review of year 3 pediatrics clerkship - geisel school of ... · pdf filereview of year 3...
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ReviewofYear3PediatricsClerkship
• ClerkshipoccursinYear3• ClerkshipDirectors
– AdamWeinsteinandAlisonHolmes• ClerkshipCoordinator
– SharonFrench• ClerkshipLength– 8weeks,6cycles
– 2WeeksInpatient,1WeekNursery,4WeeksOutpatient(changefrom2014-15)
• Sitesused– Inpatient:DH,CHOC,CPMC,Concord,Elliot– Outpt:Regional,Maine,Ft.Defiance– Nursery:DH,CPMC,CMC
• ClerkshipwaslastreviewedinJune2014• CurrentReviewTeam:3/25/26:Drs.Dick andFriedman(GAME),MECstudent
memberMariettaSmith
ActionPlanfromPriorReview• Objectives:
– Remove“complexprocedures”fromthefollowingobjective“Performandexplaintheindications,complications,andlimitations,ofsimpleprocedures(e.g.throatcultures,hearingtests)inchildren(andtoassistwithcomplexprocedures(e.g.lumbarpuncture)inchildren• DONE
– Reconciledobjectivediscrepancies-- ILIOSandCANVASnowmatch- DONE• ClinicalSkills:
– Add“AgeAppropriateHPIandPE”(replace“HPIRelevanttothisClerkship”)–DONE
– RemoveThroatCulture—notbeingdonebyallofouroutpatientpracticesasnolongeraroutinephysiciantask- DONE
– Add“Correctlywriteapediatricprescription,dosingbyweight,foramedication.”- DONE
ActionPlan(cont)• DutyHours-- midwaythroughtheyear,werecognizedthecallscheduleatCHOC—
sometimesthenightshiftweek,whileitcomplieswithresidentdutyhours,didnotcomplywiththeGeiseldutyhours(becauseofaveragingforresidents)– WecreatedapersonalhourslogforourstudentsrotatingatCHOC.Iftheyapproachthe
80hourcut-offduringtheirnightshiftweek,theyareinstructedtotakeSundayofffromthatweeksotheydonotexceed80hours. - DONE
– Oursitedirectorisoverseeingthisandmakingsureresidentsandfacultyareaware-- astherearealsoUCIrvinestudentswhodon’thavethislimitation.
• BusyWork:Wereducednumberofwrite-upsanddiscussionassignmentsto2(insteadofthe3)forthecomingyear;wehaveconsolidatedourtracking/loggingformsandsystemstoeliminatesomepreviousredundancy.- DONE
• HighValueHealthCareassignmentwillbeginthiscomingacademicyear.- DONE
CourseObjectivesCourseObjective HowStudentis
AssessedLearningActivity
1 Applyageappropriateandpediatricproblembasedknowledgetopatientcarebridgingandintegratingbasicscience,clinicalscienceandmulti-disciplinaryaspectsofdeliveryofpatientcare.
PerformanceEvaluationsFinalExamCaseDiscussionsWriteUps
WardsClinicsCLIPPCaseDiscussionsWriteUps
2 Describe (Apply?) currentknowledgeofpediatricdiseaseprevention,riskfactormodification,medicalethics,andmedical-legalissuesto clinicalproblemsinchildrenandfamilies.
PerformanceEvaluationsFinalExamWriteUps
WardsClinicsCLIPPWriteUpsCaseDiscussions
3 Gatherhistory,counselandincorporateinthecareplanthesocial,economic,culturalandpersonalfactorswhicheffectthehealthcareneedsofchildrenandtheirfamilies,describingbarriersforpediatricpatientsandtheirfamiliestoaccesstobasichealthservicesanditseffectonvulnerablepopulations
PerformanceEvaluationsWrite-ups
WardsClinicsWrite-upsFOSS
4 Establishcomfortableandmutuallyrespectfulstudent-patientandstudent-familyrelationshipswithdiversepatientsandfamiliesandestablishingarespectfulbasisforthedoctor-patientrelationship.
PerformanceEvaluationsStructuredClinicalObservations
WardsClinicsStructuredClinicalObservation
5 Interviewandcounselpediatricpatientsandtheirfamiliesskillfully,utilizinganageappropriateandpediatricproblembasedhistoryincludingeitheracomprehensiveorfocusedhistory.
