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Goals and Objectives for the Pediatric Emergency Medicine Fellowship Training
Program
OVERALL PROGRAM GOAL
The goal of the pediatric emergency medicine fellowship training program is to train pediatric
emergency physicians who will serve as leaders by becoming: 1) master clinicians, providing
safe, efficient, and effective patient care; 2) effective educators, instructing patients, families,
and other emergency care providers; and 3) productive researchers, developing skills in
research methodology and successfully generating results that add to the pediatric emergency
medicine knowledge base. Achievement of these goals is a process that occurs over the
duration of fellowship training, and the trainee will incur increasing responsibilities during the
progression through fellowship
FIRST YEAR GOALS AND OBJECTIVES
I. PATIENT CARE
A. GOAL
Pediatric emergency medicine trainees should practice patient care that is timely,
effective, appropriate, and compassionate for the management of health problems and
the promotion of health
1. Specific goals
a. Gain skill in the diagnoses and management of all types of acute pediatric illness
and injury
b. Gain skill in the rapid assessment and treatment of critical illness or injury in both
children and adults
c. Gain experience in perform both routine and life-saving procedures
d. Gain experience in managing common adult emergencies
e. Gain experience managing multiple patients and prioritizing care
B. OBJECTIVES
1. Gather accurate, essential information in a efficient manner from all sources,
including medical interviews, physical examinations, interviews with prehospital care
personnel and caretakers, medical records, and diagnostic and therapeutic
procedures
2. Generate a focused and effective patient management plan including therapy,
appropriate consultation and referral, disposition, parent/caretaker education, and
health promotion based on clinical judgment, up-to-date scientific evidence, and
patient/caretaker preference
3. Implement patient management plans
4. Competently perform the diagnostic and therapeutic procedures and emergency
stabilization considered essential to the practice of pediatric emergency medicine,
such as
a. Airway management
b. Cardiopulmonary resuscitation and support
c. Vascular access
d. Thoracentesis/thoracostomy
e. Procedural sedation
f. Lumbar puncture
g. Abscess incision and drainage
h. Laceration repair
i. Nail trephination
j. Fracture management
k. Dislocation reduction
l. Arthrocentesis
m. Paracentesis
5. Demonstrate the ability to appropriately prioritize and stabilize multiple patients and
perform other duties simultaneously
6. Provide health care services aimed at preventing health problems or maintaining
health
7. Work with other professionals, including those from other health-care and non-health
care (e.g., social work) disciplines, to provide family-centered care
8. For fellows with pediatric residency training, gain additional skills in the management
of and perform procedures on adult trauma patients
9. For fellows with pediatrics residency training, gain additional experience in stabilizing
and appropriately dispositioning adult patients
10. For fellows with emergency medicine residency training, gain additional skills in
managing critically ill newborns
11. For fellows with emergency medicine residency training, gain additional skills in
identifying and managing common pediatric dermatologic conditions
12. Gain additional skills in managing victims of maltreatment
13. Participate in Fellow Case Conference
II. MEDICAL KNOWLEDGE
A. GOAL
Pediatric emergency medicine trainees should know how to acquire and interpret
medical information and utilize this knowledge to formulate an appropriate differential
diagnosis with special attention to life-threatening conditions, demonstrate the ability to
use available medical resources effectively and concurrently with patient care, and apply
this knowledge to critical problem solving and clinical decision making
1. Specific goals
a. Develop and demonstrate an analytic approach to clinical situations
B. OBJECTIVES
1. Learn to accurately identify clinical findings
2. Identify life-threatening conditions
3. Integrate diagnostic information and generate an appropriate differential diagnosis
4. Identify the most likely diagnoses
5. Interpret laboratory and radiologic data
6. Synthesize acquired patient data
7. Demonstrate understanding of pertinent anatomic, pathophysiologic, biochemical,
and pharmacologic principles as they related to diagnosis and treatment
8. Identify how and when to access current medical information
9. Properly sequence critical actions in patient care
10. Complete disposition of patients using available resources
11. Acquire skills in design and performance of hypothesis-driven pediatric
emergency medicine research
12. Gain experience in identifying and evaluating children who are victims of non-
accidental trauma or neglect
13. Participate in Core Curriculum Review Conference
14. Participate in Pediatric Emergency Medicine Journal Club
15. Formulate and begin work on a scholarly project
III. PRACTICE-BASED LEARNING AND IMPROVEMENT
A. GOAL
Pediatric emergency medicine trainees should know how to evaluate their patient care
practices, appraise and assimilate scientific evidence, and improve their patient care
