PEDI661VM.01 (Reno)
Pediatric Critical Care

Office of Medical Education

  • Course Name: Pediatric Critical Care
  • Short Name: PEDI661VM.01 Pedi Critical Care
  • Course Number: PEDI661VM.01
  • Location: Reno
  • Department: Department of Pediatrics
  • Type: Clinical
  • Length: 2 - 4 Weeks
  • Preceptors:
    • Kris Deeter, M.D.
    • Richard Lehman, M.D.
    • Aida Field-Ridley, M.D.
    • Courtenay Petersen, M.D.
    • Maria Enrione, M.D.

Please contact the Department of Pediatrics to verify elective availability.

Goals/Objectives

  • Medical students who rotate through the PICU will gain the knowledge, skills and attitudes needed to recognize, evaluate, and initiate care for patients with disease processes that require pediatric critical care management. They will gain an understanding of the pathophysiology processes as they apply to critical illness. They will develop an appreciation and comfort level with the multi-disciplinary nature of pediatric critical care. The medical students will develop strategies for delivering multi-disciplinary care and for problem solving necessary for the care of critically ill children.

Description of Rotation

 Medical students will actively participate in bedside patient care in the PICU. They will be responsible under the supervision of the PICU nurse practitioner and PICU faculty for up to 2 initially, at maximum 3, patients in the PICU. They will be involved in the initial admission and ongoing daily care of their patients. This will include presenting the patient on daily rounds with a working assessment and ongoing plan of care, following-up on patients' plans of care, ongoing reassessments, and involvement in patient/family discussions as to patient status. They will cover the PICU for 4 weeks on dayshift (8:00 am to 4:00 pm). PICU rounds start at 0900.

Medical students are expected to take advantage of multiple educational opportunities to enhance their own educational needs. Teaching will occur on the bedside family centered multidisciplinary rounds and in small group discussions outside of rounds. The patients in the PICU require care from multiple disciplines and as such the medical students will have the opportunity to learn from other pediatric subspecialists -surgical and medical--, and other health care professionals-occupational therapists, physical therapists, speech therapists, nutritionists, pharmacists, respiratory therapists, nurse practitioners, and bedside nurses. The medical students will also be expected to go to the medical literature to learn more about aspects of their patients. The medical students will be expected to review computer based literature and present on 2 topics that relate to their patients during the rotation.

To schedule an elective, please contact 775-784-6170.

References/Materials

Pediatric Critical Care Medicine, Zimmerman (available in PICU office)

Evaluation Method

 The evaluations will be based on the standard pediatric clerkship evaluation form.

Grade

  • Honors: An exceptional performance which exceeds all course objectives
  • High Pass: A performance which exceeds most course objectives
  • Pass: A performance which meets the course objectives
  • Fail: A performance which does not meet the course objectives

Grading Criteria

The evaluations will be based on the standard pediatric clerkship evaluation form.

Application of Medical knowledge in the Clinical setting

Honors: Greater than 90% of the time the medical student will: Read about patient problems and general pediatric critical care topics independently, Summarize this information for the healthcare team on rounds or individually, Apply learned medical knowledge at the bedside

High Pass: 51-90% of the time the medical student will: Read about patient problems and general pediatric critical care topics independently, Summarize this information for the healthcare team on rounds or individually, Apply learned medical knowledge at the bedside

Pass: 10-50% of the time the medical student will: Read about patient problems and general pediatric critical care topics independently, Summarize this information for the healthcare team on rounds or individually, Apply learned medical knowledge at the bedside

Fail: <10% of the time the medical student will: Read about patient problems and general pediatric critical care topics independently, Summarize this information for the healthcare team on rounds or individually, Apply learned medical knowledge at the bedside. This student relies on attending/nurse practitioner for learning. Knowledge base of concern. Rarely can apply learned medical knowledge at the bedside.


Patient Care/Clinical Skills
Honors: Greater than 90% of the time the medical student will: Gather all the patient data, Present on rounds complete and concise presentations with emphasis on pertinent findings, and Write well organized notes. Histories and Physical exams are thorough, directed when appropriate, and reliable.

High Pass: 51-90% of the time the medical student will: Gather all the patient data, Present on rounds complete and concise presentations with emphasis on pertinent findings, and Write well organized notes. Histories and Physical exams are thorough, directed when appropriate, and reliable. Occasionally misses important data or fails to identify pertinent positive or negative information.