PerformanceEvaluationsStructuredClinicalObservationsSkillsForm
WardsClinicsStructuredClinicalObservation
CourseObjectives6 Demonstrateacomplete “age appropriate”physicalexamofchildren,with
appropriateattentiontoskill,cleanliness,infectioncontrol,patientcomfort,privacyanddevelopmentalcapacity.
PerformanceEvaluationsStructuredClinicalObservationsSkillsForm
WardsClinicsStructuredClinicalObservation
7 Defineandprioritizethepediatricpatient'sproblemsaccuratelyandgenerateanappropriatedifferentialdiagnosisforchildhoodconditions
PerformanceEvaluationsStructuredClinicalObservationsWrite-ups
WardsClinicsCLIPPStructuredClinicalObservationWrite-upsCaseDiscussions
8 Performand (RemovePerformanduseonlyexplain) explaintheindications,complications,andlimitations,ofsimpleprocedures(e.g.throatcultures,hearingtests)inchildren.
ClinicalEvaluations WardsClinics
9 Assessandinterpretabnormalitiesandfindingsoncommondiagnostictestsandstudiesincludingchestx-rays,EKGs,bloodtests,andurinalysis.
PerformanceEvaluationsFinalExamWrite-ups
WardsClinicsCLIPPWrite-upsCaseDiscussions
CourseObjectives10 Demonstrateabilitytoinformpatientsandfamiliesandassesstheirunderstanding
oftheirtreatmentoptionsandmotivatingthemtomakehealthybehavioralandtreatmentchoices.
PerformanceEvalsSkillsFormStructuredClinicalObservations
WardsClinicsCaseDiscussionsStructuredClinicalObservation
11 Communicateeffectivelywithpatientsofdifferentsocial,economicandculturalbackgroundsaroundindividualfactorsthatimpacthealth.(NOTincurrentIlios!!)
PerformanceEvalsStructuredClinicalObservations
WardsClinicsStructuredClinicalObservationFOSSCaseDiscussions
12 Communicateeffectivelyandcollegiallywithphysiciancolleaguesandothermembersofthehealth-careteamverbally,inwritingandintheelectronicmedicalrecordasitrelatestopediatricpatients.
PerformanceEvalsWriteUpsSkillsFormStructuredClinicalObservations
WardsClinicsWriteUpsCaseDiscussionsStructuredClinicalObservation
13 Behaverespectfullyandresponsiblytowardspatients,families,colleagues,andallmembersofthehealth-careteamandempathizeandberespectfulofeachpatient
PerformanceEvalsProfessionalismPoints
WardsClinicsCaseDiscussionsFOSS
14 Adheretohighethicalandmoralstandards,acceptresponsibilityforpersonalactions,acceptconstructivecriticismandrespectpatientconfidentiality,placingpatientinterestsfirst,beingmindfulofpersonalopinionandbias.
PerformanceEvalsProfessionalismPoints
WardsClinicsCaseDiscussionsFOSS
CourseObjectives15 Takeresponsibilityforhisorherownmedicaleducation,anddevelopthehabitsof
mindfulnessandreflectionandmaintainingone'sownhealth (removethisasitisnotsomethingtheclerkshipisresponsiblefororevaluating)
PerformanceEvalProfessionalismPoints
WardsClinicsCaseDiscussions
16 Incorporateconstructivesuggestionsduringpeerreview. (mightbeconsidered in14aboveandcouldberemoved)
WriteUps WriteUps
17 Identifyandcriticallyevaluaterelevantinformationaboutevidence-based,cost-consciousstrategiesinthecareofpediatricpatientsandpopulationsandtoapplythistopediatricpatientcareandtocontinuousupdatingofskills.
PerformanceEvalsIn-DepthDiscussion
WardsClinicsCaseDiscussionsInDepthDiscussionHighValueHealthCareAssignment
18 Identifyandutilizeappropriateresourcestosupportpediatricpatientcareandcomparetherolesofandcollaboratewithallmembersofthepediatricinter-professionalteam.
PerformanceEvals WardsClinics
19 Discussthelargerenvironmentandthephysician'sroleinwhichhealthcareoccursincludingtheeffectonunderservedpopulationandregionalvariationsinthedeliveryofhealthcare.