1. Specific goals
a. Analyze and assess their practice experience and perform practice-based
improvement using systematic methodology
b. Identify strengths, deficiencies, and limitations in the fellow’s own knowledge
base
c. Gain experience in designing a research project
d. Gain exposure to the principles of quality improvement
B. OBJECTIVES
1. Locate, appraise, and use scientific evidence related to their patient’s health
problems and the larger population from which the patient is drawn
2. Apply knowledge of study design and statistical methods to critically appraise the
medical literature
3. Use information technology to enhance fellow education and improve patient care
4. Facilitate the learning of students, colleagues, and other health professionals in
emergency medicine principles and practice
5. Use decision support technology to assist in patient care decisions and patient
education
6. Implement knowledge-acquisition strategies that are both effective and efficient to
correct knowledge deficit
7. Actively solicit feedback
8. Participate in formal semi-annual fellow evaluations
9. Incorporate formative evaluation feedback provided by others
10. Set annual learning and improvement goals
16. Participate in Emergency Medicine Morbidity and Mortality Conference
17. Participate in Trauma Morbidity and Mortality Conference
IV. INTERPERSONAL AND COMMUNICATION SKILLS
A. GOAL
Pediatric emergency medicine trainees should have excellent interpersonal and
communication skills that result in effective information exchange and teaming with
patients, their caretakers, and professional associates
1. Specific goals
a. Teach and supervise medical students, residents, paramedical personnel and
mid-level providers
b. Develop good communication skills with patients, parents/guardians, and
members of the health care team
c. Learn appropriate documentation skills
d. Gain skills in dealing with referring physicians
e. Gain experience in formal lecture and presentation skills
B. OBJECTIVES
1. Demonstrate the ability to respectfully, effectively, and efficiently develop a
therapeutic relationship with patients and their families based on age and
developmental stage of patient and the caregiver’s understanding of the patient’s
status.
2. Demonstrate ability to develop flexible communication strategies and be able to able
to adjust them according to the clinical situation, age of patient, and the
comprehension of both the patient and caregivers
3. Demonstrate respect for diversity, cultural, ethnic, spiritual, emotional, and age-
specific differences in patients and other members of the health care team.
4. Demonstrate effective listening skills and be able to elicit and provide information
using verbal, nonverbal, written, and technological skills
5. Demonstrate effective participation in and leadership of the health care team
6. Act effectively in a consultative role to other health care providers, including triaging
telephone referral calls and provide medical advice to referring physicians
7. Demonstrate ability to elicit a patient’s and caregiver’s motivation in seeking health
care
8. Demonstrate ability to negotiate as well as resolve conflicts
9. Demonstrate effective written communication skills with other providers and ability to
effectively summarize for the patient and their caregiver upon discharge
10. Maintain focused, timely, and legible medical records
11. Demonstrate ability to handle situations unique to pediatric emergency medicine:
a. Status of minor patients vs. emancipated minors
b. Delivering bad news to patients and their parents/caregivers
c. Child maltreatment cases and involvement of child protective services/law
enforcement
d. Parents with different expectations for medical care and/or refusal of care for
the patient
e. Conflicts between caretakers
f. Communication with prehospital personnel and nonmedical personnel
g. Recognizing social situations that may endanger the minor patient
h. Empowering and motivating the caregiver to provide correct and thorough
aftercare and follow-up for the patient
i. High-risk behaviors (e.g., substance abuse, sexual activity)
12. Develop and improve didactic teaching skills
13. Supervise medical students, residents, and mid-level providers while encouraging
independent thinking
V. PROFESSIONALISM
A. GOAL
Pediatric emergency medicine trainees should demonstrate a commitment to carrying
out professional responsibilities, adherence to ethical principles, and sensitivity to a
diverse patient population
1. Specific goals
a. Treats patients, family, and staff with respect, compassion, and integrity
B. OBJECTIVES
1. Demonstrate sensitivity to patient’s pain, emotional state, developmental status,
culture, sex, religion, sex, and sexual orientation
2. Protect patient privacy and confidentiality
3. Demonstrate commitment to ethical principles pertaining to patient care and
business practices
4. Demonstrate ability to identify and manage conflicts of interest
5. Accept responsibility for errors
VI. SYSTEMS-BASED PRACTICE
A. GOAL
Pediatric emergency medicine physicians are aware and responsive to the larger context
and system of health care and the ability to effectively call on system resources to
provide care that is optimal value and to advocate for their patients’ best interests.
