LSUHSC PEDIATRIC NEUROLOGY ROTATION
Description of Rotation:
This is a one month rotation for a total of three months. These rotations will take place
during the PGY 2 –PGY 4 year. Beeper Call will occur during this rotation. The rotation
will consist of hospital inpatient setting, and outpatient clinics.
Consultation services will include the emergency room, pediatric critical care unit and the
in- patient care unit. Residents are responsible for consultations in rotational bases
with other residents from Pediatrics, Tulane Adult Neurology and Pediatric Neurology
Fellow.
Residents will not attend longitudinal clinic during these months.
Educational Purpose/Goals:
1. To gain experience in the recognition, diagnosis, treatment, and management of
acute neurological disorders in newborns, infants, children, and adolescents.
2. To assume progressive responsibility in the care of neurological patients.
3. To provide bedside education instruction to the pediatric residents, as well
medical students on the rotation.
4. To provide consultation services to other health care services.
Assessment Summary:
The objectives (below) will be evaluated through a number of measures (tools) which are
reviewed in the preceding section (General Competencies) above.
By the end of the rotation, the resident should receive and/or complete the following
assessments:
1.
Verbal feedback from preceptors/attending staff
2.
Global written assessments
3.
One(1) NEX evaluation per pediatric staff in rotations block # 2 or 3
Orientation:
Orientation occurs on day 1 of the rotation. Expectations, duties, goals and objectives of
the rotation are discussed.
Supervision:
Residents are supervised by the precepting attending child neurologist and pediatric
neurology fellows. All cases, including management plans, must be reviewed with the
preceptor.
Literature:
 Clinical Pediatric Neurology, Fenichel
 A collection of essential articles will be provided at the beginning of the rotation
Objectives for Pediatric Neurology Rotation #1
Patient Care:
Residents will be able to provide patient care that is compassionate, appropriate and
effective for the treatment of neurological health problems and the promotion of health in
newborns, infant, children and adolescents.
Competency: Gathering Information - Gather essential and accurate information about
the patient.
Knowledge/Skills:
 Perform a comprehensive history, including a chief complaint, history of the present
illness, past medical and surgical history, family and social history and a complete
review of systems.
 Obtain detailed information regarding birth and developmental history as age
appropriate.
 Demonstrate knowledge of how to access adjunctive sources of information to the
history obtained from the family (e.g. chart)
 Perform a fundamental pediatric neurological examination.
 Convey an appreciation for the opportunity to be involved in the care of the patient.
Tools used for assessment
Global evaluation
Medical Knowledge:
Residents must demonstrate knowledge about established and evolving biomedical,
clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and how to
apply this knowledge to patient care.
Competency: Acquisition – learn about the pathophysiology, biochemistry, genetics,
and clinical presentation of the patient’s neurological disorder
Knowledge/Skills:
 Recognize and interpret abnormal neurological findings
 Utilize medical references, journal articles, and information technology to learn about
the pathophysiology, biochemistry, genetics and clinical features of the patient’s
neurological condition and generate a differential diagnosis.
 Use evidence-based medicine and accepted medical guidelines to help inform medical
decision making
Tools used for assessment
In-service examination
Practice-Based Learning and Improvement
Residents must be able to investigate and evaluate their patient care practices, appraise
and assimilate scientific evidence, and improve their patient care practices.
Competency: Life-long learning
Knowledge/Skills:
 Utilize outside resources, including the internet, medical textbooks, and journals, to
increase knowledge base in dealing directly with patient care encounters
 Independently draw upon clinical resources in order to formulate differential diagnoses
and management plans
 Incorporate feedback from staff and consultant physicians during the rotation to
improve work performance
Competency: Evidence based medicine
Knowledge/Skills:
 Wherever possible evidence based medicine should be used in basing medical
treatment decisions
 Utilize accepted standards of practice or recognized guidelines in informing practice
management
Tools used for assessment
Global assessment
Case conference
Interpersonal and Communication Skills:
Residents must be able to demonstrate interpersonal and communication skills that
result in effective information exchange and teaming with patients, their patients families,
and professional associates.
