Image-Guided Thoracentesis

Entrustable Professional Activity (EPA) Checklist: Residents must document 3 successful Thoracentesesprior to performing with indirect supervision (with direct supervision immediately available).

Guidance (circle): CT US

RESIDENT: ______Level: R1 R2 R3 R4

EXPECTATION: KNOWS KNOWS HOW SHOWS HOW ASSISTS DOES

Miller’s Pyramid

Medical Knowledge

  1. The resident knows (states) what a Thoracentesis is, why it is being performed and the indications/contraindications; knows how (describes) how to perform the procedure, including risks and benefits; shows how to perform the procedure?

Yes NoN/A

Interpersonal Communication Skills

  1. The resident introduces her-/himself to the patient, explains the procedure adequately, answers all patient and family’s questions and obtainsinformed consent?

Yes NoN/A

Patient Care & Procedural Skill

  1. The resident checks pertinent history, exams, and indications? The resident examines the patient prior to prep for appropriate entry site?

Yes NoN/A

  1. The resident performs (does) the procedurein a technically competent manner?

Scrubbed?

Time out?

Sterile technique?

Identify appropriate location, avoiding lung?

Local anesthesia?

Ensure sample is labeled & labs ordered properly?

Confirm dressing placement?

Enter post-op orders?

YesNoN/A

Medical Knowledge(& Communication Skills)

  1. The resident creates an appropriate dictation which includessignificant findings and pertinent negatives?

Yes NoN/A

Practiced based learning and improvement

  1. The resident selects appropriate additional views or maneuvers to accomplish proper puncture location?

Yes NoN/A

Systems Based Practice

  1. The resident uses principles of ALARA to minimize radiation dose?

Yes NoN/A

Professionalism

  1. The resident effectively communicates with patient, technologists and all others present before, during and after the procedure?

Yes NoN/A

The Resident performed the procedure/examination at the following level (circle one):

KNOWS KNOWS HOW SHOWS HOW ASSISTS DOES

The resident performed this procedure in a competent manner?

YesNo(If Nois selected, faculty must provide written formative feedbackin the box below.)

PROVIDE FEEDBACK IN THE BOX BELOW:

The Resident has successfully completed 3Image-Guided Thoracenteses using US or CT and is competent to perform this procedure with indirect supervision (with direct supervision immediately available).

Yes No N/A

Faculty Signature: ______Date______

Faculty Name/Title: ______