OBJECTIVES OF ORIENTATION Define the requirements and expectations of your 4 week core pediatric rotation Familiarize yourself with the Pediatrics website, the pediatrics curriculum, and the clinical teaching sites PURPOSE OF YOUR PEDIATRIC ROTATION The purpose of the Pediatric Clerkship is to provide 3rd year medical students outpatient pediatric and some inpatient and nursery (based on sites) clinical experiences where students will acquire a working knowledge of normal and abnormal growth and development recognize, understand the pathophysiology of, diagnose, and treat the common disorders of infancy, childhood, and adolescence develop an understanding of children’s and families’ perspectives of being cared for within our healthcare system through observation, inquiry, and reflection GET TO KNOW THIS WEBSITE HTTP://WWW.VCOM.EDU/PEDIATRICS/INDEX.HTML PEDIATRIC CURRICULUM COMPETENCY BASED CURRICULUM Six Domains (Communication, Problem Solving, Clinical Skills, OMM, Medical Knowledge, Professional and Ethical Behaviors) During the third year clinical rotation, students expand the knowledge they were taught in the first two years and gain the ability to apply that knowledge in the clinical setting. The third year clinical didactic pediatric curriculum is taught through: On-line case modules Online video lectures Supplemental suggested textbook reading in general pediatrics and Osteopathic manipulation PEDIATRIC CURRICULUM (SYLLABUS) PEDIATRIC CURRICULUM CLIPP Cases 11 out of the 32 Pediatric on-line interactive cases must be completed during the rotation. Mandatory cases include case 1,2,3,4,5 and 6 and then 5 additional elective cases of the student’s choice. It is highly recommended to complete all the cases. http://www.med-u.org/ VCOM Pediatrics Video Curriculum On VCOMTV website (OMS-III) On VCOM TV you have to change the site on upper right corner to OMS III Supplemental suggested textbooks: Nelson Essentials of Pediatrics, 6th edition American Osteopathic Association, and Anthony Chila. 3rd ed. Chapters 54 and 58: The Child with Ear Pain Kuchera, M. & Kuchera, W. Revised 2nd Edition. The Common Cold. P 23-30 Questions from the assigned OMM chapters will be included on your end of month exam for each core rotation HOW TO ACCESS CLIPP CASES Go to http://www.medu.org/virtual_patient _cases/clipp Click <Go to Cases> in the left frame At the login page, click the second button: <Registration> Enter your medical school email address The system will email you a login and password to use All 6 mandatory modules and 5 selective modules must have “Green Checks” Status - Review All Cards - Achieve “Good” Engagement - Session should be “Completed” VCOM TV VIDEOS Sign in as OMS-III Not OMS I-II Respiratory Complaints Newborn Conditions and Pearls (VCOM tv# 465) Newborn Exam (VCOM tv# 1176) Fever and Serious Bacterial Infection Abdominal Complaints Childhood Development (VCOM tv# 517) Pediatric Rashes Pediatric Extremity Injuries RECOMMENDED READING Required textbooks for OMSIII Great Pediatric Texts -can be referenced in the VCOM Library online SOME OTHER RESOURCES AVAILABLE AT VCOM LIBRARY Garfunkel: Pediatric Clinical Advisor, 2nd ed. - 2007 - Mosby, An Imprint of Elsevier Johns Hopkins: The Harriet Lane Handbook, 19th ed. - 2011 - Mosby, An Imprint of Elsevier * Kliegman: Nelson Textbook of Pediatrics, 19th ed. - 2011 - Saunders, An Imprint of Elsevier Paller: Hurwitz Clinical Pediatric Dermatology, 4th ed. - 2011 - Saunders, An Imprint of Elsevier New Edition Park: Park's Pediatric Cardiology for Practitioners, 6th ed. - 2014 - Mosby, An Imprint of Elsevier Piña-Garza: Fenichel's Clinical Pediatric Neurology, 7th ed. - 2013 - Saunders, An Imprint of Elsevier Polin: Pediatric Secrets, 5th ed. - 2010 - Mosby, An Imprint of Elsevier Selbst: Pediatric Emergency Medicine Secrets, 2nd ed. - 2008 - Mosby, An Imprint of Elsevier New Edition Sperling: Pediatric Endocrinology, 4th ed. - 2014 - Saunders, An Imprint of Elsevier Staheli: Pediatric Orthopaedic Secrets, 3rd ed. - 2007 - Mosby, An Imprint of Elsevier Wilmott: Kendig & Chernick's Disorders of the Respiratory Tract in Children, 8th ed. - 2012 - Saunders, An Imprint of Elsevier Wolraich: Developmental-Behavioral Pediatrics, 1st ed. - 2007 - Mosby, An Imprint of Elsevier Zitelli: Zitelli and Davis' Atlas of Pediatric Physical Diagnosis, 6th ed. - 2012 - Saunders, An Imprint of Elsevier WHAT’S REQUIRED TO SUCCESSFULLY COMPLETE THE PEDIATRIC ROTATION Patient log: It is your responsibility to keep track and records your experiences and enter them online. OMM Log: to be completed and entered online!! End of rotation Site Evaluation “VCOM Portal” Clinical Performance Evaluation Form from your preceptor >>>to be completed and entered online by the preceptor!! Review at Least 11 CLIPP cases: - Case 1 is Mandatory if it was not done in 2nd year ECE - Cases 2,3,4,5&6 are Mandatory - Additional FIVE cases, are Selective - The rest of cases are Recommended Pass the end of rotation exam CASE LOG CASE LOG To be completed online Found on the Pediatrics discipline website. Instructions for completion included in online document PEDIATRIC END OF ROTATION EXAM The Pediatrics end of rotation exam is based on content from: CLIPP cases Referenced VCOM TV videos Suggested reading references in rotation objectives American Osteopathic Association, and Anthony Chila. 