PEDIATRIC NEUROLOGY HOSPITAL ROTATION

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					                  LSUHSC PEDIATRIC NEUROLOGY ROTATION
Description of Rotation:

This is a one month rotation for a total of three months. These rotations will take place
during the PGY 2 –PGY 4 year. Beeper Call will occur during this rotation. The rotation
will consist of hospital inpatient setting, and outpatient clinics.

Consultation services will include the emergency room, pediatric critical care unit and the
in- patient care unit. Residents are responsible for consultations in rotational bases
with other residents from Pediatrics, Tulane Adult Neurology and Pediatric Neurology
Fellow.

Residents will not attend longitudinal clinic during these months.

Educational Purpose/Goals:
   1. To gain experience in the recognition, diagnosis, treatment, and management of
      acute neurological disorders in newborns, infants, children, and adolescents.
   2. To assume progressive responsibility in the care of neurological patients.
   3. To provide bedside education instruction to the pediatric residents, as well
      medical students on the rotation.
   4. To provide consultation services to other health care services.

Assessment Summary:
 The objectives (below) will be evaluated through a number of measures (tools) which are
 reviewed in the preceding section (General Competencies) above.

By the end of the rotation, the resident should receive and/or complete the following
 assessments:
    1.    Verbal feedback from preceptors/attending staff
    2.    Global written assessments
    3.    One(1) NEX evaluation per pediatric staff in rotations block # 2 or 3

Orientation:
Orientation occurs on day 1 of the rotation. Expectations, duties, goals and objectives of
 the rotation are discussed.

Supervision:
Residents are supervised by the precepting attending child neurologist and pediatric
 neurology fellows. All cases, including management plans, must be reviewed with the
 preceptor.

Literature:
     Clinical Pediatric Neurology, Fenichel
     A collection of essential articles will be provided at the beginning of the rotation
             Objectives for Pediatric Neurology Rotation #1
Patient Care:
Residents will be able to provide patient care that is compassionate, appropriate and
 effective for the treatment of neurological health problems and the promotion of health in
 newborns, infant, children and adolescents.

Competency: Gathering Information - Gather essential and accurate information about
 the patient.

Knowledge/Skills:
  Perform a comprehensive history, including a chief complaint, history of the present
 illness, past medical and surgical history, family and social history and a complete
 review of systems.
  Obtain detailed information regarding birth and developmental history as age
 appropriate.
  Demonstrate knowledge of how to access adjunctive sources of information to the
 history obtained from the family (e.g. chart)
  Perform a fundamental pediatric neurological examination.
  Convey an appreciation for the opportunity to be involved in the care of the patient.

   Tools used for assessment
     Global evaluation


Medical Knowledge:
Residents must demonstrate knowledge about established and evolving biomedical,
clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and how to
apply this knowledge to patient care.

Competency: Acquisition – learn about the pathophysiology, biochemistry, genetics,
and clinical presentation of the patient’s neurological disorder

Knowledge/Skills:
 Recognize and interpret abnormal neurological findings
 Utilize medical references, journal articles, and information technology to learn about
   the pathophysiology, biochemistry, genetics and clinical features of the patient’s
   neurological condition and generate a differential diagnosis.
 Use evidence-based medicine and accepted medical guidelines to help inform medical
   decision making

    Tools used for assessment
      In-service examination


Practice-Based Learning and Improvement
Residents must be able to investigate and evaluate their patient care practices, appraise
and assimilate scientific evidence, and improve their patient care practices.
Competency: Life-long learning

Knowledge/Skills:
 Utilize outside resources, including the internet, medical textbooks, and journals, to
    increase knowledge base in dealing directly with patient care encounters
 Independently draw upon clinical resources in order to formulate differential diagnoses
    and management plans
 Incorporate feedback from staff and consultant physicians during the rotation to
    improve work performance

Competency: Evidence based medicine

Knowledge/Skills:
 Wherever possible evidence based medicine should be used in basing medical
   treatment decisions
 Utilize accepted standards of practice or recognized guidelines in informing practice
   management


 Tools used for assessment
   Global assessment
   Case conference


Interpersonal and Communication Skills:
Residents must be able to demonstrate interpersonal and communication skills that
result in effective information exchange and teaming with patients, their patients families,
and professional associates.

