University of Florida College of Medicine – Jacksonville
Pediatric Residency Program
Continuity Clinic Information
2014-2015
Resident Responsibilities
1.
Please be on time. You are excused from all other responsibilities
during your continuity time. You are expected to remain in your
clinic as long as there are patients to be seen.
2.
Please notify your preceptors of any dates that you will not be in
their clinic including vacation dates, post-call dates, and night
shift/ night float months. Please give them as much advance notice
as possible. This is your responsibility.
3.
The Residency Review Committee (RRC) suggests that:
PL-1 see a minimum of 3 patients per session
PL-2 see a minimum of 4 patients per session
PL-3 see a minimum of 5 patients per session
4.
Complete the Hopkins Module assigned for that specific month.
You should go over this topic with your preceptor.
5.
Be a true coordinator of care for your patients. Remember to
follow-up on labs and referrals.
6.
Keep a log of the number of patients seen per day on New
Innovations in the Log Books section (see directions in the manual).
7.
Provide your preceptor and the training program with feedback in
order to improve your continuity experience. Evaluations are
completed twice a year through New Innovations. The process of
evaluation and feedback should be continual and bidirectional,
though you and your preceptor will have formal feedback sessions
at the mid-point and at the end of the academic year.
8.
Enjoy the patients and your clinic experience!
Continuity Clinic Assignments
Intern Class
2014 – 2015
Intern
Ryan Baker
Jane Benson
Lindsay Cadorette
Chris Dudek
Sara Largen
Sheena Gupta
Amr Matoq
John Sarandria
Doug Shapiro
Ankita Taneja
Location
Oceanside Pediatrics
1370 S. 13th Ave.
Jacksonville Beach, FL
Center for Women and Children (CWC)
515 W. 6th Street, MC-51
Jacksonville, FL 32206
UF Pediatric Center
6271 St. Augustine Rd.
Jacksonville, FL 32216
Carithers Pediatrics
2121 Park Street
Jacksonville, FL 32204
UF Anchor Plaza Family Medicine and Pediatric Ctr
5460 Blanding Boulevard
Jacksonville, FL
South Jax Family Health Center (DCHD)
6271 St. Augustine Rd.
Jacksonville, FL 32217
Beaches Clinic (DCHD)
1522 Penman Rd.
Jacksonville Beach, FL 32250
Naval Hospital Pediatric Clinic
2080 Child Street
Jacksonville, FL 322104
UF Complex Care Clinic
Aetna Bld Suite 1900
841 Prudential Drive
Center for Women and Children (CWC)
515 W. 6th Street, MC-51
Jacksonville, FL 32206
Preceptor
Day
Dr. Barbara O’Reilly
Thursday PM
Tuesday AM
Dr. Elisa Zenni
Tuesday PM
Thursday PM
Dr. Carmelo Cedres
Monday PM
Thursday AM
Dr. Thomas Connolly
Wednesday PM
Tuesday AM
Dr. Leslie Ravago
Thursday PM
Tuesday AM
Dr. Sylkia Martinez
Tuesday PM
Thursday AM
Dr. Laura Beverly
Dr. Patty Solo-Josephson
Thursday PM
Monday AM
Dr. Carol Budzik
Thursday PM
Tuesday AM
Dr. Kelly Komatz
Wednesday
PM
Mon AM
Monday PM
Thursday AM
Dr. Shelly Thompson
Continuity Clinic Assignments
Intern Class
2014 – 2015
Laura Travers
Jessica Win
Mandarin Pediatric Associates
10337 San Jose Blvd.
Jacksonville, FL
Baptist Pediatrics
3945 San Jose Park Dr.
Jacksonville, FL
Dr. Gary Soud
Thursday PM
Tuesday AM
Dr. Bethany Atkins
Tuesday PM
Thursday PM
Continuity Care Clinic (CCC) Preceptors Contact Information 2014-2015
Center for Women and Children (CWC)  Zenni, Auerbach, Thompson
515 W. 6th Street, MC-51
Jacksonville, FL 32206
(904)253-1080 Clinic, 253-1953 Fax
253-1067 Conference Room
253-2703 Linda Rucci, Pediatric Nurse
Dr. Elisa Zenni
Elisa.Zenni@jax.ufl.edu
Dr. Jennifer Auerbach
Jennifer.Auerbach@jax.ufl.edu
Dr. Shelly Thompson
shelly.thompson@ufl.jax.edu
Beaches Clinic (DCHD)
1522 Penman Rd.
Jacksonville Beach, FL 32250
Dr. Patty Solo-Josephson
Dr. Rachel Schare
Dr. Laura Beverly
South Jax Family Health Center (DCHD)
1736 University Blvd., South
Jacksonville, FL 32216
Dr. Sylkia Martinez
Dr. Zenaida Lavina
Agape Clinic- West Jacksonville (DCHD)
120 King Street
Jacksonville, FL 32204
Dr. Akilah Pope
(Also at Wesconnett Clinic)
(904)253-2555; Fax 253-2559
Patricia_Solo-Josephson@doh.state.fl.us
Rachel_Schare@doh.state.fl.us
Laura_Beverly@doh.state.fl.us
(904)253-1100; Fax 727-6548
Sylkia_Martinez@doh.state.fl.us
(904)253-2785
Akilah_Pope@doh.state.fl.us
Wesconnett Family Health Center (DCHD)
5150-9 Timuquana Rd.
Jacksonville, FL 32210
(904)253-1120; Fax 253-2514
Dr. Maribel Monsalve
Maribel_Monsalve@doh.state.fl.us
University of Florida Pediatric Center
6271 St. Augustine Rd.
Jacksonville, FL 32217
Dr. Carmelo Cedres
Dr. Pamela Lindor
(904)633-0460
carmelo.cedres@jax.ufl.edu
Pamela.lindor@jax.ufl.edu
Mosolf Pediatrics
2344 S. 3rd Street
Jacksonville Beach, FL 32250
www.mosolfpediatrics.com
Dr. Gregory Mosolf
(904)249-3858
mosolf@comcast.net
Oceanside Pediatrics
1370 S. 13th Ave.
Jacksonville Beach, FL
Dr. Barbara O’Reilly
(904)246-0644
oceansidepeds@aol.com
Baptist Pediatrics
3945 San Jose Park Dr.
Dr. Bethany Atkins
Dr. Kenneth Horn
(904)731-3530; Fax 737-1548
bethanyap@comcast.net (Main Contact)