Competency: Communication with patients and families
Knowledge/Skills:
 Establish effective rapport and communication with patients and their families
 Learn to interpret and address non-verbal communication presented by patients
and/or their families
 Accurately describe and explain procedures and management plan to patients
and/or caregivers in a language that is appropriate to their education
 Understand and respect religious and ethnical differences in your patient/families
in your communications with them
 Understand privacy issues in communications when dealing with a minor
Competency: Communication with team members
Knowledge/Skills:
 Impart knowledge and educate medical students
 Formulation and clear communication of consultation questions to consultative
service
 Discuss consultation findings with members of the team and family
 Integrate information from various team members and consultants into an effective
care plan
Tools used for assessment
Global evaluation
Professionalism:
Residents must demonstrate a commitment to carrying out professional responsibilities,
adherence to ethical principles, and sensitivity to a diverse patient population.
Competency: Professional behavior
Knowledge/Skills:
 Demonstrate respect, compassion, and integrity in their interaction with patients and
their families
 Be responsive and respectful to the needs of the patients
 Consistently use compassion and empathy in one's role as a physician
 Practice evidence based medicine whenever possible and be familiar with best
practice parameters and guidelines from professional societies such as the AAN,
CNS, AAP, AES, etc.
 Recognize and respond to personal stress and fatigue that might interfere with
professional duties
Competency: Ethical behavior
Knowledge/Skills:
 Demonstrate a commitment to ethical principles pertaining to the provision or
withholding of clinical care, confidentiality of patient information, and informed
consent
 Maintain professional boundaries in one's dealings with patients, family, staff, and
professional colleagues
 Demonstrate respect for patient confidentiality and privacy regulations and be aware
of HIPAA guidelines
Tools used for assessment
Global evaluation
System-based Practice:
Residents must demonstrate and awareness of and responsiveness to the larger context
of and system of health care and the ability to effectively call on system resources to
provide care that is of optimal value.
Competency: Health care delivery system
Knowledge/Skills:
 Work with health care and case managers on the ward to assess, coordinate, and
improve patient care, consistently advocating for high quality
 Be familiar with special care programs available such as palliative care, home care,
early intervention programs etc.
Competency: Cost effective practice
Knowledge/Skills:
 Practice cost-effective health care and resource allocation that does not compromise
quality of care
 Be familiar with generic alternatives with respect to cost and efficacy
Goals for Pediatric Neurology Rotation #2
Patient Care:
Competency: Synthesis - Make informed diagnostic and therapeutic decisions based
on patient information, current scientific evidence, clinical judgment, and patient
preference.
Knowledge/Skills:
 Formulate and prioritize a differential diagnosis based on patient information and/or
current scientific evidence and/or sound clinical judgment.
 Determine and implement appropriate tests and/or procedures in evaluation of the
neurological problem
 Recognize limitations of the level of training and seek help appropriately.
 Identify and utilize subspecialty support appropriately
Tools used for assessment:
Global evaluations
Patient survey
Medical Knowledge:
Competency: Analysis – critically review the relevance, application and
appropriateness of medical information acquired
Knowledge/Skills:
 Formulate a diagnosis differential and treatment plan that meets expected standards
of care for patient’s condition
Tools used for assessment:
In-service training exam
Review of treatment Plan
Practice Based Learning
Competency: Evidence based medicine
Knowledge/Skills:
 Wherever possible evidence based medicine should be used in basing medical
treatment decisions
 Utilize accepted standards of practice or recognized guidelines in informing practice
management
Tools used for assessment:
Case Conference
In-service examination
Interpersonal and Communication Skills:
Residents must be able to demonstrate interpersonal and communication skills that
result in effective information exchange and teaming with patients, their patients families,
and professional associates.