Pass: 10-50% of the time the medical student will: Gather all the patient data, Present on rounds complete and concise presentations with emphasis on pertinent findings, and Write well organized notes. Histories and Physical exams are thorough, directed when appropriate, and reliable. Occasionally misses important data or fails to identify pertinent positive or negative information. When asked for data not presented, does not know this data some of the time. Not up on all the facts related to the patient.

Fail: <10% of the time the medical student will: Gather all the patient data, Present on rounds complete and concise presentations with emphasis on pertinent findings, and Write well organized notes. Histories and Physical exams are thorough, directed when appropriate, and reliable. This student often misses important data or fails to identify pertinent positive or negative information. When asked for data not presented, does not know most of the time. Not up on all the facts related to the patient. Data gathering and reporting are incomplete or disorganized. Incomplete or uneducated physical exam.


Problem Solving Ability
Honors: Greater than 90% of the time the medical student will able to generate a differential including the most likely and "do not miss" diagnoses. Can interpret the data during presentations for complex PICU issues. Demonstrates clinical reasoning for complex PICU issues.

High Pass: 51-90% of the time the medical student will be able to generate a differential including the most likely and "do not miss" diagnoses. Can interpret the data during presentations for more moderately complex PICU issues. Demonstrates clinical reasoning for moderately complex PICU issues.

Pass: 10-50% of the time the medical student will be able to generate a differential including the most likely and "do not miss" diagnoses. Can interpret the data during presentations for simple PICU issues. Demonstrates clinical reasoning for simple PICU issues.
Can generate a differential diagnosis for simple PICU problems but as issues become more complex struggles to interpret data.

Fail: <10% of the time the medical student will be able to generate a differential including the most likely and "do not miss" diagnoses. Rarely identifies the "do not miss" diagnoses. Struggles to interpret the data during presentations for simple PICU issues. Struggles to demonstrate clinical reasoning for simple PICU issues.

Interpersonal and Communication Skills
Honors: The medical student will demonstrate: Excellent rapport with patients and colleagues, Empathy with patients and their families, Great communication skills -able to translate medical jargon to families. Respectful, Seeks feedback independently and incorporates feedback into practice. Can give feedback to others. Uses translational services in an appropriate fashion.

High Pass: The medical student will demonstrate: Average rapport with patients and colleagues, Empathy with patients and their families, Reasonable communication skills, Respectful. Accepts feedback and incorporates into practice, but does not seek out feedback independently. Uses translational services appropriately

Pass: The medical student will demonstrate: Average rapport with patients and colleagues, Empathy with patients and their families, Reasonable communication skills (does not always use appropriate family centered terminology for complex medical issues when speaking with families), Respectful. Accepts feedback but may not always incorporate into practice. Does not seek out feedback independently. May not recognize when translational services are appropriate.

Fail: The medical student often demonstrates: Poor rapport with patients and colleagues, Rarely empathetic, Disrespectful. Limited communication skills. Usually does not recognize when in over their head when talking with PICU families. Can't translate medical jargon to the level of the families. Responds to feedback poorly and does not seek it. Rarely uses translational services.


Motivation and Enthusiasm:
Honors: Greater than 90% of the time the medical student will demonstrate self-directed learning.

High Pass: 51-90% of the time the medical student will demonstrate self-directed learning but at times requires direction.

Pass: 10-50% of the time the medical student will demonstrate self-directed learning but often requires direction. Does what is needed to get by.

Fail: <10% of the time the medical student will demonstrate self-directed learning but often requires direction: Not self-directed - requires direction but does not always follow through. Often barely gets by.


Professional Characteristics:
Honors: Greater than 90% of the time the medical student is on time, well prepared, follows up on patient care without prompting. Helps out with other patients in the PICU other than their own if PICU is busy. Offers to help with in their scope of practice.

High Pass: 51-90% of the time the medical student is on time, well prepared, follows up on patient care without prompting. At times helps out with other patients in the PICU.

Pass: 10-50% of the time the medical student is on time, prepared, follows up on patient care without prompting. On occasion leaves without telling anyone, not always engaged on rounds or with what is happening in the PICU, may need prompting to follow-up on patient care issues.

Fail: <10% of the time the medical student is on time, prepared, follows up on patient care without prompting. Often leaves work undone, is unprepared. Does the minimum. Frequently late. Appears disinterested. Disrespectful.

Special Notes

This elective is limited to one student per rotation.