your pediatric emergency medicine rotation: making the most of the educational opportunities
TRANSCRIPT
Your Pediatric Emergency Medicine Rotation:
Making the Most of the Educational Opportunities
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Welcome!
The Pediatric Emergency Center (PEC) & Pediatric Urgent Center (PUC or “Walk-In”) offers a unique opportunity to participate in the care of sick and injured children.
The spectrum of disease & variations in severity is unmatched in any other pediatric rotation.
You will be directly managing patient care under the supervision of a faculty member of the Division of Emergency Medicine in the Department of Pediatrics of Emory University School of Medicine.
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Opportunities to Learn
Pediatric Emergency Medicine covers a very diverse group of medical and surgical conditions. Your rotation will include both clinical and didactic opportunities to optimize your
exposure: Experience in evaluation & management of
patients under faculty supervision Supervised clinical procedures Board-type review questions to identify strengths
and weaknesses in your knowledge base On-line resources for clinical information Small group sessions (“Precepting Sessions”)
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This Orientation
General Expectations Learning Activities FAQs
NOTE: This orientation is an introductory overview. All learners must review the resources found on our
website under “Teaching Portal”: www.pediatrics.emory.edu/divisions/emergencymedicine
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Expectations
What to expect of the faculty (attendings and fellows)
What the faculty expects of you
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Expectations of Faculty
Faculty will: give you the opportunity to examine,
assess and present patients.
assess your patients and provide feedback on areas of agreement and disagreement.
explain their recommendations and decisions.
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Expectations of Faculty cont’d
Faculty will: teach and supervise procedures.
provide feedback to you on perceived strengths and weaknesses during the rotation.
provide end of rotation evaluation.
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Expectations of the Learners
Before you begin the rotation Learning Activities During the Rotation End of rotation
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Expectations of the learners:
Before you Begin
Log onto the Teaching Portal: www.pediatrics.emory.edu/divisions/emergencymedicine
• login/password to the Teaching Portal should be provided prior to the start of your rotation: [email protected] (404) 785-7142
Make sure your name activated on the site
Complete the On-Line Pretest • Found on Teaching Portal website
• Purposes: Identify weaknesses in knowledge base Measure improvement in knowledge base
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Expectations of the Learners
Before you begin
Learning Activities End of Rotation
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Self Directed Learning
The learner must take responsibility for
identifying and addressing learning needs.
Where do I feel unsure?
How can I become more competent in this area?
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Learning Activities: Requirements
Take Pretest
Complete Learning Modules
Complete Procedure Log
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PROCEDURE LOGS
Per ACGME requirements, residents MUST keep track of their procedures.
Emory Pediatrics:
Please enter your procedures on the ACGME web site within a week of completing the rotation. Jackie Riley will be printing out the completed list and forwarding it to us.
All other Residents:
Use the procedure log provided on our website. Fax the completed log to Donna Stringfellow (404-785-7989) within a week of completing the rotation.
A copy is available for download from our website.• http://www.pediatrics.emory.edu/divisions/emergencymedicine Education Teaching
Portal Procedure Log
FAILURE TO HAND IN YOUR PROCEDURE LOG WILL RESULT IN AN INCOMPLETE GRADE FOR THE ROTATION.
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Learning Activities: Requirements
Participate in Precepting Sessions Practice reading radiographs in radiology rounds Give 1 mini-lecture Participate in discussions/workshops Observed H&P Provide feedback on the sessions
Take Post-test no later than 1 week after your last shift
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Precepting Attending Sessions
When: (excluding holidays) 11am-2pm Hughes-Spalding: Monday, Wednesday, Friday Egleston: Tuesday, Thursday
Who: Residents & students scheduled that day Led by faculty member or fellow
Purpose: Provide interactive and structured education during PEM rotation
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Precepting Attending Sessions: Preparation
Prior to session day: Go to Teaching Portal to indicate any preferred
didactic topics for attending’s mini-lecture Sign up for day to give your “mini-lecture”
(Radiology Teaching File Notebook near x-ray viewing area)
Before the session starts: Wrap up clinical work Charge (or most senior) resident of the day
prepares list of ~3-5 imaging studies to review for Radiology Rounds (see Radiology Rounds notebook)
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Precepting Attending Sessions:Activities
Radiology Rounds: (Reading Room)
11:30-12:00 HS on Mon & Wed 1:30-2:00 EG on Tu & Th• Cases presented by charge/senior resident• Cases read by residents
Other Activities “Mini-lecture” by attending “Mini-lecture” by resident or student on elective Observed H&P (at least once during month) other activities: mock codes; procedure work
shops; rounds in ED, wards, lab
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Precepting Attending Sessions:Mini-Lecture
Sign up for a day you can give your mini-lecture ASAP (you do not need to specify the topic when you choose the date)
Choose a topic relevant to pediatric emergency medicine: ideally a topic which you need more information/understanding
Plan a 15-30 minute talk/discussion: just enough time for a very focused topic!
