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:Overall

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

FM MED OB PEDS PSYCH SURG GAM NEURO

13-14

14-15

15-16

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:PE

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

FM MED OB PED PSYCH SURG 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

MeasuresofQuality– StepIICK

*valuesdepictedareSDabovetheUS/CanmeanforGeiselmeanscores

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