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Pediatrics Clerkship MPED 700 9 Credit Hours
SYLLABUS
2019-2020 ACADEMIC YEAR
Education Director: Jean Kim, MD [email protected] RWCLC 1.079
Clinical Education Specialist: Kathleen Fisher, DNP, APRN/CNS, CHSE, CCRN, CCNS [email protected] RWCLC 1.078
Undergraduate Medical Education Specialist: Maria Ramirez [email protected] Office Phone: 847-578-8703 RWCLC 1.088 7/30/19 1 CLERKSHIP DESCRIPTION
The pediatric clerkship is a major component of a medical student’s pediatric educational experience during medical school. It shares with other core clerkships common goals in developing competent general physicians. For some students this intensive clinical experience is their primary opportunity to learn about the health and illness issues of children.
Pediatrics is a unique application of human developmental biology. Thus, clinical pediatrics focuses on the impact of disease on the developing human. The pediatrician observes and treats the child within the context of the family, community, and society. Prevention of disease, in addition to its treatment, is an essential aspect of pediatrics. Pediatricians collaborate with other health professionals to meet these goals.
The clerkship curriculum provides all students with the basic skills and knowledge necessary to care for children and their families. The emphasis is upon an understanding of normal processes, such as growth and development, health assessment and maintenance, and common problems unique to children. In addition, the pediatric clerkship is an opportunity to introduce students to the intellectually and personally fulfilling aspects of pediatrics to foster interest in pediatrics as a career choice.
During the pediatric clerkship, students have contact with general and, at some sites, subspecialty pediatricians. The clerkship emphasizes those aspects of pediatrics to be mastered by all students so that they may become competent generalists. With limited time available in the core clerkship, basic skills and common issues in both health and disease will be the focus.
The CMS Pediatric Clerkship is structured in a 6-week format. As pediatrics is becoming more and more an outpatient specialty, students at every clinical site will have an extensive outpatient experience. Because students have different learning styles, the curriculum contains a variety of educational formats, each of which emphasizes active participation by the student. Students are evaluated by a thorough assessment of knowledge as well as skills and attitudes.
CLERKSHIP OBJECTIVES
1. Describe the bio-physical, clinical and epidemiological scientific principles underlying mechanisms and methods of diagnostic and therapeutic decision-making of care in emergent and non-urgent pediatric cases to include history and physical patient information gathering and prioritizing, screening, ordering and interpreting laboratory, pathologic and imaging studies. (1.2, 1.3, 1.4, 1.5, 2.1, 2.2, 2.3, 2.4)
2. Perform routine medical and diagnostic procedures for patients with pediatric conditions. (1.1, 1.6) 6/6/19 2
3. Identify factors that place individuals at risk for disease or injury including social-behavioral sciences and cost awareness and use strategies to prevent or slow the disease process. (1.9, 2.4, 2.5, 3.9, 6.3)
4. Demonstrate respect, patient autonomy, dignity, compassion, integrity, honesty, trust and compassion when engaging in working interactions and communications with patients, their families, peers, the public, the university community and other healthcare providers in the pediatric rotations. (1.8, 4.1, 4.2, 4.3, 5.1, 5.3, 7.1, 7.3)
5. Demonstrate interpersonal and communication skills that result in effective education, with patients and family members. (1.7, 3.8)
6. Identify strengths, gaps and deficiencies, and limits in one's knowledge and skill through self-awareness, feedback seeking behaviors, setting of improvement goals and learning activities with the goal of improving practice. (3.1, 3.2, 3.3, 3.5, 8.1)
7. Demonstrate use of information technology to search for, evaluate, and apply evidence-based medicine for solving clinical problems. (2.1, 3.6, 3.7, 3.10)
8. Use the knowledge of one’s own role and the roles of other health professionals to assess appropriately, address, and advance the health care needs, and advance the health of the patients and populations served. (7.2)
9. Demonstrate effective written and oral communication skills when interacting with all members of the healthcare team including the ability to prepare and organize appropriate, legible and timely medical records for pediatric patients. (1.2, 1.3, 4.5)
Reference D2L for COMPETENCY MAP
CLERKSHIP-SPECIFIC PERFORMANCES, PROJECTS, REQUIREMENTS
In addition to the required minimum patient encounters listed, the following are requirements of the clerkship:
Aquifer Pediatrics Cases
Aquifer Pediatric Cases are 32 interactive virtual patient cases are designed to encompass the learning objectives of the Council on Medical Student Education in Pediatrics (COMSEP) curriculum comprehensively. During the course of the clerkship, each student is required to
6/6/19 3 complete any 10 cases. For the cases to be educationally meaningful, they should be done in a careful and thoughtful manner. Students who demonstrate poor level of engagement, recorded as “red” by the system will not receive credit for completion of the case. All cases must be completed by the end of the clerkship (see D2L for specific due dates).
Aquifer cases are accessed at https://www.aquifer.org/courses/aquifer-pediatrics/. Students must register with their Rosalind Franklin email address.
In addition, on Aquifer are three courses: High Value Care, Medical Home, and Culture in Health Care. Students must complete the following cases by the end of the clerkship (see D2L for specific due dates). The level of engagement will be recorded. One HVC case (HVC 07 or 08) This is a high value care activity. One Medical Home case (Medical Home 03 or 04) This is an interprofessional activity. One Culture in Health Care case (any) This is a population health/disparities activity.
Required Didactic Sessions
• Orientation will occur on the first day of the clerkship at the CMS campus. Attendance at this session is mandatory. Basic introductory topics concerning the logistics of the clerkship will be covered. In addition, overview teaching of newborn care will be given in this half-day session.
• Formal teaching sessions for the clerkship consist of four mandatory lectures that are given at one site. Three of these sessions are given with remote web conferencing; one lecture is in the format of interactive jeopardy for which all students are required to attend in person. Attendance is mandatory; any missed sessions will require a make-up activity, to be determined by the clerkship director.
Other Required Assignments:
History and Physical examinations (H&P) - Observed and Written
Throughout the clerkship, students will be performing history-taking and physical examination under the supervision of the site preceptor(s). Each student is required to have a minimum of two (2) observed H&Ps with one prior to and one after the mid-term evaluation with the site director. A form is provided on D2L (“Observed H&P Evaluation form”) to help with this evaluation and should be placed in the dropbox on D2L prior to the end of the clerkship (see D2L for specific due dates).
In addition, two (2) written H&Ps must be submitted and reviewed with the site director, one prior to and one following the mid-term 6/6/19 4 evaluation. A rubric is provided on D2L to provide guidance for students as to the standard approach to pediatric H&Ps. These must be placed in the dropbox on D2L prior to the end of the clerkship (see D2L for specific due dates).
Evidence-based medicine presentation
During the pediatrics rotation, each student is required to present one clinical case to the site director with a patient management plan that is based on a literature search for evidence to support the proposed diagnostic or treatment plan. The structure for the presentation may be variable with the focus of the activity being a careful literature search and thorough understanding of the materials presented. An evaluation form is provided on D2L for the site director to use in evaluating this presentation (“Medical Student CPC Evaluation Form”). This completed form should be placed in the dropbox on D2L prior to the end of the clerkship (see D2L for specific due dates).