PerformanceEvaluations
WardsClinicsHighValueHealthCareAssignment
CourseObjectives– Comments• Appropriatenumber,understandable• Coversover-archingGeiselcompetencies• Minorlanguagechangessuggested• CANVASclinicalskillsobjectivesneedsupdating(stillcontains“assistwithcomplexprocedures”)
FormatofCourse&SessionObjectives• Courseobjectivesareprovidedinthesyllabus– AppreciatehowtheyarebrokendownbyGeiselCompetency
• Courseobjectivesarewritteninthecorrectformat• Sessionobjectivesareprovidedinthecoursematerials
• Sessionobjectivesaremostlywritteninthecorrectformat– HVHC– “Understand”wouldchangetoamoremeasureableverb
HowdoY1/2coursesprepareforY3• Questionsaskedatendofclerkship– 1=poorand5=excellent
• Openended– MorePeds ingeneral– MoreinfoonVaccines– Commonvsuncommondiseases(toomuchperceivedemphasisonthelatter)
• TrendshowsimprovementinpreparationforcommunicationandPEskills,lesssoformedicalknowledge
Results:Communication
00.51
1.52
2.53
3.54
4.55
FM MED OB PSYCH SURG PEDS GAM NEURO
13-14
14-15
15-16
Results:MedicalKnowledge
00.51
1.52
2.53
3.54
4.55
FM MED OB PED PSYCH SURG GAM NEURO
13-14
14-15
15-16
IssuesofRedundancy• Aretheremajorissuesofredundancywithothercourses?– NO– “AnticipatoryGuidance”Ilios search– onlycoveredinpediatricsclerkship
– FortunatetohaveOn-Docco-directorasclerkshipdirectortoensureappropriaterepetition
EssentialSkills
• Aretheseappropriateforthisclerkship?Yes
• Wouldyouaddorsubtractany?No
• Aretheremajorissuesofredundancywithotherclerkships?No
Skill Overlap LevelExpectedCompleteexam,ageappropriate PerformwithSupervisionCounseling:normal/abnormaldevelopment PerformwithSupervisionHEENTexam PerformwithSupervisionHPI,ageappropriate PerformwithSupervisionNewbornexam PerformwithSupervisionObesity-WeightorNutrition/Dietcounseling PerformwithSupervisionOralpresentation,amb PerformwithSupervisionOralpresentation,inptadmit PerformwithSupervisionTannerstagingexam PerformwithSupervisionWritepediatricprescription,dosingbyweight PerformwithSupervisionWritennote,amb PerformwithSupervisionWrittennote,inptadmit PerformwithSupervisionWrittennote,inptprogress PerformwithSupervision
EssentialDiagnoses
• Aretheseappropriateforthisclerkship?Yes• Wouldyouaddorsubtractany?No• Aretheremajorissuesofredundancywithotherclerkships?Appropriate
Diagnoses Overlap LevelADHD ManagewithAssistanceAsthma Yes(CFM) ManagewithAssistanceDehydration ManagewithAssistanceDiarrhea/N/V ManagewithAssistanceFailuretoThrive ManagewithAssistanceFever(sourceunknown) Yes(MEDI) ManagewithAssistanceHeadache Yes(NEURO) ManagewithAssistanceHeathmaintenance(13-17) ManagewithAssistanceHealthmaintenance(1m- 12y) ManagewithAssistanceMurmur ManagewithAssistanceNewbornvisit(0-30days) ManagewithAssistanceObesity Yes(CFM,GAM) ManagewithAssistanceOtitismedia ManagewithAssistancePharyngitis ManagewithAssistanceRash Yes(CFM,GAM) ManagewithAssistanceURI ManagewithAssistanceViralsyndrome ManagewithAssistance
ExplorationofEthicsandCulturalCompetencies
• FOSS(Fromtheothersideofthestethoscope)– Sessionatendofclerkshipforallstudentsthatincludeethicaldiscussions(appropriateinformationsharingwithfamiliesandyoungpatients)
• HighValueHealthCaresession– Includesethicalissues
