| Goals: |
- Effectively interact with child, caregivers, and social systems, assess and manage health care of children.
- Recognize and facilitate treatment of children requiring specialty intervention.
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| Objectives: |
- Understand normal child development and recognize delays in development.
- Provide appropriate anticipatory guidance for infants, toddlers and children to their parents.
- Assess and treat common childhood illnesses.
- Communicate at an appropriate level to the pediatric patient and parents.
- Recognize when a child requires admission and diagnose the cause of the illness.
Example illnesses include:
- Gasteroenteritis with dehydration
- Bronchiolitis requiring oxygen
- Failure to thrive
- Urinary tract infection in an infant
- Fever in a newborn
- Asthma
- Pneumonia
- Develop and implement an appropriate treatment plan for a sick child.
- Recognize changes in the inpatient course and make adjustment to assessment and plan accordingly.
- Learn to interact on an appropriate level with different ages and degrees of illness.
- Be comfortable with the resuscitation of a normal newborn after delivery.
- Understand the various causes of distress in a newborn such as:
- Meconium aspiration
- Blood loss
- Primary apnea, hypoxia
- Recognize a newborn in distress and implement appropriate treatments
- Become familiar with various procedures such as: umbilical artery access, umbilical venous access, and visualization of vocal cords.
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| Rotation Experiences/Activities (Items marked with * address other curriculum goals and objectives but are integrated during this rotation.) |
| Noon Lectures |
Rotation/Cycle |
Responsible Faculty |
| Abuse |
18 months |
QFP/Peds |
| ADHD |
18 months |
Phillips |
| Child Development/Anticipatory Guidance |
6 months |
QFP/ER/Peds |
| Fever in Children |
At orientation |
Kruse |
| Normal Newborn |
18 months |
.. |
| Respiratory Infections |
6 months |
Peds/QFP Faculty |
| Stabilization & Transport of the sick Newborn |
12 months |
Peds |
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| Rotation Experiences/Activities (Items marked with * address other curriculum goals and objectives but are integrated during this rotation.) |
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| Outpatient Pediatrics: |
- Observe the physician and how they interact, comparing styles and integrate the best to your practice.
- Look at patient education styles and materials.
- Patients that require specialty care, observe what is done so can tell patients what to expect, define your role in managing this child if no specialists available.
- How do they use mid-level professionals, discuss your observations with advisor.
- How do nurses’ triage and how are advice and protocols established as you will be setting up your practice and training personnel?
- Time management, how work in sick kids.
- Define and note interaction with community systems for challenged child.
- How are child behavior problems and parenting skills addressed among various physicians?
- Management of specific illnesses:
- Otitis Media
- Outpatient Pneumonia
- Urinary Tract Infections
- Respiratory Syncitial Virus
- Failure to Thrive Work up
- Pharyngitis
- Chickenpox
- Impetigo
- Sinusitis
- Parenting Issues
- Well Child Care
- Asthma Allergies
- Conjuntivitis
- How the health department plays a role in a child's health.
- Learn the immunization schedule as well as risks and benefits to immunizations for children.
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| Continuity of Care Clinic |
- Panel of children 0 – 18, with the common acute and routine problems seen in children including:
- ADHD
- Otitis media and upper respiratory illnesses
- Bronchitis
- Asthma
- Well Child exams with emphasis on developmental staging and anticipatory guidance
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| Emergency Room |
- Acute illnesses of children, trauma
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| Community Outreach Clinic (COC) |
- Children, adolescent in a group environment with social and psychiatric problems – will be periodically seen in clinic for acute illnesses, building of rapport, appropriate interventions
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| Inpatient Pediatrics/Sick Nursery |
- Obtain an accurate and complete history and physical
- Develop a management plan for the common inpatient pediatric illnesses
- Dehydration
- Diarrhea, Vomiting
- Pneumonia
- RSV
- Asthma
- Failure to Thrive
- Septic Workup
- Surgery
- Completion of 3 case studies to help facilitate the learning of illnesses commonly needing admission that may not be encountered during the month.
- Competently participate in newborn resuscitation and understand when the newborn may need more intensive assistance.
- Assist in stabilizing a sick newborn, including familiarity with common techniques such as: umbilical venous and arterial access and visualization of the vocal cords with a laryngoscope.
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| OB |
- Normal newborn and parent education and interaction
- Recognition of potential sick infant and appropriate preparation
- Resuscitation of infant
- Meconium removal
- Visualization of cords
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| Community Medicine |
- Exposure to community resources
- Birth to Three Program, teen pregnancy prevention and classes, psychological evaluation at school, Chaddock
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| Behavioral Science Rotation |
- Teen psychiatric unit
- Child interviewing skills
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| Rural Medicine |
- Rural school system and resources for children
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| Sports Medicine |
- Child athlete evaluation
- Sports physicals
- Child athlete injuries and prevention strategies
- Role of school athletic trainer, coach
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| Certification |
|
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| Video taping |
- Child interviewing skills, Well child exam
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| Surgery Subspecialties |
- Ophthalmology
- Strabismus
- ENT
- Surgical management of throat, ear and sinuses
- Speech and hearing evaluation and monitoring
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| Resource List |
- Websites from department link sites
- Pediatrics in Review
- MD Consult – Pediatrics
- Up to Date.com
- Heart Murmurs CD-ROM – In CD tower, available on supervisor's room computers, resident room computer, and conference room computer.
- CDC – Immunization Schedule
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| Rotation Mechanics - Outpatient |
- Contact attending the week before to arrange when and where to meet the first day.
- Discuss needs and goals of rotation.
- Follow attending in office having first contact with as many patients as possible.
- Discuss various illnesses with attending during “down time”, i.e. presentation, evaluation, work-up and treatment, review anticipatory guidance, etc.
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| Rotation Mechanics – Inpatient Pediatrics/Sick Nursery: |
- Contact attendings the week before to find out when they round.
- Discuss needs and goals with attending.
- Admit with work-up all new admissions to pediatric unit.
- Pre-round every a.m. and place note on chart before attendings round and be available to round with attending. If attending does not round in a.m. call attending at office and discuss patients and plans.
- Contact resident on OB and inform them you are on rotation and remind them to with any potential sick newborns (before delivery if possible).
- Come in immediately to evaluate, work-up and assist with care of any neonate that meets criteria for Level 2 nursery. You are responsible to check out sick nursery call to another resident if you will be off pager for any reason.
- Round on Level 2 patients every a.m. and place note on chart.
- Review NRP & Stable during your rotation.
- Follow newborns in Nursery if census in pediatric unit is low.
- Finish three case studies given to you at the start of the rotation
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| Resources |
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