Fluids and Electrolytes Quiz
Students are required to view an online presentation on “Fluids and Electrolytes” and to complete an online quiz on D2L (see D2L for specific due dates).
Remediation of Clerkship-Specific Performances:
• Students who do not complete all clerkship requirements by 11:59 pm on Sunday following the clerkship end date will receive an Unsatisfactory for “Clerkship-Specific Performances, Requirements or Activities,” resulting in a temporary notation of Needs Remediation for the clerkship. • Students will have one additional week (ending at 11:59 pm the following Sunday) to remediate any missing/insufficient requirements. • Per the CMS Clerkship Grading Policy, if the student passes the remediation, they will receive a grade of “Pass” for the rotation. If the student fails to remediate within this one-week remediation period, they will receive a grade of “Fail” for the rotation.
REQUIRED PATIENT ENCOUNTERS
Type of Patient/ Clinical Clinical Level of Student Benchmark/Explanation Alternative Condition Setting Responsibility
6/6/19 5 Type of Patient/ Clinical Clinical Level of Student Benchmark/Explanation Alternative Condition Setting Responsibility Abdominal pain/ I, O PP Student will participate in the evaluation of Students unable to meet the minimum PP Gastroenteritis/ other the patient. Student will obtain history, Abdominal pain/ Gastroenteritis patient gastrointestinal symptom perform physical, and participate in developing encounters will complete one of the related (Nausea, vomiting, diarrhea) clinical assessment and diagnostic and CLIPP cases 16, 22 or 27. The clerkship therapeutic plan, along with or under the coordinator will review the completion of this guidance of a resident or attending physician. case. Anemia I, O PP Student will participate in the evaluation of Students unable to meet the minimum PP the patient. Student will obtain history, Anemia patient encounters will complete one perform physical, and participate in developing of the related CLIPP cases 27 or 30. The clinical assessment and diagnostic and clerkship coordinator will review the therapeutic plan, along with or under the completion of this case. guidance of a resident or attending physician. Asthma/lower respiratory I, O PP Student will participate in the evaluation of Students unable to meet the minimum PP tract symptom the patient. Student will obtain history, Asthma/lower respiratory tract symptom perform physical, and participate in developing patient encounters will complete related CLIPP clinical assessment and diagnostic and case 12 or 13. The clerkship coordinator will therapeutic plan, along with or under the review the completion of this case. guidance of a resident or attending physician. Behavior Disorder I, O PP Student will participate in the evaluation of Students unable to meet the minimum PP the patient. Student will obtain history, Behavior Disorder patient encounters will perform physical, and participate in developing complete related CLIPP case 4. The clerkship clinical assessment and diagnostic and coordinator will review the completion of this therapeutic plan, along with or under the case. guidance of a resident or attending physician. Central Nervous System I,O PP Student will participate in the evaluation of Students unable to meet the minimum PP Symptom (Lethargy, the patient. Student will obtain history, Central Nervous System Symptom patient irritability, fussiness, perform physical, and participate in developing encounters will complete related CLIPP case 20 headache) clinical assessment and diagnostic and or 24. The clerkship coordinator will review therapeutic plan, along with or under the the completion of this case. guidance of a resident or attending physician. Dehydration I, O PP Student will participate in the evaluation of Students unable to meet the minimum PP the patient. Student will obtain history, Dehydration patient encounters will complete perform physical, and participate in developing related CLIPP case 15. The clerkship clinical assessment and diagnostic and coordinator will review the completion of this therapeutic plan, along with or under the case. guidance of a resident or attending physician.
6/6/19 6 Type of Patient/ Clinical Clinical Level of Student Benchmark/Explanation Alternative Condition Setting Responsibility Developmental Delay I, O PP Student will participate in the evaluation of Students unable to meet the minimum PP the patient. Student will obtain history, Developmental Delay patient encounters will perform physical, and participate in developing complete related CLIPP case 28 or 29. The clinical assessment and diagnostic and clerkship coordinator will review the therapeutic plan, along with or under the completion of this case. guidance of a resident or attending physician. Fever I, O PP Student will participate in the evaluation of Students unable to meet the minimum PP the patient. Student will obtain history, Fever patient encounters will complete related perform physical, and participate in developing CLIPP case 10 or 11. The clerkship coordinator clinical assessment and diagnostic and will review the completion of this case. therapeutic plan, along with or under the guidance of a resident or attending physician. Growth Disorder I, O PP Student will participate in the evaluation of Students unable to meet the minimum PP the patient. Student will obtain history, Growth Disorder patient encounters will perform physical, and participate in developing complete related CLIPP case 26. The clerkship clinical assessment and diagnostic and coordinator will review the completion of this therapeutic plan, along with or under the case. guidance of a resident or attending physician. Health Maintenance – Infant I, O PP Student will participate in the evaluation of Students unable to meet the minimum PP (1-12 mos.) the patient. Health Maintenance Student will obtain history, perform physical, – Infant patient encounters will complete and participate in developing clinical related CLIPP case 2. The clerkship coordinator assessment, along with or under the guidance will review the completion of this case. of a resident or attending physician. Health Maintenance – I, O PP Student will participate in the evaluation of Students unable to meet the minimum PP Toddler (1-4y) the patient. Health Maintenance Student will obtain history, perform physical, – Toddler patient encounters will complete and participate in developing clinical related CLIPP case 3. The clerkship coordinator assessment, along with or under the guidance will review the completion of this case. of a resident or attending physician. Health Maintenance - I, O PP Student will participate in the evaluation of Students unable to meet the minimum PP School Age (5-12y) the patient. Health Maintenance Student will obtain history, perform physical, – School Age patient encounters will complete and participate in developing clinical related CLIPP case assessment, along with or under the guidance 4. The clerkship coordinator will review the of a resident or attending physician. completion of this case.
6/6/19 7 Type of Patient/ Clinical Clinical Level of Student Benchmark/Explanation Alternative Condition Setting Responsibility Health Maintenance - I, O PP Student will participate in the evaluation of Students unable to meet the minimum PP Adolescent the patient. Health Maintenance Student will obtain history, perform physical, – Adolescent patient encounters will complete and participate in developing clinical one of the related CLIPP cases 5 or 6. The assessment, along with or under the guidance clerkship coordinator will review the of a resident or attending physician. completion of this case. Newborn Examination I, O PP Student will participate in the evaluation of Students unable to meet the minimum PP the patient. Newborn Examination patient encounters will Student will obtain history, perform physical, complete one of the related CLIPP cases 1. The and participate in developing clinical clerkship coordinator will review the assessment, along with or under the guidance completion of this case. of a resident or attending physician. Rash I, O PP Student will participate in the evaluation of Students unable to meet the minimum PP the patient. Student will obtain history, Rash patient encounters will complete related perform physical, and participate in developing CLIPP case 31 or 32. The clerkship coordinator clinical assessment and diagnostic and will review the completion of this case. therapeutic plan, along with or under the guidance of a resident or attending physician. Seizure I, O PP Student will participate in the evaluation of Students unable to meet the minimum PP the patient. Student will obtain history, Seizure patient encounters will complete perform physical, and participate in developing related CLIPP case 19. The clerkship clinical assessment and diagnostic and coordinator will review the completion of this therapeutic plan, along with or under the case. guidance of a resident or attending physician. Trauma I, O PP Student will participate in the evaluation of Students unable to meet the minimum PP the patient. Student will obtain history, Trauma patient encounters will either perform perform physical, and participate in developing an oral presentation or attend a lecture on the clinical assessment and diagnostic and topic. The site director will document therapeutic plan, along with or under the attendance/completion of this alternative. guidance of a resident or attending physician. Upper Respiratory Tract I, O PP Student will participate in the evaluation of Students unable to meet the minimum PP Symptom (Sore throat, the patient. Student will obtain history, Upper Respiratory Infection patient difficulty swallowing, perform physical, and participate in developing encounters will complete related CLIPP case otalgia) clinical assessment and diagnostic and 14. The clerkship coordinator will review the therapeutic plan, along with or under the completion of this case. guidance of a resident or attending physician.
