Ambulatory Pediatrics (PGY-2)

Description of Rotation or Educational Experience

This one-month experience is structured to give the resident an immersion experience in the care of children from a pediatrician's perspective. The resident will learn the evaluation and management of ambulatory pediatric concerns.

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. Residents are expected to:

Competencies

• Receive training to perform those clinical procedures required for their future practices in the ambulatory and hospital environments.
• Receive training that focuses on the core principles of Family Medicine: including Continuity of Care, Family-Oriented Comprehensive Care Experience, Family Medicine Center Experience, Patient Care Experience, FMC Continuity and Accessibility, Medical/Surgical Experiences, and Inpatient Experiences.

Objectives

By the end of the rotation the resident is expected to:

• Perform age-appropriate history and physical examinations on infants, children, and adolescents
• Describe the evaluation and management of:
• New onset, stable, and acute exacerbation of asthma in children
• AD(H)D
• Various pediatric exanthems including Measles, Mumps, Rubella, Polio, Roseola, Fifth's disease, contact dermatitis, tinea corporis/capitis, scabies, lice
• Common pediatric infectious diseases including, Otitis Media, Otitis Externa, pharyngitis, UTI, bronchitis, pneumonia, cellulitis, sinusitis, mononucleosis, influenza, STD
• Substance abuse issues
• Suicidal ideation in adolescents and prevention of accidents
• Discuss and implement recommendations for immunizations, immunizations schedules.

Medical Knowledge

Goal

Residents must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as the application of this knowledge to patient care. Residents are expected to:

Competencies

• This rotation fulfills family medicine-specific training and educational requirements for the Care of Neonates, Infants, Children, and Adolescents.

Objectives

By the end of the rotation the resident is expected to:

• Describe the normal growth and development of the newborn, infant, child, and adolescent.

Practice- Based Learning and Improvement

Goal

Residents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and life long learning. Residents are expected to develop skills and habits to be able to :

Competencies

• Identify strengths, deficiencies and limits in one’s knowledge and expertise;
• Systematically analyze practice, using quality improvement methods, and implement changes with the goal of practice improvement
• Participate in the education of patients, families, students, residents and other health professionals, as documented by evaluations of a resident’s teaching abilities by faculty and/or learners

Objectives

By the end of the rotation the resident is expected to:

• Correctly immunize children based on the most recent recommendations of the AAFP.
• Discuss the indications and contraindications to each vaccine, complications, and management of out-of-cycle children

Systems Based Practice

Goal

Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care. Residents are expected to:

Competencies

• Coordinate patient care within the health care system relevant to their clinical specialty
• Incorporate considerations of cost awareness and risk-benefit analysis in patient care

Objectives

By the end of the rotation the resident is expected to:

• Be able to access and update MICR.
• Be able to access CDC website for most current pediatric immunization schedule.

Professionalism

Goal

Residents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Residents are expected to demonstrate:

Competencies

• Accountability to patients, society, and the profession
• Sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation

Objectives

By the end of the rotation the resident is expected to:

• Understand the process for screening and reporting suspected child abuse.

Interpersonal and Communication Skills

Goal

Residents must demonstrate interpersonal and communication skills that result in the effective exchange of information and teaming with patients, their families, and professional associates. Residents are expected to:

Competencies

• Communicate effectively with patients and families across a broad range of socioeconomic and cultural backgrounds
• Maintain comprehensive, timely, and legible medical records

Objectives

By the end of the rotation the resident is expected to be able to:

• Discuss age-appropriate parental counseling for the infant, child, and adolescent

Teaching Methods

What teaching methods are you using on this rotation or educational experience?

• Didactic lecture
• Direct role-modeling and observation

Assessment Method (residents)

How do you measure the resident’s performance on this rotation or educational experience?

• Faculty evaluations of the rotator’s performance
• Real-time feedback during direct observation
• Resident is to generate self-observed behavior reports in each competency at least weekly over the course of this rotation.

Assessment Method (Program Evaluation)

How do you evaluate whether this educational experience is effective?

• Resident evaluation of rotation

Level of Supervision

How is the resident supervised on this rotation?

· Directly by attending physicians

Educational Resources

List the educational resources

• Relevant orientation materials are indicated and/or given at the beginning of the rotation and used throughout.

Resources and people residents have identified as useful, and encourage new rotators to become familiar with:

• Make time to talk to your colleagues who have finished the rotation
• Clinic starts at 9am, Detroit East Pediatrics
• Get the up-to-date immunization recommendations and keep them handy
• Become familiar with accessing and recording vital signs on the growth charts