docdodger55@aol.com
Mandarin Pediatric Associates
10337 San Jose Blvd.
Jacksonville, FL
Dr. Gary Soud
Dr. Kevin Kasych
(904)268-7701
ggsoudmd@aol.com
Kevin.Kasych@bmcjax.com
Jacksonville Pediatric Associates
8774 Perimeter Park Blvd.
Jacksonville, Fl
Dr. Enrique Silva
(904)642-6100; Fax 642-5154
esilva@bellsouth.net
UF Anchor Plaza Family Medicine and Pediatrics Center
5460 Blanding Boulevard
Jacksonville, FL
(904)633-0633
Dr. Leslie Ravago
leslie.ravago@jax.ufl.edu
Jacksonville Pediatrics
2606 Park Street
Jacksonville, FL
Dr. Randy Thornton
Dr. Jenny Chally
(904)388-4646
Thornnut@bellsouth.net
jachally@comcast.net
Carithers Pediatrics
2121 Park Street
Jacksonville, FL 32204
(904)387-6200
10475 Centurion Parkway North #301
(904)997-0023
Jacksonville, FL 32256
Dr. Robert Colyer
RColyer@carithersgroup.com
Dr. Thomas Connolly
TConnolly@carithersgroup.com
Children’s Medical Group
9776 San Jose Blvd Suite 1
Jacksonville, FL 32257
Dr. Dale Zimmerman
(Currently with no resident)
Orange Park Pediatrics
2140 Smith Street
Orange Park, FL 32073
Dr. Rhonda Woolwine
(Currently with no resident)
UF Pediatric Center at Baymeadows
8274 Bayberry Road
Jacksonville, FL
Dr. Carlos Arango
zimm2942@bellsouth.net
dmtedmd@bellsouth.net
(904)633-0800
carlos.arango@jax.ufl.edu
Naval Hospital Pediatric Clinic
2080 Child Street, Naval Air Station
Jacksonville, FL 32214
(904)542-7435 Kathy Mentzel, secretary
Dr. Julie Kellogg
Julie.Kellogg@med.navy.mil
Dr. Carol Budzik
Carol.Budzik@med.navy.mil
Family Care Partners
6484 Fort Caroline Rd
Jacksonville, FL 32277
Dr. Rachel Egbujor
(904) 744-7300 x 3116 (office)
(518) 527-4941
regbujor@familycarepartners.com
UF Complex Care Clinic
Aetna Building Suite 1900
841 Prudential Drive
Jacksonville, FL 32207
Dr. Kelly Komatz
(904)202-8920
Kelly.komatz@jax.ufl.edu
Rotation Guide To Continuity Clinic
FIRST YEAR RESIDENTS
*It is mandatory to go to Continuity Clinic on each rotation with
the exception of working nights in the NBN Nursery.
PEDS ED: One half day per week; Can be Morning or Afternoon clinic based
on the ED schedule; Total of 4 clinic sessions this month
COMMUNITY: Two half days per week; Go to both morning and afternoon
clinics; Total of 6 sessions this month
ACUTE CARE CLINIC: Two half days per week; Go to both morning and
afternoon clinics; Total of 6 sessions this month
NICU: One half day per week; Afternoon clinics; Total of 4 sessions this month
NBN: When on days, go one half day per week in the afternoon; Total of 2
sessions this month
WARDS: One half day per week; Total of 4 sessions this month
ELECTIVE: Two half days per week; Go to both morning and afternoon
clinics; Total of 6 sessions this month
New Innovations Instructions
Continuity Clinic Numbers
You must track the number of patients you see per session.
*PL-1 residents must see at least 3 patients per session; PL-2 residents, 4
patients per session; and PL-3 residents, 5 patients per session.
**Note: you will track these numbers in the LOG BOOKS module, NOT in the
Continuity Clinic module of New Innovations.
Monthly tracking
Keep track of the number of patients you see each day you are in the clinic. No other
information about the patient is needed – just how many you saw. Log in New
Innovations under “Log Books” – Add entry for Cont. Clinic Numbers:
In the Add Entry screen, your name and work role will appear. Add the date you were in
clinic and the number of patients you saw that day. If you did not go to clinic, do not
put in the date. If you attended clinic but had no patients, put date and 0 patients.
New Innovations RMS Evaluations
UNIVERSITY OF FLORIDA JACKSONVILLE
DEPARTMENT OF PEDIATRICS RESIDENT
BY FACULTY
CONTINUITY CLINIC
[Subject Name]
[Subject Status]
[Subject Program]
[Subject Rotation]
[Evaluation Dates]
Evaluator
[Evaluator Name]
[Evaluator Status]
[Evaluator Program]
Evaluation of the resident encompasses the six ACGME competencies: Patient Care, Medical Knowledge,
Practice-Based Learning and Improvement, Interpersonal and Communication Skills, Professionalism and
Systems-Based Practice. This evaluation also encompasses the milestones for each of these competencies and
will be used by the CCC to determine resident progression and promotion.