6/6/19 8 Type of Patient/ Clinical Clinical Level of Student Benchmark/Explanation Alternative Condition Setting Responsibility Urinary Tract Infection I, O PP Student will participate in the evaluation of Students unable to meet the minimum PP the patient. Student will obtain history, Urinary Tract Infection patient encounters will perform physical, and participate in developing complete related CLIPP case 10. The clerkship clinical assessment and diagnostic and coordinator will review the completion of this therapeutic plan, along with or under the case. guidance of a resident or attending physician.
Level of Student Responsibility
Observation (OB) clinical reasoning only Partial Participation (PP) history or physical examination Full Participation (FP) history, physical examination, and clinical reasoning
NOTE: For each Alternative Learning Experience substituted with a CLIPP case, the experience must be documented on One45 as an “alternative learning experience.”
REQUIRED AND RECOMMENDED CLERKSHIP MATERIALS
1. Nelson, “Essentials of Pediatrics, 8th ed;” Saunders. 2. CURRENT Diagnosis and Treatment Pediatrics, 23e, McGraw-Hill Companies, Inc. (Free to students through Access Medicine in Boxer Library online) 3. Zitelli and Davis’ Atlas of Pediatric Physical Diagnosis, 7th ed; Saunders. 4. Shelf-Life Pediatrics. Lippincott Williams & Wilkins, 2015 ISBN-13: 978-1-4511-8957-5 5. The Harriet Lane Handbook, 20e (Pediatrics) 6. UpToDate App and Website (Free to students through Boxer Library) 7. DynaMed Plus App and Website (Free to students through Boxer Library) 8. AccessMedicine App (Free to students through Boxer Library, App is very different from Boxer Library accessed Website)
Additional resources including growth charts, immunization schedules, etc. are available on D2L under “Resources.”
EVALUATION, EXAMINATION, AND REMEDIATION POLICIES 6/6/19 9
Refer to D2L for:
• CMS Clerkship Absence Policy document for examination and other clinical experience remediation guidelines. • Clerkship Absence Request Form • CMS Clerkship Grading Policy • Clinical Evaluation Standards • Required Minimum Patient Encounters are included in the syllabus and indicate specific patient type/clinical condition remediation guidelines. • CMS Clerkship Remediation/Rescheduled Exam Policy document for specific make-up/retake examination guidelines. • CMS Exam Conduct Policy • RFUMS Exam Loaner Laptop Policy
NBME Online Shelf Exam:
The NBME Online Shelf Exam is typically held at the RFUMS Campus on the last Friday of the rotation from 9:00 a.m. to 12:00 p.m. However, please refer to D2L for the most recent updates.
The NBME is responsible for grading exams. No challenges are accepted for NBME exams. Scores will be available approximately 1-2 weeks after the exam has been completed, but will not be published until clinical evaluations have been received.
In general, Clerkship Directors will determine how the student will make up patient encounters, clinical activities or other clerkship requirements. Clerkship Directors will determine if and when the student will be required to repeat the clerkship. Clerkship Directors will use case-by- case evaluation and coordinate with the Office of Student Affairs & Education.
CMS Remediation Procedures:
Eligibility Criteria for Remediation: At the end of the rotation, students who have an unsatisfactory/failing grade in any of the applicable course components (final exam, clinical evaluation, and/or performances) will be offered remediation for the component(s) they have failed.
Process for Remediation: Students are required to take exams, if applicable, as scheduled and in the proscribed manner outlined in the CMS Clerkship Retake/Rescheduled Exam Policy. Clinical evaluations and/or rotation-specific performances requiring remediation will be
6/6/19 10 addressed by the Education Director based upon the deficits.
Remediation Grading Outcomes: If the student passes the remediation, they receive a grade of “Pass” for the rotation. If the student fails the remediation, they receive a grade of “Fail” for the rotation. A failure will result in the student repeating all or part of the rotation at the discretion of the Education Director, in consultation with the Assistant Dean of Clinical Education.
Maximum number of attempts to remediate: Students will have one opportunity to pass a remediation.
Please reference the following additional Polices and Guidelines posted to D2L:
• SEPAC Handbook • SEPAC Policy • Clinical Grade Appeal Policy • Clerkship/Sub-Internship Grade Appeal Form • Student Policies Handbook • Testing Accommodations Guidelines • CMS Learner Mistreatment Policy and Procedures • Medical Student Work Hours Policy • Off-Site Secure Storage Policy • Teacher-Learner Expectations • CMS Professionalism Policy and Procedures • CMS Dress Code Policy • Ebola Virus Policy • Exposure Incidents Policy • Alcohol and Drug Use Policy
Administrative Professionalism in Pediatrics:
This type of professionalism refers to the non-clinical aspects of professionalism. Physicians and medical students demonstrate their administrative professionalism in many ways. Some aspects of administrative professionalism address timely completion of medical records, timely communication with patients and peers, and presentation for didactic sessions and committee work on time.
Examples of infractions in administrative professionalism in Pediatrics include, but not limited to*:
6/6/19 11 • Unexcused tardiness or absence at the mandatory Pediatrics orientation. • Unexcused tardiness or absence at the mandatory Pediatrics simulation activity. • Unexcused tardiness and/or absences at your clinical site without informing the clinical site, Office of Student Affairs and/or the Pediatrics Undergraduate Medical Education assistant. • Signing in for another student at the Pediatrics orientation, Pediatrics simulation activity and/or NBME shelf examination. • Unexcused assignments submitted after clerkship-specific stated deadlines ( mid-clerkship feedback form, required case logs and/or remediation assignments).
The deadlines for clerkship requirements are posted in D2L under “Clerkship Requirements & Forms.” *Note: The list of administrative infractions for this requirement includes the examples mentioned above. This list is not all-inclusive.
Administrative professionalism is a clerkship requirement for the Pediatrics clerkship’s professionalism component of the clinical grade. Given the short duration of the Pediatrics rotation and limited mandatory activities, minimization of administrative professionalism infractions is essential to maximize clinical exposure for medical students. If there are no infractions during the 4 week rotation, there will be no alteration to your professionalism grade.
