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MEDIZINISCHE FAKULTÄT

PRACTICAL YEAR LOGBOOK FOR

STUDENTS IN THE TERM

ORTHOPAEDICS

Klinik und Poliklinik für Orthopädie, Physikalische Medizin und Rehabilitation

Klinikum der Universität München

Lehre-orthopaedie@med.uni-muenchen.de

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Practical Year Logbook for the term in

Orthopaedics

Name ______________________________________________

Matriculation number ______________________________________________

Date of birth ______________________________________________

Phone ______________________________________________

Email ______________________________________________

Current term: from___________________ to ____________________

Term number: 1 2 3

Name of the hospital: ______________________________________________

Terms already completed:

___________________________________________________________________

I am spending half of my term abroad: yes no

I am spending the entire term abroad: yes no

Country: ______________________________________________________

Only necessary for PJ-Mobility:

Official seal of LMU, for the recognition of the term completed by the home university

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Dear students,

We are happy to present you this logbook for Orthopaedics. It describes all the practical experiences

you should complete and all the skills you should acquire during this term. This is to ensure that you

are ideally prepared for the third part of your Medical Licensing examination at the end of your

Practical Year and to help you to identify and close any gaps in your theoretical and practical

knowledge base. We are also trying to prepare you for the responsibilities you will be carrying in

your later professional life early on.

You should use this logbook to document your personal learning progress, and get feedback from

your responsible supervisor on a regular basis. It is important that you take the initiative and request

assistance in learning from the on-call doctors if you have found gaps in your knowledge.

A mentor will be there for all the questions and problems you might encounter during this term. He

or she will also be responsible for supervising your learning progress.

Please make sure to complete this logbook as requested and to have doctors sign for the skills you

have acquired, as this logbook will be collected, checked and evaluated by us.

We are always grateful for constructive feedback to help us improve these logbooks and our teaching

goals and would therefore be grateful if you could complete the evaluation at the end. Thank you in

advance for helping us to improve the organization of the practical year for future generations of

students.

We wish you an enjoyable and productive term!

Prof. Dr. Dipl.-Ing. V. Jansson

Direktor der Klinik für Orthopädie, Physikalische Medizin und

Rehabilitation

Prof. Dr. H.R. Dürr

Orthopädie PJ-Beauftragter der LMU

Dr. Carolin Melcher

Orthopädie PJ-Beauftragte der LMU

Prof. Dr. med. Martin Fischer PD Dr. med. Matthias Angstwurm

Dean of Clinical Medicine at LMU Course Instructor of the Practical Year at LMU

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INHALT

Part 1: General information ............................................................................................................................ - 5 -

Contact / information .................................................................................................................................. - 5 -

Vaccines ........................................................................................................................................................ - 5 -

Stays abroad ................................................................................................................................................. - 5 -

Logbook as foundation for letters of reference ....................................................................................... - 5 -

Educational activities .................................................................................................................................. - 5 -

“Testing” in your practical year ................................................................................................................ - 6 -

Instruction manual for this logbook .......................................................................................................... - 6 -

Mentoring conferences ............................................................................................................................... - 7 -

Part 2: Educational objectives and expertises ............................................................................................. - 8 -

General objectives ....................................................................................................................................... - 8 -

Personal objectives ...................................................................................................................................... - 8 -

Defining the levels of competence ............................................................................................................ - 9 -

Practical skills ............................................................................................................................................. - 10 -

Evaluation of the student´s performance by the responsible ward physicans ................................. - 13 -

Medical attendance of your own patients .............................................................................................. - 15 -

Practical year seminar topics ................................................................................................................... - 16 -

Part 3: Additional ........................................................................................................................................... - 17 -

Optional learning expertises .................................................................................................................... - 17 -

Evaluation forms ........................................................................................................................................ - 18 -

Comments ................................................................................................................................................... - 18 -

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PART 1: GENERAL INFORMATION

CONTACT / INFORMATION

Important information concerning the organization and procedures during your practical year can be

found on the website of the Dean of the Medical Faculty: www.mecum.med.uni-muenchen.de

We have consciously decided against listing all the rules and regulations, as this information is

always available in its most recent form online and we wanted to place the emphasis on the more

substantial details.

If you have any questions regarding the organization of your practical year, please contact the dean's

office, they will gladly help you. If you have any questions concerning the contents, please contact

either your term supervisor, the Practical Year Coordinator or PD Dr. Angstwurm:

Central PJ-Coordination Practical Year Coordinator at LMU

PJ_Koordination@med.uni-muenchen.de Tel: 004989/4400-52415

PD Dr. med. Matthias Angstwurm Course Instructor of the Practical Year at LMU Matthias.Angstwurm@med.uni-muenchen.de

Tel: 004989/4400-52207

VACCINES

For the protection of you and your patients you should have sufficient immunity against mumps,

measles, rubella, diphtheria, chicken pox and pertussis. For your own protection you should be

vaccinated against Hepatitis B and if possible Hepatitis A.

