Adult Rheumatology — Transition to Discipline

TTD2 Recognizing emergency rheumatologic situations and following up appropriately

Key Features:
- This EPA focuses on the initial assessment of patients with medical emergencies as well as timely and appropriate calls for additional assistance.
- Examples include urgencies or emergencies related to synovial fluid interpretation (including what tests to order and differentiating septic from inflammatory and non-inflammatory disorders); hemophagocytic lymphohistiocytosis (HLH) / macrophage-activation syndrome (MAS); serious infections and conditions related to immune suppression; connective tissue disease emergencies; vasculitis emergencies; and scleroderma emergencies.
- This EPA may be observed in a simulation or clinical setting.

Assessment Plan:
Direct or indirect observation by supervisor
Use Form 1. Form collects information on:
- Setting: inpatient; outpatient; emergency room; simulation; telephone
- Case mix (select all that apply): serious infections and conditions related to immune suppression; CTD emergency; vasculitis emergency; scleroderma emergency; suspected septic arthritis with synovial fluid interpretation; HLH/MAS
Collect 3 observations of achievement
- At least 2 examples of the case mix
- At least 1 suspected septic arthritis with synovial fluid interpretation

Form

F1: Observation

Milestones

• ME 1.4. Recognize urgent problems that may need the involvement of more experienced colleagues and seek their assistance

• ME 2.2. Focus the clinical encounter, performing it in a time-effective manner without excluding key elements

• ME 2.2. Develop a differential diagnosis relevant to the patient’s presentation

• ME 2.2. Select and/or interpret appropriate initial investigations

• ME 2.4. Develop and implement plans for initial management

• COL 1.3. Communicate effectively with physicians and other health care professionals

• COL 3.1. Identify patients requiring handover to other physicians or health care professionals

• L 2.1. Apply knowledge of local resources for optimal patient care

• P 1.1. Exhibit appropriate professional behaviours

Context Variables

• Setting (single-choice)
  • inpatient
  • outpatient
  • emergency room
  • simulation
  • telephone
• Case mix (multiple-choice)
  • serious infections and conditions related to immune suppression
  • CTD emergency
  • vasculitis emergency
  • scleroderma emergency
  • suspected septic arthritis with synovial fluid interpretation
  • HLH/MAS

Requirements

• Collect 3 observations of achievement (minimum 3)
• At least 2 examples of the case mix (minimum 2)
• At least 1 suspected septic arthritis with synovial fluid interpretation (minimum 1)
  • Only counts when Case mix is suspected septic arthritis with synovial fluid interpretation