CourseLearningOpportunities• Clinicalexperiences
– 2weeksinpt,1weekNursery,4weeksoutpt• SmallGroupSessions(orientationandFridayafternoons)
– TopicalandCaseBasedreasoning• Assignments
– CLIPPcases(32cases)– High-ValueHealthCareassignment– 2writeups(inpt andoutpt)
• Peerreviewofwriteups• Primaryliteraturereviewwithwriteups
– Embryologygroupactivity• Structuredclinicalobservations(3)• Simulation
– CriticalcaresimulationsinSim Center
Assessment• Eachcompetencyassessedusingvariousmethods– MK:50%finalexam/50%ClinicalEvaluations– PC:50%ClinicalEvals /50%writeups– CPLI:50%ClinicalEvals /50%InDepthDiscussion– CS:50%CE/50%Writeups– PMCHS:33%CE/67%NurseryAssignments– Professionalism:clinicalevals,assignments
Measuresof
Quality–AAMCGQ
Geiselmean2011
Geiselmean2012
Geiselmean2013
Geiselmean2014
Geiselmean2015
Allschoolsmeans2015
CFM 3.2 3.1 2.9 3.2 3.5 3.3
MED 3.5 3.6 3.5 3.6 3.6 3.5
NEURO 3.1 3.4 2.7 3.1 3.1 3.1
OBGYN 3.1 3.0 3.0 3.1 3.1 3.1
PEDS 3.3 3.1 3.2 3.5 3.6 3.4
PSYCH 3.5 3.6 3.4 3.7 3.6 3.3
SURG 3.0 2.8 2.9 3.1 3.3 3.3
MeasuresofQuality– AAMCGQ“Ratethequalityofyoureducationalexperiencesinthefollowingclinicalclerkships.”[1=poor;2=fair;3=good;4=excellent]
Measuresof
Quality–AAMCGQ
PEDIGeisel 2014 Geisel2015 AllSchools2015
Observedtakingrelevantportionsofpthistory? 96.4 97.3 90
Observed performingrelevantportionsofphysicalorMSE? 97.6 95.9 91.9
Provided withmidclerkshipfeedback? 98.8 100 95.2
MeasuresofQuality– AAMCGQ
PercentansweringYestoquestion(goalis100%)
Measuresof
Quality–AAMCGQ
PEDIGeisel 2014 Geisel2015 AllSchools2015
Faculty providedeffectiveteaching 4.4 4.4 4.4
Residents providedeffectiveteaching 4.4 4.4 4.3
MeasuresofQuality– AAMCGQ
Scale:StronglyDisagree– 1toStronglyAgree- 5
Measuresof
Quality–AAMCGQ
Clerkships OverallSatisfactionAY2014-2015
PEDS 4.5
MED 4.5
CFM 4.5
PSYCH 4.3
SURG 4.2
GAM 4.2
OBGYN 4.2
NEURO 4.0
MeasuresofQuality– CourseEvaluation
scale[1=poor;2=fair;3=good;4=verygood;5=excellent]
scale[1=poor;2=fair;3=good;4=verygood;5=excellent]
MeasuresofQuality– CourseEvaluationPediatrics
2013-14 2014-15 2015-16
OverallExperience 4.24(I: 4.19/O:4.46) 4.51(I:4.18/O:4.54) 4.22(I:4.17
Objectiveswelldefinedandclearly presented 4.33/4.41 4.34/4.54 4.41
Ability forY1and2topreparemeforthisclerkship
3.02 3.26 3.54
Expectationswelldefinedand clear 4.21/4.33 4.20/4.53 4.17/4.59
Volumeadequate forlearning 4.21/4.58 4.15/ 4.55 4.31/4.7
Varietyofdxadequateforlearning 4.38/4.08 4.32/4.23 4.36/4.19
Quality ofteachingbyattendings 4.33/ 4.48 4.32/4.63 4.75/4.7
Qualityofteaching byresidents 4.18/4.52 4.14/4.84 4.36/4.78
Directors responsivetoconcerns 4.59/4.61 4.49/4.78 4.29/4.84
Methodsusedto eval studentperformancemadeclear 4.08/4.25 4.07/4.4 4.11
Qualityof mid-clerkshipfeedback 4.06/4.29 4.11/4.3 4.14/4.57
MeasuresofQuality– StudentComments
Strengths
Area AY15-16 AY14-15 Representative Quote
Breadth ofclinicalexperiences 24 36
“IthinkIwasabletogetawide-rangeofexposure(differentpractices,differentpatientpopulations)”
Teaching &Didactics 20 28
“Alloftheresidentsandattendings withwhomIworkedweregreatteachers,happytohavemeontheirteams,andgavegreatfeedbacktohelpmegrow.”
