OUTPATIENT CLINIC
GOALS AND OBJECTIVES – ORGANIZED BY CORE COMPETENCIES
Background:
The outpatient clinic experience rotation involves care of patients referred for cardiology consultation in
the outpatient clinic. The care team in the clinic includes cardiology fellows, pediatric residents doing
cardiology elective roations, a nurse clinician and a clinic nurse as well as the attending physicians.
There are also medical students in clinic at times. The goal for the rotation is learning how to safely and
professionally evaluate and care for a patient referred for initial cardiology consultation or followed in a
pediatric cardiology out-patient clinic. In addition, another goal is for the fellow to assume an increasingly
independent role in making the plans for evaluation and management of the patient with the attending
physician as the guide and mentor. For effective care for the patients, it is essential to see the patients in
a timely fashion, evaluate any test results that are initially available, determine if further testing is needed
and create a care plan for the patient that includes plans for further follow up, if necessary. The time in
the outpatient clinic involves the fellow working closely with the clinic nurse and other members of the
care team as well as with the patients and their families to create a smooth, time-efficient outpatient
experience for the patient. Coordinating any necessary referrals for other clinic evaluations or testing is
also part of the complete evaluation of an outpatient. Concluding the visit with a dictated letter to the
referring physician is also an essential part of the outpatient clinic experience.
Systems Based
Practice
Professionalism
Interpersonal
Communication
Skills
Practice Based
Learning
Medical
Knowledge
Patient Care
Year of Training
The YEAR of Training is listed for clinical training in Pediatric Cardiology. In other words, YEAR 1 of
clinical training in Pediatric Cardiology and YEAR 2 of clinical training in Pediatric Cardiology. The
specific objectives for the inpatient service rotation are as listed below:
Out-Patient Service
Goal: Learn how to safely and professionally evaluate and care for a patient referred for initial consultation
or followed in a pediatric cardiology out-patient clinic
Perform a thorough and complete
medical history and physical
1
X
X
X
X
X
examination
Recognize the components of
the medical history that are
unique to pediatric cardiology.
Include all the required
components, including chief
complaint, problem list,
1
X
X
X
present/interval history, past
medical and surgical history,
medications, drug allergies,
social history, family history, and
review of systems
Review the available paper and
electronic records, previous laboratory
data, including echocardiograms,
1
X
X
electrocardiograms, etc prior to
obtaining the history and performing
the physical examination
Request previous medical records and
1
X
X
X
X
X
X
X
1
X
X
X
X
1
X
X
X
X
X
1
X
X
X
1
X
X
X
2
X
X
X
1
X
X
X
1
X
1
Professionalism
X
X
X
X
X
X
X
X
X
X
1
X
X
X
1
X
X
X
Systems Based
Practice
Interpersonal
Communication
Skills
X
Practice Based
Learning
Patient Care
2
Medical
Knowledge
Year of Training
laboratory and other test results on the
day of the clinic visit
Demonstrate the ability to perform a
cardiovascular examination, including
the ability to explain differences in
diagnoses and pathophysiology based
on murmur characteristics and other
physical findings
Present the medical history, physical
examination, and pertinent laboratory
data to the attending in an organized
manner
Discuss the diagnoses and plan of
action, including proposed additional
tests, and your rationale with the
attending
Develop a rational diagnostic and
treatment plan
Identify changes in clinical course,
physical examination, and laboratory
findings and interpret them, based on
diagnosis and pathophysiology
Interpret the electrocardiograms,
echocardiograms, radiological
examinations, and laboratory test
results obtained in the clinic that day
Contact the referring physician and
others about new and clinically
important information and
recommendations on the day of the
clinic
Dictate a report to the referring
physician and other physicians
involved in the patient’s care on the
day of the clinic visit.
Include in the report a problem list, all
the components of the medical history,
physical examination, laboratory and
test results, diagnoses and
recommendations
Establish a plan with the attending
regarding which of you will
communicate with the patient and
family following the visit to ensure that
important information and
recommendations were understood
List the causes of hypertension,
propose diagnostic plans that are
X
X
X
Professionalism
Systems Based
Practice
Interpersonal
Communication
Skills
X
X
1
X
X
X
X
X
1
X
X
X
X
1
X
X
Practice Based
Learning
Patient Care
1
Medical
Knowledge
Year of Training
etiologically appropriate, and provide a
hierarchy of treatment regimens
List the etiologies of dyslipidemia,
provide appropriate diagnostic plans,
and propose appropriate treatment
regimens
Coordinate appropriate patient followup and intervention
Communicate medical information
effectively to patients, parents, and
guardians
Utilize medical literature to assist with
patient care
X
X