• Any unexcused absence at the mandatory Pediatrics orientation, Pediatrics simulation activity, unexcused assignments submitted after clerkship-specific stated deadlines will result in the Education Director contacting the students informing him/her of the specific infraction and a reduction of the professionalism grade by one level. • 2 or more unexcused episodes of tardiness at the Pediatrics orientation, Pediatrics simulation activity, or at the assigned clinical site will result in a reduction of the professionalism grade by one level. • Two or more unexcused absences at the mandatory Pediatrics orientation, Pediatrics simulation activity, unexcused assignments submitted after clerkship-specific stated deadlines will result in the Education Director contacting the students informing him/her of the specific infractions and a reduction of the professionalism grade by two levels. • Signing in for another student at the Pediatrics orientation, simulation activity and/or NBME shelf examination will result in an autonomic “needs remediation” grade in professionalism.
The Pediatrics Education Director is responsible for determining the administrative infractions, appropriate remediation(s), identifying remediation activities and deciding when remediation is successful. In addition, the Education Director can determine any additional administrative professionalism infractions as serious and will be addressed on a case-by-case basis.
The remediation for any/all of the 3 infractions may include one or more of the following remediations: • Writing a reflection on the type of infraction and how it may affect one’s professionalism when a physician
6/6/19 12 • Referral to the Professionalism Committee • Referral to the SEPAC Committee • Meeting with another specified faculty member • Any additional remediation appropriate to the infractions
If a student fails the administrative professionalism clerkship requirement, i.e. a total of 3 infractions, the student will receive a ‘needs remediation’ grade for this clerkship requirement. Upon remediation of this requirement, the highest attainable grade a student will receive for their clerkship is a PASS.
Holiday Schedule:
You must follow the holiday schedule for your site, not Chicago Medical School's schedule.
Weather Emergencies:
If the University is closed due to extreme weather, check with your clinical site regarding its status. Unless otherwise directed by your Site Director, you should go to your clinical site.
ACADEMIC ACCOMMODATION
Rosalind Franklin University of Medicine and Science is committed to providing equal access to learning opportunities for students with documented disabilities. To ensure access to this class and your program, please contact the ADA Coordinator at 847.578.8354 or [email protected] to engage in a confidential conversation about the process for requesting accommodations in the classroom and clinical settings.
Accommodations are not provided retroactively. Students are encouraged to register with the ADA Coordinator as soon as they begin their program. Rosalind Franklin University of Medicine and Science encourages students to access all resources available. More information can be found on the Academic Support InSite page or by contacting the ADA Coordinator.
OTHER CLERKSHIP INFORMATION
6/6/19 13
Pediatric Clerkship-Specific Educational Goals for 2019-20: Adapted from Council On Medical Student Education in Pediatrics (COMSEP) Curriculum
Definition of terms used in the document:
• Rationale: This section outlines the reasons that a specific topic or clinical issue is included in the curriculum. • Prerequisites: Knowledge of the material in this section is assumed. A student should have acquired the knowledge and developed the skills and attitudes listed in this section before the beginning of the pediatric clerkship. • Competencies: The knowledge, skills, or attitudes that students should be able to demonstrate. • Universal (U): a skill, attitude, or behavior not specific to pediatrics that is essential to all aspects of clinical medicine. • Core Pediatric (CP): a skill, attitude, or behavior specific to pediatrics and expected of students by the end of the clerkship experience. • Mastery (M): a skill, attitude, or behavior specific to pediatrics that is expected of students with advanced training in pediatrics not necessarily during the clerkship experience. • Processes: the types of patients, real or simulated, that a student should see during the clerkship experience
The core goals/objectives of the pediatric clerkship are for the student to:
1. Recognize the importance of growth and development and its clinical application from birth through adolescence (physical, physiologic, and psychosocial).
Rationale Growth is a defining feature of childhood. Genetic and environmental factors influence the rate of growth and the final stature and body habitus the child attains. Regular monitoring of growth provides the clinician with one of the best indicators of the underlying health of the child.
Prerequisites Knowledge of the genetic, endocrine, nutritional, and psychosocial influences on growth
Competencies Knowledge 1. Describe variants of normal growth in healthy children, (e.g. familial short stature and constitutional delay). (CP)
6/6/19 14 2. Identify and describe abnormal growth patterns based on the family growth history and the child's previous growth e.g. microcephaly, macrocephaly, short stature, obesity, growth abnormalities related to specific physical findings. (CP) 3. Identify failure to thrive and overweight/obesity in a child or adolescent using BMI and other growth measures and outline the differential diagnosis and initial evaluation. (CP) Skills • Demonstrate ability to measure and assess growth including height/length, weight, and head circumference and body mass index in patient encounters using standard growth charts. (CP)
Processes All students on the Pediatric Clerkship should see a patient with a patient with real or possible (e. g. parental concern) issues related to growth (e.g. failure to thrive, obesity, short stature, macrocephaly, microcephaly, constitutional delay, small for gestation age). This is listed as a “growth disorder” minimum patient encounter.
Rationale The physical maturation and intellectual, social and motor development of the child follow predictable patterns, and provide the physician with a good indicator of the child's health and neurological function. The clinician must be familiar with normal patterns of development in order to detect deviations that might be the first sign of a medical or psychosocial problem.
Prerequisites Preclinical coursework in the scientific underpinning of neurology and neurobiologic development
Competencies Knowledge 1. Describe the four developmental domains of childhood as defined by the Denver Developmental exam (e.g. gross motor, fine motor, language, and social development. (CP) 2. Describe how abnormal findings on the development screening tools would suggest a diagnosis of developmental delay (CP), autism (M), pervasive developmental delay (M), and mental retardation. (M) 3. Describe the initial evaluation and need to refer a patient with evidence of developmental delay or abnormality. (M) Skills • Demonstrate an ability to assess psychosocial, language, physical maturation, and motor development in pediatric patients using appropriate resources (e.g. Bright Futures, the Denver Developmental Standard Test 2, and HEADSS. (CP) Key features might include the following: 1. Newborn/Infant –Disappearance of primitive reflexes; changes in tone and posture; cephalocaudal progression of motor milestones during the first year; stranger anxiety.
6/6/19 15 2. Toddler/child - Separation and autonomy in two to three-year olds; sequence of language development; concept of school readiness 3. Adolescent - Sequence of physical maturation (e.g. Tanner scales), cognitive development, and assessment of psychosocial and emotional development (e.g. HEADSS).
Processes All students on the Pediatric Clerkship should see a patient with a patient with real or possible (e.g. parental concerns) issues related to development (e.g. delayed or possibly delayed language, motor, fine motor, or social adaptive skills). This is listed as “developmental delay” minimum patient encounter.
2. Develop strategies for disease and injury prevention and health promotion.
Rationale Physicians routinely incorporate strategies for prevention of illness and injury into routine health supervision. Immunizations have resulted in a drastic reduction in the rates of certain infectious diseases. Injuries cause the majority of deaths in childhood and adolescence. Illness and injury prevention must be a prominent and recurrent theme during health maintenance and other health care visits. The American Academy of Pediatrics most medical groups no longer use the term "accident" as most childhood injuries are believed to be predictable and preventable.
Prerequisites • Knowledge of clinical epidemiologic concepts as they pertain to estimation of health risk and prevention of illness and injury. • Understanding of the impact that culture, socioeconomic status and environment have on illness and injury prevalence and patterns. • An understanding of childhood development in order to better understand risk and provide age appropriate prevention strategies.