“[Didactics] weretypicallyshort,interactive,andtothepoint-- veryhelpfulallaround.Lovedjeopardyattheend!”
Organization,ClerkshipDirectors,& SharonFrench
7 20
“Thisisaverywell-constructedclerkshipthatisbalancedandexceptionally-designed.”
“TheweeklyemailswereUBERhelpful”
CLIPP 5 11 “CLIPPcaseswerehelpfulincoveringmanydiagnosesthatIdidn'tseeinclinic.”
MeasuresofQuality– StudentCommentsSuggestionsforImprovements
Area AY15-16 AY14-15 Representative Quote
NumberofAssignments &DueDates
23 13
“Ithinkrightnowthereareever-so-slightlytoomanypartsthatleadtotoomuchoverheadforthestudent.Whilemanageable,itisjustbarely;considerallthejuggling:3separatesites,HVHC,FOSS,Inpatientwrite-upwithin-depth,outpatientwrite-upwithin-depth,32CLIPPs,newbornnurseryembryologyprojectcoordinatedamong4peoplespreadacrossthecountryanddoingtheirnurseryrotationsatdifferenttimes,3librarianchats(alsotryingtocoordinatewithmultiplepeople,acrosstimezones),2structuredclinicalfeedbacks,thepurpleform,mid-clerkshipfeedbacksessions...there'salotofthingsstuffedinto7weeks”
“Itwashardtokeeptrackofalltheassignmentsandduedatesespeciallywhenthecanvassiteandemailsstateddifferentdates.”
Structure(Inpatient,
Outpatient,&Nursery)
14 2
Requestsforincreasedinpatienttime,possiblydecreasednurserytime
Write-UpGuidance 6 0-1
“forthosenotcomingoffofmedicine,write-upsweredifficulttounderstandwhatwentintoa"good"academicwriteup...perhapshavinganoptionalworkshoptodiscusstheelementswithexamplesofwhatyouarelookingfor”
MeasuresofQuality– StudentComments
• Otherissuesfromstudentcomments– Resolvetechnologyproblemsforstudentsconnectingremotely
– MovingNICU/PICUSimstoearlierinclerkship– KnowledgeorSkillsinYear1&2
• Moretimecouldbededicatedtocommonpediatricconditions– “Ithinkalargepartoftheproblemis…randomlecturesthrowninthemiddlehereandtherethatoftenlumpabunchofstufftogetherandmaybegetbrushedasidebecauseofrelativeunimportanceonexams(2-3questionsperfinal).”
– “Thepedi stuffwassoscatteredthatitwastoughtoputitallbacktogetherintheclinic.”
Recommendations• CourseObjectives– Minorwordchangestobetteralignwithintendedlearning
• Obj 2:Describe currentknowledgeofpediatricdiseaseprevention,riskfactormodification,medicalethics,andmedical-legalissuestoclinicalproblemsinchildrenandfamilies.- ChangeDescribetoApply
• Obj 4:Establishcomfortableandmutuallyrespectfulstudent-patientandstudent-familyrelationshipswithdiversepatientsandfamiliesandestablishingarespectfulbasisforthedoctor-patientrelationship.– Removephraseinredtextasthelanguageisredundant.
• Obj 6:Demonstrateacomplete“ageappropriate”physicalexamofchildren,withappropriateattentiontoskill,cleanliness,infectioncontrol,patientcomfort,privacyanddevelopmentalcapacity. - Addageappropriate
Recommendations• CourseObjectives
– Obj 8:Performandexplaintheindications,complications,andlimitations,ofsimpleprocedures(e.g.throatcultures,hearingtests)inchildren. - removeperformasexpectationat3rd yearlevelisreallytounderstandandexplain,notperform.
