Adult Endocrinology and Metabolism — Core of Discipline

C1 Managing patients presenting with an emergency related to an endocrine condition or its treatment

Key Features:
- This EPA focuses on timely assessment and management, including consulting with or referring to other services for definitive management of the problem.
- Examples of emergent/urgent presentations include diabetic ketoacidosis/HHS, severe hyper/hypocalcemia, thyroid storm/severe hyperthyroidism, myxedema coma, adrenal crisis, and diabetes insipidus.
- This EPA may be observed in simulation or in case discussion.

Assessment Plan:
Direct and/or indirect observation by supervisor or clinical fellow
Use Form 1. Form collects information on:
- Presentation: DKA/HHS; other (write in)
Collect 4 observations of achievement
- No more than 1 DKA or HHS
- At least 1 observation by supervisor

Form

F1: Observation

Milestones

• ME 2.1. Determine the acuity of the issue and the priorities for patient care

• ME 1.4. Perform a clinical assessment that addresses all relevant issues

• ME 2.2. Select and/or interpret investigations

• ME 2.2. Integrate the clinical data to establish the diagnosis

• ME 2.4. Determine the setting of care appropriate for the patient’s health needs

• ME 2.4. Develop a management plan

• COL 1.2. Consult as needed with other health care professionals, including other physicians

• COL 1.2. Work effectively with members of the interprofessional team to implement a management plan

• COM 5.1. Document the encounter to convey the clinical assessment and the rationale for decisions and/or recommendations

• P 4.1. Maintain professionalism while managing stressful situations

Context Variables

• Presentation (single-choice)
  • DKA/HHS
  • other

Requirements

• Collect 4 observations of achievement (minimum 4)
• No more than 1 DKA or HHS
  • Only counts when Presentation is DKA/HHS
• At least 1 observation by supervisor (minimum 1)
  • Only counts when Assessor kind is Faculty