To improve performance and knowledge of preoperative evaluation, perioperative managment and anesthesia in Geriatric Patients.

On completion of module 1, the resident should be able to:
1) List risk factors for adverse outcomes in non-cardiac surgery.
2) Work through an appropriate preoperative evaluation based on the risk factors identified in objective 1.
3) Identify preventive measures that may be taken to avoid adverse surgical or anesthetic outcomes.

On completion of module 2, the resident should be able to:
1) List the elements of a history necessary for an effective pre-anesthesia evaluation.
2) List the appropriate physical exam elements for an effective pre-anesthesia evaluation.
3) List the appropriate preoperative testing with indications.
4) List and evaluate patients for preoperative risk factors for cardiac disease.
5) Clinically assess functional capacity.
6) Demonstrate ability to interpret preoperative testing and evaluate mental status.

On completion of module 3, the resident should be able to describe:
1) The fluid management plan in this patient and in elders in general receiving spinal anesthesia.
2) The unique intraoperative complications associated with orthopedic surgery.
3) The problems associated with spinal anesthesia in the elderly patient.
4) The pathophysiologic consequences of arterial tourniquets.
5) Risk factors for the development of bradycardia and cardiac arrest during spinal anesthesia.

On completion of Module 4, the resident should be able to:
1) List the causes and treatments for postoperative delirium.
2) List the signs and symptoms of fluid overload in the PACU.
3) List the various options for pain control in the elderly post op.

On completion of module 5 and 6, the resident should be able to:
1) List the elements of a history necessary for an effective pre-anesthetic evaluation.
2) List the appropriate physical exam elements for an effective pre-anesthetic evaluation.
3) List the appropriate preoperative testing with indications.
4) List and evaluate patients for major preoperative risk factors for cardiac disease, pulmonary disease, sepsis, and renal disease.
5) Clinically assess functional capacity.
6) Demonstrate the ability to interpret preoperative testing, evaluate mental status, assess hydration, oxygenation, nutrition, manage polypharmacy, counsel the patient regarding their candidacy for various types of anesthesia and their anesthetic risk.