3rd ed. Chapters 54 and 58: The Child with Ear Pain Kuchera, M. & Kuchera, W. Revised 2nd Edition. The Common Cold 110 question exam on the last Friday of rotation 100 general pediatric questions 10 OMM questions Exam questions are monitored for validity and no question challenges will be accepted. HOW I AM EVALUATED?? PERFORMANCE Evaluation: Preceptor evaluation VCOM uses a competency based evaluation form which includes the osteopathic core competencies. These competencies evaluated include: Medical knowledge Communication Physical exam skills Problem solving and clinical decision making Professionalism and ethics Osteopathic specific competencies Additional VCOM values OBJECTIVE Evaluation: End of rotation exam THE WEEKEND BEFORE…. Watch the Newborn Exams video on VCOM. TV Review Developmental Milestones – make a cheat sheet to take with you Resources http://brightfutures.aap.org/index.html http://www.healthyfuturesva.com/discovery.html http://www.healthychildren.org http://www.cdc.gov/ncbddd/actearly/milestones/index.html Review components of Health Maintenance exams Well-child care accounts for 25% of visits to primary care practitioners for children younger than 15 and 40% for children younger than 1 year. These visits constitute a large percentage of pediatricians’ time, with the average time for preventive care visits ranging from 16 to 19 minutes 1 http://www.comsep.org/home/index.cfm TIPS FOR PERFORMING WELL CLINICALLY DO: Make life easier for your team/preceptor – be helpful Show enthusiasm Make yourself available Demonstrate your knowledge Ask for and respond to feedback Read on at least one topic seen in clinic nightly Take ownership of your patient DON’T: Disappear Say negative things about other physicians Pretend you know an answer when you don’t Study so much that patient care suffers Stay on your computer or phone A WORD ABOUT PRECEPTORS Your preceptors are appointed clinical faculty in the department of pediatrics Preceptors are busy physicians, community leaders, partners, spouses, parents, etc, in other words…HUMAN You are important to them, but not always the first thing on their list Mutually respect and learn from your differences and similarities You will have one lead preceptor, but expect to interact with everyone in the practice or community Meet the preceptors: http://www.vcom.edu/pediatrics/faculty.html INDIVIDUAL SITE INSTRUCTIONS FOR STUDENTS: Please access the student portal for individual instructions at your rotation sites. Most sites will ask you to be at the office M-F from 8am-5pm. Hours and expectations vary between different sites and even between individual physicians. If your physician is working on the weekend or after office hours and asks you to participate, this is expected and can be an important part of the learning process. It is YOUR responsibility to contact your site preceptor or coordinator prior to the first day of your rotation to ask about time and location of your first day. INDIVIDUAL SITE INSTRUCTIONS You should inform your preceptor on the first day if there will be any absences during your rotation (such as VCOM required functions) Ask your preceptor for feedback…they will be evaluating your performance at the middle and the end of the month. Mid-rotation do not count toward your grade, but are useful in correcting problems before they do reflect on your final evaluation PROFESSIONALISM DRESS FOR SUCCESS WHAT NOT TO WEAR WHAT TO BRING!!!! Bring your white coat…although you may not be required to wear it (most pediatricians do not wear one b/c they can by scary to the children) Ask your preceptor about his/her preference. Stethoscope Otoscope and Ophthalmoscope for some sites Reading material (in case you have downtime) You might need a packed lunch (depends on location) Leave your PDA’s, cell phones, computers in your bag and avoid using them during patient care time Patient case log And most importantly… patience and a smile!!!! USEFUL/FUN WEBSITES www.aap.org http://newborns.stanford.edu/PhotoGallery/ http://library.med.utah.edu/pedineurologicexam/h tml/home_exam.html http://www.healthyfuturesva.com/discovery.html http://www.med.umich.edu/pediatrics/ebm/ http://www.cdc.gov/vaccines/