Competency: Communication with patients and families

Knowledge/Skills:
    Establish effective rapport and communication with patients and their families
    Learn to interpret and address non-verbal communication presented by patients
      and/or their families
    Accurately describe and explain procedures and management plan to patients
      and/or caregivers in a language that is appropriate to their education
    Understand and respect religious and ethnical differences in your patient/families
      in your communications with them
    Understand privacy issues in communications when dealing with a minor

Competency: Communication with team members

Knowledge/Skills:
 Impart knowledge and educate medical students
 Formulation and clear communication of consultation questions to consultative
   service
 Discuss consultation findings with members of the team and family
 Integrate information from various team members and consultants into an effective
   care plan
   Tools used for assessment
      Global evaluation

Professionalism:
Residents must demonstrate a commitment to carrying out professional responsibilities,
adherence to ethical principles, and sensitivity to a diverse patient population.

Competency: Professional behavior

Knowledge/Skills:
 Demonstrate respect, compassion, and integrity in their interaction with patients and
   their families
 Be responsive and respectful to the needs of the patients
 Consistently use compassion and empathy in one's role as a physician
 Practice evidence based medicine whenever possible and be familiar with best
   practice parameters and guidelines from professional societies such as the AAN,
   CNS, AAP, AES, etc.
 Recognize and respond to personal stress and fatigue that might interfere with
   professional duties

Competency: Ethical behavior

Knowledge/Skills:
 Demonstrate a commitment to ethical principles pertaining to the provision or
   withholding of clinical care, confidentiality of patient information, and informed
   consent
 Maintain professional boundaries in one's dealings with patients, family, staff, and
  professional colleagues
 Demonstrate respect for patient confidentiality and privacy regulations and be aware
   of HIPAA guidelines

   Tools used for assessment
     Global evaluation

System-based Practice:
Residents must demonstrate and awareness of and responsiveness to the larger context
of and system of health care and the ability to effectively call on system resources to
provide care that is of optimal value.

Competency: Health care delivery system

Knowledge/Skills:
 Work with health care and case managers on the ward to assess, coordinate, and
   improve patient care, consistently advocating for high quality
 Be familiar with special care programs available such as palliative care, home care,
   early intervention programs etc.

Competency: Cost effective practice
Knowledge/Skills:
 Practice cost-effective health care and resource allocation that does not compromise
   quality of care
 Be familiar with generic alternatives with respect to cost and efficacy




Goals for Pediatric Neurology Rotation #2

Patient Care:

  Competency: Synthesis - Make informed diagnostic and therapeutic decisions based
  on patient information, current scientific evidence, clinical judgment, and patient
  preference.

  Knowledge/Skills:
 Formulate and prioritize a differential diagnosis based on patient information and/or
current scientific evidence and/or sound clinical judgment.
 Determine and implement appropriate tests and/or procedures in evaluation of the
neurological problem
 Recognize limitations of the level of training and seek help appropriately.
 Identify and utilize subspecialty support appropriately

       Tools used for assessment:
       Global evaluations
       Patient survey


Medical Knowledge:

Competency: Analysis – critically review the relevance, application and
appropriateness of medical information acquired

Knowledge/Skills:
 Formulate a diagnosis differential and treatment plan that meets expected standards
   of care for patient’s condition

  Tools used for assessment:
    In-service training exam
    Review of treatment Plan

Practice Based Learning

Competency: Evidence based medicine

Knowledge/Skills:
 Wherever possible evidence based medicine should be used in basing medical
   treatment decisions
 Utilize accepted standards of practice or recognized guidelines in informing practice
   management

  Tools used for assessment:
    Case Conference
    In-service examination

Interpersonal and Communication Skills:
Residents must be able to demonstrate interpersonal and communication skills that
result in effective information exchange and teaming with patients, their patients families,
and professional associates.

