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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
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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
[email protected] Tel: 004989/4400-52415
PD Dr. med. Matthias Angstwurm Course Instructor of the Practical Year at LMU [email protected]
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.