Newborn

Rotation Goals and Objectives

  1. General Description

A.  The purpose of this rotation is to provide the clinical experiences and didactic teaching to develop competence in the care of healthy and ill newborns. An understanding of maternal history, principles of infant feeding, common newborn problems, management of newborn emergencies and parent education in routine newborn care will be stressed.

B.  Level: PGY - 1

C.  Location: Renown and Saint Mary's nurseries, NICU

D.  Duration: 1 four week block rotation

E.  The Newborn Rotation is a full-time rotation.

F.  Residents are expected to continue their continuity clinic during this rotation. They will be scheduled at the Family Medicine Clinic up to three half-days a week

G. Duty Hour: Submission is required during this rotation.

H.  Evaluation: Residents will be evaluated in the newborn nursery by direct observation of their performance. The supervising attending physicians will observe residents as they examine infants, interact with families, participate in clinical rounds, and document infant findings and progress. An online evaluation of each resident's performance will be discussed with the resident.

2.  Patient Care

A.  Recognize the important factors in the maternal history and delivery process which affect the newborn. These include: pertinent social issues, chronic medical conditions in the mother (i.e., diabetes, seizure disorder), genetic risk factors, maternal/infant Rh/ABO status, maternal drug use, maternal infection, type of delivery, APGAR scores, etc.

B.  Become competent in the examination of the newborn infant. This includes recognition of normal and abnormal physical characteristics and estimation of gestational age.

C.  Present patients and prepare learning topics for morning nursery rounds. These involve both a formal review of newborn issues as they relate to specific patients, but also discussions of the major topics of concern in newborn care.

D.  Participate in NICU bedside rounds and continuity newborn clinics in the afternoons (future goal). Any additional time is to be used for self-study on newborn topics from the reading list and obtaining NRP/STABLE certification.

E.  Develop skills in arranging follow-up care particularly for infants with significant medical or psychosocial risks. This includes working closely with neonatologists, community primary care physicians and social workers.

3.  Medical Knowledge

A.  Develop a practical knowledge of the following topics: breast and bottle feeding, parental counseling in routine newborn care, recognition of psychosocial factors that may affect maternal/infant interaction, circumcision and newborn screening.

B.  Recognize the following common problems in the newborn period and develop a diagnostic approach and management plan for each: prematurity and postmaturity, respiratory distress, jaundice, suspicion and treatment of newborn infection, maternal mental health issues that affect infant health (i.e. postpartum depression, neonatal hypoglycemia and infant of diabetic mother, maternal history of drug abuse, congenital heart disease, and developmental dysplasia of the hip.

4.  Practice-based learning and improvement

A.  Scientific evidence will be reviewed by the resident and attending physician in the context of their patients. The practical implementation of evidence-based medicine will be discussed as the medical decision making is reviewed.

B.  Medical evidence will be reviewed and presented during the daily morning rounds sessions.

C.  Information technology will be utilized by the resident as he or she is required to research topics and utilize its electronic health record.

5.  Interpersonal and communication skills

A.  The resident will observe and be observed, taught and evaluated in the performance of obtaining patient histories, documenting histories, writing prescriptions, educating caregivers about newborn care, treatment plans and prognosis, teaching medical students and other learners, and interactions with patients, families, hospital staff and physicians.

6.  Professionalism

A.  The attending physician will observe and assess the resident's sense of personal responsibility including attendance, promptness, motivation, completion of duties, and appropriate dress.

B.  Ethical and legal practice skills will be taught.

C.  Respect for cultural, age, gender and socioeconomic differences will be taught, observed and evaluated.

D.  The resident is expected to treat patients, families and colleagues with respect, understanding, sympathy and honesty.

7.  Systems-based practice

A.  The resident will learn to become aware of available resources and the cost effectiveness of testing and therapeutic options.

B.  The resident will gain an increasing understanding of the role of the patient, physician, support staff, and insurer in the health care environment.

C.  The resident will gain an increasing understanding in the role of the hospital and outpatient clinic in the health care environment.

D.  Through the coordination of care for the newborn patients, the resident will become aware of the breadth of available resources in our community as well as to the limitations of the resources in our community. In this regard, the resident will be expected to work very closely with social workers and hospital case coordinators to assist in providing the best care available to our patients. 

Updated: May 2, 2018