PLEASE NOTE NEW GRADING SCALE
1 = NOVICE: Minimal knowledge and/or skill
2 = ADVANCED BEGINNER: Developing knowledge and/or skill
3 = COMPETENT: Must be at this level at COMPLETION of residency training
4 = PROFICIENT: EXCEEDS expected expectations of a trainee, performs at a junior faculty level
5 = EXPERT: Has reached MASTERY of this knowledge/skill, performs at an advanced faculty level
Further detail regarding the grading of milestones is available at: Milestone Grading Definitions
PATIENT CARE
Gathers essential and accurate information about the patient
1
1
2
3
4
5
N/A
Organizes and prioritizes responsibilities to provide patient care that is safe, effective and efficient
2
1
2
3
4
5
N/A
5
N/A
Provides transfer of care that ensures seamless transitions
3
1
2
3
4
Makes informed diagnostic and therapeutic decisions that result in optimal clinical judgment
4
1
2
3
4
5
N/A
4
5
N/A
Develops and carries out management plans
5
1
2
3
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New Innovations RMS Evaluations
1
Performs age appropriate developmental surveillance, developmental screening, school performance
monitoring and job performance monitoring
2
3
4
5
N/A
1
Performs physical exam and age-appropriate screening procedures with special focus on agedependent concerns and patient or family concerns
2
3
4
5
N/A
6
7
Provides longitudinal care for a variety of healthy and chronically-ill children of all ages
8
1
9
1
2
3
4
5
N/A
Uses appropriately or is familiar with the following treatments and techniques in the Continuity clinic
- Universal precautions; Hand washing between patients; Isolation techniques; Administration of
nebulized medication; Injury, wound and burn care; Intramuscular, subcutaneous and intradermal
injections
2
3
4
5
N/A
MEDICAL KNOWLEDGE
Locates, appraises, and assimilates evidence from scientific studies related to their patients' health
10
1
2
3
4
5
N/A
1
Performs health promotion (well child care) visits at recommended age based on nationally
recognized periodicity schedules
2
3
4
5
N/A
1
Provides age-appropriate anticipatory guidance to parent(s) or caregiver(s), and child or adolescent,
according to recommended guidelines
2
3
4
5
N/A
11
12
PRACTICE-BASED LEARNING AND IMPROVEMENT
Identifies strengths, deficiencies, and limits in one's knowledge and expertise
13
1
2
3
4
5
N/A
1
Identifies and performs appropriate learning activities to guide personal and professional
development
2
3
4
5
N/A
1
Systematically analyzes practice using quality improvement methods, and implements changes with
the goal of practice improvement
2
3
4
5
N/A
14
15
Incorporates formative evaluation feedback into daily practice
16
1
2
3
4
5
N/A
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New Innovations RMS Evaluations
INTERPERSONAL AND COMMUNICATION SKILLS
1
Communicates effectively with patients, families and the public, as appropriate, across a broad range
of socioeconomic and cultural backgrounds
2
3
4
5
N/A
1
Demonstrates the insight and understanding into emotion and human response to emotion that
allows one to appropriately develop and manage human interactions
2
3
4
5
N/A
17
18
PROFESSIONALISM
19
1
Exhibits humanism, compassion, integrity and respect for others; based on the characteristics of an
empathetic practitioner
2
3
4
5
N/A
Has a sense of duty and accountability to patients, society and the profession
20
1
2
3
4
5
N/A
1
Exhibits high standards of ethical behavior which includes maintaining appropriate professional
boundaries
2
3
4
5
N/A
1
Shows self-awareness of one's own knowledge, skill and emotional limitations that leads to
appropriate help-seeking behaviors
2
3
4
5
N/A
1
Exhibits trustworthiness that makes colleagues feel secure when one is responsible for the care of
patients
2
3
4
5
N/A
1
Has the capacity to accept that ambiguity is part of clinical medicine and recognizes the need for and
utilizes appropriate resources in dealing with uncertainty.
2
3
4
5
N/A
21
22
23
24
SYSTEMS-BASED PRACTICE
Coordinates patient care within the health care system relevant to his/her clinical specialty
25
1
2
3
4
5
N/A
Advocates for quality patient care and optimal patient care systems
26
1
2
3
4
5
N/A
Works in inter-professional teams to enhance patient safety and improve patient care quality
27
1
2
3
4
5
N/A
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New Innovations RMS Evaluations
GENERAL
28
Strengths
Remaining Characters: 5,000
29
Areas to Improve
Remaining Characters: 5,000
Return to Questionnaire List
New Innovations, Inc. ©1995-2013
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GOAL 1: HEALTH PROMOTION and SCREENING.
Provide comprehensive health care promotion,
screening and disease prevention services to
infants, children, adolescents and their families
in the ambulatory setting.
1.1: Perform health promotion (well child
care) visits at recommended ages based
on nationally recognized periodicity
schedules (e.g. AAP Health Supervision
Guidelines, Bright Futures, GAPS).
1.2: Perform a family centered health
supervision interview
3
4
5
X
X
X
3
4
5
X
X
X
3
4
5
X
X
X
Systems-based
practice
Professionalism
Practice-based
Learning & Imp
Interpersonal &
Comm. Skills
Medical Knowledge
Patient Care
PL - 3
PL - 2
COMPETENCIES
PL - 1
ROTATION: CONTINUITY CLINIC
X
a) Define family and identify
significant family members and
other significant caretakers and
what role they play in the child’s
life
b) Identify patient and family
concerns
c) Discuss health goals for the visit
with the patient and family
d) Prioritize agenda for the visit
with the patient and family
e) Elicit age appropriate
information regarding health,
nutrition, activities, and health
risks
1.3: Perform age appropriate
developmental surveillance,
developmental screening, school
performance monitoring and job
performance monitoring
X
a) Identify risks to optimal
developmental progress (e.g.,
prematurity, SES, family/genetic
conditions, etc.)
b) Identify patient and parental
concerns regarding development,
school, and/or work.
c) Perform standardized, validated,
accurate developmental screening
1=Minimal knowledge about this problem/task
2=Developing approach to dx/management/task
3=Able to handle routine patients/tasks
4=Able to handle most patients/tasks, including mod-high acuity and/or complexity
5=Able to handle almost any patient/task, regardless of acuity or complexity
7/18/2011
Systems-based
practice
Professionalism
Practice-based
Learning & Imp
Interpersonal &
Comm. Skills
Medical Knowledge
Patient Care
PL - 3
PL - 2
COMPETENCIES
PL - 1
ROTATION: CONTINUITY CLINIC
tests for infants and children until
school age
1.4: Critically observe interactions
between the parent and the infant, child,
or adolescent
1.5: Perform physical exam with special
focus on age-dependent concerns and
patient or family concerns.
1.6: Order or perform and interpret
additional age-appropriate screening
procedures, using nationally recognized
periodicity schedules and local or state
expectations.
1.7: Order or perform appropriate
additional screening procedures based
on patient and family concerns.
1.8: Perform age appropriate
immunizations using nationally
recognized periodicity schedules
3
4
5
X
3
4
5
X
X
X
3
4
5
X
X
X
3
4
5
X
X
X
3
4
5
X
X
1=Minimal knowledge about this problem/task
2=Developing approach to dx/management/task
3=Able to handle routine patients/tasks
4=Able to handle most patients/tasks, including mod-high acuity and/or complexity
5=Able to handle almost any patient/task, regardless of acuity or complexity
X
X
X
7/18/2011
1.9: Provide age-appropriate anticipatory
guidance to parent(s) or caregiver(s),
and child or adolescent, according to
recommended guidelines (e.g., AAP TIPP
program, Bright Futures, GAPS), on
topics including:
3
4
5
3
4
5
X
X
X
X
X
Systems-based
practice
Professionalism
Practice-based
Learning & Imp
Interpersonal &
Comm. Skills
Medical Knowledge
Patient Care
PL - 3
PL - 2
COMPETENCIES
PL - 1
ROTATION: CONTINUITY CLINIC
X
a) Promotion of healthy habits (e.g.
physical activity, reading, etc.)
b) Injury and illness prevention
c) Nutrition
d) Oral Health
e) Age appropriate medical care
f) Promotion of social competence
g) Promotion of positive
interactions between the parent
and infant/child/adolescent
h) Promotion of constructive family
communication, relationships
and parental health
i) Promotion of community
interactions
j) Promotion of responsibility
(adolescence)
k) Promotion of school
achievement (middle childhood,
adolescence)
l) Sexuality (infancy, early and
middle childhood, adolescence
m) Prevention of substance
use/abuse (middle childhood,
adolescence)
n) Physical activity and sports
o) Interpretation of screening
procedures
p) Prevention of violence
1.10. Work collaboratively with
professionals in the medical, mentalhealth, educational and community
system to optimize preventive health
services for children.
