists of Ankle / Foot / TMJ and occurs during the remaining track season. It also parallels the clinical increase of patients with running injuries, which seems to occur as the outdoor weather improves. The curriculum component and observations associated with TMJ (Mandibular) dysfunction are less critical to our population and also take place in this final module.
Clinical Reasoning / Critical Inquiry is included as a component of the first module. It is critical to provide sufficient training in clinical reasoning at the onset of the residency, in order to establish a high expectation for the resident’s practice of this skill throughout the entire program. The resident’s growth and progress through the residency is vitally linked to their utilization and growth of clinical reasoning skills.
The resident is also required to complete an Integration Project, which “promotes the resident’s continued integration of practice, research, and scholarly inquiry consistent with the Program’s mission and philosophy.” (Interpretive Guideline, Credentialing Application document, January 2010). Examples of potential projects include the following: membership on an Evidence-Based Practice (EBP) team to develop a Clinical Practice Guideline for a specific condition, an individual research initiative such as case study/series that could be submitted as a poster presentation or for publication, and a Cincinnati Children’s Performance Improvement project to enhance all areas of clinical practice. The scope of this project spans the entire residency period. During the first quarter, the resident explores interest areas and considers project options. The resident uses the second quarter to make decisions and perform “project planning” (combining well with the leadership emphasis of the same quarter). The resident devotes the most time for significant progress on their project during the third quarter. Completion, implementation, and assessment of the project, then occurs during the fourth quarter. If the project is appropriate for submission as a poster / platform at CSM, it should be ready to submit the proposal by the typical deadline in May / June.
This residency places a special emphasis on the leadership development of the resident. The design of the curriculum includes a leadership training portion of the curriculum that occurs primarily during module two. The philosophy of this program is that an Orthopaedic specialist has the professional responsibility to serve as a leader in the field of physical therapy. The mission of this Program includes helping the resident gain awareness of their particular leadership strengths and providing opportunities for them to develop these skills. By doing this, the Program strives to prepare the resident for career-long service as a leader in their profession, in their place of employment, and in their community.
The resident has three hours of devoted mentoring time with the Residency Director each week. Two hours of this time are unopposed mentoring time in the clinic where the resident serves as primary patient care provider. The third hour is a weekly scheduled meeting, during which the resident and Residency Director discuss questions, evidence, and clinical reasoning directly related to patient care.
A broad scope of additional clinical observations and mentoring opportunities are provided to the resident. These experiences included observation in Orthopaedic department clinics, sports medicine department clinics, Orthopaedic surgery observation, SMBC research activities, and specialty clinic observation such as Runner’s clinic, Pain clinic, Rheumatology clinic. The resident is also encouraged to volunteer alongside an Orthopaedic / sports PT team member as they perform injury screenings in a community running clinic and to a local dance group. The weekly “One-on-one Clinical Mentoring Schedule and Log” is used to record the experiences that are required for the curriculum and others that are optional / supplemental.
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