PEDIATRIC INFECTIOUS DISEASES CONSULTATION SERVICE RESIDENT ELECTIVE
At the University of Illinois College of Medicine at Peoria
and the Children’s Hospital of Illinois
Revised 3/2011
ATTENDING PHYSICIANS: Barry M. Gray, MD, and Kanokporn Mongkolrattanothai, MD
The resident and attending physician(s) will have a face-to-face orientation meeting at the
beginning of the rotation to review learning objectives and an exit interview at the end.
EDUCATIONAL PURPOSE FOR THE ROTATION
Residents are strongly encouraged to rotate on the Pediatric Infectious Diseases Service to gain
experience in diagnosis and management of both common and unusual infections in children.
The resident will expect to see a wide variety of conditions on the inpatient service, including
nosocomial infections, fever of unknown origin, congenital infection, and problems of
immunocompromised patients. In the outpatient clinic the resident will participate in the care of
patients sent to us for evaluation of difficult diagnoses, such as unexplained fever and recurrent
infection. Every patient will be treated as an opportunity to apply an evidence-based approach
to infectious disease problems.
There is usually only one resident on the service each month, sometimes with the addition of a
Third or Fourth Year medical student. Expectations and responsibilities of the resident will be
geared to the current level of training and include the six ACGME general competencies.
PATIENT CARE
The resident will evaluate new and current patients, present their findings and assessments to
the attending and create appropriate documentation for patient encounters. The resident is
expected to:
 Demonstrate caring and respectful behaviors with patients, parents, and peers.
 Gather essential and accurate information for evaluation and care of patients.
 Prioritize both infectious and non-infectious patient problems and their interactions.
 Understand and weigh alternatives for diagnosis and treatment.
 Participate in the development of management plans and follow-up care.
 Review and evaluate literature pertinent to the patient’s problem.
 Provide accurate, appropriate information and counseling for patients and families.
 Pay due attention to measures to prevent healthcare-associated and future infections.
 Work with attending physicians, other consultants, social services, and other members of
the patient’s team to provide effective patient- and family-centered care.
MEDICAL KNOWLEDGE
 Use printed and electronic reference sources to learn about a patient’s clinical conditions,
including the Pediatric Red Book, infectious disease texts, online searches, certain
useful websites, and consultation with outside experts.
 Have or develop a filing system (paper and/or electronic) for storage of useful literature.
 Demonstrate an investigatory and analytic approach to infectious diseases and
assessment of the evidence base.
 Complete at least one “Answering Clinical Questions Resident Assignment Sheet”
 Review the pharmacology and use of antimicrobial agents.
 Understand the practical application of outpatient antimicrobial administration.
 Be familiar with the following specific problem areas:
 fever without focus, prolonged fever of unknown origin, and periodic fever syndromes
 perinatal and intrauterine infections, including evaluation of the HIV-exposed infant
 basic evaluation for immunodeficiency
 central nervous system infections, pneumonias, osteomyelitis, and endocarditis
 urinary tract infection, neurogenic bladder, and tracheostomy-dependent patients
 vascular catheter, CSF shunt, and other device-related infections
 infections due to resistant microbes, especially MRSA and certain Gram-negatives
 use of imaging, microbiology, serology, and other ancillary disciplines
 immunization and vaccine-preventable infections
 prevention of healthcare-associated infections
(See Selected Readings and Resources, below)
PRACTICE-BASED LEARNING AND IMPROVEMENT
 Recognize one’s own limitations and the limits of our collective knowledge of conditions
under our care.
 Show willingness to learn from mistakes and seek feedback on clinical performance.
 Find, evaluate, and assimilate evidence from scientific studies related to patient problems.
 Use knowledge of statistical methods and study design to assess clinical investigations.
 Develop strategies for life-long learning and become your own best teacher.
 Use your teaching skills to facilitate the learning of students and colleagues.
INTERPERSONAL AND COMMUNICATIONS SKILLS
 Write legible, pertinent, well organized reports and progress notes.
 Understand the responsibilities and limitations of your role as a consultant.
 Use effective listening, narrative, and non-verbal skills to elicit and provide information.
 Develop and sustain ethical, therapeutic relationships with patients and their families.
