2008 - 2009 Medical Student Orientation Packet
7501 Pediatric Externship
University of Minnesota Medical School
Department of Pediatrics
Office of Medical Education
Mission Statement
To foster in medical students an understanding of the uniqueness of infants, children, and adolescents in health and disease through patient contact and directed educational experiences.
Goals & Objectives
The Pediatric Externship will enable the student to:
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learn a body of information about infants, children, and adolescents which will provide a foundation for their medical careers
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foster the development of sound professional attitudes, including integrity, a commitment to patients/families, the ability to communicate clearly and effectively both verbally and in writing, and to stimulate a commitment to continuing education
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observe skillfully and analyze the behavior of children and their families
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develop differential diagnoses and clinical decision-making based on an accurate history and physical examination
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continue to develop and refine habits of self-directed and life-long learning
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communicate effectively and empathetically with children and their families, regardless of ethnic or socioeconomic backgrounds
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utilize effective interviewing techniques necessary for obtaining an organized and complete pediatric history
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conduct and record a thorough and accurate physical examination
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develop accurate and complete problem lists, assessments, and plans
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use information obtained from clinical sources (history, physical examination, laboratory, and chart) and pediatric literature to make clinical decisions
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perform various common pediatric procedures under supervision of resident and staff
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monitor effectively and efficiently the hospitalized patient under supervision of resident and attending physician
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present a patient during rounds or case conferences in an efficient, organized, and thorough manner
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describe the importance of psychosocial and environmental influences on the children and their families
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demonstrate knowledge of the importance of effective cooperation between physicians, nurses, and other professionals, and consistently show appropriate professional conduct and appearance
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demonstrate an understanding of the pathophysiology of common pediatric diseases
The Pediatric 7-501 externship is intended to teach you to react with empathy and sound medical judgment in clinical encounters with infants, children, and adolescents. The externship is designed to provide basic pediatric skills and knowledge necessary for all students, regardless of the area of specialization you select. To accomplish these goals you must develop a basic understanding of normal growth and development, the influence of the environment on health, the impact of hospitalization on the child/family unit, and basic principles of common diseases affecting children.
This rotation in pediatrics is will provide a continuation of the clinical education that was initiated during Physician and Patient III. You will be expected to hone your abilities, to assess your patients, and to make clinical decisions based on your assessments.
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Expectations of Students
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Patient work ups
You will be expected to perform a complete admitting history and physical examination on your patients. In addition, you will be expected to synthesize the information obtained from the history and physical to develop an assessment and plan. Your write-up is very important as it will become a permanent part of the patient's medical record. Periodically (frequency determined by site), you will be expected to hand in write-ups which will be critiqued. (Link here to “Elements of a Pediatric History and Physical” and “Examples of Histories and Physicals”
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Patient Monitoring
You will be expected to monitor your patients regularly, and write daily progress notes and orders under the direction of your resident.
Case Presentations
It is important for you to begin to develop your skills at formal case presentations by presenting to your senior resident, attending physician, or at case conferences.
Discharge Letters
Some of your patients will require a dictated discharge letter. This is the responsibility of the student. This is an important learning experience because it gives you an opportunity to crystallize your thinking about your patient. (Link here to “Elements of a Pediatric Discharge Summary”
Outpatient Care
Some rotation sites include an outpatient experience in the clinic. When seeing outpatients you are expected to perform a brief history and physical examination, and formulate an assessment and plan. Once again, your chart write-up will become a permanent part of the patient's record; therefore, it is important for it to be organized, legible, and complete.
Written Exam
There will be a written exam given on the final morning of the course. The exam will be the Pediatric Shelf examination, and will be administered to the entire class at a location at the University campus. You will receive an email regarding the specifics of the exam during the rotation. Due to the strict guidelines for taking the test, all students are expected to take the exam on the assigned date. There will be no call for students the night prior to the exam.
Learning Opportunities
Grading
Your grade will be based on:
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60% evaluations by your residents, attendings, and nursing staff.