Competencies Knowledge 1. Describe how risk of illness and injury change during growth and development and give examples of the age-and development-related illnesses and injuries. (CP) 2. List the immunizations currently recommended from birth through adolescence and identify patients whose immunizations are delayed. (CP) 3. Describe the rationale, and general indications and contraindications of immunizations. (CP) Explain how screening for family violence may serve as an important preventive health practice. (CP) 6/6/19 16 4. Describe the key components of a pre participation sports physical. (M) 5. Describe infection control precautions that help limit the spread of infectious diseases in patients and health care providers (e.g. hand washing, masks, and N-95 masks in patients with tuberculosis). (U) Skills • Provide age-appropriate anticipatory guidance for the following: motor vehicle safety, infant sleeping position, falls, burns, poisoning, fire safety, choking, water safety, bike safety, sexually transmitted diseases, firearms and weapons. (CP)
3. Develop clinical problem solving skills for pediatric care.
Rationale Patients often come to medical attention because of a specific problem or complaint. The physician must solve the problems posed by the patient using information obtained from the history, the physical examination and, when appropriate, laboratory tests and/or imaging studies. In the problem-solving process, the physician typically develops differential diagnoses for each of the problems identified. The diagnostic process demands knowledge of disease etiology, pathophysiology and epidemiology and of the patient's gender, ethnicity, environment and prior health status. When the patient is an infant, child, or adolescent, the physician must also consider the effects of age, physical growth, developmental stage and family environment. Commonly occurring illnesses are first considered, but other, less common disorders may need to be included in the evaluation of various clinical problems.
Prerequisites • Pathophysiology of common diseases. • Fundamentals of epidemiology. • Principles of pharmacology including pharmacokinetics and pharmacodynamics, and indications for drugs. • Basic clinical data gathering skills.
Competencies Knowledge 1. List the age appropriate differential diagnosis for pediatric patients presenting with each of the following symptoms. (CP) (See appendix for CP and M level differential diagnosis) • Abdominal pain • Fever without a source • Rash • Cough and/or wheeze • Headache • Rhinorrhea • Diarrhea • Limp or extremity pain • Seizures • Fever and rash • Otalgia • Sore throat
6/6/19 17 • Vomiting 2. List the age appropriate differential diagnosis for pediatric patients presenting with each of the following physical findings. (CP) (See appendix for CP and M level differential diagnosis) • Abdominal mass • Hepatomegaly • Petechiae and/or purpura • Bruising • Lymphadenopathy • Red or wandering eye • Heart murmur • Splenomegaly • White pupillary reflex
3. List the age appropriate differential diagnosis for pediatric patients presenting with each of the following laboratory findings. (CP) (See appendix for CP and M level differential diagnosis) • Anemia • Proteinuria • Hematuria • Positive Mantoux skin test (PPD) 4. Describe the epidemiology, clinical, laboratory, and radiographic findings, of each of the core pediatric level conditions listed for each presenting complaint. (CP) 5. Explain how the physical manifestations of disease (CP) and the evaluation (CP) and management (M) may vary with the age of the patient. Be able to give specific examples. 6. Discuss the characteristics of the patient and the illness that must be considered when making the decision to manage the patient in the hospital or in the outpatient setting. (M) 7. Describe the epidemiology, clinical, laboratory, and radiographic finding for each of the mastery level conditions listed for each presenting complaint. (M) Skills For each of the symptoms and presentations listed above: 1. Demonstrate an ability to generate an age-appropriate differential diagnosis and problem list based on the interview and physical examination. (CP) 2. Outline a diagnostic plan based on the differential diagnosis, and justify the diagnostic tests and procedures taking into account the test's sensitivity, specificity, and predictive value, as well as its invasiveness, risks, benefits, limitations, and costs. (MU) 3. Interpret the results of diagnostic tests or procedures, recognizing the age-appropriate values for commonly used laboratory tests, such as the CBC, urinalysis, and serum electrolytes. (M) 4. Formulate a therapeutic plan appropriate to the working diagnosis (MU) 5. Formulate an educational plan to inform the health care team and family of your thought process and decisions. (MU) 6. Search for relevant information using electronic (or other) data bases and critically appraise the information obtained to make evidence based decisions. (U)
Processes 6/6/19 18 In addition to studying the above, all students on the Pediatric Clerkship should see a patient or patients with the conditions listed in Minimum Patient Encounters, which include the following: • Upper respiratory tract complaint e.g. sore throat, difficulty swallowing, otalgia • Lower respiratory tract complaint e.g. cough, wheeze, shortness of breath • Gastrointestinal tract complaint e.g. nausea, vomiting, diarrhea, abdominal pain • Skin or mucous membrane complaint e.g. rash, pallor • Central nervous system complaint e.g. headache, lethargy, irritability, fussiness • Fever without localizing findings
4. Develop the communication skills needed to care for children, adolescents and their families.
Patient Communication Skills 1. Conduct an effective interview by adapting the interview to the visit (e.g., first visit, acute care, health supervision), or chief complaint, (U) 2. Demonstrate effective verbal and non-verbal communications skills with children and their parents or families that include: • Establishment of rapport taking into account the patient's age and development stage (CP) • Use of communication techniques that enable development of a therapeutic alliance being sensitive to the unique social condition and cultural background of the family (U) • Identification of the primary concerns of the patient and/or family (U). • Discussion of medical information in terms understandable to patients and families avoidance of medical jargon (U) 3. Correctly identify the need for an interpreter in specific patient-physician interactions. (U) 4. Effectively communicate information about the diagnosis, diagnostic plan, and treatment to the patient and family and assess the patient and families understanding (M). 5. Describe the important role of patient education in treatment of acute and chronic illness, and prevention of disease. (M) 6. Observe and reflect on the communication of "bad news" to parents, children and adolescents. (M)
Processes Students are required to be observed by an attending physician while obtaining a patient history during the clerkship.
5. Demonstrate competency in examining children and adolescents.
Rationale An essential skill for success as a clinician and lifelong learner is clinical problem solving. The process of going from a patient's chief
6/6/19 19 complaint to the creation of an appropriate differential diagnosis and the formulation of a diagnostic therapeutic plan is the core of clinical medicine. Skills essential for competent medical care include the ability to conduct an interview, perform a physical examination, manage medical data, communicate written and oral information, integrate basic science knowledge, search and read the literature critically, and teach. The care of individual patients requires the application of all of these skills.
Prerequisites • Introductory course in physical diagnosis which includes general physical examination techniques and the use of diagnostic instruments. • Basic competency in patient interviewing to include an understanding of different styles of questions used in the medical review, such as open-ended, directed, follow-up, and summary questions. • Awareness of the effects of personal and cultural differences in the provision of care.