1=Minimal knowledge about this problem/task
2=Developing approach to dx/management/task
3=Able to handle routine patients/tasks
4=Able to handle most patients/tasks, including mod-high acuity and/or complexity
5=Able to handle almost any patient/task, regardless of acuity or complexity
X
X
7/18/2011
GOAL 2: COMMON SIGNS and SYMPTOMS
(Ambulatory setting). Evaluate and
manage common signs and symptoms
associated with the practice of pediatrics
in the Ambulatory setting.
2.1: Evaluate and manage the following
signs and symptoms that present in the
context of health care promotion:
3
4
5
X
X
X
Systems-based
practice
Professionalism
Practice-based
Learning & Imp
Interpersonal &
Comm. Skills
Medical Knowledge
Patient Care
PL - 3
PL - 2
COMPETENCIES
PL - 1
ROTATION: CONTINUITY CLINIC
X
a) Infancy: malpositioning of feet, hip
clicks, skin rashes, birthmarks,
jitteriness, hiccups, sneezes,
wheezing, heart murmur, vaginal
bleeding and/or discharge, foul
smelling umbilical cord
with/without discharge;
undescended testicle, breast tissue,
breast drainage, malpositioning of
feet, malrotation of lower
extremities, developmental delays,
sleep disturbances, difficulty
feeding, dysconjugate gaze, failure
to thrive, frequent infections,
abnormal head shape or size,
evidence of abuse or neglect,
abdominal masses, abnormal
muscle tone
b) General: constitutional symptoms,
excessive crying, failure to thrive,
fatigue, fever, weight loss or gain,
dental caries, excessive thumbsucking or pacifier use, sleep
disturbances, difficult behaviors,
variations in appetite, variations in
toilet training, overactivity, somatic
complaints, poor school
performance, attention problems,
fatigue, masturbation, anxiety,
violence.
c) Cardiorespiratory: chest pain, cough
cyanosis, dyspnea, heart murmur,
hemoptysis, hypertension,
inadequate respiratory effort,
rhythm disturbance, shortness of
breath, stridor, syncope,
1=Minimal knowledge about this problem/task
2=Developing approach to dx/management/task
3=Able to handle routine patients/tasks
4=Able to handle most patients/tasks, including mod-high acuity and/or complexity
5=Able to handle almost any patient/task, regardless of acuity or complexity
7/18/2011
Systems-based
practice
Professionalism
Practice-based
Learning & Imp
Interpersonal &
Comm. Skills
Medical Knowledge
Patient Care
PL - 3
PL - 2
COMPETENCIES
PL - 1
ROTATION: CONTINUITY CLINIC
tachypnea, wheezing.
d) Dermatologic: Congenital nevus
and other birth marks, ecchymoses,
edema, paleness, petechiae,
pigmentary changes, purpura,
rashes, urticaria, vascular lesions,
foul smelling umbilical cord.
e) EENT: Acute visual changes;
dysconjugate gaze; conjunctival
injection; ear or eye discharge; ear,
throat, eye pain, edema, epistaxis;
nasal foreign body; hoarseness;
stridor.
f) Endocrine: growth disturbance,
short stature, heat or cold
intolerance, normal and abnormal
timing of pubertal changes,
polydipsia, polyuria.
g) GI/Nutrition/Fluids: Abdominal
pain, mass or distention; ascites;
constipation; dehydration;
diarrhea; dysphagia; encopresis;
hematemesis; inadequate intake of
calories or fluid; jaundice; melena;
rectal bleeding; regurgitation;
vomiting.
h) Genitourinary/Renal: Change in
urine color, dysuria, edema,
enuresis, frequency, hematuria,
oliguria, pain referable to the
urinary tract, scrotal mass, pain or
edema, trauma to urinary tract or
external genitalia, undescended
testicle, enuresis.
i) GYN: Asymmetry of breast
development, abnormal vaginal
bleeding, pelvic or genital pain,
vaginal discharge or odor; vulvar
trauma or erythema, delayed onset
of menses, missed or irregular
periods.
j) Hematologic/Oncologic: Abnormal
bleeding, bruising,
hepatosplenomegaly,
lymphadenopathy, masses, pallor.
1=Minimal knowledge about this problem/task
2=Developing approach to dx/management/task
3=Able to handle routine patients/tasks
4=Able to handle most patients/tasks, including mod-high acuity and/or complexity
5=Able to handle almost any patient/task, regardless of acuity or complexity
7/18/2011
Systems-based
practice
Professionalism
Practice-based
Learning & Imp
Interpersonal &
Comm. Skills
Medical Knowledge
Patient Care
PL - 3
PL - 2
COMPETENCIES
PL - 1
ROTATION: CONTINUITY CLINIC
k) Musculoskeletal: Malpositioning of
feet, malpositioning of legs, hip
clicks, abnormal gait, abnormal
spine curvature, arthritis or
arthralgia, bone and soft tissue
trauma, limb or joint pain, limp,
variations in alignment (e.g.,
intoeing).
l) Neurologic: Delays in
developmental milestones, ataxia,
diplopia, headache, head trauma,
hearing concerns, gait disturbance,
hypotonia, lethargy, seizure,
tremor, vertigo, visual disturbance,
weakness.
m) Psychiatric/Psychosocial: Acute
psychosis, anxiety, behavioral
concerns; conversion symptoms,
depression, hyperactivity,
suspected child abuse or neglect.
GOAL 3: COMMON CONDITIONS
(Ambulatory setting). Recognize and
manage common childhood conditions
presenting to the Ambulatory setting.