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Precepting Attending Sessions:Observed H&Ps
Our goal is to have at least 1 observed H&P for each resident during the rotation
Attending will provide verbal & written feedback
The written feedback form is evidence that you were observed during an H&P
The observed H&P can be performed during any shift during your rotation: it does not have to be during a Precepting Session
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Precepting Attending Sessions: FAQs
Am I expected to come to sessions when I’m not scheduled to work? No. But you are welcome to join us any time
Am I expected to give a mini-lecture again if I did none during a previous rotation? Yes. One mini lecture per rotation
Are all students/residents expected to give a mini-lecture? Only those rotating on Pediatric Emergency Medicine for 2
weeks or more
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Precepting Attending Sessions: FAQs
What if it’s busy in the department? 15-30 minutes before each session you should prepare by
wrapping up your work, limit taking on new responsibilities. If the department is unusually busy the precepting and shift attendings will discuss which residents should stay in the department and which can participate in the Precepting Session. Often residents will switch out to allow each other to participate in at least some of the Teaching Session.
What if I’d rather stay in the department? Up to you: whatever you feel is the best learning
opportunity
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Precepting Attending Sessions
After the session you should receive an e-mail with a link to give your feedback on the session. Please take this opportunity to share your comments and advice!
Other Questions/Comments:
Michael Greenwald, MD
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Resources
Texts, Journals, Articles PEM website:
www.pediatrics.emory.edu/divisions/emergencymedicine
• Resident Handbook• Clinical Guidelines• Learning Modules
Ask questions! Ask for feedback Question attendings on their decisions E-mail faculty with your questions
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Clinical Guidelines found on PEM website
Acute Gastroenteritis Asthma & bronchiolitis respiratory score Asthma Algorithm Asthma Guidelines Bronchiolitis Guidelines Burn Algorithm Burn Guidelines Chest X-Ray and Asthma Closed Head Injury < 2 years old : AAP Guidelines Closed Head Injury > 2 years old : AAP Guidelines Diabetic Ketoacidosis : Evaluation & Management
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Clinical Guidelines found on PEM website
Fever Guidelines part 1, 0-28 days Fever Guidelines part 2, 29-60 days Fever Guidelines part 3, 2-6 months Fever Guidelines part 4, 6-24 months Fever/Neutropenia Rev 7/2006 Hyperbilirubinemia : Emory Neonatology Rev 2001
Long Board Sexual Abuse Guideline Sickle Cell Disease and Acute Chest Syndrome Sickle Cell Disease and Fever : Inpatient Sickle Cell Disease and Fever : Outpatient Sickle Cell Disease and Pain : Outpatient Tumor Lysis Syndrome
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End of Rotation
Complete Post Test
Complete Learning Modules
Submit Procedure Log
Complete evaluations on faculty/rotation
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FAQs
Why do we rotate between the emergency department and urgent care?
Each side of the Emergency Department offers unique aspects of pediatric acute and urgent care
Faculty are assigned to these areas based on their expertise
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FAQs:
How should present a case?
Summarize the case briefly (should be able to do in 1 breath!)
Present Differential Diagnosis with rationale Most likely & Most serious conditions Not a laundry list
Present your Plan with rationale
NOTE: This is where the learning is at!
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FAQs
What should I say when presenting to the attending when I do not know what to make of my patient’s complaints?
Summarize the case for yourself Think of reasonable explanations for the
symptoms Research the condition before and after
presenting
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FAQs
What are the requirements to pass the rotation?
Complete Post Test Complete Learning Modules Complete and submit Procedure log Complete rotation evaluation Passing (Acceptable) summary attending
evaluation
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FAQs :Who evaluates me?
Feedback on students and residents may come from a number of sources including attendings, fellows, staff (e.g. nurses), parents of patients.
You can always solicit feedback from any of the above individuals: ask during or at the end of your shift!
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FAQs :Who evaluates me?
We try hard to address any concerns with examples and in a timely manner.
Final evaluation is a summary of feedback prepared by either the PEM program coordinator or your program director.
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FAQs
Who is my PEM program coordinator? Emory Pediatrics: Dr John Cheng Emory Emergency Medicine: Dr David Goo Morehouse Pediatrics: Dr Taryn Taylor Morehouse Family Practice: Dr Tiffany McKinnie Emory Transitional Residents: Dr Mike Ziegler Emory Psychiatry: Dr Debbie Young Emory Family Practice: Dr Debbie Young Emory School of Medicine (MS4): Dr Mike Ziegler Emory Nurse Practitioner Students: Dr Tracy Merrill Emory Physician Assistant Students: Dr Mike Ziegler
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FAQs
Can I take this rotation again as an elective?
YES!
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We hope you learn a lot
during your rotation in the
Pediatric Emergency Department!