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30% your performance on the NBME Shelf Exam for Pediatrics
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10% your performance based on evaluations by Chief Resident and Site Director
The above expectations and other personal qualities will be used as a basis for evaluation. Final grades will be awarded by the site coordinator following a discussiono of each student's performance. All marginal performances will be discussed at the Pediatric Clerkship Committee meeting. The Pediatric Clerkship Committee consists of the Course Director, the Site Directors, Chief Residents, and the Year 3 and 4 Director.
NBME Shelf Exam- Passing the shelf exam is required to pass the clerkship. Passing Grade for the Shelf is set at 60. If a student achieves a grade on the shelf below passing a grade of incomplete will be assigned for the course. It is the students responsibility to schedule a time to retake the exam. This should be arranged through the course director. If the student passes on the second attempt, the highest grade the student can receive for the course is "excellent". Failure of the shelf a second time requires further remediation which can be arranged through the site director. This may include repeating the course.
Clerkship Failure- Failing grades can be assigned based on clinical performance, professional concerns, and failure of the NBME Shelf Exam.
Honors- Honors grades on the Pediatric Clerkship are given to the top 25% of students. In addition to honors performance clinically, students must demonstrate superior knowledge through a score of 75 or high on the Pediatric Shelf Examination.
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Clinical Site Descriptions
University of Minnesota Children's Hospital, Fairview
The University of Minnesota Children's Hospital, Fairview is a 216-bed pediatric hospital located on the east and west banks of the Mississippi River in Minneapolis. The hospital, affiliated with the University of Minnesota Medical School, provides a broad spectrum of pediatric programs and services-- ranging from pediatric general surgery, imaging and neonatal, pediatric intensive care, and cardiac services to oncology and blood, marrow, and organ transplantation. Innovative approaches and affiliation with the University of Minnesota have led to several firsts, including the first successful pediatric bone marrow transplant, infant heart transplant in Minnesota and cochlear ear implant surgery for a child. Call is every fourth night while on the inpatient service until 10 pm. The general pediatric teaching service uses bedside rounding led and facilitated by pediatric hospitalists to provide patient-centered care and education.
Children's Hospitals & Clinics - Minneapolis
Minneapolis Children's is a 163-bed private hospital that provides a broad range of general pediatric educational opportunities for residents and students. Four teams, each consisting of one senior resident, one to two junior residents, and two to three medical students accept admissions to a teaching service. With support from the team, students take responsibility for direct patient care. Supervision is provided by community and hospital-based pediatricians, pediatric subspecialists and in-house pediatric hospitalists. Call is every fourth night with your team.
Children's Hospitals & Clinics- St. Paul
St. Paul Children's is a 105-bed private hospital with an emphasis for students and residents on inpatient care. There are four teams, each consisting, on average, of two senior residents, one or two interns, and three medical students. Call is every fourth night with your team. Community and hospital-based primary care and subspecialist pediatricians provide supervision for patient care. Students work directly with faculty preceptors to provide ongoing care to patients and families during their hospitalization.
Hennepin County Medical Center
HCMC is a county hospital with very busy clinic and nursery areas and a 7-bed Peds ICU and 18-bed Pediatric ward. Students rotate through a comprehensive set of educational experiences in each of the above areas during the course of their 6-week clerkship. Patients represent a wide diversity of cultural and socioeconomic backgrounds. There are four teams, each consisting of one senior resident, one or two interns, and one or two students. Call is every fourth night with your team. The HCMC pediatricians are committed to medical student education and have a variety of interests, including: clinical research, asthma, infectious disease, child abuse, public health, and adolescent medicine, among others.
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Program Contacts
Directors and Coordinator:
Sites Contacts:
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The University of Minnesota is committed to the policy that all persons shall have equal access to its programs, facilities, and employment without regard to race, color, creed, religion, national origin, sex, age, marital status, disability, public assistance status, veteran status, or sexual orientation.
This publication is available in alternative formats upon request. Please contact:
Juliet Massie
Pediatric Education, MMC 391
420 Delaware Street SE,
Minneapolis, MN 55455
(612) 624-4418 or e-mail: juliet@umn.edu
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