3.1: Evaluate and manage the common
conditions and situations presenting in
the context of health promotion visits
3
4
5
X
X
X
X
a) Infancy: Breast feeding, bottle
feeding, colic, congenital hip
dislocation, constipation,
strabismus, colic, parent-infant
interactional issues, sleep
problems, child care decisions,
separation protest, stranger
anxiety, failure to thrive, recurrent
respiratory and ear infections,
positional foot deformities, rashes,
teething, injury prevention and
safety
b) General: Colic, failure to thrive,
fever, overweight, iron deficiency,
lead exposure, strabismus, hearing
problems, child care decisions,
1=Minimal knowledge about this problem/task
2=Developing approach to dx/management/task
3=Able to handle routine patients/tasks
4=Able to handle most patients/tasks, including mod-high acuity and/or complexity
5=Able to handle almost any patient/task, regardless of acuity or complexity
7/18/2011
c)
d)
e)
f)
g)
h)
Systems-based
practice
Professionalism
Practice-based
Learning & Imp
Interpersonal &
Comm. Skills
Medical Knowledge
Patient Care
PL - 3
PL - 2
COMPETENCIES
PL - 1
ROTATION: CONTINUITY CLINIC
well-child and well adolescent care
(including anticipatory guidance),
parental issues (financial stress,
divorce, depression, tobacco,
alcohol or substance abuse,
domestic violence, inadequate
support networks)
Allergy/Immunology: Allergic
rhinitis, angioedema, asthma, food
allergies, recurrent infections,
serum sickness, urticaria.
Cardiovascular: congenital heart
disease (outpatient management of
minor illnesses), congestive heart
failure, heart murmurs, Kawasaki
disease, palpitations, rheumatic
fever.
Dermatology: abscess, acne, atopic
dermatitis, cellulitis and superficial
skin infections, impetigo,
molluscum, tinea infections, viral
exanthems, verruca vulgaris, other
common rashes of childhood and
adolescence.
Endocrine/Metabolic: Diabetes
mellitus, diabetes insipidis,
evaluation for possible
hypothyroidism, growth failure or
delay, gynecomastia,
hyperthyroidism, precocious or
delayed puberty.
GI/Nutritional: Appendicitis,
bleeding in stool, constipation,
encopresis, foreign body ingestion,
gastroenteritis, gastroesophageal
reflux, hepatitis, inflammatory
bowel disease, nutritional issues,
pancreatitis.
GU/Renal: Electrolyte and acidbase disturbances (mild), enuresis,
glomerulonephritis, hematuria,
Henoch Schonlein purpura,
nephrotic syndrome, obstructive
uropathy, proteinuria, undescended
testicles, UTI/pyelonephritis.
1=Minimal knowledge about this problem/task
2=Developing approach to dx/management/task
3=Able to handle routine patients/tasks
4=Able to handle most patients/tasks, including mod-high acuity and/or complexity
5=Able to handle almost any patient/task, regardless of acuity or complexity
7/18/2011
i)
j)
k)
l)
m)
n)
o)
p)
Systems-based
practice
Professionalism
Practice-based
Learning & Imp
Interpersonal &
Comm. Skills
Medical Knowledge
Patient Care
PL - 3
PL - 2
COMPETENCIES
PL - 1
ROTATION: CONTINUITY CLINIC
Gynecologic: Genital trauma (mild),
labial adhesions, pelvic
inflammatory disease, vaginal
discharge or foreign body
Hematology/Oncology: Abdominal
and mediastinal mass (initial work
up), anemia, hemoglobinopathies,
leukocytosis, neutropenia,
thrombocytopenia.
Infectious Disease: Cellulitis,
cervical adenitis, dental abscess
with complications, initial
evaluation and follow-up of serious,
deep tissue infections,
laryngotracheobronchitis, otitis
media, periorbital and orbital
cellulitis, phayrngitis, pneumonia
(viral or bacterial), sinusitis, upper
respiratory tract infections, viral
illness, recurrent infections.
Musculoskeletal: Apophysitides,
femoral retro- and anteversion,
fractures, growing pains, hip
dysplasia, limp, metatarsus
adductus, sprains, strains, tibial
torsion.
Pharmacology/Toxicology: Common
drug poisoning or overdose,
ingestion avoidance (precautions).
Neurology/Psychiatry: Acute
neurologic conditions (initial
evaluation), behavioral concerns,
discipline issues, temper tantrums,
biting, developmental delay,
seizures (evaluation and
adjustment of medications), ADHD,
learning disabilities, substance
abuse.
Pulmonary: Asthma, bronchiolitis,
croup, pneumonia; sinusitis,
tracheitis, viral URI and LRI.
Surgery: pre- and post-op
evaluation of surgical patients
(general, ENT, ortho, urology,
1=Minimal knowledge about this problem/task
2=Developing approach to dx/management/task
3=Able to handle routine patients/tasks
4=Able to handle most patients/tasks, including mod-high acuity and/or complexity
5=Able to handle almost any patient/task, regardless of acuity or complexity
7/18/2011
Systems-based
practice
Professionalism
Practice-based
Learning & Imp
Interpersonal &
Comm. Skills
Medical Knowledge
Patient Care
PL - 3
PL - 2
COMPETENCIES
PL - 1
ROTATION: CONTINUITY CLINIC
neurosurgical, etc.).
GOAL 4: DIAGNOSTIC TESTING
(Ambulatory setting). Utilize common
diagnostic tests and imaging studies
appropriately in the outpatient
department.
4.1: Demonstrate understanding of the
common diagnostic tests and imaging
studies used in the outpatient setting, by
being able to:
3
4
5
X
X
a) Explain the indications for and
limitations of each study.
b) Know or be able to locate ageappropriate normal ranges (lab
studies).
c) Apply knowledge of diagnostic
test properties, including the use
of sensitivity, specificity, positive
predictive value, negative
predictive value, likelihood
ratios, and receiver operating
characteristic curves, to assess
test utility in clinical settings.
d) Recognize cost and utilization
issues.
e) Interpret the results in the
context of the specific patient.
f) Discuss therapeutic options for
correction of abnormalities.
1=Minimal knowledge about this problem/task
2=Developing approach to dx/management/task
3=Able to handle routine patients/tasks
4=Able to handle most patients/tasks, including mod-high acuity and/or complexity
5=Able to handle almost any patient/task, regardless of acuity or complexity
7/18/2011
4.2: Use appropriately the common
laboratory studies in the Continuity Clinic
and Outpatient setting:
3
4
5
X
X
3
4
5
X
X
Systems-based
practice
Professionalism
Practice-based
Learning & Imp
Interpersonal &
Comm. Skills
Medical Knowledge
Patient Care
PL - 3
PL - 2
COMPETENCIES
PL - 1
ROTATION: CONTINUITY CLINIC
a) CBC with differential, platelet
count, RBC indices.
b) Blood chemistries: electrolytes,
glucose, calcium, magnesium,
phosphate.
c) Renal function tests.
d) Tests of hepatic function (PT,
albumin) and damage (liver
enzymes, bilirubin).
e) Serologic tests for infection (e.g.,
hepatitis, HIV).
f) CRP, ESR.
g) Routine screening tests (e.g.,
neonatal screens, lead).
h) Tests for ova and parasites
i) Thyroid function tests.
j) Culture for bacterial, viral, and
fungal pathogens, including stool
culture.
k) Urinalysis.
l) Developmental and behavioral
screening tests.
