Learning objectives

Aimed at deepening knowledge of interventional cardiology, vascular diagnostics, pulmonology, thoracic surgery, pediatric and adult cardiac surgery. The student will acquire professional skills related to the execution of echocardiographic examinations, tests for the evaluation of cardiorespiratory function, tests for the conduction of extracorporeal circulation in adults and children. There are several internship experiences in contexts in which the student can experiment with the knowledge and techniques learned.

Prerequisites and basic notions

Passing first-year preparatory examinations and first-year internship

Program

Cardiovascular Perfusion:
Technical Skills:
- All skills acquired in YEAR 1 in items a,b,c, d.
The following objectives are added to point (c) "During surgery":
- recognition of the surgical steps preceding ECC
- autonomous choice of cannulae and sharing with Tutor
- after administration of heparin to the patient autonomously checking the ECC circuit and Check-list with Tutor supervision
- interruption of CEC circuit for cannulation
- Vent and Coronary suction testing
- ACT suitability check
- ECC circuit connection, arterial cannula pulse check and cannula resistances
- Start ECC in tandem with Tutor
- cardioplegia administration at cross clamp in tandem with Tutor
- conduction and management of ECC and central phase ECC equipment in tandem with Tutor in standard adult elective interventions
- aortic declamping in tandem with Tutor
- weaning from ECC in tandem with Tutor
- control shunts closed ECC circuit and stop aspirates at protamine administration
- decannulation of pc in tandem with Tutor
Extra cardiac surgery operation room goals:
- learn about cardiovascular assist implantation equipment (IABP, IMPELLA, ECMO, VAD)
- tandem ECMO/VAD circuit assembly and filling
- know Hyperthermia machine operating principle, assembly and tandem filling
Non-Technical Skills:
All NTS listed in the 1st year objectives with the following additions:
- Communication with the team during all phases of the intervention regarding the specific activities of the Perfusion Technician in tandem with Tutor (principle of dual feed back)
Elettrophysiology:
Technical Skills:
- History data collection
- Know the components of the ECG graphical trace
- Know the arrhythmological pictures (AF, BAV,etc.) and be able to identify the patient's rhythm type
- Know the continuous graphic ecg monitoring systems
(holter, external loop, event recorder, implantable loop recorder)
- Read and interpret traces of continuous monitoring systems
- Know the indications for PM and ICD implantation
- Know the types and classifications of PM and ICDs
- Know the main algorithms of PM and ICD
- Know how to perform a tandem check of a PM and ICD and recognize a possible malfunction
- Know and use remote device monitoring systems
Non-Technical Skills:
- patient reception and patient empowerment for the purpose of the procedure
- Clear, comprehensive, and effective communication before, during, and after the procedure
Echocardiography:
Technical Skills:
- Collection of medical history data.
- Proper positioning of the patient on the crib and measurement of blood pressure
- Electrocardiographic electrode placement.
- Knowing and being able to correctly use the main echocardiographic sets (gain, compression, depth, scale, Doppler setting, etc.);
- Know how to identify the anatomy of echocardiographic structures and know how to recognize echocardiographic sections.
- Know how to perform echocardiographic acquisitions according to European protocol in tandem with Tutor.
- Know and be able to perform the main standard echocardiographic measurements under medical tutoring.
Non-Technical Skills:
- patient reception and patient empowerment for the purpose of the procedure
- Clear, comprehensive and effective communication before, during and after the procedure

Bibliography

Didactic methods

Stage and professional workshops

Learning assessment procedures

Evaluation of stage period with final theoretical-practical examination

Evaluation criteria

1) Insufficient: the student does not attend internship at all or attends little by not reaching the minimum amount of hours stipulated in the educational regulations not showing interest in internship activities;
the student attends internship reaching the minimum amount of hours not showing interest in the activities without reaching the minimum objectives set.
2) Sufficient: the student attends internship with low interest in the discipline reaching the minimum amount of hours established by the didactic regulations. Performs technical activities only on the Tutor's instructions.
3) Fair: the student regularly attends internship with interest in the discipline: performs technical activities in known situations in a discontinuous but autonomous manner; in unknown situations performs the activities on the Tutor's indication without delving into the specifics.
4) Good: the student attends regularly and with interest: performs technical activities in known and unknown situations in an autonomous and continuous way with interest in deepening with the Tutor.
5) Excellent: the student attends regularly and exceeds the prescribed amount of internship hours; performs technical activities completely independently in both known and unknown situations. Deepens areas of disciplinary interest both with Tutor and in self-study with use of available resources (books, literature, case reports, comparison with other Tutors, Physicians, health care personnel, etc...)

Criteria for the composition of the final grade

The average of the scores from stage period corresponds to a starting score with which the student is presented, which will be integrated with the score of the theoretical practical

Exam language

Italiana