Competency: Communication with patients and families
Knowledge/Skills:
 Accurately describe and explain procedures and management plan to patients
and/or caregivers in a language that is appropriate to their education
 Understand and respect religious and ethnical differences in your patient/families
in your communications with them
Competency: Communication with team members
Knowledge/Skills:
 Integrate information from various team members and consultants into an effective
care plan
Tools used for assessment:
Global evaluation
360 evaluations
Professionalism:
Residents must demonstrate a commitment to carrying out professional responsibilities,
adherence to ethical principles, and sensitivity to a diverse patient population.
Competency: Professional behavior
 Practice evidence based medicine whenever possible and be familiar with best
practice parameters and guidelines from professional societies such as the AAN,
CNS, AAP, AES, etc.
 Recognize and respond to personal stress and fatigue that might interfere with
professional duties
Competency: Ethical behavior
 Maintain professional boundaries in one's dealings with patients, family, staff, and
professional colleagues
Tools used to for assessment
Global evaluations
Peer evaluations
System-based Practice:
Residents must demonstrate and awareness of and responsiveness to the larger context
of and system of health care and the ability to effectively call on system resources to
provide care that is of optimal value
Competency: Cost effective practice
Knowledge/Skills:
 Practice cost-effective health care and resource allocation that does not compromise
quality of care
 Be familiar with generic alternatives with respect to cost and efficacy
Tools used for evaluation:
Global evaluations
Case conference
Objectives for Pediatric Rotation # 3
Patient Care:
Residents will be able to provide patient care that is compassionate, appropriate and
effective for the treatment of neurological health problems and the promotion of health in
newborns, infant, children and adolescents.
Competency: Partnering with patients/families – Establish and carry out patient
management plans; counsel patients and families.
Knowledge/Skills:
 Accurately describe and explain procedures to patients and/or caregivers in a
language that is appropriate to their education
 Communicate information to other providers when necessary and appropriate.
 Communicates, answers questions and calls and provides emotional support as
appropriate
Tools used for assessment
NEX evaluation
Global evaluation
Medical Knowledge:
Residents must demonstrate knowledge about established and evolving biomedical,
clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and how to
apply this knowledge to patient care.
Competency: Application – apply acquired medical knowledge appropriately to clinical
care
Knowledge/Skills:
 Generate a differential diagnosis based on acquired medical knowledge
 Use newly acquired knowledge to educate patient care team
Tools used for assessment
In-service examination
Case Conference
Pediatric Grand Rounds Presentation
Global evaluation
Practice-Based Learning and Improvement
Residents must be able to investigate and evaluate their patient care practices, appraise
and assimilate scientific evidence, and improve their patient care practices.
Competency: Quality improvement
Knowledge/Skills:
 Incorporate learned knowledge and feedback into changing and improving practice
management
Competency: Teaching Skills
Knowledge/Skills:
 Review educational resources and methods of access to medical information as
applicable to child neurology to other members of the team
Tools used for assessment
Case conference
Global evaluation
Interpersonal and Communication Skills:
Residents must be able to demonstrate interpersonal and communication skills that
result in effective information exchange and teaming with patients, their patients families,
and professional associates.
Competency: Scholarly Communication
Knowledge/Skills:
 Regular presentations at pediatric neurology grand rounds
 Attendance at monthly journal club
 Participation in weekly case vignette sessions
Tools used for assessment
Case Conference
Pediatric Grand Rounds Presentation
Professionalism:
Residents must demonstrate a commitment to carrying out professional responsibilities,
adherence to ethical principles, and sensitivity to a diverse patient population.
Competency: Cultural competence
Knowledge/Skills:
 Demonstrate a sensitivity and responsiveness to patients age, gender, and disabilities
System-based Practice:
Residents must demonstrate and awareness of and responsiveness to the larger context
of and system of health care and the ability to effectively call on system resources to
provide care that is of optimal value.
Competency: Patient safety and advocacy/Systems causes of error
Knowledge/Skills:
 Advocate for the promotion of health and the prevention of disease and injury in
populations
 Be familiar with Clinic safety policy and reporting of adverse events as documented in
the policy section on the intranet home page
Tools used for assessment
Global evaluations
Case conference
Revised 6/07