4.3: Use the common imaging,
diagnostic or radiographic studies when
indicated for patients evaluated in
Continuity Clinic:
a) Plain radiographs of the chest,
extremities, abdomen, skull,
sinuses.
b) CT, MRI, angiography,
ultrasound, nuclear scans
(interpretation not expected)
and contrast studies when
indicated.
c) Bone age films
d) Appropriately order and use the
electrocardiogram and
echocardiogram.
1=Minimal knowledge about this problem/task
2=Developing approach to dx/management/task
3=Able to handle routine patients/tasks
4=Able to handle most patients/tasks, including mod-high acuity and/or complexity
5=Able to handle almost any patient/task, regardless of acuity or complexity
7/18/2011
Systems-based
practice
Professionalism
Practice-based
Learning & Imp
Interpersonal &
Comm. Skills
Medical Knowledge
Patient Care
PL - 3
PL - 2
COMPETENCIES
PL - 1
ROTATION: CONTINUITY CLINIC
e) Skin test for tuberculosis
GOAL 5: MONITORING and THERAPEUTIC
MODALITIES (Ambulatory Setting).
Understand how to use physiologic
monitoring and special technology in the
Ambulatory setting, including issues
specific to care of the chronically ill child.
5.1. Demonstrate understanding of the
monitoring techniques and special
treatments commonly used in the
Continuity Clinic:
3
4
5
X
X
3
4
5
X
X
X
X
X
X
X
a) Discuss indications,
contraindications and
complications.
b) Demonstrate proper use of
technique or treatment for children
of varying ages.
c) Interpret results of monitoring
based on method used, age and
clinical situation.
5.2: Appropriately use the monitoring
techniques commonly used in the
Continuity Clinic:
a) Pulse oximetry.
b) Repeated assessment of
temperature, heart rate,
respiratory rate, blood pressure,
as clinically indicated during an
office visit.
5.3: Use appropriately or be familiar with
the following treatments and techniques
in the Continuity Clinic:
a)
b)
c)
d)
Universal precautions.
Hand washing between patients.
Isolation techniques.
Administration of nebulized
medication.
e) Injury, wound and burn care.
1=Minimal knowledge about this problem/task
2=Developing approach to dx/management/task
3=Able to handle routine patients/tasks
4=Able to handle most patients/tasks, including mod-high acuity and/or complexity
5=Able to handle almost any patient/task, regardless of acuity or complexity
7/18/2011
f)
Systems-based
practice
Professionalism
Practice-based
Learning & Imp
Interpersonal &
Comm. Skills
Medical Knowledge
Patient Care
PL - 3
PL - 2
COMPETENCIES
PL - 1
ROTATION: CONTINUITY CLINIC
Intrsmuscular, subcutaneous
and intradermal injections.
5.4: Recognize normal and abnormal
findings at tracheostomy, gastrostomy,
or central venous catheter sites, and
demonstrate appropriate intervention or
referral for problems encountered.
5.5: Demonstrate skills for assessing and
managing pain.
3
4
5
X
X
3
4
5
X
X
3
4
5
X
3
4
5
X
a) Use age-appropriate pain scales in
assessment.
b) Describe indications for and use of
behavioral techniques and
supportive care, and other nonpharmacologic methods of pain
control.
GOAL 6: PROFESSIONAL COMPETENCIES
IN BRIEF: (Ambulatory setting): Maintain
standards of professional performance
while working in the continuity and
outpatient setting.
Competency 1: Patient Care. Provide familycentered patient care that is development- and
age-appropriate, compassionate, and effective
for the treatment of health problems and the
promotion of health.
Use a logical and appropriate clinical
approach to the care of outpatients,
applying principles of evidence-based
decision-making and problem solving.
Provide sensitive support to patients and
their families in the outpatient setting.
Provide effective preventive health care
and anticipatory guidance to patients
and families in continuity and outpatient
settings.
Competency 2: Medical Knowledge.
Understand the scope of established and
evolving biomedical, clinical, epidemiological and
social-behavioral knowledge
needed by a pediatrician; demonstrate the ability
1=Minimal knowledge about this problem/task
2=Developing approach to dx/management/task
3=Able to handle routine patients/tasks
4=Able to handle most patients/tasks, including mod-high acuity and/or complexity
5=Able to handle almost any patient/task, regardless of acuity or complexity
X
7/18/2011
to acquire, critically interpret and apply this
knowledge in patient care.
Demonstrate a commitment to acquiring
the base of knowledge needed for care
of children in the continuity and general
ambulatory setting.
Know and/or access medical information
efficiently, evaluate it critically, and apply
it to outpatient care appropriately.
Competency 3: Interpersonal Skills and
Communication. Demonstrate interpersonal and
communication skills that result in information
exchange and partnering with patients, their families
and professional associates.
Provide effective patient education,
including reassurance, for conditions
common to the outpatient setting.
Communicate and work effectively with
health professionals, specialists and
providers who refer patients to you, both
as the primary provider and as the
consulting pediatrician.
Maintain accurate, legible, timely, and
legally appropriate medical records in the
Continuity Clinic and Pediatric Outpatient
Department.
Competency 4: Practice-based Learning and
Improvement. Demonstrate knowledge, skills and
attitudes needed for continuous self-assessment,
using scientific methods and evidence to investigate,
evaluate, and improve one's patient care practice.
Identify standardized guidelines for
diagnosis and treatment of conditions
common to outpatient care, and adapt
them to the individual needs of specific
patients.
Work with health care team members to
assess, coordinate, and improve patient
care in the outpatient setting.
Establish an individual learning plan,
systematically organize relevant
information resources for future
reference, and plan for continuing
acquisition of knowledge and skills.
3
4
5
3
4
5
1=Minimal knowledge about this problem/task
2=Developing approach to dx/management/task
3=Able to handle routine patients/tasks
4=Able to handle most patients/tasks, including mod-high acuity and/or complexity
5=Able to handle almost any patient/task, regardless of acuity or complexity
Systems-based
practice
Professionalism
Practice-based
Learning & Imp
Interpersonal &
Comm. Skills
Medical Knowledge
Patient Care
PL - 3
PL - 2
COMPETENCIES
PL - 1
ROTATION: CONTINUITY CLINIC
X
7/18/2011
Competency 5: Professionalism. Demonstrate a
commitment to carrying out professional
responsibilities, adherence to ethical principles and
sensitivity to diversity.
