Pediatrics: Inpatient

Rotation Goals and Objectives

  1. General Description
    1. Family Physicians commonly care for pediatric patients. Family Physicians actual practices vary considerably in the extent to which they provide inpatient care for pediatric patients. This portion of the curriculum is designed to provide residents with the skills and expertise expected of family physicians with active practices involving the care of inpatient pediatric patients. These rotations will complement the inpatient family medicine rotations.
    2. Residents will work with several faculty physicians specializing in pediatrics. The resident will be supervised at all times by a faculty pediatrician. With the support of the faculty physician, the resident will be responsible for the comprehensive care of all patients assigned to them. These patients may be located in the emergency department, the pediatric inpatient ward or the pediatric intensive care unit. 
    3. Level: PG 1 year
    4. Location: Renown Regional Medical Center
    5. Duration: 4 week block rotation, two times during the PG 1 year
    6. Pediatrics: Inpatient is a full time rotation.
    7. Residents are expected to follow their patients in the Family Medicine Center during this rotation. One half day per week will be spent in the Family Medicine Center.
    8. Work hour form submission is required at the completion of this rotation.
    9. Evaluation of Rotation
      1. The evaluation of the resident on this rotation will be done by the completion of an evaluation form by the attending physicians at the completion of the rotation. The resident should seek verbal feedback about his/her performance during the rotation.
      2. The resident will fill out a rotation evaluation for at the end of the rotation.
      3. The knowledge, skills and competencies acquired during this rotation will be evaluated by a Family Medicine attending physician as the resident provides care to patients in the Family Medicine Center.
      4. The resident's performance on the American Board of Family Medicine In-Training examination will also be used to assess knowledge in this area.
  2. Patient Care skills to be mastered
    1. Performance and documentation of complete pediatric history taking
    2. Performance and documentation of complete pediatric physical examination
    3. Performance of writing admission, daily care, and discharge notes and orders for hospitalized pediatric patients
    4. The evaluation and treatment of common problems for which children are admitted to the hospital including each of the following diagnoses
      1. Fever with no known source, bronchiolitis, asthma, pneumonia, hypoxia, urinary tract infection, gastroenteritis, dehydration, sepsis/meningitis, failure to thrive
    5. Performance of procedures to include bladder catheterization, vascular access, and lumbar puncture
    6. The coordination of comprehensive care for hospitalized patients
    7. Recognition of the role of the family and other psychosocial factors in the care of hospitalized patients.
    8. Develop an understanding of what consultative services are useful to a hospitalized patient
    9. Develop an understanding of the multidisciplinary services that are useful to hospitalized patients
    10. The arrangement of discharge and follow up care for patients who have been hospitalized.
  3. Medical Knowledge skills to be mastered
    1. An increasing knowledge base to care for the breadth of patients that pediatricians and family physicians care for in the hospital setting.
      1. Specific medical topics should be reviewed and learned on a daily basis based on the diagnoses and disorders of patients currently admitted to the resident's service.
      2. Knowledge of the presentation, etiologies, usual course, complications, treatment, follow up care, and pathophysiology of the most common diagnoses, including the following list, must be mastered.
        1. a. Fever with no known source, bronchiolitis, asthma, pneumonia, hypoxia, urinary tract infection, gastroenteritis, dehydration, sepsis/meningitis, failure to thrive
  4. Practice Based Learning and Improvement
    1. This competency is addressed longitudinally throughout the rotation.
      1. Scientific evidence will be reviewed by the resident and attending physician in the context of their patients.
      2. The practical implementation of evidence-based medicine will be discussed as the medical decision making is reviewed.
      3. Medical evidence will be reviewed and presented during the daily morning rounds sessions.
      4. Information technology will be utilized by the resident as he or she is required to research topics as directed by the attending physician.
      5. Information technology will be utilized as the hospital implements its electronic health record.
      6. The resident will also be evaluated on the steps they took during the rotation to improve their shortcomings.
  5. Interpersonal and Communication Skills
    1. This competency is addressed longitudinally throughout the rotation.
      1. The resident will observe and be observed, taught and evaluated in the performance of obtaining patient histories, documenting histories, writing prescriptions, educating patients about treatment plans and prognosis, teaching medical students and other learners, and interactions with patients, families, hospital staff and physicians.
  6. Professionalism
    1. This competency is addressed longitudinally throughout the rotation.
      1. The attending physician will observe and assess the resident's sense of personal responsibility including attendance, promptness, motivation, completion of duties, and appropriate dress.
      2. Ethical and legal practice skills will be taught
      3. Respect for cultural, age, and gender differences will be taught, observed and evaluated.
      4. The resident is expected to treat patients, families and colleagues with respect, understanding, sympathy and honesty
  7. Systems Based Practice
    1. This competency is addressed longitudinally throughout the rotation.
      1. The resident will learn to become aware of available resources and the cost effectiveness of testing and therapeutic options
      2. The resident will gain an increasing understanding of the role of the patient, physician, support staff, and insurer in the health care environment
      3. The resident will gain an increasing understanding in the role of the hospital in the health care environment.
      4. Through the coordination of care for the hospitalized 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.

Revision: May 2, 2018 by Richard D. Williams, MD