Department of Psychiatry and Human Behavior
Hasbro Children’s Hospital
Revised Date 3/2008
PEDS WARDS
Overview of Rotation
Neurology rotations in the Brown Psychiatry Residency constitute a core training experience during which residents
learn to perform competent neurological evaluations and treatment of neurological illnesses. The rotation requires a high
degree of organization and efficiency, as well as a strong commitment to professionalism. This latter quality is a core
value, which should guide residents in decision-making about which steps to take on behalf their patients, as well as their
own education.
Description of Rotation
Wards Goals and Objectives – Interns
The Pediatric Wards rotations are inpatient clinical experiences involving the initial workup,
management, and coordinated discharge of admitted patients during the course of their
hospitalizations for acute and chronic illnesses. The Wards experience for Interns will afford an indepth look at the scope of inpatient medical and psychosocial care provided by generalist and
specialist pediatricians, across the age ranges from birth through young adulthood.
Patient Care: Interns are expected to provide patient care that is compassionate, appropriate and
effective for the promotion of health and prevention of illness. Interns must:








Gather accurate and appropriate information for each patient encounter in which they
participate.
Perform physical examinations of children across all pediatric age ranges
Gain skill in performing thorough and appropriate examinations of children admitted
to Hasbro Children's Hospital
Gain skill in evidence-based and cost-conscious utilization of laboratory, radiographic,
and other testing resources
Gain skill in the accurate analysis of available information to make diagnostic
interventions and institute appropriate therapeutic decisions
Gain skill in development and implementation of an appropriate management plan for
each patient
Gain skill in providing appropriate patient follow-up (labs, etc.), communication with
outpatient physicians, and continuity of patient care
Gain skill in identifying circumstances requiring subspecialty consultation, and in
arranging for and following up on such consults
Medical Knowledge: Residents and interns must demonstrate a growing proficiency in obtaining
knowledge through didactic lecture, case based discussions, specific readings (both online and
through reference literature) and evidence-based medicine. They will apply an open-minded,
analytical approach to acquiring new knowledge, access and critically evaluate current medical
information and scientific evidence, and apply this knowledge to clinical problem-solving, clinical
decision-making, and critical thinking. Interns must:

Gain skill in evaluating and managing patients with signs and symptoms that present
to the general pediatric floors
Rev.3/2008









Demonstrate growing knowledge and skill in the evaluation and management of
common inpatient diseases
Demonstrate growing knowledge and understanding of the common diagnostic tests
and imaging studies used in inpatient care, including their indications, cost, and ageappropriate normal findings
Demonstrate growing knowledge of the appropriate use of common laboratory studies
in the inpatient setting, including indications and age-appropriate normal ranges
Describe appropriate use of common inpatient monitoring techniques, including
indications, contraindications, and complications
Interpret and describe appropriate responses to results of monitoring based on method
used, patient age, and clinical situation
Gain skill in appropriate use of standard inpatient treatments and techniques such as
universal precautions, NG tube placement, administration of nebulized medications,
wound care, IV fluids, IV pharmacotherapy, and transfusion
Describe abnormal findings at tracheostomy, gastrostomy, and central venous catheter
sites, together with appropriate intervention or referral for problems encountered
Gain skill in assessment and age-appropriate management of pain
Gain competence in identifying medical and psychiatric conditions requiring
subspecialty consultation
Practice-Based Learning and Improvement: Residents and interns are expected to continuously
investigate and evaluate patient care practices, appraise and assimilate clinical information to make
appropriate patient management decisions and learn from error. Interns must:






Critically review pediatric literature and web-based information relevant to patients in
their care
Demonstrate evidence-based medical reasoning and justification for suggested
interventions
Evaluate their own performance, identify knowledge gaps, and target self-directed
learning to fill in these gaps
Demonstrate the capacity to learn from error
Provide, request and accept feedback, and strive to improve their own performance
Work well with other learners to enhance knowledge
Interpersonal and Communication Skills: Residents are expected to consistently demonstrate
interpersonal and communication skills that result in effective information exchange. They must be
able to collaborate with patients, their families and professional associates. Interns must:





Gain skill in effectively communicating with patients, families, hospital staff, and
hospital-based physicians
Gain skill in communication with community physicians and providing seamless
continuity of care with outpatient medical providers
Gain skill in conflict resolution, when appropriate
Communicate relevant information through accurate dictations, written medical
records, patient presentations, sign-outs, and use of electronic prescribing
Avoid medical jargon when speaking with patients and families
Rev.3/2008



Gain skill in communicating effectively and respectfully with patients from a wide
range of cultural and socioeconomic backgrounds
Gain skill in appropriate use of interpreters
Demonstrate a growing ability to counsel and educate patients and families
Professionalism: Residents are expected to demonstrate a commitment to carry out professional
responsibilities, adhere to ethical principles and be sensitive to diversity. They must have a
responsible attitude toward their patients, their profession, and society. Interns must:











Consistently act in the best interests of patients
Demonstrate a caring and respectful demeanor when interacting with patients and
families
Interact respectfully and collegially with hospital staff
Maintain patient and family confidentiality
Demonstrate sensitivity to ethical principles, culture, age, gender, religious belief,
sexual orientation, and disability
Describe the role of the ethics consult in inpatient care
Acknowledge and properly report errors
Demonstrate capacity to discuss errors honestly with families
Be conscientious, punctual, and reliable
Maintain patient flow as circumstances demand
Gain skill in management of challenging patients and families
Systems-Based Practice: Residents are expected to practice quality health care that is cost-effective
and advocate for patients within the health care system. They are expected to consistently
demonstrate an understanding of the interconnectedness and dependence of multidisciplinary
services. Interns must:






Advocate for patients and families as they navigate system complexities
Demonstrate a developing knowledge of billing and coding and their supporting
documentation
Gain skill in the appropriate use of Case Management services and Discharge
Planning
Describe key issues in inpatient and home management of technology-dependent
children, including tracheostomy, chronic mechanical ventilation, chronic parenteral
nutrition (HAL), gastrostomy tube feeding, and permanent central venous catheter
Gain skill in coordinating with subspecialty consultants to ensure that appropriate
questions are being asked and information is being effectively communicated between
patients, families, and medical staff
Participate in multidisciplinary health care team meetings as appropriate for their
patients
Rev.3/2008
Description of Rotation
Wards Goals and Objectives – PGY-2
The pediatric Wards rotations are inpatient clinical experiences involving the initial workup,
management, and coordinated discharge of admitted patients during the course of their
hospitalizations for acute and chronic illnesses. The Wards experience for Senior Residents will
provide for deepening understanding the scope of inpatient medical and psychosocial care provided
by generalist and specialist pediatricians, across the age ranges from birth through young adulthood.
Senior residents in the Wards will be responsible for running the Teams and their activities, and for
teaching Interns and medical students. PL2 residents are assigned to hospitalist and clinic teams with
significant attending physician presence for consultation as they refine their independent decisionmaking and patient management skills.
Patient Care: Senior residents are expected to provide patient care that is compassionate,
appropriate and effective for the promotion of health and prevention of illness. Senior residents
must:
 Gather accurate and appropriate information for each patient encounter
 Perform physical examinations of children across all pediatric age ranges
 Demonstrate skill in performing thorough and appropriate examinations of children
admitted to Hasbro Children's Hospital
 Demonstrate skill in evidence-based and cost-conscious utilization of laboratory,
radiographic, and other testing resources
 Demonstrate skill in the accurate analysis of available information to make diagnostic
interventions and institute appropriate therapeutic decisions
 Demonstrate skill in development and implementation of an appropriate management
plan for each patient
 Demonstrate skill in providing appropriate patient follow-up (labs, etc.),
communication with outpatient physicians, and continuity of patient care
 Appropriately identify circumstances requiring subspecialty consultation, and in
arranging for and following up on such consults
Medical Knowledge: Residents and Senior residents must demonstrate a growing proficiency in
obtaining knowledge through didactic lecture, case based discussions, specific readings (both online
and through reference literature), and evidence-based medicine. They will apply an open-minded,
analytical approach to acquiring new knowledge, access and critically evaluate current medical
information and scientific evidence, and apply this knowledge to clinical problem-solving, clinical
decision-making, and critical thinking. Senior residents must:
 Demonstrate consistent skill in evaluating and managing patients with signs and
symptoms that present to the general pediatric floors
 Demonstrate knowledge and skill in the evaluation and management of common
inpatient diseases
 Demonstrate confident knowledge and understanding of the common diagnostic tests
and imaging studies used in inpatient care, including their indications, cost, and ageappropriate normal findings
Rev.3/2008