– Obj 14and16:Adheretohighethicalandmoralstandards,acceptresponsibilityforpersonalactions,acceptconstructivecriticismandrespectpatientconfidentiality,placingpatientinterestsfirst,beingmindfulofpersonalopinionandbias.- addacceptconstructivecriticismtoObj 14andremovefrom16tocondense
– Obj 15:Takeresponsibilityforhisorherownmedicaleducation,anddevelopthehabitsofmindfulnessandreflectionandmaintainingone'sownhealth (removethisasitisnotsomethingtheclerkshipisresponsiblefororevaluating)
Recommendations• VerticalIntegration
– Discussaddingmaterialtoyears1and2oncommonpediatriccancers(especiallyleukemia),vaccinations,andmoreemphasisonpediatricconditionsmostcommonlyseenintheclinic.
• LearningActivities– Betterdefineamountoftimeexpectedtobespentongroupembryology
project– IncreasetimeoninpatientrotationsinCAgivenimplicationsofstudenttravel
toanfromthesesite.• Assignments
– Givennumberofassignmentsand3differentrotationsinshortamountoftime,continuetobeveryclearonduedatesasmanystudentsfeltthiswasdifficultytokeeptrackof
ActionPlan• Willchangecourseobjectivesassuggested(seenextslides)
• Cont toworkwithSBM– AcuteLymphoblasticLeukemia(latestconversationwasre:aPBLcasein2to4yearoldwiththiscondition)
– WillalsoreviewdiscusscollaboratewithSBMIDdirectoraboutvaccines
– RecentlyrevisedSBMIDsessiontoemphasizemorecommoninfections(RSV,Otitis,etc…)overlesscommon(HIV)inchildren
– WillreviewcontentwithotherpediatricpresentersinSBMtoemphasizethecommonclinicalillnessesanticipatedinthepediatricclerkship
ActionPlan• Learningactivities
– Revisinginstructionsforwrite-ups,discussions,andembryologyprojectsoexpectationsmoreclear
– In16-17studentsatCHOCandCPMCwillbedoing3weeksinpatient,3weeksoutpatient,1weeknurseryinresponsetostudentaswellassitedirectorfeedbackonthis
• Assignments– Sharonwillcontinuetosendweeklyemailsaboutassignments
andduedates• DutyHours
– AtCHOC,theUCIrvinestudentsfollowresidentACGMEdutyhours;ourstudentsdonot(wehaveadifferentpolicywhichisbothstricterandmorelenientindifferentways)
– Thiscreatesanunnecessarytensionthereforourstudents– WewishtorevisitwhyGeiseldoesnotfollowtheresident
ACGMEdutyhourswiththeMEC
CourseObjectivesCourseObjective HowStudentis
AssessedLearningActivity
1 Applyageappropriateandpediatricproblembasedknowledgetopatientcarebridgingandintegratingbasicscience,clinicalscienceandmulti-disciplinaryaspectsofdeliveryofpatientcare.
PerformanceEvaluationsFinalExamCaseDiscussionsWriteUps
WardsClinicsCLIPPCaseDiscussionsWriteUps
2 Apply currentknowledgeofpediatricdiseaseprevention,riskfactormodification,medicalethics,andmedical-legalissuesto clinicalproblemsinchildrenandfamilies.
PerformanceEvaluationsFinalExamWriteUps
WardsClinicsCLIPPWriteUpsCaseDiscussions
3 Gatherhistory,counselandincorporateinthecareplanthesocial,economic,culturalandpersonalfactorswhicheffectthehealthcareneedsofchildrenandtheirfamilies,describingbarriersforpediatricpatientsandtheirfamiliestoaccesstobasichealthservicesanditseffectonvulnerablepopulations
PerformanceEvaluationsWrite-ups
WardsClinicsWrite-upsFOSS
4 Establishcomfortableandmutuallyrespectfulstudent-patientandstudent-familyrelationshipswithdiversepatientsandfamiliesandestablishingarespectfulbasisforthedoctor-patientrelationship.
PerformanceEvaluationsStructuredClinicalObservations
WardsClinicsStructuredClinicalObservation
5 Interviewandcounselpediatricpatientsandtheirfamiliesskillfully,utilizinganageappropriateandpediatricproblembasedhistoryincludingeitheracomprehensiveorfocusedhistory.
