Vascular Neurology

Faculty contact:

Drs. Luke Bradbury and Jamie Elliott

Vascular Neurology Schedule:

• Monday- Friday, with Saturday AM rounds unless arranged for Sunday AM with weekend attending
• Pre-round on inpatients
• Morning report
• Rounds
• Noon conference
• Clinical care activities or clinic in the afternoon

Supervision:

The vascular neurology faculty member on duty that day.

Conferences

See Conferences

Required reading, AHA guidelines:

• Early management of adults with ischemic stroke (and 3 to 4.5 hour update)
• Management of spontaneous intracerebral hemorrhage in adults
• Management of aneurysmal subarachnoid hemorrhage
• Definition and evaluation of transient ischemic attack
• Prevention of stroke in patients with ischemic stroke or transient ischemic attack

Recommended reading:

Caplan’s Stroke and/or Adam’s Cerebrovascular Disease (will be provided by program)

Goals and Objectives:

Patient Care

• Goal: Fellow development of patient care skills sufficient for the safe and effective independent practice of vascular neurology
  • Objective: Rapid and appropriate triage, diagnosis, and management of acute stroke patients in a variety of clinical settings
    • Evaluation: Faculty evaluation of direct supervision of acute stroke care
  • Objective: Appropriate clinical care of neurological and medical issues in stroke patients after the acute phase to avoid complications and maximize recovery
    • Evaluation: Faculty evaluation of direct supervision of subacute stroke care
  • Objective: Appropriate clinical care of patients at elevated risk for stroke to lower that risk as appropriate
    • Evaluation: Faculty evaluation of direct supervision of stroke prevention

Medical Knowledge

• Goal: Fellow development of medical knowledge sufficient for the safe and effective independent practice of vascular neurology
  • Objective: Understanding of the science of vascular neurology sufficient for clinical care
    • Evaluation: Faculty evaluation of medical knowledge based on discusions during patient care

Practice-Based Learning and Improvement

• Goal: Fellow development of practice-based learning and improvement sufficient for the safe and effective independent practice of vascular neurology
  • Objective: Fellow case review with the multiple faculty to discuss merits of choices made and alternatives
    • Evaluation: Faculty and fellow evaluation of benefit of fellow case review
  • Objective: Effective evidence identification and appraisal for clinical questions
    • Evaluation: Faculty evaluation of this ability as questions arise during clinical care where the fellow is asked to find evidence, and after EBM discussions during journal club

Interpersonal and Communication Skills

• Goal: Fellow development of interpersonal and communication skills sufficient for the safe and effective independent practice of vascular neurology
  • Objective: Determination of the precise time of stroke symptom onset or time the stroke patient was last known well in patients with communication limitations
    • Evaluation: Faculty evaluation of direct supervision of acute stroke care
  • Objective: Effective discussion of end-of-life care options
    • Evaluation: Faculty evaluation of direct supervision of these discussions

Professionalism

• Goal: Fellow development of professionalism sufficient for the safe and effective independent practice of vascular neurology
  • Objective: The fellow will learn ethical, regulatory, and legal aspects of stroke care, including the difference between standard and investigational tests and treatments, and ethical and legal issues involved in end-of-life care
    • Evaluation: Faculty evaluation of direct supervision of these care issues

Systems-Based Practice

• Goal: Fellow development of systems-based practice sufficient for the safe and effective independent practice of vascular neurology
  • Objective: The fellow will demonstrate the ability to work in a multidisciplinary fashion with nurses, case managers, social workers, therapists, primary care physicians, and the various medical and surgical specialties involved in the care of stroke patients
    • Evaluation: Faculty evaluation of direct supervision of interactions with these groups
  • Objective: The fellow will learn how to triage patients and allocate resources such as inpatient beds, tests, and treatments to provide high quality, cost-effective care
    • Evaluation: Faculty evaluation of direct supervision of patient care
  • Objective: The fellow will become familiar with clinical practice guidelines and participate in the creation and review of stroke program policies and procedures relevant to patient care
    • Evaluation: Faculty evaluation of direct supervision of involvement in these activities

Evaluation Matrix:

Latest revision: 11/30/2023 Jamie Elliott, MD, PhD