Demonstrate personal accountability to
the well being of patients (e.g.,
following-up lab results, writing
comprehensive notes and seeking
answers to patient care questions).
Demonstrate a commitment to
professional behavior in interactions with
staff and professional colleagues.
Adhere to ethical and legal principles and
be sensitive to diversity.
Competency 6: Systems-Based
Practice. Understand how to practice high quality
health care and advocate for patients within the
context of the health care system.
Identify key aspects of health care
systems (e.g., public and private
insurance) as they apply to the primary
care provider, such as the role of the
PCP in decision-making, referral, and
coordination of care.
Demonstrate sensitivity to the costs of
clinical care in the outpatient setting,
and take steps to minimize costs without
compromising quality.
Recognize and advocate for families who
need assistance to deal with system
complexities, such as lack of insurance,
multiple medication refills, multiple
appointments with long transport times,
or inconvenient hours of service.
Recognize one's limits and those of the
system; take steps to avoid medical
errors.
Systems-based
practice
Professionalism
Practice-based
Learning & Imp
Interpersonal &
Comm. Skills
Medical Knowledge
Patient Care
PL - 3
PL - 2
COMPETENCIES
PL - 1
ROTATION: CONTINUITY CLINIC
X
3
4
5
3
4
5
X
PROCEDURES
GOAL 7. Technical and therapeutic
procedures. Describe the following procedures,
including how they work and when they should
be used; competently perform those commonly
used by the pediatrician in practice.
X
X
Breast pump use
1=Minimal knowledge about this problem/task
2=Developing approach to dx/management/task
3=Able to handle routine patients/tasks
4=Able to handle most patients/tasks, including mod-high acuity and/or complexity
5=Able to handle almost any patient/task, regardless of acuity or complexity
7/18/2011
Systems-based
practice
Professionalism
Practice-based
Learning & Imp
Interpersonal &
Comm. Skills
Medical Knowledge
Patient Care
PL - 3
PL - 2
COMPETENCIES
PL - 1
ROTATION: CONTINUITY CLINIC
Medication delivery: IM/SC/ID
Medication delivery: inhaled
PPD: placement
Pulmonary function tests: peak flow
meter
GOAL 8. Diagnostic and screening
procedures. Describe the following tests or
procedures, including how they work and when
they should be used; competently perform those
commonly used by the pediatrician in practice.
ADHD home and school questionnaires
3
4
5
X
X
X
Behavioral screening questionnaire (e.g.
Eyberg Child Behavior Inventory,
Pediatric Symptom Check List)
Developmental screening test
Hearing screening
PPD: interpretation
Scoliosis, scoliometer
Tympanometry evaluation: interpretation
Vision screening
1=Minimal knowledge about this problem/task
2=Developing approach to dx/management/task
3=Able to handle routine patients/tasks
4=Able to handle most patients/tasks, including mod-high acuity and/or complexity
5=Able to handle almost any patient/task, regardless of acuity or complexity
7/18/2011
New Innovations RMS Evaluations
Interpersonal Skills Checklist
Evaluator:
Subject:
Status:
INITIATES THE SESSION
1) Greets caregiver/patient appropriately
(introduces self and role, identifies
how caregiver & patient want to be
addressed, identifies others in room &
relationship to child, uses nonverbal
greeting).
Yes
Comments
Yes, but
No
Needs
No Opportunity
Improvement
to Observe
Remaining Characters: 5000
2) Demonstrates respect (respectful tone,
Comments
Yes, but
No
confident & professional, appropriate
Yes
Needs
No Opportunity
nonverbal behavior).
Improvement
to Observe
Remaining Characters: 5000
3) Makes a personal connection with
caregiver & patient
Yes
Comments
Yes, but
No
Needs
No Opportunity
Improvement
to Observe
Remaining Characters: 5000
4) Identifies and confirms basic reason
for visit
Yes
Comments
Yes, but
No
Needs
No Opportunity
Improvement
to Observe
Remaining Characters: 5000
5) Negotiates agenda (identifies what
they and patient/caregiver expect to
accomplish during visit)
Yes
Comments
Yes, but
No
Needs
No Opportunity
Improvement
to Observe
Remaining Characters: 5000
GATHERS INFORMATION/BUILDS RELATIONSHIPS
6) Explores patient problem by having
Comments
Yes, but
No
patient tell story of why they are there Yes
No Opportunity
Needs
(questions appropriately, no leading or
Improvement
to Observe
double barreled questions, listens
without interrupting, treats each
Remaining Characters: 5000
patient individually, encourages
patient to continue verbally and
nonverbally, picks up verbal and
nonverbal clues, reading/writing
doesn't interfere with dialogue)
7) Accepts patient/caregiver information
as credible unless proven wrong
(avoids making assumptions).
Yes
Comments
Yes, but
No
Needs
No Opportunity
Improvement
to Observe
Remaining Characters: 5000
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New Innovations RMS Evaluations
8) Determines and acknowledges patients
ideas regarding cause of problem.
Yes
Comments
Yes, but
No
Needs
No Opportunity
Improvement
to Observe
Remaining Characters: 5000
9) Explores concerns regarding the
problem.
Yes
Comments
Yes, but
No
Needs
No Opportunity
Improvement
to Observe
Remaining Characters: 5000
10) Encourages expression of emotion.
Comments
Yes, but
No
Yes
Needs
No Opportunity
Improvement
to Observe
Remaining Characters: 5000
11) Emphasizes with and supports
patient/caregiver (avoids being
judgmental).
Yes
Comments
Yes, but
No
Needs
No Opportunity
Improvement
to Observe
Remaining Characters: 5000
12) Explores socioeconomic/psychological/
emotional/cultural factors.
Yes
Comments
Yes, but
No
Needs
No Opportunity
Improvement
to Observe
Remaining Characters: 5000
13) Summarizes at end of line of enquiry
before moving on.
Yes
Comments
Yes, but
No
Needs
No Opportunity
Improvement
to Observe
Remaining Characters: 5000
14) Progresses using transitional
statements.
Comments
Yes, but
No
Yes
Needs
No Opportunity
Improvement
to Observe
Remaining Characters: 5000
15) Structures logical sequences
prioritizing needs.
Yes
Comments
Yes, but
No
Needs
No Opportunity
Improvement
to Observe
Remaining Characters: 5000
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New Innovations RMS Evaluations
16) Attends to timing ("Anything else
before we move on?")
Comments
Yes, but
No
Yes
Needs
No Opportunity
Improvement
to Observe
Remaining Characters: 5000
GIVES INFORMATION
17) Treats patient/caregiver as partner in
care.