PerformanceEvaluationsStructuredClinicalObservationsSkillsForm
WardsClinicsStructuredClinicalObservation
CourseObjectives6 Demonstrateacomplete “age appropriate”physicalexamofchildren,with
appropriateattentiontoskill,cleanliness,infectioncontrol,patientcomfort,privacyanddevelopmentalcapacity.
PerformanceEvaluationsStructuredClinicalObservationsSkillsForm
WardsClinicsStructuredClinicalObservation
7 Defineandprioritizethepediatricpatient'sproblemsaccuratelyandgenerateanappropriatedifferentialdiagnosisforchildhoodconditions
PerformanceEvaluationsStructuredClinicalObservationsWrite-ups
WardsClinicsCLIPPStructuredClinicalObservationWrite-upsCaseDiscussions
8 Explain theindications,complications,andlimitations,ofsimpleprocedures(e.g.throatcultures,hearingtests)inchildren.
ClinicalEvaluations WardsClinics
9 Assessandinterpretabnormalitiesandfindingsoncommondiagnostictestsandstudiesincludingchestx-rays,EKGs,bloodtests,andurinalysis.
PerformanceEvaluationsFinalExamWrite-ups
WardsClinicsCLIPPWrite-upsCaseDiscussions
CourseObjectives10 Demonstrateabilitytoinformpatientsandfamiliesandassesstheirunderstanding
oftheirtreatmentoptionsandmotivatingthemtomakehealthybehavioralandtreatmentchoices.
PerformanceEvalsSkillsFormStructuredClinicalObservations
WardsClinicsCaseDiscussionsStructuredClinicalObservation
11 Communicateeffectivelywithpatientsofdifferentsocial,economicandculturalbackgroundsaroundindividualfactorsthatimpacthealth.(NOTincurrentIlios!!)
PerformanceEvalsStructuredClinicalObservations
WardsClinicsStructuredClinicalObservationFOSSCaseDiscussions
12 Communicateeffectivelyandcollegiallywithphysiciancolleaguesandothermembersofthehealth-careteamverbally,inwritingandintheelectronicmedicalrecordasitrelatestopediatricpatients.
PerformanceEvalsWriteUpsSkillsFormStructuredClinicalObservations
WardsClinicsWriteUpsCaseDiscussionsStructuredClinicalObservation
13 Behaverespectfullyandresponsiblytowardspatients,families,colleagues,andallmembersofthehealth-careteamandempathizeandberespectfulofeachpatient
PerformanceEvalsProfessionalismPoints
WardsClinicsCaseDiscussionsFOSS
14 Adheretohighethicalandmoralstandards,acceptresponsibilityforpersonalactions,acceptconstructivecriticismandrespectpatientconfidentiality,placingpatientinterestsfirst,beingmindfulofpersonalopinionandbias.
PerformanceEvalsProfessionalismPointsWrite-Ups
WardsClinicsCaseDiscussionsFOSSWrite-Ups
CourseObjectives15 Takeresponsibilityforhisorherownmedicaleducation,anddevelopthehabitsof
mindfulnessandreflectionandmaintainingone'sownhealth (removethisasitisnotsomethingtheclerkshipisresponsiblefororevaluating)
PerformanceEvalProfessionalismPoints
WardsClinicsCaseDiscussions
16 Incorporateconstructivesuggestionsduringpeerreview. (mightbeconsidered in14aboveandcouldberemoved)
WriteUps WriteUps
16 Identifyandcriticallyevaluaterelevantinformationaboutevidence-based,cost-consciousstrategiesinthecareofpediatricpatientsandpopulationsandtoapplythistopediatricpatientcareandtocontinuousupdatingofskills.
PerformanceEvalsIn-DepthDiscussion
WardsClinicsCaseDiscussionsInDepthDiscussionHighValueHealthCareAssignment
17 Identifyandutilizeappropriateresourcestosupportpediatricpatientcareandcomparetherolesofandcollaboratewithallmembersofthepediatricinter-professionalteam.
PerformanceEvals WardsClinics
18 Discussthelargerenvironmentandthephysician'sroleinwhichhealthcareoccursincludingtheeffectonunderservedpopulationandregionalvariationsinthedeliveryofhealthcare.
PerformanceEvaluations
WardsClinicsHighValueHealthCareAssignment