PROFESSIONALISM
 Understand the principles of professionalism:
 Establish trust with patients and staff by being honest, reliable, and cooperative.
 Observe ethical principles, patient confidentiality, and informed consent.
 Show regard for the skills and opinions of colleagues and all members of the health care
team.
 Demonstrate sensitivity to patient/family culture, gender, age, preferences, and disabilities.
SYSTEMS-BASED PRACTICE
 Be an advocate for your patients, especially in dealing with system complexity.
 Use checklists, practice guidelines, and systematic approaches to reduce errors.
 Understand the ecological and pharmacological factors involved in minimizing the spread
of multi-resistant organisms. Practice and preach careful antibiotic use.
 Write pertinent, clear, well organized reports and progress notes.
TEACHING METHODS
The learning experience is centered primarily on patients seen in the course of hospital and
outpatient consultations. This is supplemented by pertinent literature searches and readings
from various sources.
The resident will maintain a “Check of List of Pediatric Infections” that serves as a record of
his/her patients and discussions. Since many infections are seasonal, the list also serves to
identify conditions that deserve study but may not be seen during a given month. Mini seminars
and slide presentations will also cover selected topics in depth.
Consultation Rounds
The resident will be prepared to present patients to the attending(s) during consultation rounds
and other times as appropriate for patient care. These are a teaching rounds and may cover all
aspects of the clinical problems presented by our patients. In general, they also serve as times
for interaction, consultation, and discussion with other members of the patient’s healthcare
team.
Mini Seminars
The attendings conduct informal mini seminars with the resident and student if present. These
may be illustrated with a slide show and analysis of pertinent literature. They are intended to
foster open discussion, questioning, and a deeper understanding of clinical and scientific
principles.
Board Review Materials
The resident is expected to review the infectious disease sections in PREP and MedStudy,
available at the Pediatric Residency office.
 Complete the two sets of “Study and Board Questions” and discuss with attending. This is
“open book” and you may use any resources you wish.
Pediatric Infectious Disease Noon Conference and Morning Report
The resident is expected to prepare a patient case-based presentation for either the Pediatric
Infectious Disease Noon Conference (usually the 4th Tuesday of the month) or for Morning
Report. This will include an evidence-based analysis of pertinent diagnostic and therapeutic
features and discussion of basic science aspects of the disease and its pathogenesis. This
must be ready with enough time for review and coaching by the attendings.
Infection Prevention and Control
The resident is expected to attend rounds at least one time with the OSF Infection Control
practitioners. Please make arrangements with Lori Grooms, RN (655-2754). The resident is
also encouraged to attend the monthly OSF Hospital Infection Control Committee meeting.
Microbiology and Use of the Clinical Laboratory
The resident is expected to spend two mornings in the clinical microbiology laboratory to
become familiar with current practices of culture and identification of bacterial, viral, and fungal
agents. Part of this time will be spent in the serology section, where rapid antigen testing,
enzyme immunoassays (EIA), and fluorescent antibody techniques are used. PCR screening
for MRSA has also been added to the microbiology section. Please make arrangements with
Terri Endicott, OSF System Laboratory microbiology supervisor (624-9088).
Pediatric Research Laboratory
The resident will have the opportunity to visit our Pediatric Research Laboratory and about the
molecular biology tools used for studying Staphylococcus aureus and other organisms. This will
also serve as an introduction to molecular diagnostic procedures used increasingly in clinical
infectious disease.
Resources
The resident will be familiar with:
The pediatric Red Book (AAP)
Selected pediatric infectious disease textbooks, especially Long SS, Principles and Practice of
Pediatric Infectious Diseases, 3rd ed. (UIC online library through MDConsult/books)
PubMed and other online sources
The Infectious Diseases Society of America compendium of practice guidelines at
www.idsociety.org
Specialize websites include:
The Illinois Perinatal HIV Hotline www.hivpregnancyhotline.org,
AIDSINFO: www.aidsinfo.nih.gov
The Immune Deficiency Foundation www.primaryimmune.org
The CDC’s MMWR and Travel’s Health at www.cdc.gov
The Illinois Department of Health website www.idph.state.il.us .
Method of Evaluation
Attendings will evaluate performance in verbal and written tasks by direct observation and
discussion.