ROTATION DESCRIPTION

 

 

ROTATION:               Pediatrics

 

PRECEPTORS:      Pediatricians Admitting to WMH

 

DURATION:               One Month each in PG-1 and PG-2

 

 

1.   GOALS/OBJECTIVES OF ROTATION:

      A.  Outpatient

      --    Learn normal growth and development and develop a systematic approach to well-child visits.

      --    Learn how to give appropriate anticipatory guidance to new parents.

--    Diagnose and manage common problems in office pediatrics.

      --    Recognize abnormal growth and/or development and know when and how to make appropriate referrals.

      --    Learn the importance of patient education and become familiar with available resources.

      --    Differentiate patients who can be managed as outpatients from those who need admission.

      --    Develop methods to efficiently and thoroughly see patients in a busy office practice.

 

      B.   Inpatient

      --    Diagnose and manage frequently encountered pediatric problems in a community-based hospital.

      --    Recognize complex or infrequently encountered problems which require consultation and/or referral.

      --    Develop procedural skills to include IV's, lumbar punctures, nasogastric intubation, ABG's.

    

2.   EXPECTATIONS OF ROTATION:

      The rotation will center around residents working with pediatrician preceptors in 4 week blocks. The resident's responsibility will be to participate in preceptors’ office practices, as well as being responsible for providing inpatient care to any pediatric patient admitted to Waukesha Memorial Hospital by the pediatric groups of Waukesha Medical Centers or Waukesha Pediatric Associates. In addition, the resident will take Teaching Service call q4 nights.

 

A. Outpatient 

      The office or outpatient experience is an important portion of the rotation. This will consist of the resident initially observing preceptors evaluate and manage patients. However, as the resident gains outpatient experience they will have opportunities to provide the initial evaluation of outpatients in preceptors’ offices and participate in developing and implementing management plans. The typical process would involve the resident seeing a patient prior to the preceptor, staffing their findings with the preceptor, and developing management plans in consultation with the preceptor. The preceptor would then perform any additional evaluation. Finally, the resident and preceptor would initiate treatment. The resident is expected to write notes detailing the evaluation and management of each patient. All efforts will be made to coordinate the resident's required WFPC continuity clinics (see below) with the schedule of the preceptor. 

 

B. Inpatient  

      The resident will be responsible for performing the initial evaluation and management of any patients from Waukesha Medical Center and Waukesha Pediatric Associates who are admitted to Waukesha Memorial Hospital. This may include evaluating any of the preceptor’s patients who present to the emergency room for conditions that may require hospitalization. The resident will then develop an initial management plan in consultation with the preceptor. They will summarize any findings and the initial plan in a short written note and a dictated history and physical. The resident will follow patients during the hospitalization and develop ongoing management plans with the preceptor. Daily progress notes are required on weekdays and weekends when TS overflow policy is not in effect.

 

      The resident should remain aware of daily progress of each patient even when progress notes are not required.

 

      The resident should perform all procedures under the supervision of the preceptor. Procedure cards/PDA's should be used to document all procedures.

3.  SUGGESTED PREPARATION/REFERENCES:

      --    Nelson's Pediatrics

      --    Harriet Lane useful for quick reference

      --    Nelson's antibiotic guide useful for quick reference

 

The resident should also discuss with preceptors which resources preceptors have found most useful.

 

4.  REQUIRED CONTINUITY CLINICS AT THE WAUKESHA FAMILY PRACTICE CENTER:

All residents have a panel of patients for whom they serve as the primary care provider. There are required clinics each week which take precedence over rotation responsibilities. For PG-1 residents in their first 6 months, one 1/2 day per week on a day that is not post-call. For PG-1 residents in their last 6 months, one to two 1/2 days per week that are not post-call. For PG-2 residents, two 1/2 days per week that are not post-call. As described above, there will be an effort made to coordinate these clinics with the preceptor's schedule in order to minimize the impact on the rotation. Every effort will be made to avoid placing Peds residents in evening clinic; if it is necessary to do so, this will be limited to 1 clinic per month on non-post-call.

 

5. TYPICAL DAY/WEEK:

Except for required clinics as described above and lectures required by the residency as part of the longitudinal curriculum, the resident's schedule will be determined by the preceptor's schedule.

 

6.  CALL:

            Call will be q4 and divided with the residents on TS. Call may be taken from home. The resident on call will be responsible for all pediatric admissions for the pediatric groups of Waukesha Medical Center and Waukesha Pediatric Associates, cross-coverage of all previously admitted patients on the pediatric service, and all TS admissions. During weekend call coverage, the pediatric resident is primarily responsible for TS patients. The resident will round on pediatric patients, and write notes if time permits. Residents may also be involved in interesting teaching cases for other pediatricians when their workload is light.

 

            7.   AVAILABLE EDUCATION EXPERIENCES/CONFERENCES:

The resident is expected to do additional reading about interesting cases they encounter. Whenever possible the resident should discuss this reading with the preceptor. The preceptor is encouraged to help the resident find good, evidence-based resources in addition to communicating personal knowledge and experiences.

     

8.   VACATIONS:

            Up to two days of vacation or CME are allowed, but this cannot conflict with call responsibilities.

 

9.   EVALUATION:

      The resident should discuss personal expectations for the rotation with the preceptor. The resident should review the evaluation form with the preceptor at the beginning of the rotation. The resident should obtain feedback from each preceptor on their performance midway through the rotation. The preceptors will complete an evaluation form and review this with the resident at the midway point and at the end of the rotation. The resident should then return the evaluation forms to the curriculum coordinator, who will distribute the completed forms to Dr. Fay and the resident's advisor for their review.   

 

10. CRITERIA FOR SUCCESSFUL COMPLETION:

            Completed evaluation forms from each preceptor indicating that the resident has actively participated in the rotation as described, has satisfactorily completed all responsibilities, and has not demonstrated any significant deficits in knowledge or performance (this includes meeting all call and clinical responsibilities).

 

 

 

 

Revised: 05/23/05 (DLF:lmc)

F:\SHARE\WFPC\Admin\Curriculum Coordinator\Rotation Descriptions\Pediatrics.doc