ASSESSMENT

Residents' learning will be assessed by:

 * Residents will discuss 90% of patients on controlled substances with a preceptor during the office visit. This will be evaluated by a sampling of random charts at the end of each academic year. During that discussion, residents will demonstrate competence in the fields of chronic pain and addiction by:
 * Screening patients at initiation of medications for addiction and documenting that screen (100%)
 * Discussing and setting goals and expectations with the patient and documenting that discussion (100%); these goals will be periodically, and at least biannually, reexamined for attainment
 * Screen patients for ongoing side effects of medications and misuse of medications with a validated tool at least yearly (90%). As indicated, residents will discuss plans to wean patients from controlled substances judiciously in order to minimize patient suffering.
 * Residents will demonstrate competence regarding modalities of care for patients with chronic pain and addiction. This will include
 * Understanding of narcotic and non-narcotic medications for chronic pain, and appropriate choices of each for specific diagnosis. This will be evaluated via discussion with preceptors during the visits.
 * Red flags for addiction and abuse; this will be evaluated during the small group exercises and using the Office of Substance Abuse cases.
 * Appropriate physical medicine treatment modalities and their indications. This will be discussed during preceptor visits.
 * Different settings for treatment of addiction such as substance abuse counseling, IOP, and inpatient detoxification. This will be discussed during small group exercises.

 