STAYS ABROAD

You are required to complete this logbook even if you are out of Germany. Please note exactly where

you are completing your term on the corresponding pages in this logbook. If you are completing

your entire term or the last part of your term outside of Germany you will need to turn this logbook

to the practical year coordination office in Pettenkoferstraße 8a (Room D0.48). Please inform yourself

about the insurances you need for your stay abroad.

LOGBOOK AS FOUNDATION FOR LETTERS OF REFERENCE

If you are planning to ask for letters of reference at the end of your term please inform the

department secretary before handing in your logbook. This will allow the department to make a copy

of your logbook to serve as a basis for the letter of recommendation. If you have completed

additional optional learning experiences such as night or weekend call duty please note this at

section 3 of your logbook under “Optional learning experiences” with the date and signature of your

supervisor so that these experiences can be included in your letter of reference.

EDUCATIONAL ACTIVITIES

Please make sure you inform yourself in advance about the available programs to further your

medical education via the internet or in the hospital. It may also be possible for you to make your

own contribution to these educational activities and benefit from "learning by teaching". For example

you might be able to present your own patient or research your own topic. Student presentations will

be followed by a discussion led by the responsible lecturer. A list of suggested topics may be found

in part 2 of this logbook.

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“TESTING” IN YOUR PRACTICAL YEAR

Every clinic should, if possible, offer voluntary oral assessments for students in order to prepare you

for the oral-practical examination at the end of your practical year. There is no danger of failing such

a voluntary oral assessment. Please make sure to inform yourself of the possibilities available at your

clinic. Ideally you should have the possibility of taking a trial examination. In this trial examination a

lecturer will assign you a patient and ask you to perform a history and physical examination. You will

then be asked to write a short summary of the case. At the end of the allotted time the examiner will

provide feedback on your case report and ask you a series of questions about the case to simulate an

oral examination.

You might like to use the last appointment with your mentor fur such a trial examination, make sure

to ask him or her about this in advance. The practical year coordination office additionally offers you

the opportunity to take part in the so-called “mP³-exams". Please inform you about this on the

Mecum-Homepage.

INSTRUCTION MANUAL FOR THIS LOGBOOK

The logbook is designed for carrying it with you and enables you to continuously document your

progress (print-out in DIN A5!). In part 2 of the logbook, there is a list of learning goals for your

term.

Please evaluate your skills at the beginning of the term and fill in the corresponding column (see part

2: defining the levels of competence). At the end of your term you need to achieve 70% of the total

score. Otherwise you need to repeat the term.

At all university and teaching hospitals the completion of this logbook is a requirement for

obtaining the certificate for this term. Please make sure to tear out, complete and hand in the

evaluation at the end of this logbook. It can be handed in together with the logbook to Central

PJ-Coordination at the Poliklinik (Pettenkoferstr. 8a) in room D0.48.

PJ-Mobility:

If you are completing your term at the LMU in the context of PJ-mobility, you are obligated to use

this LMU logbook. The term will be only acknowledged by your home university, in presence of the

official seal of the LMU (pg. 2) along with the certificate for the term.

The seal can be obtained at the dean’s office, located at the following address:

Bavariaring 19 80336 München

The opening hours can be found at www.mecum.med.uni-muenchen.de/sprechzeiten/studiendekanat.

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MENTORING CONFERENCES

On your first working day one of the doctors will be allocated to you as your personal mentor for the

duration of the practical year term. If this is not the case directly address a doctor and ask for

support. His responsibility will be to support your training on the device of this logbook. He should

enable you to achieve the required learning objectives and be accessible for your questions and

problems during your term in our department. Once a month there should be a feedback discussion

with your mentor.