Yes
Comments
Yes, but
No
Needs
No Opportunity
Improvement
to Observe
Remaining Characters: 5000
18) Explains rationale for diagnostic
procedures (test, exams, offers
choices).
Comments
Yes, but
No
Yes
Needs
No Opportunity
Improvement
to Observe
Remaining Characters: 5000
19) Discusses treatment options with
caregiver/patient.
Yes
Comments
Yes, but
No
Needs
No Opportunity
Improvement
to Observe
Remaining Characters: 5000
20) Educates caregiver/patient about
physical situation (feedback from
tests, explain anatomy/diagnosis).
Comments
Yes, but
No
Yes
Needs
No Opportunity
Improvement
to Observe
Remaining Characters: 5000
21) Discusses lifestyle issues/prevention
strategies.
Yes
Comments
Yes, but
No
Needs
No Opportunity
Improvement
to Observe
Remaining Characters: 5000
22) Is truthful and upfront with patient
without avoiding the issues at hand.
Comments
Yes, but
No
Yes
Needs
No Opportunity
Improvement
to Observe
Remaining Characters: 5000
23) Adapts to patient/caregiver level of
understanding.
Yes
Comments
Yes, but
No
Needs
No Opportunity
Improvement
to Observe
Remaining Characters: 5000
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New Innovations RMS Evaluations
CLOSES THE SESSION
24) Encourages caregiver/patient to
discuss any additional points.
Comments
Yes, but
No
Yes
Needs
No Opportunity
Improvement
to Observe
Remaining Characters: 5000
25) Closes session by summarizing briefly.
Yes
Comments
Yes, but
No
Needs
No Opportunity
Improvement
to Observe
Remaining Characters: 5000
26) Gives clear directions for use of
prescribed medications or over the
counter medications advised.
Comments
Yes, but
No
Yes
Needs
No Opportunity
Improvement
to Observe
Remaining Characters: 5000
27) Asks caregiver/patient to explain
condition/treatment back to physician. Yes
Comments
Yes, but
No
Needs
No Opportunity
Improvement
to Observe
Remaining Characters: 5000
28) Discusses next visit with caregiver/
patient.
Comments
Yes, but
No
Yes
Needs
No Opportunity
Improvement
to Observe
Remaining Characters: 5000
29) Discusses any referrals with caregiver/
Comments
Yes, but
No
patient (where to go, why and who
Yes
Needs
No Opportunity
seeing).
Improvement
to Observe
Remaining Characters: 5000
Return to Questionnaire
New Innovations Residency Management Suite ©1995-2008 New Innovations, Inc.
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Internet‐based Ambulatory Curriculum
Orientation Information Sheet
Introduction
Your training program is offering you an interactive ambulatory curriculum available online. By
completing teaching modules, you will be asked to answer questions on patient scenarios designed to
illustrate important teaching points in ambulatory care. Detailed summary answers will provide links to
important studies that have impacted the approach to management. A pretest and posttest will allow
you to assess your knowledge on the topic, and you will be able to compare your scores with others who
have also completed the module. At the completion of the annual cycle, an end‐of‐year posttest will be
distributed to assess your knowledge in ambulatory care. The website is optimized for desktop, laptop,
tablet and mobile devices.
Registration
To register for the ambulatory care curriculum web site, set your browser to www.hopkinsilc.org or
www.peaconline.org and click on the "new user" link and select the Pediatric curriculum. When
registering, you will need a 3‐character passcode to complete registration. Your code is: q5d.
You will need to include a valid e‐mail address and select a user ID and password. If you forget your user
ID/password, the welcome page of the website has a link to email you this information. Once you are on
the website, you should check your profile, including PGY year, by clicking on the profile icon located at
the top right corner of your screen.
Website function
The ambulatory curriculum website was entirely rebuilt in June 2013 to improve its function and add
enhancements. There are two main functions of the website: a teaching function and an evaluation
function. (At this time, the evaluation function is being beta‐tested with the Internal Medicine programs;
it is not available for the Pediatric programs.)
The teaching function consists of interactive modules on topics in ambulatory care. This function has
been in place for several years and has been very successful.
The evaluation function consists of an evaluation system allowing your attendings and patients to
evaluate you and create profiles of your strengths and area for improvement. Not all residency
programs will be using the evaluation function.
Since the website is entirely new, we expect some "bugs" to surface, and thank you in advance for
forwarding any concerns or comments to us. There is a help icon on the website to use in contacting us.
Links
We make every attempt to link to the key studies that have had an impact on clinical decision‐making.
While not every study that we have identified as relevant to a particular topic is available online, most
modules have links to 20‐30 references. Some module topics lend themselves better to studies (e.g.,
asthma) than others (e.g., toilet training). Please fill out a “trouble ticket” if a link is not working.
Forums sections
You are encouraged to communicate with other residents by using the Forums section on the website.
Any user (resident or administrator) can post comments in this section that will be viewable to all
registrants, regardless of training program. Participants are invited to comment on cases and questions
in the modules, but may also choose to share interesting and instructive clinical vignettes from their
own practice.
We reserve the right to remove comments that are deemed inappropriate.
Privacy concerns
The ambulatory care program is educational, and individual scores are designed to inform individual
users about how much they may or may not be learning. Your program director and their designees can
track your individual performance, much like they see your scores on the In‐training Exam. Other
residents and administrators from other programs cannot see your individual performance. Your
program director and their designees can also tell which modules you have completed. You must
complete the final feedback question on a module to get credit for the module. Some programs set
minimum passing scores on modules. If your score on the post‐test is below the minimum passing score,
you will have to complete the module again until you score at or above the minimum to get credit for it.
Administrators from your program are provided information on individual utilization as a marker of
participation in the curriculum. In addition, each program administrator can access group scores, which
are average scores from all members of your program who have completed a module. These group
scores can be compared with the average scores from all other programs participating in the curriculum.
A small number of modules may have survey questions included in them. Your responses to these
questions are not included in any performance evaluation, and are strictly confidential. You will note
when registering with the curriculum that we use data generated by the website for research on the
educational impact of the curriculum. Registration with the website implies informed consent that you
allow us to analyze your responses as part of the group data that we collect.
Technical Concerns
As with all web sites, you may find on occasion that the web site is unavailable or particularly slow. We
anticipate adding and improving features of the website throughout the academic year, so you will see
changes from time to time. We apologize in advance for any inconvenience that this may cause, and
suggest that you check back later. If you have frequent technical difficulties with the website, please feel
free to contact us.