Introduction
The fellow will determine with the attending at the start of the day which case they will follow. The fellow will be in the OR for baselines and/or for critical portions of the case, monitors remotely during less critical portions, and writes the preliminary summary of the IOM report. Writing the report triggers a record of the procedure to be placed in the procedure log administered by the program coordinator monthly. The coding department notifies the program coordinator of such procedures.
The fellows will have better access to live cases via reading stations in the IOM reading room or through Citrix. This independent access will facilitate participation by the fellow in live communication with IOM Tech’s and attendings through the case. The aim would be for 1 case per day of IOM provided it does not conflict with other scheduled fellowship activities or prescheduled clinics. Fellow-directed readings and/or other didactics will be reviewed with an attending once per week.
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Goals
- The fellow will learn how to use Intra-operative neuromonitoring techniques to improve surgical outcomes.
- The fellow will understand the neuroanatomy, IOM techniques (EEG, MEPs, VEP, SSEPs, direct cortical stimulation) and when these tools should be used.
- They will recognize that they are part of a team and will communicate with patients, allied staff, and referring providers with empathy, professionalism, and by effective transfer of knowledge, especially between IOM technologist and surgeons. They will participate in the timely reporting of studies.
- The fellow will be involved in improving the quality of the care of IOM through QI projects, scholarly activities, and/or participation in multi-disciplinary planning of surgery and neuromonitoring.
Objectives and Evaluation Matrix
IOM Rotation ObjectivesUpon completion of the curriculum, fellows will . . . | ||
| EPA # | EPA Description | Milestones |
| 1 | Know type of monitoring modalities and indications for each in IOM and evoked potentials | PC3, PC4, PC5, PC6, PC7, MK1, MK5, SP3 |
| 2 | Describe trouble shooting and ways to differentiate physiology from artifactual changes in IOM (BAER, EEG, SSEPs, MEP) | PC3, PC4, PC5, PC6, PC7, MK1, MK5, SP3 |
| 3 | Perform direct cortical stimulation at bedside and/or in the OR for language and/or motor mapping | PC1, PC2, PC3, MK1, MK3 |
| 4 | Demonstrate professional and effective communication with OR team (surgeon and anesthesiologist) and IOM technologists | PC1, PC2, PC3, MK1, MK3 |
| 5 | Learn the effects of anesthesia and systemic effects on IOM modalities and EP | PC3, PC4, PC5, PC6, PC7, MK5, PL1 |
| 6 | Know alarm criteria of IOM modalities | PC3, PC4, PC5, PC6, PC7, MK5, PL1 |
| 7 | Know placement of electrodes for commonly used IOM modalities | IC1, IC2, IC3 |
Schedule
Monday-Friday they will spend time in the UW OR with initial hook ups and then subsequently participate in remote review of studies from the EEG/IOM lab.
Conferences
Attend per conference requirements, additionally review IOM articles/book with an attending.
Work Hours
Standard work hours
Latest Revision: 04/20/2023, Smitha Holla, MD
