Learning Objectives

Patient Care

• Residents will learn to perform an appropriately focused history and physical exam
• Residents will gain exposure to basic procedures such as venous blood draw, IV placement, lumbar puncture, bladder catherization, limb immobilizations, laryngoscopy, intubations, bag-valve mask ventilation, suturing, simple foreign body removal, and sedation and analgesia
• Residents will learn to recognize and stabilize sick children with deteriorating condition, using principles taught in PALS
• Residents will learn to develop appropriate differential diagnosis for acute outpatient illnesses
• Residents will develop and implement appropriate diagnostic and treatment plans
• Residents will learn to utilize and interpret appropriate lab and imaging modalities
• Residents will demonstrate stabilization skills in the critically ill or injured child
• Residents will learn indications for hospital admissions
• Residents will learn appropriate use and interaction with surgical and subspecialty pediatric consultants
• Residents will exposed to and learn direction of prehospital care, patient transfer between facilities, and the proper approach to referring physician interactions
• Residents will improve their ability to prioritize and multitask, adjusting their pace to ED patient acuity, volume, and flow
• Residents will work effectively as a part of the health care team
• Residents will provide support to critically ill patients and their families
  • The importance of guided Family Presence for critical events and procedures will be emphasized
• Residents will be sensitive to the needs of families who use the ED for minor illness care

Medical Knowledge

• Residents will develop an understanding of established and evolving medical knowledge about urgent and emergency care pediatrics including the febrile infant, seizures, respiratory distress and hypoxia, acute respiratory infections, dehydration, toxin ingestions, trauma, shock and a wide spectrum of minor acute illnesses
• Residents will gain knowledge about exacerbations and complications of chronic illnesses such as asthma, congenital heart disease, neoplastic disease, metabolic disease, solid organ and bone marrow transplant, and chronic gastrointestinal problems
• Residents will demonstrate a commitment to acquiring the base of knowledge needed for the care of emergently ill and injured children in the ED
• Residents will demonstrate the ability to efficiently access, critically evaluate, and appropriately apply medical information
• Residents will become well-versed in the Emergency Medical Treatment and Active Labor Act (EMTALA)

Communication Skills

• Residents will develop interpersonal, listening, and communication skills to facilitate effective partnering with patients and families, staff, preceptors, referring healthcare providers and consultants
• Residents will demonstrate the ability to effectively educate and reassure patients about commonly seen conditions
• Residents will facilitate communication with the primary care physician (PCP)
• Residents will gain experience delivering well-organized and complete case presentations
• Residents will develop in their role as a teacher to students, colleagues, nurses and families
• Residents will develop an effective follow-up plan with all families
• Residents will assist in maintaining accurate, timely, and legally appropriate medical records

Practice-Based Learning and Improvement

• Residents will develop skills to use scientific methods to evaluate their care and learn through their experiences
• Residents will continue to enhance their knowledge and utilization of evidence based medicine
• Residents will identify their personal learning needs and utilize educational materials and their preceptors to continually enhance knowledge and procedure skills
• Identified areas of weakness will trigger an organized remediation plan with their faculty preceptor and, if necessary, Program Director

Professionalism

• Residents will demonstrate sensitivity, compassion and respect for patients, families, staff and other colleagues
• Residents will present themselves in a dignified fashion
• Residents will adhere to ethical and legal principles
• Residents will gain familiarity with ethical and legal issues that arise in the ED, such as end of life care, issues of privacy and consent for adolescents, rights of parents to refuse treatment, reporting of child abuse and neglect, and obligations of ED physicians to facilitate follow up care
• Residents will demonstrate gender and cultural sensitivity
• Residents will demonstrate a commitment to professionalism despite the pace and stress of the ED setting
• Residents will arrive on time for all scheduled shifts, notifying the attending in advance of any changes

Systems-Based Practice

• Residents will learn to provide cost effective care without compromising quality
• Residents will learn to recognize and advocate for patients and families who need assistance in negotiating the complexities of the care system
• Residents will continue to expand their understanding of the relationship between the ED and a child's PCP
• Residents will recognize their own limits and those of the system
• Residents will take steps to avoid medical errors

Assessment of rotation performance will include

• Direct observation of the Resident’s care of children and performance of procedures
• Two or more attending-observed H&Ps during the month
• Standardized evaluation form
• An informal mid-month evaluation to identify any significant areas requiring improvement