1. Specific goals
a. Learn appropriate use of consultants and other resources
b. Gain experience in overseeing emergency department flow
c. Gain skills in emergency department administration
B. OBJECTIVES
1. Understand, access and appropriately utilize resources, providers, and systems
necessary to provide optimal emergency care to the pediatric patient
2. Demonstrate understanding of special resources for the pediatric patient including
but not limited to Child Protective Services, pediatric mental health resources,
pediatric sub-specialty providers in the community, and community based clinics.
3. Understand different medical practice models and delivery systems, and how to best
use them to care for the individual pediatric patient and their caregivers
4. Practice cost-effective health care and resource allocation that does not compromise
the quality of care of the pediatric patient
5. Advocate for quality patient care and assist patients and their caregivers in dealing
with system complexities and advancement through the health care system
6. Demonstrate good communication with the patient’s caregivers and primary care
providers to ensure adequate follow-up, proper access to consultants and optimal
level of care while in the ED
7. Facilitate referrals to appropriate pediatric subspecialists/other health care
professionals.
8. Work with health care managers and health care providers to asses, coordinate and
improve health care for the pediatric patient.
9. Demonstrate understanding of how these activities can affect system performance
10. Participate in fellowship meetings
11. Participate in division meetings
SECOND YEAR GOALS AND OBJECTIVES
All of the first year goals and objectives, plus:
I. PATIENT CARE
A. GOALS
1. Become highly skilled in the diagnoses and management of all types of acute
pediatric illness and injury
2. Become skilled in managing multiple patients and prioritizing care
3. Become adept at most common emergency procedures, and continue to acquire
new skills
4. Continue to gain experience with adult emergencies
B. OBJECTIVES
1. Manage a patient care zone in the emergency department under the close
supervision of a faculty physician
2. For fellows with pediatrics residency training, gain additional skills in identifying and
management common obstetric and adolescent gynecologic conditions
3. For fellows with pediatrics residency training, gain additional exposure to the
emergency medical services system
4. For fellows with pediatrics residency training, gain additional experience in stabilizing
and appropriately dispositioning adult patients
5. For fellows with emergency medicine residency training, gain additional skills in
managing critically ill newborns
6. For fellows with emergency medicine residency training, gain additional skills in
identifying and managing common pediatric neurologic conditions
7. For fellows with emergency medicine residency training, gain additional skills in
identifying and managing common pediatric primary care issues
8. Gain additional skills in identifying and managing common pediatric cardiac
conditions
9. Gain additional skills in identifying and managing common pediatric neurologic
conditions
II. MEDICAL KNOWLEDGE
A. GOALS
1. Improve pediatric emergency medicine knowledge base
2. Continue to improve subspecialty knowledge base
3. Continue to work on research goals
B. OBJECTIVES
1. Continue improve skill at accurately identifying clinical findings and creating
differential diagnoses
2. Gain exposure to EMS and disaster medicine
3. Collect data for scholarly project
III. PRACTICE-BASED LEARNING AND IMPROVEMENT
A. GOAL
1. Continue to analyze and assess their practice experience and perform practice-
based improvement using systematic methodology
2. Continue to identify strengths, deficiencies, and limitations in the fellow’s own
knowledge base
3. Continue to develop quality improvement skills
B. OBJECTIVES
1. Use the elective rotation to pursue areas of interest and/or address knowledge base
deficiencies
2. Continue to make management decision using the principles of evidence-based
medicine
IV. INTERPERSONAL AND COMMUNICATION SKILLS
A. GOALS
1. Continue to improve bedside clinical teaching skills
2. Continue to improve formal lecture and presentation skills
3. Demonstrate leadership skills in the emergency department
B. OBJECTIVES
1. Increase level of medical student, resident, and mid-level provider supervision
