AMBULATORY CARE CLINIC
The Ambulatory Care portion of your Junior Pediatrics Clerkship is to be
held in the Women's and Children's Clinic.
The Clinic is located at the corner of
EVALUATION OF THE CORE SKILLS
1. Students will be evaluated on a one-on-one basis by a preceptor on each patient that they exam. A grade of Pass/Fail will be given to the student after each one half-day session via My Evaluations. Supervision and feedback are immediate.
2. Objective and direct observation: Complete/problem focused history and physical exam with emphasis on:
a. Ear exam
b. Heart and lung exam with RR, HR. and BP.
c. History taking, doctor-patient communication, physical examination, and interactive skills with patients. (Direct observation of all students on first day of outpatient rotation by either staff in ACCESS or by residents in PACC.)
3. The residents will do some direct observation of the junior students performing aspects of the history and physical examination, specifically the items listed in number 2.
4. Log all patient encounters in My Evaluations (patient log). Fill in the Procedure portion for your Direct Observation and HEADS exam patients.
5. Copy the completed clinic record (yellow sheet) and place it in your folder in the Student Conference room. There are 2 copy machines in the clinic that you may use.
JUNIOR STUDENTS/RESIDENT SUPERVISORS
During part of your general ambulatory rotation, an upper level resident will be your immediate supervisor in the PACC or a staff physician, if a resident is not available.
The resident or staff physician in PACC will be responsible for your evaluation for each session.
Each one-half day encounter in the PACC with a resident should include some observation by the student of the resident performing a history and a physical examination on a patient, developing the subsequent diagnosis and treatment plan for the patient.
On the first one-half day session that the student is in clinic (8:30 a.m. - 12 p.m. or 1 p.m. - 5 p.m.), the resident will directly observe and evaluate the student performing a history and physical examination on a patient, arriving at a diagnosis and developing a treatment plan for that patient.
The resident will then give immediate feedback to the student on his/her performance. The resident will, also, immediately grade (Pass/Fail) the student on his/her performance in My Evaluations. The grading does not have to be done with the student present but should be done ASAP for best results. Each student should have two evaluations completed each day (one for the a.m. session and one for the p.m. session).
Student and resident assignments will be made and posted in the General Pediatric Ambulatory Care Clinic.
THE GOALS AND OBJECTIVES OF
THE PEDIATRIC
OUTPATIENT CLINIC
Goals
1. Foster the best possible environment for learning newborn, child, and adolescent health care.
2. Provide students with the opportunity to interview, communicate, examine, and interact appropriately with patients and their families in an ambulatory setting.
3. Provide students with the necessary information to develop competence in the core skills and core knowledge topics outlined in the core curriculum.
4. Provide students with the opportunity to understand the role of the pediatrician in the coordination of medical and psychosocial care of a patient in an ambulatory setting.
5. Provide students with adequate role models to attain the appropriate professional conduct and attitudes necessary for a good and effective physician to possess.
Objectives
At completion of the Pediatric Clerkship, all students
should be able to:
1. Obtain an adequate history and perform an age-appropriate physical examination on an infant, child, or adolescent patient.
2. Document the pertinent positive and negative findings in an accurate and concise manner.
3. Organize and present patient data in a focused and effective manner.
4. Demonstrate appropriate use of laboratory, diagnostic, and imaging studies in order to accurately diagnose a patient’s illness.
5. Arrive at a differential diagnosis and/or diagnosis and formulate a plan for treatment and final disposition of the patient in an outpatient setting.
6. Communicate the diagnosis, treatment, and disposition of the patient with the patient and/or the primary caregiver.
7. Recognize the psychological and social needs of the patient and caregiver.
8. Use effectively resource materials such as textbooks of Pediatrics, Pediatric journals, and lectures to increase basic fundamental knowledge of Pediatrics.
9. Develop life-time habits of self-learning and self-directed study, learn how to perform literature searches and use other computer-based resources to stay current with medical advances in patient care.
10. Present effectively a seminar concerning an assigned topic with the use of visual aids.
11. Describe correctly the indications and performance of specific pediatric procedures.
12. Exhibit professional attitudes and behaviors befitting a physician.
13. Perform a HEEADSSS exam on an adolescent patient.
GOALS AND OBJECTIVES OF
THE PEDIATRIC URGENT
Goals
1. Teach students the care of priority I or seriously ill pediatric patients.
2. Provide the student with the opportunity to observe pediatric procedures commonly required in the diagnosis and care of seriously ill pediatric patients.
3. Provide the student with the opportunity to observe the role of the pediatrician in the collaboration of care of seriously ill patients with other health professionals.
Objectives
At completion of the Pediatric Clerkship, the students will be able to:
1. Identify the patient requiring immediate medical attention and intervention.
2. Develop a differential diagnosis and plan of management for common illnesses (such as: neonate with fever, fever without a focus, possible sepsis, seizures, dehydration, asthma exacerbation, sickle cell anemia with fever and/or pain crisis, pneumonia with and without hypoxia, or apparent-life threatening event).
3. Describe the indications and use of laboratory, X-Ray, etc for the diagnosis and management of common illnesses.
4. Describe the indications and technique for pediatric procedures such as lumbar puncture (LP), venipuncture, suprapubic aspiration (SPA), IV placement, and urethral catheterization in a seriously ill pediatric patient.