General Competencies (all skills are CP unless specifically designated U or M) 1. Demonstrate sensitivity to confidentiality, privacy, and modesty, during the medical interview and physical examination (U) (see professionalism) 2. Demonstrate an ability to perform an age-appropriate history and physical examination in children of all ages (CP) Physical Examination Skills 1. Demonstrate the role of patient observation in determining the nature of a child's illness and developmental stage (CP) 2. Conduct a pediatric physical examination appropriate to the nature of the visit or complaint (complete vs. focused) (U) and the age of the patient (CP) 3. Demonstrate an ability to perform the following examination skills (CP) Appearance • Interpret the general appearance of the child, including size, morphologic features, development, behaviors and interaction of the child with the parent and examiner. • Identify signs of acute and chronic illness in a neonate, infant, toddler, school aged child, and adolescents as evidenced by skin color, respiration, hydration, mental status, cry and social interaction. Vital signs • Measure vital signs, demonstrating knowledge of the appropriate blood pressure cuff size and normal variation in temperature depending on the route of measurement (oral, rectal, axillary or tympanic) • Identify variations in vital signs based on age of the patient, the presence or absence of disease, and testing modalities (e.g. blood pressure cuff size). Growth (See section on Growth) • Accurately graph and interpret height (length), weight, and head circumference • Calculate, plot, and interpret BMI (U) 6/6/19 20 • Describe the usefulness of longitudinal data in assessing growth Development (See section on Development) • Accurately identify and interpret major developmental milestones of the neonate, infant, toddler, school-aged child, and adolescent. HEENT • Observe, measure, and describe head size and shape, symmetry, facial features, and ear position as part of the examination for dysmorphic features • Identify sutures and fontanels in neonates and interpret the findings. • Identify the red reflex and discuss how it is used to detect corneal opacities and intraocular masses. • Detect the corneal light reflection and discuss how it is used to identify strabismus • Assess hydration of the mucous membranes. • Assess dentition (U) • Observe the tympanic membrane using an otoscope and an insufflator • Identify the structures of the oropharynx (e.g. uvula, tonsils, palate, tongue) and recognize signs of pathology (U) Neck • Palpate lymph nodes and describe what anatomic areas they drain (U) • Demonstrate maneuvers that test for nuchal rigidity • Palpate the thyroid and any neck masses (U) Chest • Observe, measure and interpret the rate, pattern and effort of breathing (U) • Identify normal variations of respiration and signs of respiratory distress e.g. grunting, flaring, and retraction (U) • Identify normal breath sounds and findings consistent with respiratory pathology such as stridor, wheezing, crackles and asymmetric breath sounds (U) • Identify transmitted upper airway sounds (U) • Observe and describe breast tissue according to developmental stage (e.g. Tanner scale) (CP) and palpate breast tissue (M) Cardiovascular • Identify the pulses in the upper and lower extremities through palpation. • Observe and palpate precordial activity (U). • Describe cardiac rhythm, rate, and quality (such as intensity, pitch, and location) of the heart sounds and murmurs and variation with maneuvers through auscultation. (U) • Assess peripheral perfusion, using a test for capillary refill. (U) • Identify central versus peripheral cyanosis
6/6/19 21 Abdomen • Palpate the liver, spleen and kidneys, and interpret the finding based on the age of the patient. • Assess the abdomen for distention, tenderness, and masses through observation, auscultation, and palpation (U) • Determine the need for a rectal examination, (CP) and demonstrate the age-appropriate technique (M) Genitalia • Describe the difference in appearance of male and female genitalia at different ages and developmental (e.g. Tanner) stages. • Palpate the testes (CP) and identify genital abnormalities in males, including cryptorchidism (CP), hypospadias, phimosis, hernia, hydrocele and testicular mass (M). • Recognize genital abnormalities in females including signs of virilization (CP) imperforate hymen, labial adhesions and signs of injury.(M) Extremities • Examine the hips of a newborn for developmental dysplasia of the hip using the Ortolani and Barlow maneuvers • Observe and describe the gait of children at different ages. • Identify age-related variations in the examination of the extremities, such as tibial torsion, genu valgus, flat feet, etc. (M) • Recognize pathology, such as joint effusions, signs of trauma, and inflammation(CP) and restricted or excessive joint mobility (M) Back • Perform and interpret a screening test for scoliosis. • Examine the back for midline tufts of hair, pits, sacral dimples, or masses. Neurologic examination • Elicit the primitive reflexes that are present at birth and describe how they change as the child develops. • Assess the quality and symmetry of tone, strength and reflexes, using age-appropriate techniques. (M) • Assess the major developmental milestones of newborns, infants, toddlers, school aged, children, and adolescents. Skin • Describe and assess turgor, perfusion, color, hypo and hyperpigmented lesions, and rashes through observation and palpation (U) • Identify jaundice, petechiae, purpura, bruising, vesicles, and urticaria. (U)
Processes Students are required to be observed by an attending physician while performing physical examination during the clerkship.
6/6/19 22 6. Demonstrate the knowledge necessary for the diagnosis and initial management of common acute and chronic illnesses. (See #3 for common acute illnesses)
Rationale Pediatricians are more frequently being asked to care for children with chronic medical conditions and exacerbations of their chronic illness. Physicians will need to understand the long term medical needs, implications and complications of the disorder for the patient as well as the family.
Prerequisites An understanding of the pathophysiology and epidemiology of the following chronic illnesses: allergies, asthma, sensory impairment, cerebral palsy disability, cystic fibrosis, sickle cell disease, seizure disorder, diabetes mellitus, childhood malignancy, AIDS.
Competencies Knowledge 1. Describe the clinical features of chronic medical conditions seen in children such as: (CP) • asthma • epilepsy • sickle cell disease • atopic dermatitis • malignancy (e.g. acute lymphocytic • HIV/AIDS (M) • cerebral palsy leukemia and Wilms tumor) • sensory impairment (M) • cystic fibrosis • obesity • diabetes mellitus • seasonal allergies 2. Describe how chronic illness can influence a child's growth and development, educational achievement, and psychosocial functioning. (CP) 3. Describe the impact that chronic illness has on the family's emotional, economic and psychosocial functioning. (U) 4. Describe the impact of a patient's culture on the understanding, reaction to, and management of a chronic illness (U) 5. Describe the contributions of each member of a multidisciplinary health care team in caring for children with a chronic illness. (M) 6. Identify the key components of delivering "Bad News" in relation to chronic illness. (MU) 7. Explain the management strategies for common chronic illnesses seen in children such as asthma, seasonal allergies, diabetes, and atopic dermatitis (M) Skills 1. Perform a medical interview and a physical examination in a child with a chronic illness that includes the (CP) • effects of the chronic illness on growth and development, • emotional, economic and psychosocial functioning of the patient and family, the • treatments used, including "complementary and alternative therapies." 6/6/19 23
Processes Students on the clerkship should see one or more patients with one of the chronic medical conditions listed above. This can be in the context of an acute or routine visit. (Minimum patient encounters)
7. Recognize the influence of family, community, and society on the child during health and disease.
Rationale Cultural, ethnic and socioeconomic factors also affect personal and family traits and behaviors, with varying effects on child rearing practices. Recognition of and respect for difference are important, yet the student must be alert for the child or adolescent at risk in different family environments, given that the physician's primary obligation is to promote the best interest of the patient.