Demonstrate confident knowledge of the appropriate use of common laboratory
studies in the inpatient setting, including indications and age-appropriate normal
ranges
Demonstrate appropriate use of common inpatient monitoring techniques, including
indications, contraindications, and complications
Accurately interpret and respond appropriately to results of monitoring based on
method used, patient age, and clinical situation
Demonstrate appropriate use of standard inpatient treatments and techniques such as
universal precautions, NG tube placement, administration of nebulized medications,
wound care, IV fluids, IV pharmacotherapy, and transfusion
Describe abnormal findings at tracheostomy, gastrostomy, and central venous catheter
sites, together with appropriate intervention or referral for problems encountered
Demonstrate skill in assessment and age-appropriate management of pain
Competently identify medical and psychiatric conditions requiring subspecialty
consultation
Practice-Based Learning and Improvement: Residents and Senior residents are expected to
continuously investigate and evaluate patient care practices, appraise and assimilate clinical
information to make appropriate patient management decisions and learn from error. Senior residents
must:
 Critically review pediatric literature and web-based information relevant to patients in
their care
 Demonstrate evidence-based medical reasoning and justification for suggested
interventions
 Evaluate their own performance, identify knowledge gaps, and target self-directed
learning to fill in these gaps
 Demonstrate the capacity to learn from error
 Provide, request and accept feedback, and strive to improve their own performance
 Work appropriately with hospitalists and other in-house attending physicians,
demonstrating growing capacity for reliable independent decision-making and patient
management
 Work well with other learners to enhance knowledge
Interpersonal and Communication Skills: Residents are expected to consistently demonstrate
interpersonal and communication skills that result in effective information exchange. They must be
able to collaborate with patients, their families and professional associates. Senior residents must:
 Communicate effectively with patients, families, hospital staff, and hospital-based
physicians
 Communicate promptly and clearly with community physicians and provide seamless
continuity of care with outpatient medical providers
 Communicate relevant information through accurate dictations, written medical
records, patient presentations, sign-outs, and use of electronic prescribing
 Avoid medical jargon when speaking with patients and families
 Communicate effectively and respectfully with patients from a wide range of cultural
and socioeconomic backgrounds
 Demonstrate skill in conflict resolution, when appropriate
Rev.3/2008


Appropriately use interpreters
Demonstrate ability to counsel and educate patients and families
Professionalism: Residents are expected to demonstrate a commitment to carry out professional
responsibilities, adhere to ethical principles and be sensitive to diversity. They must have a
responsible attitude toward their patients, their profession, and society. Senior residents must:
 Consistently act in the best interests of patients
 Demonstrate a caring and respectful demeanor when interacting with patients and
families
 Interact respectfully and collegially with hospital staff
 Maintain patient and family confidentiality
 Demonstrate sensitivity to ethical principles, culture, age, gender, religious belief,
sexual orientation, and disability
 Appropriately use ethics consults in inpatient care
 Acknowledge and properly report errors
 Discuss errors honestly with families
 Be conscientious, punctual, and reliable
 Maintain patient flow as circumstances demand
 Demonstrate skill in management of challenging patients and families
Systems-Based Practice: Residents are expected to practice quality health care that is cost-effective
and advocate for patients within the health care system. They are expected to consistently
demonstrate an understanding of the interconnectedness and dependence of multidisciplinary
services. Senior residents must:
 Advocate for their patients and families as they navigate system complexities
 Demonstrate knowledge of billing and coding and their supporting documentation
 Appropriately use Case Management services and Discharge Planning
 Describe key issues in inpatient and home management of technology-dependent
children, including tracheostomy, chronic mechanical ventilation, chronic parenteral
nutrition (HAL), gastrostomy tube feeding, and permanent central venous catheter
 Demonstrate skill in coordinating with subspecialty consultants to ensure that
appropriate questions are being asked and information is being effectively
communicated between patients, families, and medical staff
 Consistently participate in multidisciplinary health care team meetings as appropriate
for their patients
Rev.3/2008
Description of Rotation
Wards Goals and Objectives – PGY-3
The pediatric Wards rotations are inpatient clinical experiences involving the initial workup,
management, and coordinated discharge of admitted patients during the course of their
hospitalizations for acute and chronic illnesses. The Wards experience for Senior Residents will
provide for deepening understanding the scope of inpatient medical and psychosocial care provided
by generalist and specialist pediatricians, across the age ranges from birth through young adulthood.
Senior residents in the Wards will be responsible for running the Teams and their activities, and for
teaching Interns and medical students. PL3 residents work with considerable independence and
autonomy in patient management, and are responsible for interfacing with a significant number of
community-based attendings who are not available in-house. In addition to leading their teams they
supervise residents rotating in from other services (e.g., Family Practice, Emergency Medicine) who
require teaching and oversight re: systems as well as clinical medicine.
Patient Care: Senior residents are expected to provide patient care that is compassionate,
appropriate and effective for the promotion of health and prevention of illness. Senior residents
must:
 Gather accurate and appropriate information for each patient encounter in which they
participate.
 Perform physical examinations of children across all pediatric age ranges
 Demonstrate skill in performing thorough and appropriate examinations of children
admitted to Hasbro Children's Hospital
 Demonstrate skill in evidence-based and cost-conscious utilization of laboratory,
radiographic, and other testing resources
 Demonstrate skill in the accurate analysis of available information to make diagnostic
interventions and institute appropriate therapeutic decisions
 Demonstrate skill in development and implementation of an appropriate management
plan for each patient
 Demonstrate skill in providing appropriate patient follow-up (labs, etc.),
communication with outpatient physicians, and continuity of patient care
 Appropriately identify circumstances requiring subspecialty consultation, and in
arranging for and following up on such consults
Medical Knowledge: Residents and Senior residents must demonstrate a growing proficiency in
obtaining knowledge through didactic lecture, case based discussions, specific readings (both online
and through reference literature), and evidence-based medicine. They will apply an open-minded,
analytical approach to acquiring new knowledge, access and critically evaluate current medical
information and scientific evidence, and apply this knowledge to clinical problem-solving, clinical
decision-making, and critical thinking. Senior residents must:
 Demonstrate consistent skill in evaluating and managing patients with signs and
symptoms that present to the general pediatric floors
 Demonstrate competent knowledge and skill in evaluation and management of
common inpatient diseases
Rev.3/2008