Competency: Communication with patients and families

Knowledge/Skills:
    Accurately describe and explain procedures and management plan to patients
      and/or caregivers in a language that is appropriate to their education
    Understand and respect religious and ethnical differences in your patient/families
      in your communications with them

Competency: Communication with team members

Knowledge/Skills:
 Integrate information from various team members and consultants into an effective
   care plan
   Tools used for assessment:
      Global evaluation
      360 evaluations



Professionalism:
Residents must demonstrate a commitment to carrying out professional responsibilities,
adherence to ethical principles, and sensitivity to a diverse patient population.

Competency: Professional behavior
 Practice evidence based medicine whenever possible and be familiar with best
   practice parameters and guidelines from professional societies such as the AAN,
   CNS, AAP, AES, etc.
 Recognize and respond to personal stress and fatigue that might interfere with
   professional duties
Competency: Ethical behavior
 Maintain professional boundaries in one's dealings with patients, family, staff, and
  professional colleagues

      Tools used to for assessment
         Global evaluations
         Peer evaluations
System-based Practice:
Residents must demonstrate and awareness of and responsiveness to the larger context
of and system of health care and the ability to effectively call on system resources to
provide care that is of optimal value


Competency: Cost effective practice

Knowledge/Skills:
 Practice cost-effective health care and resource allocation that does not compromise
   quality of care
 Be familiar with generic alternatives with respect to cost and efficacy

    Tools used for evaluation:
      Global evaluations
      Case conference



Objectives for Pediatric Rotation # 3

Patient Care:
Residents will be able to provide patient care that is compassionate, appropriate and
 effective for the treatment of neurological health problems and the promotion of health in
 newborns, infant, children and adolescents.

Competency: Partnering with patients/families – Establish and carry out patient
management plans; counsel patients and families.

Knowledge/Skills:
 Accurately describe and explain procedures to patients and/or caregivers in a
language that is appropriate to their education
 Communicate information to other providers when necessary and appropriate.
 Communicates, answers questions and calls and provides emotional support as
    appropriate

    Tools used for assessment
     NEX evaluation
    Global evaluation

Medical Knowledge:
Residents must demonstrate knowledge about established and evolving biomedical,
clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and how to
apply this knowledge to patient care.

Competency: Application – apply acquired medical knowledge appropriately to clinical
care
Knowledge/Skills:
 Generate a differential diagnosis based on acquired medical knowledge
 Use newly acquired knowledge to educate patient care team

   Tools used for assessment
     In-service examination
     Case Conference
     Pediatric Grand Rounds Presentation
     Global evaluation


Practice-Based Learning and Improvement
Residents must be able to investigate and evaluate their patient care practices, appraise
and assimilate scientific evidence, and improve their patient care practices.

Competency: Quality improvement

Knowledge/Skills:
 Incorporate learned knowledge and feedback into changing and improving practice
    management

Competency: Teaching Skills

Knowledge/Skills:
 Review educational resources and methods of access to medical information as
   applicable to child neurology to other members of the team


   Tools used for assessment
     Case conference
     Global evaluation

Interpersonal and Communication Skills:
Residents must be able to demonstrate interpersonal and communication skills that
result in effective information exchange and teaming with patients, their patients families,
and professional associates.
Competency: Scholarly Communication

Knowledge/Skills:
 Regular presentations at pediatric neurology grand rounds
 Attendance at monthly journal club
 Participation in weekly case vignette sessions

   Tools used for assessment
     Case Conference
     Pediatric Grand Rounds Presentation


Professionalism:
Residents must demonstrate a commitment to carrying out professional responsibilities,
adherence to ethical principles, and sensitivity to a diverse patient population.

Competency: Cultural competence

Knowledge/Skills:
 Demonstrate a sensitivity and responsiveness to patients age, gender, and disabilities



System-based Practice:
Residents must demonstrate and awareness of and responsiveness to the larger context
of and system of health care and the ability to effectively call on system resources to
provide care that is of optimal value.

Competency: Patient safety and advocacy/Systems causes of error

Knowledge/Skills:
 Advocate for the promotion of health and the prevention of disease and injury in
  populations
 Be familiar with Clinic safety policy and reporting of adverse events as documented in
   the policy section on the intranet home page


   Tools used for assessment
     Global evaluations
     Case conference


Revised 6/07

				
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