Pediatric Critical Care Fellowship: Neonatal Intensive Care Rotation
CanMEDS Roles
CanMEDS Key Competencies
Methods to achieve
competencies
1. Medical expert
a. knowledge:
Understand the pathophysiology, diagnosis, and management of neonates with:
a) Cyanotic and acyanotic congenital heart disease
b) Necrotizing enterocolitis—risk factors, diagnosis, indications for surgery or
conservative management
c) Omphalocele and gastroschisis
d) Hyaline membrane disease and chronic lung disease and the similarities
with ARDS
e) Nutritional requirements in the term and pre-term neonate
f) Indications and administration of surfactant
g) Congenital Diaphragmatic Hernia
h) Brain injury and multi-organ failure
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a)
b)
c)
d)
e)
f)
Assesment of gestational age
airway management of neonates
placement of umbilical arterial and venous lines
placement of percunateous intravenous central catheters
placement of thoracotomy tubes and needle drainage of pneumothoraces
paracentesis
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a) to understand the issues involved in communicating bad news to patients
and families
b) to be able to explain complicated medical issues in simple terms to families
c) to develop the ability to communicate with families and the medical team in
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b) skills:
2. Communicator
Updated April 2014
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daily morning rounds
sign over rounds
formal and informal
teaching sessions
self-directed reading
fellow seminars
journal club
performance of
procedures on patients
in the ICU
daily patient management
daily communication
with families to update
them on the condition
observation of nursing
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3. Collaborator
tense situations or crises
d) to understand and counsel families around the issue of withdrawal of lifesustaining treatment in neonates with terminal or very poor prognosis
e) to efficiently and accurately verbally sign over and/or communcate patient
plans in a variety of rounds and patient handover
f) to efficiently and accurately record and transmit patient information in a
written record
interaction and families
conduct family meetings
as appropriate
a) to communicate effectively and in a timely manner with consulting services
b) to communicate care plans clearly and precisely to all members of the allied
health teams
c) to work in a collaborative manner with fellow learners
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4. Manager
Updated April 2014
a) effectively balance time between patient care, learning and stress
management
b) learn to triage neonates from various referral centres
c) manage fatigue and recognize when they are unsafe
d) effectively prioritize a heavy workload
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fill out consult forms
specifically and speak to
consultants directly about
reasons for consults
summarize the care plan
at the end of daily work
rounds
learn about all patients in
the unit during rounds
and regularly ask fellow
learners about their need
for help
discussing strategies with
attending staff
informal one on one
sessions with staff
use of organizational aids
such as to do lists, etc
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5. Health
Advocate
a) to understand the stresses families face with infants requiring prolonged
admission for prematurity or chronic illness
b) be aware of the relative costs of different diagnostic and treatment
modalities
c) demonstrate proficiency with obtaining informed consent
d) understand the concept of futility
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6. Scholar
a) learn the skills necessary to research and present critical care rounds if
asked to
b) demonstrate a basic understanding of biostatistics, study design
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7. Professional
Updated April 2014
a) ensure detailed and complete follow-up and handover of all patients under
the residents care
b) develop the appropriate conflict resolution skills necessary in a high stress
environment
c) understand the responsibility, and the liability involved with the transfer of
a patient from an institution to another
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discuss cost issues on
rounds with attending and
pharmacists
discussions on rounds
and with families
obtaining informed
consent from families for
blood transfusions and
research studies
ethics seminars and
patient centred
discussions
teach junior house staff
and allied health
professionals using both
informal and formal
teaching methods
fellow seminars
morning sign in and sign
out rounds
family meetings,
discussions with staff and
ethicists
organize transfers of
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patients to and from
referring hospitals under
the supervision of the
attending physician
Updated April 2014
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