Goals and Objectives: Pediatric Nuclear Medicine
(1 Year Curriculum-Nuclear Residency Program)
Description of Rotation or Educational Experience
Residents entering the one year program have already have had exposure to pediatric
nuclear medicine during the residency in Diagnostic Radiology. Therefore, they are
already familiar with general principles of diagnostic imaging. The goal of the pediatric
nuclear medicine training is to provide the fundamentals of nuclear medicine practice in
children, including familiarity with the range of diagnostic imaging studies performed.
Over the course of the year, residents will gain an increased familiarity with diagnostic
imaging in pediatric nuclear medicine. Residents are expected to function largely
independently (with appropriate supervision) in prescribing, performing and assessing
adequacy, interpreting and reporting pediatric nuclear medicine imaging studies.
Patient Care
Goal
Residents must be able to provide patient care that is compassionate, appropriate, and
effective for the treatment of health problems and the promotion of health.
Objectives
In the first 3 months residents are expected to:
1. Learn to care appropriately for pediatric patients while they are in the Nuclear
Medicine suite.
2. Communicate effectively with pediatric patients and their families during the
interview, so that an appropriate history and physical examination can be
obtained. Obtain information from medical record and clinical physicians.
3. Learn the specialized protocols and modifications for pediatric patients and be
able to select appropriate procedures.
After the introductory period, residents are expected to:
1. In addition to all the above, become more sophisticated and independent in the
care of pediatric patients in the nuclear medicine laboratory.
2. Demonstrate more advanced skills in pediatric patient care (history, physical
examination, treatment of complications).
3. Demonstrate facility with hospital computer and PACS systems for pediatric
patient care.
4. In short, able to take responsibility for almost all routine patient management
while the patient is in the pediatric nuclear medicine department.
Medical Knowledge
Goal
Residents must demonstrate knowledge of established and evolving biomedical, clinical,
epidemiological, and cognate (e.g. epidemiological and social-behavioral) sciences, and
the application of this knowledge to patient care.
Objectives
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In the first 3 months residents are expected to:
1. Learn the main imaging modalities, planar, SPECT and PET and appropriate
pharmaceuticals, as they apply to a pediatric population.
2. Improve knowledge of normal and abnormal scintigraphic appearance in pediatric
patients.
3. Further develop skills to interpret nuclear medicine studies, formulate differential
diagnoses and draft reports of pediatric patients.
4. Demonstrate facility with hospital computer and PACS systems.
After the introductory period, residents are expected to:
1. Acquire increasingly sophisticated knowledge of the imaging and non-imaging
modalities, radiopharmaceuticals, and scintigraphic appearance in pediatric studies.
2. Learn the indications for pediatric nuclear medicine studies, the differences in the
protocols between pediatric and adult patients and gain a thorough knowledge of the
principles of pediatric scan interpretation.
3. Accurately dictate reports and communicate results in pediatric nuclear medicine
with reduced supervision.
4. Demonstrate facility with independently running the pediatric nuclear laboratory
(with reduced level of supervision).
Practice- Based Learning and Improvement
Goal
Residents must demonstrate the ability to perform practice-based learning and
improvement that involves investigation and evaluation of their own patient care,
appraisal and assimilation of scientific evidence, and improvements in patient care.
Objectives
Residents are expected to develop skills and habits to be able to:
1. .. Utilize available information technology for access to the most recent scientific
data. Independently seek out new data in printed and electronic formats.
2. Collect pediatric cases of interest, either due to unusual or classic presentations of
disease or due to difficulties in diagnoses. Present these at the nuclear medicine
correlation conferences.
3. Participate in annual self-assessment exercise, identify strengths and limitations
and develop own learning goals.
Systems Based Practice
Goal
Residents must be aware of systems-based practice, as manifested by actions that
demonstrate an awareness of and responsiveness to the larger context and system of
health care, and the ability to call effectively on system resources to provide care that is
of optimal value.
Objectives
Residents are expected to:
1. Fully understand the relative merits of the different pediatric nuclear medicine
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imaging studies (versus other imaging procedures such as ultrasound and IVP)
and be able to make recommendations to the clinical service concerning the
optimum studies for detecting suspected pathology.
2. Understand appropriateness criteria for pediatric nuclear medicine studies and the
relative strengths and weaknesses of the various procedures.
3. Demonstrate basic knowledge about the costs of pediatric imaging studies and
play an active role in trying to control health care cost expenditures. This
includes recommending equally effecting imaging studies that are less expensive,
whenever appropriate.
Professionalism
Goal
Residents must demonstrate professionalism, as manifested through a commitment to
carrying out professional responsibilities, adherence to ethical principles, and sensitivity
to a diverse patient population.
Residents are expected to::
1. Dress appropriately at all times.
2. Interact on a professional level with pediatric patients and their family members,
demonstrating great sensitivity toward their anxiety, and placing appropriate and
compassionate patient care above self-interest at all times.
3. Demonstrate strong ethical principles. This includes good work ethic with prompt
appearance on the pediatric nuclear medicine service at appropriate times.
4. Establish professional relationships with the pediatric nuclear medicine
technologists and student technologists with whom they interact and progressively
develop team leader skills.
5. Not discriminate based on age, ethnicity, gender, disability or sexual orientation.
Interpersonal and Communication Skills
Goal
Residents must demonstrate interpersonal and communication skills that result in
effective information exchange and collaboration with patients, their families, and other
health professionals.
Objectives
Residents are expected to (to be):
1. Gain mastery of pediatric nuclear medicine report dictation. Dictate study
findings clearly and concisely with minimal direction. Over time, the resident
will be expected to compose the report with progressively less assistance.
2. Able to verbally communicate the results of pediatric nuclear medicine studies
concisely and clearly to inquiring referring physicians.
3. Able to communicate effectively with technologists, patients and clinical
physicians with whom they interact during the course of a work day in pediatric
nuclear medicine. This includes leadership skills and demonstration of
empathy/understanding for both patients and their primary caretakers
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Teaching Methods
Formal, didactic lectures on relevant subject material
Small group teaching on individual cases
Conferences and Journal Club
Teaching files on service, teaching files on internet
Written material in textbooks; scientific articles provided by faculty
Hands-on laboratory (first year)
Self education is expected
Assessment Method (residents)
Focused direct observation by the faculty (written quarterly evaluations)
Assessment of residents’ draft reports
Assessment of presentations at conferences
In-house examination
In-training ABNM examination
Assessment by clerical and technologist team members
Self-assessment tool
Assessment Method (Program Evaluation)
Annual formal program evaluation
Quarterly meetings with the Program Director
Frequent informal discussions with the Associate Program Director
Level of Supervision
During the first three months supervision by the faculty is direct. During the second nine
months, residents take on greater responsibility including supervision of radiology
residents, quality control of images, appropriateness review. Responsibility on the
nuclear medicine service continues but all dictated reports are reviewed by the faculty.
The faculty decides as a group whether the resident has sufficient knowledge and skills to
be promoted to “Supervisory Fellow” at which time responsibility is given to “run” the
service (with reduced supervision by the faculty).
Educational Resources
Textbooks in the Fellow Library
Taubman Medical Library
Electronic Teaching File
Access to Internet, Medline Search and PubMed with full text of articles
Rev 1/27/09
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