Appropriately use common diagnostic tests and imaging studies in inpatient care,
demonstrating competent knowledge of their indications, cost, and age-appropriate
normal findings
Appropriately use common laboratory studies in the inpatient setting, demonstrating
competent knowledge of their indications and age-appropriate normal ranges
Appropriately use common inpatient monitoring techniques, demonstrating competent
knowledge of their indications, contraindications, and complications
Accurately interpret and respond appropriately to results of monitoring based on
method used, patient age, and clinical situation
Appropriately use standard inpatient treatments and techniques (e.g. universal
precautions, NG tube placement, administration of nebulized medications, wound
care, IV fluids, IV pharmacotherapy, transfusion)
Demonstrate competent knowledge of abnormal findings at tracheostomy,
gastrostomy, and central venous catheter sites, and implement appropriate intervention
or referral for problems encountered
Demonstrate skill in assessment and age-appropriate management of pain
Appropriately identify medical and psychiatric conditions requiring subspecialty
consultation
Practice-Based Learning and Improvement: Residents and Senior residents are expected to
continuously investigate and evaluate patient care practices, appraise and assimilate clinical
information to make appropriate patient management decisions and learn from error. Senior residents
must:
 Critically review pediatric literature and web-based information relevant to patients in
their care
 Demonstrate evidence-based medical reasoning and justification for suggested
interventions
 Evaluate their own performance, identify knowledge gaps, and target self-directed
learning to fill in these gaps
 Demonstrate appropriate balance of independence and coordination in managing care
of patients of community physicians
 Demonstrate the capacity to learn from error
 Provide, request and accept feedback, and strive to improve their own performance
 Work well with other learners to enhance knowledge
Interpersonal and Communication Skills: Residents are expected to consistently demonstrate
interpersonal and communication skills that result in effective information exchange. They must be
able to collaborate with patients, their families and professional associates. Senior residents must:
 Communicate effectively with patients, families, hospital staff, and hospital-based
physicians
 Communicate promptly and clearly with community physicians and provide seamless
continuity of care with outpatient medical providers
 Communicate relevant information through accurate dictations, written medical
records, patient presentations, sign-outs, and use of electronic prescribing
 Avoid medical jargon when speaking with patients and families
Rev.3/2008




Communicate effectively and respectfully with patients from a wide range of cultural
and socioeconomic backgrounds
Demonstrate skill in conflict resolution
Appropriately use interpreters
Demonstrate skill in counseling and educating patients and families
Professionalism: Residents are expected to demonstrate a commitment to carry out professional
responsibilities, adhere to ethical principles and be sensitive to diversity. They must have a
responsible attitude toward their patients, their profession, and society. Senior residents must:
 Consistently act in the best interests of patients
 Demonstrate a caring and respectful demeanor when interacting with patients and
families
 Model respectful and collegial interaction with hospital staff
 Maintain patient and family confidentiality
 Demonstrate sensitivity to ethical principles, culture, age, gender, religious belief,
sexual orientation, and disability
 Appropriately use ethics consults in inpatient care
 Acknowledge and properly report errors
 Discuss errors honestly with families
 Be conscientious, punctual, and reliable
 Maintain patient flow as circumstances demand
 Demonstrate skill in management of challenging patients and families
Systems-Based Practice: Residents are expected to practice quality health care that is cost-effective
and advocate for patients within the health care system. They are expected to consistently
demonstrate an understanding of the interconnectedness and dependence of multidisciplinary
services. Senior residents must:
 Advocate for their patients and families as they navigate system complexities
 Demonstrate knowledge of billing and coding and their supporting documentation
 Skillfully supervise and instruct residents rotating in to the Wards from other services
 Appropriately use Case Management services and discharge planning
 Competently describe key issues in inpatient and home management of technologydependent children (e.g., tracheostomy, chronic mechanical ventilation, chronic
parenteral nutrition (HAL), gastrostomy tube feeding, and permanent central venous
catheter) and work to facilitate their successful resolution
 Demonstrate competence in coordinating with subspecialty consultants to ensure that
appropriate questions are being asked and information is being effectively
communicated between patients, families, and medical staff
 Consistently participate in multidisciplinary health care team meetings as appropriate
for their patients
Rev.3/2008