Humanism and Professionalism in Patient and Family Encounters: Knowledge 1. Describe and demonstrate behaviors that respect the patient's modesty, privacy, and confidentiality. (U) 2. Describe the practical applications of the major ethical principles (i.e. justice, beneficence, non-malfeasance and respect for autonomy) (U) Skills 1. Demonstrate communication skills with patients and families that convey respect, integrity, flexibility, sensitivity, and compassion. (U) 2. Demonstrate respect for patient, parent, and family attitudes, behaviors and lifestyles, paying particular attention to cultural, ethnic, and socioeconomic influences to include actively seeking to elicit and incorporate the patient's, parent's and family's attitudes into the health care plan. (U) 3. Demonstrate behaviors and attitudes that promote the best interest of patients and families, including showing flexibility to meet the needs of the patient and family. (U)
8. Develop attitudes appropriate for clinical practice.
Rationale Knowledge, skills, clinical reasoning, and informed decision making while crucial to a physician's practice of medicine, are insufficient to guarantee successful clinical interactions. A physician must have well-developed interpersonal skills that facilitate communication, and must also demonstrate attitudes, behaviors and beliefs that serve to promote the patient's best interest. In particular, each student must recognize that pediatrics poses unique challenges to professional conduct and attitudes. The patient constantly changes as growth and development proceed. The patient's ability to participate actively in the clinical interaction progresses, as does his or her
6/6/19 24 knowledge, experience and concerns. The adolescent presents specific challenges, including such issues as privacy, risk-taking behaviors, confidentiality and personal involvement with health. The role of parents in the clinical interaction, and their knowledge, experience, and concerns also develop and change as an individual child grows and as subsequent children are born. The way a physician communicates can have a lasting effect in how parents, children and adolescents handle situations and interact with the physician. Cultural, ethnic and socioeconomic factors also affect personal and family traits and behaviors, with varying effects on child rearing practices. Recognition of and respect for difference are important, yet the student must be alert for the child or adolescent at risk in different family environments, given that the physician's primary obligation is to promote the best interest of the patient. Professional conduct extends to the educational process: Students have a personal responsibility for their own education and for development of life-long learning skills. They must interact with all staff, including their peers and their teachers, in a manner that demonstrates respect for each individual and that promotes personal and group learning.
Prerequisites Well-developed data gathering skills, knowledge of ethical principles, and a basic understanding of health law issues are essential foundations for the student. Students should have completed an introductory course on medical ethics providing a basic understanding of ethical principles (autonomy, beneficence, nonmaleficence, and justice) and their application in clinical medicine
Competencies A. Humanism and Professionalism in Patient and Family Encounters: Knowledge 1. Describe and demonstrate behaviors that respect the patient's modesty, privacy, and confidentiality. (U) 2. Describe the practical applications of the major ethical principles (i.e. justice, beneficence, non-malfeasance and respect for autonomy) (U) Skills 1. Demonstrate communication skills with patients and families that convey respect, integrity, flexibility, sensitivity, and compassion. (U) 2. Demonstrate respect for patient, parent, and family attitudes, behaviors and lifestyles, paying particular attention to cultural, ethnic, and socioeconomic influences to include actively seeking to elicit and incorporate the patient's, parent's and family's attitudes into the health care plan. (U) 3. Demonstrate behaviors and attitudes that promote the best interest of patients and families, including showing flexibility to meet the needs of the patient and family. (U)
B. Professionalism with Members of the Health Care Team Knowledge 1. Describe the characteristics of the impaired physician and reflect on your responsibilities to identify and report concerning
6/6/19 25 behavior (M) Skills 1. Demonstrate collegiality and respect for all members of the health care team. (U)
C. Professionalism in the Learner Role Skills 1. Demonstrate a positive attitude and regard for education by demonstrating intellectual curiosity, initiative, honesty, responsibility, dedication to being prepared, maturity in soliciting, accepting, and acting on feedback, flexibility when differences of opinion arise, and reliability (including completing all assignments with honesty). (U) 2. Identify and explore personal strengths, weaknesses, and goals – in general and within specific patient encounters. (U) 3. Describe the impact of stress, fatigue, and personality differences on learning and performance. (U)
D. Professionalism and Society Knowledge 1. Describe a pediatrician's role and responsibility in advocating for the needs of patients (individual and populations) within society. (M) Skills 1. Demonstrate behaviors that enhance the experience of the entire group of learners. (M)
DIAGNOSIS LIST (from COMSEP Curriculum Competencies and Objectives 2011)
This is a list of the diagnosis listed as either core pediatric (CP) or universal (U) in the curriculum. In many circumstances, the student only needs to know the context, e.g. that the newborn screen is useful in detecting PKU deficiency. For others, students should know the epidemiology, clinical manifestations, differential diagnosis, and initial therapeutic plan (e.g. bronchiolitis).
Abdominal Pain Encephalitis Large For Gestation Infant (LGA) Retinoblastoma Abnormal Growth Patterns Encopresis Latent Tuberculosis Rhinorrhea Acetaminophen Overdose Enuresis Legg-Calve-Perthes Disease Risk-Taking Behavior Acidosis (Severe) Epilepsy Lethargy School Failure Acne Failure To Thrive Leukocoria Seasonal Allergies Acute Lymphocytic Leukemia (ALL) Familial Short Stature Limp Seborrhea Acute Otitis Media Feeding Problem Lymphadenopathy Seizures Alcohol Overdose Fever Macrocephaly Sepsis Allergic Rhinitis Fissure Meckel's Diverticulum Septic Arthritis
6/6/19 26 Anaphylaxis Foreign Body Aspiration Meningitis Sexual Abuse Anemia Gastroenteritis Meningococcemia Shock Animal Bite Gastroesophageal Reflux Disease Microcephaly Short Stature Appendicitis Glomerulonephritis Minor Head Injury Sickle Cell Anemia Asthma Head Banging Monilial Infections Sinusitis Atopic Dermatitis Head Injury Mononucleosis Sleep Problems Attention Deficit Headache Narcotic Overdose Slipped Capital Femoral Epiphysis Bacterial Adenitis Hearing Loss Neglect Scabies Bone Fracture Heart Murmur (Innocent) Nephrotic Syndrome Small For Gestation Infants (SGA) Brief Resolved Unexplained Event (BRUE, Hematuria Lice Splenomegaly aka ALTE) Bronchiolitis Febrile Seizure Nursemaids Elbow Status Epilepticus Candida Dermatitis Hemophilia Nutritional Deficiencies Strabismus Cataracts Henoch Schönlein Purpura Obesity Streptococcal Pharyngitis Cellulitis Hepatitis Orthostatic Proteinuria Substance Abuse Cerebral Palsy Hepatomegaly Osgood Schlatter Disease Suicidal Child Abuse Hydronephrosis Osteomyelitis Temper Tantrums Colic Hyperkalemia Otalgia Tension Headache Congestive Heart Failure Hypernatremia Otitis Externa Thalassemia Conjunctivitis Hypoglycemia Otitis Media With Effusion Transient Synovitis Constipation Hypokalemia Otitis Media, Acute And Recurrent Tremulousness Constitutional Growth Delay Hyponatremia Pertussis Trisomy 21 Contact Dermatitis Hypothyroidism Petechiae Tuberculosis Croup Hypoxemia PKU Deficiency Turner Syndrome Cystic Fibrosis Idiopathic Thrombocytopenic Purpura Pneumonia Urinary Tract Infection Dehydration Impetigo Poor Feeding Urticarial Depression Inappropriate ADH Secretion Positive Mantoux Skin Test (PPD) Vasculitis Developmental Delay Increased Intracranial Pressure Postnasal Drip Viral Exanthema Developmental Dysplasia Of The Hip Innocent Murmur Prematurity Viral Infections Viral Upper Respiratory Tract Diabetes Mellitus Intussusception Proteinuria Infection Diabetic Ketoacidosis Iron Deficiency Anemia Purpura Vomiting Diarrhea Iron Overdose Pyelonephritis Wheeze Drug Abuse Irritability Pyloric Stenosis Wilms Tumor Drug Withdrawal Jaundice Renal Failure
6/6/19 27 Eating Disorder Kawasaki Disease Respiratory Distress
References: COMSEP Third Year Curriculum, updated August 2011, http://comsep.org/educationalresources/currthirdyear.cfm
SITE DIRECTORS, FACULTY AND STAFF
Site Faculty Extension e-mail Advocate Children’s Hospital Oak Lawn Rabi Sulayman, M.D. 708-684-5675 [email protected] 4440 W. 95th Street, Suite 210 Department Chairman Oak Lawn, IL 60453 Department of Pediatrics
Parking: Park in the pay structure on day Seetal Mishra, M.D. 708-605-5567 [email protected] one. After that you will be able to park in Suite 131NO the employee lot for free and walk a short Administrative Extension e-mail distance to the hospital. However, usually the gates for the employee/staff/student Ellen Metzger 708- 684-5682 [email protected] lots are open so you can park in there on day 1 also. There is also a shuttle from the lot to the hospital.