My Mentor/My Mentors:

First talk:

___________________________________________________________________________

Date and signature of your mentor

Second talk:

___________________________________________________________________________

Date and signature of your mentor

Final talk:

___________________________________________________________________________

Date and signature of your mentor

Trial examination (optional)

Evaluation of performance:

Date / Signature of your mentor:

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PART 2: EDUCATIONAL OBJECTIVES AND EXPERTISES

GENERAL OBJECTIVES

- To develop the ability to independently care for individual patients under the supervision of medical

teaching staff

-To show accountability to patients and colleagues

- To develop practical skills in the context of the relevant theoretical knowledge

- To further develop communicative, social and emotional skills

- To integrate relevant differential diagnoses in your daily routine

- To develop problem-oriented approaches

- To learn to establish a clinically founded working diagnosis

- To independently establish an appropriate treatment plan

PERSONAL OBJECTIVES

Please define your personal educational objectives for this term in the following table:

Personal objectives Achieved

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DEFINING THE LEVELS OF COMPETENCE

The varying levels of competence are defined as follows:

Level 1: Factual knowledge (1 point)

The student has theoretical knowledge relevant to the medical procedure.

Level 2: Practical knowledge (2 points)

The student has seen the medical procedure being done, either on a patient or during a

demonstration. He or she should be able to elaborate on some facts concerning this procedure and

be able to place it into its clinical and/or scientific context.

Level 3: Competence to act under supervision (3 points)

The student has completed the procedure him/herself under supervision, either on a patient or in

a simulation on a model.

Level 4: Competence to act autonomously (4 points)

The student has completed the medical procedure independently and in an appropriate situation,

with appropriate knowledge of the indication(s) and possible complications/consequences.

In this context please note that the levels of competence in the right column admittedly are meant as

objective targets, but we regrettably cannot ensure you to achieve the target in every single expertise

(due to the various teaching hospitals you can be deployed at). Because of that you get the

acknowledgement of successfully concluding your term by achieving >70% of the target score (see

Part 1: “Instruction manual for this logbook”).

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PRACTICAL SKILLS

The column "beginning of term" is to be completed by

yourself, try and judge your skills before starting this term.

The other columns have to be signed by either your mentor

or an attending physician.

Beginning of term

Half term

End of term

Goal

General medical skills

Structured patient history incl. presentation 4

Structured physical examination incl. neurological evaluation and documentation

4

Presenting patients incl. differential diagnosis and treatment options during the round

4

Drawing venous blood and inserting peripheral venous catheters

4

Implanting and analyzing ECG 4

Hygienic and surgical disinfection of hands 4

Adequately and safely scrubbing in, putting on sterile clothing and working sterilely

4

Appropriate and sterilely changing of bandages 4

Appropriate removal of sutures and stitches 4

Removal of drains (Robinson, Redon, chest drain) 4

Writing doctor´s letters and case discussions 4

Interpretation of X-ray 4

Interpretation of CT and MR scans 3

Apply local anesthesia 3

Request a council for patients 3

Leading ward rounds of own patients 3

Writing prescriptions and incapacity certifications 3

Conduct a pre-operation discussion 2

Practical skills

Conduct a pain history (including the use of a visual analogue scale)

4

Specific orthopaedic examination of the hip 4

Specific orthopaedic examination of the knee 4

Specific orthopaedic examination of the shoulder 4

Specific orthopaedic examination of the vertebrae 4

Applying a spica cast 3

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Beginning of term

Half term

End of term

Goal

Applying a Gilchrist bandage 3

Performing cutaneous back- and-forth suture 3

Performing intracutaneous suture 3

Performing subcutaneous suture 3

Knotting techniques in the OR 3

Applying a sterile bandage in the OR 3

Description and evaluation of a lesion 3

Punction of a joint or a retention 2

Infiltration of a joint 2

Sonography of joints 2

Applying a clubfoot bandage 2

Sonography of an infant´s hip 2

Planning an endoprosthesis 2

Planning an axial adjustment 2

Administration of blood transfusion (incl. Bloodtyping) 2

Dealing with coagulation factors 2

Principles of acute perioperative pain therapy 2

Management of chronic pain 2

Substances and their dosages in the pain therapy scheme of WHO

2

Surgeries

Implantation of hip endoprosthesis 2

Implantation of knee endoprosthesis 2

Change of endoprosthesis 2

Knee arthroscopy 2

Shoulder arthroscopy 2

Adjustment of an infant´s clubfoot 2

Eight-Plates (epiphysiodesis) for adjustment 2

Instrumentation at the vertebrae 2

Decompression of spinal canal resp. nucleotomy 2

Osteotomy for foot adjustment (hallux, claw toes) 2

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Beginning of term

Half term

End of term

Goal

Tumour resection 2

Defect reconstruction after tumour resection 2

Technique of patient positioning

Adequately place a patient in the supine position 3

Adequately place a patient in the prone position 3

Adequately place a patient in the beach-chair position 3

Adequately place a patient on the extension table 3

Properly secure and cushion a patient 3

Applying and handling of a blood arrest / lack of blood 3

Sum of each column 175

Total score: 175

Number of points at half term:

Date/signature:

