Pediatrics ER (PGY-3)

Description of Rotation or Educational Experience

This six-week experience is designed to allow the resident to gain a working knowledge of common emergency problems and is taught by Childrens Hospital Emergency Medicine physicians. The resident will staff the ER on various shifts to see the full spectrum of care and also maintain a presence at the family practice center

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 be able to:

• Discuss the approach to the patient presenting with a pediatric emergency
• Effectively prioritize and triage patients and perform a focused but thorough history and physical

The resident is encouraged to familiarize themselves with the following procedures during this rotation:

• Use of activated charcoal
• Suturing
• Wound treatment and dressings
• Wound debridement
• Nasogastric lavage
• Use of syrup of Ipecac
• Splinting of extremities
• Cardiopulmonary resuscitation
• Foley Catheter insertion
• Arterial Blood Gas

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 Emergency Medicine and the Care of Neonates, Infants, Children, and Adolescents.

Objectives

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

• Discuss the use and correct interpretation of emergency diagnostics including electrocardiograms; and chest, abdomen, extremity and spine radiographs and laboratory testing
• Discuss the evaluation and management of a patient with:
• Compromised airway, dyspnea, respiratory distress, respiratory failure
• Chest pain including immediate management of life threatening conditions and further evaluation of non life-threatening conditions
• Abdominal pain including immediate life-threatening problems and the further evaluation of non life-threatening conditions
• GI bleeding
• Diarrhea and / or emesis
• Loss of consciousness including syncope and seizures
• Strokes or TIA
• Mental status changes including delirium and dementia
  Musculoskeletal problems including arthritis and low-back pain
• Gynecologic emergencies including vaginal bleeding, vaginal discharge, pelvic pain, pelvic masses, and victims of sexual assault
• Trauma including blunt and penetrating
• Poisonings and drownings

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;
• 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

Insert a measurable objective for the one or two competencies you have chosen.

• Use laboratory tests appropriately

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
• Advocate for quality patient care and optimal patient care systems
• Work in interprofessional teams to enhance patient safety and improve patient care quality

Objectives

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

• Provide appropriate consultation and/or referral

Professionalism

Goal

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

Competencies

• Compassion, integrity, and respect for others
• 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 be able to:

• Display appropriate professional attitudes and behaviors in emergencies

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
• Communicate effectively with physicians, other health professionals, and health related agencies

Objectives

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

• Communicate bad news to families in effective and sensitive way.

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.