Site Faculty Extension e-mail Advocate Children’s Hospital Park Ridge Lisa Cheng, M.D. 847-569-7896 [email protected] 1775 Dempster Street, 6 South Park Ridge, IL 60068
Parking: You can park in the staff/student lot at the intersection of Dempster St. & Luther Ln. However, this lot can fill up. There is also a dirt lot on the East end of the lot, where you may
6/6/19 28 park. If there really is no parking in the middle Akanksha Hanna, MD. [email protected] of the day you can pull up to the parking Administrative Extension e-mail garage, show your student ID and they will let you park in there. (They will know if the lot is Marisol Hernandez-Martinez 847- 723-6464 Marisol.hernandez- full). [email protected]
Site Faculty Extension e-mail Aurora Health Clinics Jennifer Nelson, M.D. 847-274-7530 [email protected] 10400 75th Street, Administrative Extension e-mail Kenosha, WI 53142 Paul Westerman 262-741-2007 [email protected]
Site Faculty Extension e-mail Centegra Health Systems McHenry Joanne Knapik, M.D. 815-338-6600 [email protected] 4200 Medical Center Drive Administrative Extension e-mail (Route 31 & Bull Valley Road) McHenry, IL 60050 Edie Best 815- 759-8151 [email protected]
Parking: At McHenry, there is ample parking with no cost or permit required. You are NOT allowed to park in patient parking for any reason.
Site Faculty Extension e-mail Mercy Health System Nathan Kakish, M.D. 815-337-1538 [email protected] (Scheduled through Centegra Site Administrative Extension e-mail Coordinator) Deb Hansing 815-337-1538 [email protected]
Site Faculty Extension e-mail Saint Anthony Hospital Alejandro Clavier, M.D. 773-484- 4338 [email protected]
6/6/19 29 3124 W 59th St Administrative Extension e-mail Chicago, IL 60629 Belinda Cadena 773-484- 4338 [email protected]
Site Faculty Extension e-mail St. Anthony Hospital Oscar Linares, M.D. 773-484- 4338 [email protected] 2645 W 51st St Administrative Extension e-mail Chicago, IL 60632 Belinda Cadena 773-484- 4338 [email protected]
Site Faculty Extension email Advocate Good Shepherd Hospital (GSH) Marina Goodman-Flider, 847-842-4120 [email protected] 450 West Highway 22 M.D. Barrington, IL 60010 Administrative Extension e-mail Bonnie Boodee (847) 842-4447 [email protected]
Site Faculty Extension e-mail Advocate Condell Medical Center Tova Appleson, M.D. 847-990-5565 [email protected] 801 S. Milwaukee Ave. Libertyville, IL 60048 Administrative Extension e-mail Tree Knar [email protected]
Site Faculty Extension e-mail
Southwest Pediatrics Jonathan Belgrad, M.D. [email protected] 8100 W. 119th Street Palos Park, IL 60464 Administrative Extension e-mail And 9400 Bormet Drive Mokena, IL 60448
6/6/19 30 Nancy Cuthburt - Manager 708-479-7684 [email protected] Mon. & Fri. - Mokena office Kristy Abell 708-361-3300 Tues. or Wed. - Palos Park
Site Faculty Extension e-mail Dr. Gabriel Pediatrics Faye Montes, M.D. 847-623-4464 [email protected] 15 Tower Ct. Suite 150 Administrative Extension e-mail Gurnee, IL 60031
Cindy Williams 847-623-4464 [email protected] Site Faculty Extension e-mail Associates In Pediatrics (2 Locations) Patrick Esposito, M.D. 847-742-6888 [email protected] 1015 Summit Street Elgin, IL 60120 and
1530 Randall Road Elgin, IL 60123
6/6/19 31 Site Faculty Extension e-mail
Lake County Health Department Danilo Alesna, M.D. 847-473-4030 [email protected] 2215 14th St North Chicago, IL 60064
Site Faculty Extension e-mail Samir Suleiman, M.D., S.C. (2 locations) Samir Suleiman, M.D. [email protected] 7617 W. Belmont Ave. Elmwood Park, IL 60707 and
8780 W. Golf Road, Suite 105 Niles, IL Administrative Extension e-mail Crystal Miller-Reyes 708-583-1410 [email protected] Niles Office Site Faculty Extension e-mail
MD Pediatric Center Omar Sawlani, M.D. 708-425-2880 [email protected] Dr. Omar Sawlani, Site Director or 4400 W Oak Lawn, IL 60453 [email protected] 95th Street, Suite 104
6/6/19 32 Site Faculty Extension e-mail
Billings Clinic Erin Allen, M.D. 406-238-5059 [email protected] 801 N. 29th St. Billings, MT 59107 Administrative Extension e-mail
Kristina McComas 406-238-5059 [email protected]
Site Faculty Extension e-mail
Pediatrust Margaret Stefani, D.O. 847-381-6700 [email protected] 912 W Northwest Highway, Suite G-7 Fox River Grove, IL 60021
Site Faculty Extension e-mail
Wafaa G. Hanna M.D. Wafaa Hanna, M.D. 708-478-4666 [email protected] 18210 South La Grange Road Suite 109 Tinley Park, IL 60487
6/6/19 33 CLERKSHIP SCHEDULE FOR 2019-2020
Rot. 1: 7/8/19 - 8/16/19 Rot. 2: 8/19/19 - 9/27/19 Rot. 3: 9/30/19 - 11/8/19 Rot. 4: 11/11/19 - 12/20/19 Rot. 5: 1/6/20 - 2/14/20 Rot. 6: 2/17/20 - 3/27/20 Rot. 7: 3/30/20 - 5/8/20 Rot. 8: 5/11/20 - 6/19/20
CONTACT HOURS
Lectures 8 Team-based learning 2 Patient Contact 192 Online learning 12 Exams 3 TOTAL 217
7/30/19 34