Number of points at the end of term:

Date/signature:

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EVALUATION OF THE STUDENT´S PERFORMANCE BY THE RESPONSIBLE

WARD PHYSICANS

Very

go

od

Go

od

Sati

sfacto

ry

Fra

gm

en

tary

Inad

eq

uate

Expert knowledge

Sen

siti

ve

Em

path

ic

Ind

iffe

ren

t

Do

min

an

t

Co

nte

mp

tuo

us

Contact with patients

Very

accu

rate

an

d

dep

en

dab

le

Accu

rate

an

d

dep

en

dab

le

Ind

iffe

ren

t

So

meti

mes

inaccu

rate

an

d

un

dep

en

dab

le

Usu

all

y t

oo

in

accu

rate

an

d

un

dep

en

dab

le

Accuracy and dependability

Well

-co

nceiv

ed

Usu

all

y

syst

em

ati

c

Fra

nti

c

So

mew

hat

un

sch

ed

ule

d

Mis

sin

g

Work scheduling

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Very

in

dep

en

den

t a

nd

in

no

vati

ve

Mu

ch

co

mm

itm

en

t, a

cti

vely

en

gag

ed

Dil

igen

t

Wo

rk e

ffo

rt i

s d

ete

rmin

ed

b

y t

he t

ask

´s a

ttra

cti

on

Sh

ow

s li

ttle

in

tere

st

Readiness for work

Is a

ble

to

re

co

gn

ize b

asi

c

facts

on

his

/her

ow

n

Sh

ow

s au

ton

om

ou

s ju

dg

men

t

Oft

en

has

dif

ficu

ltie

s to

get

to t

he h

eart

of

the

matt

er

Cau

ses

avo

idab

le

mis

co

ncep

tio

ns

Oft

en

dep

en

den

t

Cogitation and sagacity

Very

sw

ift

Qu

ick

Avera

ge

Oft

en

no

t ab

le

to f

inis

h w

ork

Leaves

beh

ind

u

nd

on

e w

ork

Work pace

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MEDICAL ATTENDANCE OF YOUR OWN PATIENTS

Your own patients will be assigned to you on the ward for whom you will be -under guidance and

supervision- independently responsible. You will accompany them during their whole treatment on

the ward and -under guidance- take the patient’s history, conduct a physical examination and write

the discharge letter resp. the epicrisis.

Every student in the practical year has to accompany at least 10 patients during the term and has to

present them in the context of a case discussion:

Patient initials Diagnoses Date/signature

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

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PRACTICAL YEAR SEMINAR TOPICS

Suggested seminar topics:

Congenital joint malposition

Degenerative diseases I Joints (arthrosis)

Degenerative diseases II Vertebrae

Inflammatory diseases I Joints

Inflammatory diseases II Vertebrae

Inflammatory diseases III Rheumatism

Diseases of tendons/synovial tendon sheaths/ligaments/fascias/bursas

Bones I Neoplasia

Bones II Aseptic necrosis

Neuromuscular diseases

Technical Orthopaedics und shoe adjustment

Physiotherapy

Sports medical problems of skeletal and locomotor system

If needed other topics may be added to this list.

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PART 3: ADDITIONAL

OPTIONAL LEARNING EXPERTISES

Date/signature Task

Other:

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EVALUATION FORMS

In the following pages you will find a form for comments as well as a structured evaluation form for you to fill out. Please write down the name of the hospital, because this is the only way to acquire information about the quality of teaching in the different hospitals. This evaluation does not impact your grade or completion of the term. The evaluation is anonymous and treated as confidential.

Please separate the evaluation form and submit the completed forms along with your logbook in your

clinic. In return, you will receive your certificate for the term. If you do not wish to assess, please

note so in the form, yet still submit the page as well.

Thank you!

COMMENTS

Name of the hospital:

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Postal address for turning in logbooks:

Klinikum der Universität München, Med. Poliklinik

PJ-Koordination (Raum D0.48 im ZeUS)

Pettenkoferstraße 8a

80336 München

Imprint: Prof. Dr. med. Martin Fischer Prof. Dr. med. Dipl.-Ing. V. Jansson PD Dr. med. M. Angstwurm Prof. Dr. H.R. Dürr Dr. med. Miriam Gisi Dr. med. Carolin Melcher Translation: Karolin Bail 4. edition in English, 2018

We kindly thank those responsible in the particular departments for their support in creating the

logbooks.

In the interest of readability we predominantly use the masculine appellation. This neither reflects

the actual composition of students and employees, nor is the addressed audience meant to be

restricted.

The contents of this logbook are without any claim to completeness.