2. Continue to develop and improve didactic teaching skills
3. Demonstrate effective participation in and leadership of the health care team by
overseeing the operations of a patient care zone in the emergency department
V. PROFESSIONALISM
A. GOAL
1. Demonstrate leadership in the emergency department
B. OBJECTIVES
1. Demonstrate effective participation in and leadership of the health care team by
overseeing the operations of a patient care zone in the emergency department
VI. SYSTEMS-BASED PRACTICE
A. GOAL
1. Improve skills in overseeing emergency department flow
2. Continue to advocate for families and their needs within the health care system
B. OBJECTIVES
1. Become more efficient in the utilization of subspecialty consultants
2. Ensure patients can appropriately obtain follow-up care
3. Support the use of resources within the health care system (e.g., interpreter
services, patient ambassadors) to improve the quality of care provided in the ED
4. For emergency-medicine trained fellows, secure post-graduation employment
THIRD YEAR GOALS AND OBJECTIVES
All of the first and second year goals and objectives, plus:
I. PATIENT CARE
A. GOALS
1. Function in the role of junior faculty in the pediatric ED, with minimal input from
attending faculty
2. Be able to provide initial stabilization for most adult emergencies and arrange
appropriate transfer to definitive care
B. OBJECTIVES
1. Mastery of the skills to elicit a concise, problem-focused history and physical
examination in critical and non-critical emergency department patients of all ages
2. Continue to gain proficiency with the common emergency medicine procedures
3. For fellows with pediatrics residency training, gain additional exposure to toxicologic
emergencies
4. For fellows with pediatrics residency training, gain additional experience in stabilizing
and appropriately dispositioning adult patients
II. MEDICAL KNOWLEDGE
A. GOALS
1. Attain a sufficient knowledge base so that the fellow can operate independently in
the ED
2. Continue to develop critical analysis and research skills to help in the acquisition of
medical knowledge
B. OBJECTIVES
1. Demonstrate understanding of pertinent anatomic, pathophysiologic, biochemical,
and pharmacologic principles as they related to diagnosis and treatment
2. Formulate patient management plans using an evidence-based approach
3. Complete the scholarly project
III. PRACTICE-BASED LEARNING AND IMPROVEMENT
A. GOALS
1. Continue to analyze and assess practice experience and perform practice-based
improvement using systematic methodology
2. Continue to identify strengths, deficiencies, and limitations in the fellow’s own
knowledge base
3. Continue to develop quality improvement skills
B. OBJECTIVES
1. Use the elective rotation to pursue areas of interest and/or address knowledge base
deficiencies
2. Formulate a life-long learning plan
IV. INTERPERSONAL AND COMMUNICATION SKILLS
A. GOALS
1. Become a skilled bedside clinical teacher
2. Become a skilled lecturer
5. Become a leader in the emergency department
C. OBJECTIVES
1. Provide supervision of medical students, residents, and mid-level provider
supervision that ensures not only appropriate patient care but also inspires
independent thinking
2. Develop an effective, concise, and clear presentation style
3. Direct the health care team by overseeing all operations of a patient care zone in the
emergency department with minimal faculty input
V. PROFESSIONALISM
A. GOAL
1. Continue to serve as a role model for patients, parents, other clinicians and ancillary
staff
B. OBJECTIVES
1. Demonstrate sensitivity to patient’s pain, emotional state, developmental status,
culture, sex, religion, sex, and sexual orientation
2. Continue to communication with all emergency department team members in a
respectful, honest, and compassionate manner
VI. SYSTEMS-BASED PRACTICE
A. GOAL
1. Continue to gain experience in overseeing emergency department flow
2. Gain skills in emergency department administration
B. OBJECTIVES
1. Gain exposure to financial issues pertaining to the operation of a division of pediatric
emergency medicine
2. Gain exposure to interactions between division leadership and representatives from
the multispecialty group, hospital administration, and medical school
3. Secure post-fellowship employment
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